2型糖尿病患者血糖控制与精神心理因素的相关性研究

摘要

目的 探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血糖控制与精神心理因素的相关性.方法 随机抽取197位T2DM患者进行糖化血红蛋白(HbA1c)含量测定,并采用广泛性焦虑量表(GAD-7)、抑郁症筛查量表(PHQ-9)、糖尿病痛苦量表(DDS)和阿森斯失眠量表(AIS)调查患者焦虑、抑郁、痛苦及睡眠质量情况,分析HbA1c含量与精神心理因素的相关性.结果 在本研究197例患者中,中度焦虑和重度焦虑共143例,占72.6%,轻度、中度、中重度和重度抑郁患者共98例,占49.8%,可能有睡眠问题或有睡眠障碍共172例,占87.3%,中等痛苦和重度痛苦共55例,占27.9%.采用相关性研究Spearman分析表明HbA1c含量与焦虑评分GAD-7呈正相关关系(P＜0.001),相关系数为0.843,HbA1c与睡眠质量评分AIS呈正相关关系(P＜0.001),相关系数为0.908.将T2DM患者根据HbA1c含量进行分组,发现糖化血红蛋白含量越高,则患者焦虑评分GAD-7和睡眠质量评分AIS则越大,呈明显的正相关.另外,单因素分析及多因素分析(逐步回归法)分析表明肥胖的男性T2DM患者更容易发生焦虑及睡眠障碍.结论 HbA1c含量高低与焦虑、睡眠障碍存在相关性,并且HbA1c含量越高,则患者焦虑和睡眠障碍程度越高.%Objective To investigate the correlation between glycemic control and psychological factors in patients with type 2 diabetes mellitus (T2DM). Methods T2DM patients (n=197) were randomly chosen and given the level detection of glycated hemoglobin (HbAlc). The status of anxiety, depression and sleeping quality were investigated by using scale of generalized anxiety disorder-7 (GAD-7), scale of patient health questionnaire-9 (PHQ-9), Diabetes Distress Scale (DDS) and Athens Insomnia Scale (AIS) in all patients. The correlation between level of HbA1c and psychological factors was analyzed. Results Among 197 patients, there were 143 (72.6%) with moderate and severe anxiety, 98 (49.8%) with mild, moderate and severe depression, 172 (87.3%) with possible sleeping problem or sleep disorder, and 55 (27.9%) with moderate and severe distress. The results of Spearman correlation analysis showed that HbA1c level was positively correlated to GAD-7 scores (P<0.001, r=0.843), and HbA1c level was positively correlated to AIS scores (P<0.001, r=0.908). After T2DM patients were divided into groups according to HbA1c level, HbA1c level and GAD-7 scores and AIS scores had significant positive correlation. The results of single-factor and multi-factor analyses (stepwise regression method) showed that obese male T2DM patients were easily suffered from anxiety and sleeping disorder. Conclusion The level of HbA1c is correlated to anxiety and sleeping disorder, and the higher the HbA1c level, the severer the anxiety and sleeping disorder.