Depressive Symptoms and Metabolic Dysregulation Control: A Closer Look at Control Challenges in T2DM Patients

IF 4.7 2区医学 Q1 PSYCHIATRY

Depression and Anxiety Pub Date : 2024-09-27 DOI:10.1155/2024/7115559

Yang Yang, Zhenhua Xing

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引用次数: 0

Abstract

Background: Patients with type 2 diabetes mellitus (T2DM) face an increased risk of developing depression and metabolic dysregulation, which can lead to a higher risk of cardiovascular disease (CVD). However, the relationship between the severity of depression and metabolic dysregulation in patients with T2DM remains unclear. This study aimed to investigate this association using data from the ACCORD-health-related quality of life study.

Methods and Results: Patient Health Questionnaire-9 (PHQ-9) scores and medication regimens were assessed at baseline, 1, 3, and 4 years, and HbA1c, blood pressure, and lipid levels were monitored every 4 months over a 4-year period. The severity of depressive symptoms was categorized as none (0–4 points), mild (5–9 points), or moderate–severe (10–24 points) based on PHQ-9 scores. Among the participants, 62% developed depressive symptoms at some point during the 4-year follow-up period, with 21% experiencing persistent depressive symptoms. Participants with moderate-to-severe depression exhibited 0.18% (0.12, 0.24) higher levels of HbA1c, 1.11 mmHg (95% CI, 0.04, 2.15) of SBP, 0.90 mmHg (95% CI, 0.22,1.58) of DBP, and 2.12(95% CI, −0.03, 4.27) mg/dL of LDL, and 0.97 (95% CI, 0.38, 1.56) mg/dL lower levels of HDL compared to their counterparts without depressive symptoms. Moreover, as the severity of depressive symptoms increased, variability in HbA1c and blood pressure levels also increased. Furthermore, patients with more severe depressive symptoms demonstrated suboptimal adherence to medication regimens.

Conclusion: Our study found a significant association between depressive symptoms severity and metabolic control in T2DM patients. Greater depressive severity correlated with poorer glycemic, blood pressure, and lipid control, alongside increased variability in these parameters. Additionally, patients with severe depressive symptoms showed suboptimal medication adherence. Addressing mental health in T2DM management is crucial to improve metabolic control and reduce CVD risks.

Trial Registration: ClinicalTrials.gov identifier: NCT00000620

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抑郁症状与代谢失调控制：近距离观察 T2DM 患者的控制挑战

背景：2 型糖尿病（T2DM）患者患抑郁症和代谢失调的风险增加，这可能导致心血管疾病（CVD）风险升高。然而，T2DM 患者抑郁的严重程度与代谢失调之间的关系仍不清楚。本研究旨在利用 ACCORD--健康相关生活质量研究的数据调查这种关系。方法和结果：在基线、1 年、3 年和 4 年时评估了患者健康问卷-9（PHQ-9）得分和用药方案，并在 4 年期间每 4 个月监测一次 HbA1c、血压和血脂水平。根据 PHQ-9 评分，抑郁症状的严重程度分为无（0-4 分）、轻度（5-9 分）和中度-重度（10-24 分）。在为期 4 年的随访期间，62% 的参与者在某个阶段出现了抑郁症状，其中 21% 的人持续出现抑郁症状。中度至重度抑郁症患者的 HbA1c 水平高出 0.18% (0.12, 0.24)，SBP 高出 1.11 mmHg (95% CI, 0.04, 2.15)，DBP 高出 0.90 mmHg (95% CI, 0.22, 1.58)，DBP 高出 2.与没有抑郁症状的同龄人相比，低密度脂蛋白水平低 2.12（95% CI，-0.03，4.27）毫克/分升，高密度脂蛋白水平低 0.97（95% CI，0.38，1.56）毫克/分升。此外，随着抑郁症状严重程度的增加，HbA1c 和血压水平的变化也会增加。此外，抑郁症状更严重的患者对药物治疗的依从性也不理想。结论我们的研究发现，T2DM 患者的抑郁症状严重程度与代谢控制之间存在明显关联。抑郁症严重程度越高，血糖、血压和血脂控制越差，同时这些参数的变异性也越大。此外，有严重抑郁症状的患者对药物治疗的依从性较差。在 T2DM 管理中关注心理健康对于改善代谢控制和降低心血管疾病风险至关重要。试验注册：临床试验注册：ClinicalTrials.gov identifier：NCT00000620

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来源期刊

Depression and Anxiety 医学-精神病学

CiteScore

15.00

自引率

1.40%

发文量

审稿时长

4-8 weeks

期刊介绍： Depression and Anxiety is a scientific journal that focuses on the study of mood and anxiety disorders, as well as related phenomena in humans. The journal is dedicated to publishing high-quality research and review articles that contribute to the understanding and treatment of these conditions. The journal places a particular emphasis on articles that contribute to the clinical evaluation and care of individuals affected by mood and anxiety disorders. It prioritizes the publication of treatment-related research and review papers, as well as those that present novel findings that can directly impact clinical practice. The journal's goal is to advance the field by disseminating knowledge that can lead to better diagnosis, treatment, and management of these disorders, ultimately improving the quality of life for those who suffer from them.