{"title":"抑郁症状与代谢失调控制：近距离观察 T2DM 患者的控制挑战","authors":"Yang Yang, Zhenhua Xing","doi":"10.1155/2024/7115559","DOIUrl":null,"url":null,"abstract":"<div>\n <p><b>Background:</b> 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.</p>\n <p><b>Methods and Results:</b> 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.</p>\n <p><b>Conclusion:</b> 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.</p>\n <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT00000620</p>\n </div>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2024 1","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/7115559","citationCount":"0","resultStr":"{\"title\":\"Depressive Symptoms and Metabolic Dysregulation Control: A Closer Look at Control Challenges in T2DM Patients\",\"authors\":\"Yang Yang, Zhenhua Xing\",\"doi\":\"10.1155/2024/7115559\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n <p><b>Background:</b> 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.</p>\\n <p><b>Methods and Results:</b> 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.</p>\\n <p><b>Conclusion:</b> 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.</p>\\n <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT00000620</p>\\n </div>\",\"PeriodicalId\":55179,\"journal\":{\"name\":\"Depression and Anxiety\",\"volume\":\"2024 1\",\"pages\":\"\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2024-09-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/7115559\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Depression and Anxiety\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/2024/7115559\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Depression and Anxiety","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/2024/7115559","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Depressive Symptoms and Metabolic Dysregulation Control: A Closer Look at Control Challenges in T2DM Patients
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.
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.
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