肥胖患者体重、血清素水平、心理健康状况、睡眠障碍与代谢的相关性

V. Tkachenko, T. Bagro
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引用次数: 0

摘要

背景。肥胖的显著蔓延促使研究人员通过研究激素、神经化学和心身成分之间的关系和依赖性来寻找致病治疗方法。该研究的目的是确定肥胖患者的体重、血清素水平、心理健康状况、睡眠障碍和新陈代谢之间的关系。材料和方法。在一项队列前瞻性研究中,对75例肥胖患者进行了为期6个月的观察。根据检测到的心理社会特征和睡眠障碍分为两组,采用以患者为导向的方法进行适当的治疗。检查内容包括体重指数(BMI)、腹部肥胖指数(体表面积、腰臀比、圆度指数、体型指数、腹容积指数)、血压、血脂、空腹血糖、胰岛素、瘦素、血清素、心理社会状态和睡眠质量评估(医院焦虑抑郁量表(HADS)、贝克抑郁量表(BDI)、汉密尔顿焦虑评定量表(HAM-A)、爱普worth嗜睡量表(ESS)、匹兹堡睡眠质量指数(PSQI),生活质量采用SF-36问卷。采用IBM SPSS Statistics、Statistica 12、Excel 2010进行统计学分析。结果。基线时,患者为I级和II级肥胖。Тhe计算的腹部肥胖指标、脂质和碳水化合物代谢指标、饮食行为、焦虑和抑郁、睡眠质量、嗜睡和瘦素水平得分均超过推荐值,而血清素水平、SF-36得分较低,但动态显著改善。在基线时,BMI、腹部肥胖指数、血压、脂质和碳水化合物代谢指标、瘦素、HADS、BDI、HAM-A、ESS、PSQI总体评分存在较强的直接相关性;BMI与高密度脂蛋白和血清素水平呈负相关。血清素与BMI、腹部肥胖指数(体表面积、体型指数、腹容积指数、圆锥度指数)、血压、脂质和碳水化合物代谢指标、HADS、HAM-A、BDI、PSQI整体评分、睡眠质量、潜伏期、持续时间、效率和ESS呈高度负相关。结论。BMI高与血清素水平低、焦虑和抑郁水平升高、嗜睡、睡眠和生活质量恶化、脂质和碳水化合物代谢紊乱相关,是肥胖和其他非传染性疾病发生的相互加重因素;在确定以患者为导向的肥胖综合治疗方法时,必须考虑到这一点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The correlation between body weight, serotonin levels, mental health status, sleep disorders and metabolism in patients with obesity
Background. The significant spread of obesity stimulates researchers to search for etiopathogenic treatment by studying the relationships and dependencies of the hormonal, neurochemical and psychosomatic components. The purpose of the study is to determine the correlation between body weight, serotonin level, mental health status, sleep disorders and metabolism in obese patients. Materials and methods. In a cohort, prospective study, 75 patients with obesity were observed for 6 months. They were divided into 2 groups depending on the detected psychosocial characteristics and sleep disorders with the appropriate treatment using a patient-oriented approach. The examination included studying body mass index (BMI), abdominal obesity indices (body surface area, waist/hip ratio, conicity index, a body shape index, abdominal volume index), blood pressure, lipid profile, fasting glucose, insulin, leptin, serotonin, assessment of psychosocial status and sleep quality with Hospital Anxiety and Depression Scale (HADS), Beck’s Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), quality of life using the SF-36 questionnaire. Statistical analysis was performed using IBM SPSS Statistics, Statistica 12, Excel 2010. Results. At baseline, the patients had obesity class I and II. Тhe calculated indices of abdominal obesity, indicators of lipid and carbohydrate metabolism, scores of questionnaires of eating behavior, anxiety and depression, quality of sleep, sleepiness and leptin level exceeded the recommended values, while the level of serotonin, the scores of the SF-36 had low values that significantly improved in dynamics. Strong direct correlations at baseline were found between BMI, abdominal obesity indices, blood pressure, indicators of lipid and carbohydrate metabolism, leptin, HADS, BDI, HAM-A, ESS, PSQI global score; a strong inverse (negative) relationship was noted between BMI and the levels of high-density lipoprotein and serotonin. A high negative correlation was found between serotonin and BMI, abdominal obesity indices (body surface area, a body shape index, abdominal volume index, conicity index), blood pressure, indicators of lipid and carbohydrate metabolism, HADS, HAM-A, BDI, PSQI global score, sleep quality, latency, duration, efficiency and the ESS. Conclusions. The high BMI correlates with a low level of serotonin, increased level of anxiety and depression, drowsiness, deterioration of the quality of sleep and life, disorders of lipid and carbohydrate metabolism, which are mutually aggravating factors for the development of obesity and other non-infectious diseases; it must be taken into account when determining approaches to comprehensive patient-oriented treatment of obesity.
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