Clinical Studies In Patients With Diabetes Mellitus And Prevalence Of Depression And Related Hormone Changes

ObjectiveThe purpose of this study is to investigate the prevalence of type2diabetes with depression and analysis the different endocrine hormone-related indicators between diabetic with depressive state (whose main syndrome is disharmony between the liver and stomachy deficiency of the heart-yin) and diabetic non-depressed patients, to guide clinical.Methods1. Self-Rating Depression Scale (SDS) investigation of endocrine department Guang’anmen Hospital, China Academy of Chinese Medical Sciences outpatients and hospitalized patients with type2diabetes. Collect basic information such as gender, age, duration of diabetes, marital status, education, occupation, etc. Establish a database and calculate the prevalence of type2diabetes with depression.2. Patients who hospitalized from June2012to November2013and the SDS standard score greater than or equal to50points should do the next questionnaire—"disharmony between the liver and stomach... deficiency of the heart-yin main syndromes" questionnaire survey. Contains a total of80cases of disharmony between the liver and stomach、deficiency of the heart-yin main syndromes type diabetes mellitus patients with depression as the observation group. And55cases treatment in the same period whose SDS standard score less than50points we named non-depressed patients with type2diabetes were randomly selected as a control group. The first overall comparison, then the male and female were compared separately. Observations:general information including gender, age, duration of diabetes, marital status, education, occupation, BMI, heart rate, blood pressure, treatment programs, etc. Main outcome measures included:adrenal function three:aldosterone (ALD), cortisol (COR) adrenocorticotropic hormone (ACTH); Thyroid function:thyrotropin-releasing hormone(TSH), total thyroxine (TT4), free thyroxine (FT4), total three triiodothyronine (TT3), free triiodothyronine three (FT3); Sex hormones:estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), testosterone (T), progesterone (P). Secondary outcomes include:relevant indicators of islet function and liver and kidney function and other biochemical markers.Results1. This study investigated a total of1200cases of type2diabetes, including327cases of outpatients and inpatients873cases. The prevalence of type2diabetes with depression is31.7%.The prevalence rate of outpatient (38.2%) is higher than that of hospital (29.2%), and female (41.7%) higher than men (21.4%).2. Secondary and below education accounted for60%of the observation group, Significantly higher than control group (P<0.05). Overall comparative on adrenal function:observation group ALD increased (172.87±66.785pg/ml than146.31±42.286pg/ml, P<0.05), COR increased (13.71±5.641ug/dl than10.02±4.233ug/dl, P<0.01), ACTH increased (31.01±19.548pg/ml than24.51±15.225pg/ml, P<0.05); sex hormones:FSH increased (36.43±28.555mIU/ml than25.81±21.769mIU/ml, P<0.05), LH increased (15.64±12.248mIU/ml than11.64±8.729mIU/ml, P<0.05); no significant differences in thyroid function. Comparison of male and female separately, male in the observation group in adrenal function: ALD increased (196.18±79.267pg/ml than123.31±33.366pg/ml, P<0.01), COR increased (14.99±6.082ug/dl than8.00±3.130ug/dl, P<0.01), ACTH increased (39.84±25.376pg/ml than25.04±12.555pg/ml, P<0.05); thyroid function:TSH decreased (1.43±0.662Uiu/ml than2.30±1.686Uiu/ml, P<0.05), FT4increased (1.20±0.293ng/ml than0.99±0.150ng/ml, P<0.01); no significant differences in terms of male hormones. Women in the observation group, although no statistically significant differences in adrenal function than women in the control group, but the average of ALD, COR, ACTH increased; no significant differences in thyroid function; female hormones:the women in the observation group FSH increased (47.47±26.355mIU/ml than36.03±19.79mIU/ml,P<0.05).There are no significant differences in secondary outcome measures.Conclusions1. The prevalence of type2diabetes with depression is31.7%, outpatient is higher than hospital, and female higher than men.2. There is a dysfunction of the nervous, endocrine system in diabetic with depression status (main syndrome is disharmony between the liver and stomach, deficiency of the heart-yin). Specific performance in the hyperfunction of HPA axis (COR, ACTH increased), and ALD increased; the dysfunction of HPT axis (within the range of normal value of male TSH decreased, FT4increased); the dysfunction of HPG axis (FSH, LH increased).