The Relationship Between5-hydroxytryptamine And Diabetic Peripheral Neuropathy With Depression

Objective: To investigate whether5-hydroxytryptamine（5-HT）can be consideredas the clinical index that identifies diabetic peripheral neuropathy (DPN) withdepression and evaluates depression severity, which provides the basis for clinicaldiagnosis and treatment.Methods：Several cases of hospitalized patients with a diagnosis of diabeticperipheral neuropathy from10,2013to3,2014were chosen as the objects of study. Byusing the Toronto scale, they were divided into three groups (mild, moderate, severe)according to the degree of neuropathy. Every group was divided into the depressiongroup and the non-depression group according to SDS, and the level of5-hydroxytryptamine was compared between the two groups. Patients havingdepression and DNP were also divided into three groups (mild, moderate, severe) usingthe Depression score, and differences in the level of5-hydroxytryptamine among thegroups were compared. Moreover, diabetic patients without depression and DPN wereselected as the control group at the same timeResults：1.194cases of patients with a diagnosis of diabetic peripheralneuropathy selected, out of which67light ones,72medium ones, and55heavy oneswere found. According to the evaluation of SDS scale，there were98patients withdepression and DPN,25mild ones,39moderate ones, and34severe ones. In addition,there were96patients with DPN but without depression and were divided into42mildones,33moderate ones, and21severe ones. Among98patients with depression andDPN, there were30light ones,46medium ones, and22heavy ones, based on severity of depression. A total of23diabetic subjects were selected as control group. Accordingto severe of DPN, the patients were divided into three groups respectively, comparedwith the control group, the gender, age, marital status, duration of diabetes,diabetic complication, level of education, monthly income, profession had no significantdifference among the groups（P>0.05）. According to severe of depression, the patientswere divided into three groups respectively, compared with the control group, thegender, age, marital status, duration of diabetes, diabetic complication,level of education, monthly income, profession had no significant difference among thegroups（P>0.05）.2. Serum level of5-HT in the control group was3.41±0.56ng/ml，while that inthe mild, moderate and severe DPN group were1.56±0.31ng/ml，1.43±0.25ng/ml，1.15±0.17ng/ml respectively. The differences between them were statistically significant（P<0.05）.3. Among patients with mild, moderate and severe DPN, serum levels of5-HT inthe depression group were1.29±0.33ng/ml、1.08±0.26ng/ml、0.62±0.16ng/mlrespectively, which were significantly lower than those in the non-depression group,levels of5-HT in the non-depression group were1.82±0.27ng/ml、1.76±0.21ng/ml、1.68±0.19respectively (P<0.05for all groups). However, levels of5-HT graduallydecreased with aggravation of neuropathy both in depression and non-depression groups,the differences within groups were not statistically significant (P>0.05).4. Among patients with DPN and depression, the serum levels of5-HT graduallydecreased with increasing severity of depression. The levels of5-HT were1.59±0.18ng/ml、1.33±0.31ng/ml、0.65±0.22ng/ml in patients with mild, moderate andsevere depression respectively, the difference within the group was statisticallysignificant（P<0.05）， While the levels of FPG、HbA1C、2hPG、TC、TG、 LDL、HDL-C and BMI among these patients had no significant difference（P>0.05）.Conclusion：Serum level of5-HT can be considered as the index to evaluatewhether the DPN patients have depression or not,and also to assess the depressionseverity.