Status Of Diabetes Mellitus And Its Relationship With Anxiety And Depression In Patients With Renal Transplantation

Objective:We investigated the incidence of diabetes after kidney transplantation and the level of anxiety and depression in this study, and analyzed the correlation between the level of anxiety and depression and occurrence of PTDM (post transplant diabetes mellitus), which could provide relevant reference or guidance for health education of patients after kidney transplantation.Methods:This study is a longitudinal study. By random sampling method and the self-assessment lists of Zung establishment of anxiety and depression self rating scale, we chose 226 cases of adult relatives living donor renal transplantation in a provincial hospital of jinan between January 2014 and December 2015. We evaluated patient’s anxiety, depression, and fasting glucose levels in the preoperative, postoperative 1 month,3 months and 6 months, Respectively. And we collected basic clinical data of patients, including gender, age, height, weight, the primary disease, family history, hpi, past medical history, use of anti-rejection drugs, blood sugar monitoring results, patients with dietary carbohydrate content, etc.All the data was input with Excel 2010, significance difference was analyzed with statistical software SPSS 19.0. The statistical methods such as descriptive statistics method, t test, chi-square test, Pearson correlation analysis and one factor logistic regression analysis were used.Result:1. This study selected 226 patients. After 6 months’follow-up, there were 80 patients were diagnosed as diabetes mellitus (PTDM group) and 146 patients were not diagnosed as diabetes mellitus (NPTDM group), the incidence rate of PTDM was 35.4%.2. The blood sugar levels of the two groups of patients were elevated compared with preoperative. Specifically, the blood sugar level between preoperative and postoperative half year was different, and the difference was statistically significant in PTDM group (P< 0.05), and the result is similar for NPTDM group (P< 0.01). For the two different groups, the blood sugar level of three months and half year was higher in PTDM group than NPTDM group, and the difference was statistically significant in PTDM group (P< 0.05).The anxiety and depression levels of PTDM group after 3 months and half a year were higher than NPTDM group. The level of anxiety and depression was higher than that of preoperative after half a year, and the difference was statistically significant in PTDM group (t=14.127,P<0.05), (t=7.365, P< 0.05). On the contrary, the level of anxiety and depression was similar as that of preoperative after half a year in NPTDM group, and no statistical significance was found (P> 0.05).The anxiety & depression levels and blood glucose were significantly positive correlation for PTDM patients (r= 0.098, P< 0.01), (r= 0.205, P< 0.01). Logistic regression analysis revealed that the psychological factor played a role of PTDM incidence.3. Carbohydrates in the daily diet of patients in PTDM (221.445±59.779) were significantly higher than that in NPTDM patients (209.447±42.740), and the difference was statistically significant between the two groups (t=4.150,P<0.05). And there was a positive correlation between carbohydrate and blood glucose (r=0.272,P<0.01)。4. The PTDM was not associated with patient gender.5. older than 40 years old and less than 40 years old and both difference was statistically significant (P=0.011, x2=6.430).There was significant difference for body mass index (bmi) in the event of PTDM (P=0.000, x2=14.114)6. There was significant difference for in the event of PTDM of the anti-rejection drugs (CSA, FK506) application (P=0.000, x2=16.133). Logistic regression analysis revealed that drug played a role for PTDM incidence.Conclusion:1. The blood glucose levels continue to rise for renal transplantation patients after half a year, and the incidence rate of PTDM in this study was 35.4%.2. The patients after renal transplantation were situated in mild-to-moderate of anxiety and depression. Of which, the level of anxiety and depression in PTDM group is higher than NPTDM group.3. The anxiety and depression level was significantly positively related with PTDM and blood sugar after kidney transplantation.4. The body mass index (BMI), age, immunosuppressants, carbohydrate were different between PTDM patients and PTDM ones, and they were factors related with PTDM. There were no correlation between PTDM and gender.