The Study On The Related Factors Of Coexisting Depression In Patients With Type 2 Diabetes And The Correlation With Serum Proinflammatory Cytokines

BackgroundType 2 Diabetes is a disease that caused by the body cannot effectively use insulin.Type 2 diabetes is a long term metabolic disease,characterized with high concentration of blood glucose,low insulin symptom,and anti-insulin symptom etc.Depression can always be found as a serious psychological disorder;it may cause suicide,25 folds higher in patients than normal people.Both diabetes and depression are high-incidence diseases.However,Patients of type 2 diabetes get 2-fold higher chance to have depression than the health people.The depression in type 2 diabetes patients may obviously cause worse situation than the other patients,with high medication cost,high disability rate,and low living quality etc.Thus,it is the rational to research why the type 2 diabetes patients may have the higher chance to get depression.ObjectiveWith the epidemiology,we want to test whether there is relationship between type 2 diabetes and depression in Heilongjiang province,China.After the epidemiological investigation,we plan to analyze and explain the possible correlation between type 2 diabetes and depression.At the same time,we may measure the level of serum inflammation cytokines to investigate whether serum inflammation cytokine level is relevant to the depression in type 2 diabetes patients.Our research will serve insight for the research,prevention,and treatment of the type 2 diabetes.MethodsWe plan a cross-section research.This research covers the 509 type 2 diabetes patients,treated by Jiamusi general hospital,Division of Metabolism & Endocrinology in 2016.Type 2 diabetes patients filled the PHQ-9 self-estimate form to screen the depression.Based on the score of the PHQ-9 form,the patients were separated into 2 groups with or without the depression.With the face-to-face inquiry,thorough epidemiological investigation was performed,including the demographic characteristics,food and living habits,history of disease and medication;the body check was performed,including weight,height,waist parameter,and hip parameter;biochemical investigation was performed,including fasting plasma glucose,cortisol,insulin before diet,C-peptide before diet,HbA1 c,uric acid etc.With SPSS 19.0,all these factors were analyzed with univariate analysis,and logistic regression analysis was done to screen the independent relevant factors which were relevant to the depression in type 2 diabetes patients.We also checked the inflammation cytokines(IL-6?IL-1??IL-10)of part of the patients.The level of the Proinflammatory cytokines was compared between 2 groups with or w/o depression.Results285 type 2 diabetes patients have the depression,who is 56% of total patients.Female patients get the higher percentage than male.Univariate analysis shows many factors are significant different between 2 groups,including gender,age,education,frequency of social life,working pressure,exercise,sleeping quality,late sleep/ reversed biological clock,vegetable eating,tea habit,diabetes complications,Gastrointestinal inflammation,Hypoglycemic agent usage,anti-inflammatory drugs and antibiotics usage,body weight,height,waist/hip ratio,cortisol level,C-peptide before diet,and HbA1c(P <0.05).Logistic regression analysis showed high working pressure,diabetes complications,and low sleeping quality is independently positive relevant with the depression in type 2 diabetes patients,while fresh vegetable eating habit is negatively relevant with it.The results about inflammation cytokines showed that type 2 diabetes patients with depression have statistically significant higher Proinflammatory cytokines(IL-6,IL-1 ?,IL-10)than those patients,w/o depression(P<0.05).ConclusionHigh working pressure,diabetes complications,and low sleeping quality is independently positive relevant with the depression of type 2 diabetes patients,while the habit of eating fresh vegetable is negatively relevant with it.Type 2 diabetes patients with depression have statistically significant higher level of Proinflammatory cytokine(IL-6,IL-1 ?,IL-10)than those patients,w/o depression.The higher concentration of Proinflammatory cytokines may play roles in the formation of depression in type 2 diabetes patients.