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首页> 外文期刊>BMC Psychiatry >Depression differed by midnight cortisol secretion, alexithymia and anxiety between diabetes types: a cross sectional comparison
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Depression differed by midnight cortisol secretion, alexithymia and anxiety between diabetes types: a cross sectional comparison

机译：抑郁症在不同类型的糖尿病之间因午夜皮质醇分泌，运动障碍和焦虑而有所不同：横断面比较

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Background Increased prevalence of depression is found in both type 2 diabetes (T2D) and type 1 diabetes (T1D). Melancholia and atypical depression differ by cortisol secretion and clinical features. The aim was to compare the clinical presentation of T1D and T2D patients in relation to self-reported depression, self-reported anxiety, alexithymia, obesity, and midnight salivary cortisol (MSC). Methods Comparative cross-sectional design. The participants were consecutively recruited from one hospital diabetes outpatient clinic: 24 T2D patients (31–59?years) and 148 T1D patients (32–59?years). Self-reported depression, anxiety and alexithymia were assessed by Hospital Anxiety and Depression scale and Toronto Alexithymia Scale-20. MSC, HbA1c, anthropometrics and data from medical records were collected. Multiple logistic regression analyses were performed. Results Comparisons of prevalence between diabetes types showed for T2D/T1D: depression 25%/12% ( P =?0.10); high MSC (≥9.3?nmol/L) 38%/22% ( P =?0.13); alexithymia 25%/13% ( P =?0.12); anxiety 38%/35% ( P =?0.82). The prevalence of high MSC did not differ between depressed and non-depressed T2D patients (17% vs. 44%, P =?0.35), but differed between depressed and non-depressed T1D patients (53% vs. 18%, P =?0.003). The alexithymia prevalence differed between depressed and non-depressed T2D patients (67% vs.11%, P =?0.018), and between depressed and non-depressed T1D patients (47% vs. 11%, P P =?0.15), but differed between depressed and non-depressed T1D patients (76% vs. 30%, P 2) was 83% for depressed T2D patients and 6% for depressed T1D patients. In the T2D patients, depression was associated with alexithymia (Adjusted odds ratio (AOR) 15.0). In the T1D patients, depression was associated with anxiety (AOR 11.0), foot complications (AOR 8.5), HbA1C >70?mmol/mol (AOR 6.4), and high MSC (≥9.3?nmol/L) (AOR 4.8). Conclusions The depressed T2D patients had traits of atypical depression, without associated high MSC (≥9.3?nmol/L) and anxiety, but the association with alexithymia was strong. The depressed T1D patients had traits of melancholia with associated high MSC and anxiety. The obesity prevalence was high in depressed T2D patients and low in depressed T1D patients.
机译：背景技术在2型糖尿病（T2D）和1型糖尿病（T1D）中都发现抑郁症患病率增加。忧郁症和非典型性抑郁症的皮质醇分泌和临床特征不同。目的是比较T1D和T2D患者与自我报告的抑郁症，自我报告的焦虑症，运动障碍，肥胖症和唾液皮质醇（MSC）的临床表现。方法比较截面设计。参与者是从一家医院的糖尿病门诊诊所连续招募的：24名T2D患者（31-59岁）和148名T1D患者（32-59岁）。通过医院焦虑和抑郁量表和多伦多Alexithymia量表20评估自我报告的抑郁，焦虑和焦虑症。收集了MSC，HbA1c，人体测量学和病历数据。进行了多个逻辑回归分析。结果两种类型糖尿病的患病率比较显示：T2D / T1D：抑郁症为25％/ 12％（P =？0.10）;高MSC（≥9.3nmol/ L）38％/ 22％（P =？0.13）;读写障碍25％/ 13％（P =？0.12）;焦虑38％/ 35％（P =？0.82）。抑郁和非抑郁的T2D患者间高MSC的患病率无差异（17％vs. 44％，P =？0.35），而抑郁和非抑郁T1D患者之间的差异却不大（53％vs. 18％，P = 0.003）。抑郁症和非抑郁症的T2D患者的运动障碍患病率不同（67％vs.11％，P =？0.018），抑郁症和非抑郁症的T1D患者（47％vs. 11％，PP =？0.15），但抑郁和非抑郁T1D患者之间的差异（分别为76％和30％，P 2 ）为抑郁T2D患者为83％，抑郁T1D患者为6％。在T2D患者中，抑郁症伴有运动障碍（校正比值比（AOR）15.0）。在T1D患者中，抑郁症与焦虑症（AOR 11.0），足部并发症（AOR 8.5），HbA1C> 70？mmol / mol（AOR 6.4）和高MSC（≥9.3？nmol / L）（AOR 4.8）有关。结论抑郁型T2D患者具有非典型性抑郁特征，无高MSC（≥9.3nmol/ L）和焦虑症，但与运动障碍的相关性强。抑郁的T1D患者具有忧郁症的特征，伴有较高的MSC和焦虑症。肥胖的患病率在抑郁的T2D患者中较高，而在抑郁的T1D患者中较低。

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