中老年糖尿病患者抑郁症状的高危识别

doi:10.3969/j.issn.1004-583X.2023.06.006

摘要/Abstract

摘要：

目的分析中老年糖尿病患者抑郁症状的检出情况,为识别合并抑郁症状的高危群体提供依据。方法选取2018 年中国健康与养老追踪调查数据中符合糖尿病诊断,以及正在使用某种方法进行治疗的45岁及以上的中老年糖尿病患者。采用流调中心抑郁水平评定10条目量表(CESD-10)问卷,≥10分为抑郁症状。采用单因素和多因素Logistic回归分析,对不同特征的糖尿病患者抑郁症状的检出情况进行比较。结果共纳入糖尿病患者1815例,其中790例(43.5%)存在抑郁症状。Logistic回归分析显示,合并肺部疾病、脑卒中、肾脏疾病、记忆相关疾病、关节炎慢性病,学历为初中及以下、女性、居住地为农村是检出糖尿病患者抑郁症状的危险因素。结论中国中老年糖尿病患者抑郁症状的检出情况处于较高水平,特别是女性、居住地在农村、低学历、合并肺部疾病、脑卒中、肾脏疾病、记忆相关疾病及关节炎的患者更应得到关注。

关键词: 糖尿病, 抑郁, 高危群体

Abstract:

Objective To detect the depressive symptoms in middle-elderly patients with diabetic, and to provide evidence for identifying high-risk groups of pooled diabetic and depression. Methods According to the 2018 China Health and Retirement Longitudinal Study (CHARLS) data, a total of 1815 eligible middle- elderly diabetic patients aged 45 years and over were recruited, including these patients who was being treated with a certain method. Depression score was adopted by the 10-item Center for Epidemiological Studies Depression Scale (CESD-10) questionnaire, and the presence of depressive symptoms was defined as ≥10 points. Univariate and multivariate Logistic regression analysis were performed to analyze the detection of depressive symptoms in middle-elderly patients with diabetic.Resultss There were 790 (43.5%) patients pooled diabetic and depressive symptoms among 1815 patients. In the results of Logistic regression analysis, pulmonary disease, stroke, kidney disease, memory-related disease, arthritis chronic disease, education level of junior high school and below, female, and rural residence were the risk factors for depressive symptoms in middle-elderly patients with diabetic. Conclusion The detection rate of depressive symptoms in middle-elderly diabetic patients is at a high level in China, especially women, living in rural areas, low educational background, patients with lung disease, stroke, kidney disease. The memory related diseases, arthritis and chronic diseases should be paid more attention.

Key words: diabetes mellitus, depression, high-risk groups

中图分类号:

R587.1

吴亚楠, 延天美, 梁鹏, 魏立民. 中老年糖尿病患者抑郁症状的高危识别[J]. 临床荟萃, 2023, 38(6): 516-520.

Wu Yanan, Yan Tianmei, Liang Peng, Wei Limin. High-risk identification of depressive symptoms in middle-elderly patients with diabetes[J]. Clinical Focus, 2023, 38(6): 516-520.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2023.06.006

https://huicui.hebmu.edu.cn/CN/Y2023/V38/I6/516

图/表 2

表1 糖尿病患者合并抑郁症状的检出情况[例(%)]

Tab. 1 Detection of depressive symptoms in diabetic patients (n[%])

项目	例数	抑郁症状	χ²值	$P$ 值
性别
男女	818 997	262(32.0) 528(53.0)	80.074	<0.010
年龄(岁)
45~60	528	214(40.7)
60~70	630	275(43.7)	2.970	0.226
>70	659	301(43.5)
吸烟
是否	418 1397	146(34.9) 644(46.1)	16.332	<0.010
饮酒
是否	1280 535	602(47.0) 188(43.5)	21.704	<0.010
婚姻状态
已婚	1576	657(41.7)
离婚/丧偶	236	130(55.1)	18.886	<0.010
未婚	3	3(100)
教育水平
初中及以下	1134	581(51.2)
高中及同等水平	398	140(35.2)	80.899	<0.010
大学及以上	283	69(24.4)
居住地
农村城镇	1200 615	587(48.9) 203(33.0)	41.864	<0.010
医保类型
无	29	17(58.6)
城镇居民	245	105(42.9)
城镇职工	409	113(27.6)	68.060	<0.010
新农合	1072	537(50.1)
其他	60	42(30.0)
治疗方式
无	491	218(44.4)
胰岛素	275	133(48.4)	3.970	0.137
口服降糖药	1049	439(41.8)
高血压	1142	510(44.7)	1.606	0.205
血脂异常	922	422(45.8)	3.839	0.050
肿瘤	31	13(41.9)	0.032	0.857
肺部疾病	322	192(59.6)	41.285	<0.010
肝脏疾病	178	89(50.0)	3.365	0.067
心血管疾病	627	314(50.1)	16.737	<0.010
脑卒中	164	91(55.5)	10.494	<0.010
肾脏疾病	296	169(57.1)	26.489	<0.010
记忆相关疾病	63	46(73.0)	23.090	<0.010
关节炎	758	426(56.2)	85.060	<0.010

表1 糖尿病患者合并抑郁症状的检出情况[例(%)]

Tab. 1 Detection of depressive symptoms in diabetic patients (n[%])

项目	例数	抑郁症状	χ²值	$P$ 值
性别
男女	818 997	262(32.0) 528(53.0)	80.074	<0.010
年龄(岁)
45~60	528	214(40.7)
60~70	630	275(43.7)	2.970	0.226
>70	659	301(43.5)
吸烟
是否	418 1397	146(34.9) 644(46.1)	16.332	<0.010
饮酒
是否	1280 535	602(47.0) 188(43.5)	21.704	<0.010
婚姻状态
已婚	1576	657(41.7)
离婚/丧偶	236	130(55.1)	18.886	<0.010
未婚	3	3(100)
教育水平
初中及以下	1134	581(51.2)
高中及同等水平	398	140(35.2)	80.899	<0.010
大学及以上	283	69(24.4)
居住地
农村城镇	1200 615	587(48.9) 203(33.0)	41.864	<0.010
医保类型
无	29	17(58.6)
城镇居民	245	105(42.9)
城镇职工	409	113(27.6)	68.060	<0.010
新农合	1072	537(50.1)
其他	60	42(30.0)
治疗方式
无	491	218(44.4)
胰岛素	275	133(48.4)	3.970	0.137
口服降糖药	1049	439(41.8)
高血压	1142	510(44.7)	1.606	0.205
血脂异常	922	422(45.8)	3.839	0.050
肿瘤	31	13(41.9)	0.032	0.857
肺部疾病	322	192(59.6)	41.285	<0.010
肝脏疾病	178	89(50.0)	3.365	0.067
心血管疾病	627	314(50.1)	16.737	<0.010
脑卒中	164	91(55.5)	10.494	<0.010
肾脏疾病	296	169(57.1)	26.489	<0.010
记忆相关疾病	63	46(73.0)	23.090	<0.010
关节炎	758	426(56.2)	85.060	<0.010

表2 Logistic回归分析糖尿病患者合并抑郁症状的危险因素

Tab. 2 Influencing factors of depressive symptoms in patients with diabetes by Logistic regression analysis

变量	β	SE	值	Wald χ²	值	95%
男(以女性为参照)	-0.638	0.135	0.528	23.839	<0.001	0.405~0.689
吸烟(以不吸烟为参照)	0.007	0.145	1.007	0.002	0.961	0.758~1.339
饮酒(以不饮酒为参照)	-0.108	0.131	0.897	0.689	0.406	0.694~1.159
婚姻状态(以未婚为参照)
已婚	-20.770	23128.937	0.000	0.000	0.999	0.000~0.000
离婚/丧偶	-20.437	23128.937	0.000	0.000	0.999	0.000~0.000
受教育程度(以高等教育为参照)
初等教育及以下	0.511	0.182	1.668	7.917	0.005	1.168~2.381
中等教育	0.235	0.192	1.264	1.493	0.222	0.868~1.842
居住地(以乡村为参照)
城镇	-0.318	0.135	0.728	5.523	0.019	0.559~0.949
医疗保险(以无保险为参照)
城镇职工	-0.906	0.433	0.404	4.370	0.037	0.173~0.945
城镇居民	-0.766	0.431	0.465	3.157	0.076	0.200~1.082
新农合	-0.437	0.413	0.646	1.122	0.290	0.288~1.450
其他	-0.773	0.52	0.462	2.212	0.137	0.167~1.278
血脂异常	0.168	0.11	1.184	2.326	0.127	0.953~1.470
肺部疾病	0.518	0.144	1.678	12.873	<0.001	1.265~2.227
心血管疾病	0.084	0.118	1.088	0.512	0.474	0.864~1.371
脑卒中	0.41	0.186	1.507	4.881	0.027	1.047~2.168
肾脏疾病	0.408	0.146	1.503	7.815	0.005	1.130~2.001
记忆相关疾病	1.072	0.318	2.921	11.332	0.001	1.565~5.451
关节炎	0.434	0.11	1.543	15.471	<0.001	1.243~1.916

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