Volume 4,Issue 7
2型糖尿病与糖尿病共病抑郁患者的临床指标差异及抑郁标志物研究
目的：比较单纯2型糖尿病（type 2 diabetes mellitus ，T2DM）患者与糖尿病共病抑郁（type 2 diabetes comorbid depression, T2DD）患者在人口学特征、代谢指标、炎症指标及内分泌指标等方面的差异，筛选潜在抑郁标志物。方法：选取2024年1月至12月新疆生产建设兵团第五师医院内分泌科收治的132例2型糖尿病患者。所有参与者均签署知情同意书，并接受详细的问卷调查和体检。研究数据包括社会人口学信息、临床信息、实验室检查和心理评估。心理评估采用流调中心用抑郁量表（CES-D）和Beck抑郁量表（BDI），CES-D≥20且BDI≥5定义为抑郁状态。采集外周静脉血，检测血小板计数（PLT）、中性粒细胞计数(NE)、淋巴细胞计数(LY)、平均血小板体积（MPV）、血小板压积（PCT）、血小板分布宽度（PDW）、糖化血红蛋白（HbA1c）、纤维蛋白原（FIB）、血脂谱（TC、TG、HDL-C、LDL-C）、胰岛素（INS）和C肽（C-P）、促甲状腺激素 （TSH）、25-羟基维生素D（25-OH-VD）。同时记录人口学数据：性别、年龄、身高、体重。采用SPSS 26.0进行统计学分析。结果：两组在民族、性别、年龄构成、BMI、PLT、MPV、PCT、PDW、HbA1c、TC、TG、HDL-C、LDL-C、TSH水平上差异均无统计学意义（P均>0.05），SII、FIB、25-OH-VD、INS、C-P有统计学意义，但进行多因素logistic回归分析后，显示25-OH-VD是T2DD最强的独立危险因素（P=0.006）、OR=0.901（95%CI: 0.838-0.970），SII（系统性免疫炎症指数）和C-P水平也显示出一定的预测价值，值得在临床实践中关注。结论:联合使用C-P、SII和25-OH-VD可显著提高T2DD的诊断准确性，在实际临床中，可先使用SII进行初步筛查，再结合C-P和25-OH-VD进行确认诊断。
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