单相抑郁症患者抗抑郁治疗对血糖血脂的影响
Effect of antidepressant therapy on blood glucose and blood lipid in patients with unipolar depression

摘要：目的 探讨单相抑郁患者出现代谢异常的情况及可能原因。方法 103例住院的单相抑郁症患者和100例健康对照。患者组抗抑郁药治疗3周。检测治疗前后代谢指标(空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇)变化。结果 单相抑郁症患者治疗前空腹血糖、总胆固醇及高密度脂蛋白胆固醇明显高于健康对照，差异有统计学意义(P<0.05)。治疗后代谢指标与正常对照间没有显著性差异(P>0.05)。抗抑郁药治疗后，血清空腹血糖水平较基础值有明显下降，差异有统计学意义(P<0.05)。复发单相抑郁症患者空腹血糖及总胆固醇指标均明显高于健康对照(P=0.049；P=0.031)；年龄>30岁的患者空腹血糖及总胆固醇指标高于年龄≤30岁的患者，差异有统计学意义(P=0.001；P=0.016)。空腹血糖和发病次数正相关，可建回归方程Y空腹血糖=0.26x发病次数+4.01。结论 抑郁反复发作增加了发生代谢问题的风险；抗抑郁药治疗有助于空腹血糖的改善；单相抑郁代谢风险或许与疾病反复发生有关，与药物治疗关联不大。
ABSTRACT: Objective This study investigated the occurrence and possible causes of metabolic abnormalities in patients with unipolar depression. Methods We recruited 103 hospitalized patients with unipolar depression and 100 healthy controls. The patient group was treated with antidepressants for 3 weeks. Metabolic indicators (fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein) were measured before and after treatment. Results Fasting blood glucose, total cholesterol and high-density lipoprotein were significantly higher in patients with unipolar depression than in healthy controls (P<0.05). The metabolic index did not significantly differ between the two groups after treatment (P>0.05). After treatment with antidepressants, serum fasting blood glucose level was significantly lower than the baseline value (P<0.05). Fasting blood glucose and total cholesterol were significantly higher in patients with recurrent unipolar depression than in the healthy controls (P=0.049, P=0.031). The patients aged above 30 years had significantly higher fasting blood glucose and total cholesterol levels than those aged 30 or younger (P=0.001, P=0.016). Fasting blood glucose level was positively correlated with the number of episodes, and a regression equation could be established as Yfasting blood glucose=0.26xincidence times +4.01. Conclusion Repeated episodes of depression increase the risk of metabolic problems. Antidepressant treatment helps improve fasting blood glucose. The risk of unilateral depression metabolism may be related to the recurrent disease and has little to do with drug treatment