摘要
目的研究焦虑障碍与2型糖尿病(T2DM)患者胰岛素抵抗之间的关系,及心理干预对胰岛素抵抗的影响。方法对T2DM患者及健康人群进行焦虑状态/特质询问表(STAI)测试,分别选取基线资料匹配的有、无焦虑障碍T2DM患者52例和54例作为研究对象。所有对象均检测空腹血糖、空腹胰岛素、皮质醇(CRO)、白细胞介素6(IL-6)水平并计算胰岛素抵抗指数(HOMA-IR)、β细胞功能指数(HBCI)及胰岛素分泌功能指数(IS)。对焦虑障碍患者进行心理干预4～6周,再次行STAI测试并重复上述生化指标检查。结果焦虑障碍T2DM患者血清IL-6、CRO及HOMA-IR等指标明显高于无焦虑障碍患者(P均<0.01),HBCI及IS明显低于无焦虑障碍患者(P均<0.01);心理干预4～6周后状态焦虑阳性率明显下降(P<0.01),特质焦虑阳性率下降不明显(P>0.05);焦虑障碍改善明显患者的CRO、IL-6、HOMA-IR的下降及HBCI、IS的升高亦明显(P均<0.01)。结论焦虑障碍与T2DM患者胰岛素抵抗密切相关;心理治疗有助于减轻焦虑障碍、改善胰岛素抵抗。
Objective To study the relationship between anxiety disorder and insulin resistance in patients with type 2 diabetes,and explore the impact of the psychological intervention on insulin resistance.Methods A total of 106 patients with type 2 diabetes were enrolled in this study,and they were divided into anxiety disorder group （group A,n=52） and no-anxiety disorder group （group B,n=54） based on with or without anxiety.Basic data of two groups were well matched.All patients were tested using the State-Trait Anxiety Inventory（STAI）-form Y questionnaire.The fasting blood glucose（FPG）,fasting insulin（FINS）,fasting blood cortisol （CRO） and fasting serum interleukin-6 （IL-6） were detected. Insulin resistance index （HOMA-IR）,B-cell function index（HBCI） and insulin secretary function index（IS）were calculated.Psychological treatment was given in group A.Four to six weeks after psychological intervention,the test of STAI-form Y questionnaire was completed again,and the aforementioned observational targets were repeated.Results The levels of IL-6,CRO and HOMA-IR were higher,while HBCI and IS levels lower （all P〈0.01） in group A than those in group B.After psychological intervention,the positive rate of state anxiety was lower significantly （P〈0.01）,while trait anxiety didn′t improve significantly （P〈0.05）.In the patients whose anxiety obviously improved,levels of IL-6,CRO and HOMA-IR decreased,and HBCI and IS increased significantly （all P〈0.01）.Conclusions Emotional disorder exists in part patients with type 2 diabetes,and there is a close correlation between anxiety disorder and insulin resistance.Psychological treatment may reduce anxiety disorder,thus it could reduce insulin resistance.
出处
《中国临床研究》
CAS
2010年第7期565-567,共3页
Chinese Journal of Clinical Research
