本文選題：焦慮障礙 + 糖尿病��； 參考：《四川大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年06期

【摘要】：目的探討下丘腦-垂體-腎上腺軸(HPA軸)、下丘腦-垂體-甲狀腺軸(HPT軸)在焦慮障礙合并糖尿病中的可能中介作用。方法選取562例住院焦慮障礙患者作為研究對象。測量其促甲狀腺激素(TSH)、總?cè)饧谞钕僭彼?TT3)、游離三碘甲狀腺原氨酸(FT3)、總四碘甲狀腺原氨酸(TT4)、游離四碘甲狀腺原氨酸(FT4)、促腎上腺皮質(zhì)激素(ACTH)、皮質(zhì)醇(PTC)等神經(jīng)內(nèi)分泌指標(biāo),同時(shí)進(jìn)行口服葡萄糖糖耐量實(shí)驗(yàn)(oral glucose tolerance test,OGTT)。計(jì)算胰島素抵抗指數(shù)(HOMA IR)、胰島素敏感指數(shù)(WBISI)。結(jié)果焦慮障礙共病糖尿病患者83例(14.8%)。在40歲人群中,FT4、HPT軸異常與焦慮障礙患者糖尿病患病率有關(guān)(P0.05)。年齡(OR=1.067,95%CI:1.041~1.094,P=0.000)、FT4(OR=1.104,95%CI:1.022~1.193,P=0.012)、PTC(OR=1.001,95%CI:1.000~1.003,P=0.025)是焦慮障礙伴發(fā)糖尿病的影響因素。當(dāng)PTC、HPA軸異常時(shí),HOMA IR增高、WBISI降低(P0.05);當(dāng)ACTH、HPT軸、FT4、TT3異常時(shí)WBISI降低(P0.05)。結(jié)論 HPA或HPT軸的異�？赡苁墙箲]障礙伴發(fā)糖尿病的中介機(jī)制,早期關(guān)注并干預(yù)神經(jīng)內(nèi)分泌異�？赡苡兄诜婪督箲]障礙患者糖尿病的發(fā)生。
[Abstract]:Objective to investigate the role of hypothalamus-pituitary-adrenal axis (HPA) and hypothalamus-pituitary-thyroid axis (HPT) in anxiety disorder with diabetes mellitus.Methods 562 inpatients with anxiety disorder were selected as study objects.The neuroendocrine indexes such as TSH, TT3, FT3, TT4, FT4, ACTH and PTC were measured.Oral glucose tolerance test (oral glucose tolerance test) was performed at the same time.The insulin resistance index (Homa IRI) and insulin sensitivity index (ISI) were calculated.Results there were 83 patients with diabetes mellitus with anxiety disorder.The abnormal HPT axis of FT4 was associated with the prevalence of diabetes in patients with anxiety disorder (P 0.05).1. 067 and 95: 1.041: 1.094 P0. 000 FT4: 1.022 1.193 P0. 012 are the influential factors of anxiety disorder associated with diabetes mellitus (1. 001 CI: 1. 000) and 1. 003. 0. 025 (P = 0. 025), which is a major factor in the development of diabetes mellitus (P 0. 025, P 0. 025), and it is also an important factor in the development of diabetes mellitus (P 0. 025) and anxiety disorder (1. 001: 1. 003 P0. 025).When the HPA axis of PTC was abnormal, the HOMA-IR was increased and the level of WBISI was decreased (P 0.05), while the WBISI was decreased when the T 3 was abnormal in the HPT axis of ACTH.Conclusion the abnormality of HPA or HPT axis may be the mediating mechanism of anxiety disorder associated with diabetes mellitus. Early attention and intervention of neuroendocrine abnormalities may be helpful to prevent the occurrence of diabetes in patients with anxiety disorder.
【作者單位】： 四川大學(xué)華西醫(yī)院心理衛(wèi)生中心;
【基金】：西部精神醫(yī)學(xué)協(xié)會(huì)基金(No.wcpa fund 2014-7)資助
【分類號】：R587.1;R749.72

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