| Objective: Some recent researches have investigated that anxiety and depression are significantly associated with the developent,progression,and treatment of type 2diabetes.However,so far,few studies have reported anxiety,depression,and estrogen level associated with diabetic peripheral neuropathy,DPN.Therefore,the objective of this study aims to explore the psychological factors affecting patients with type 2diabetes and related risk factors,further study of anxiety,depression,estrogen level and diabetic peripheral neuropathy in China.Methods: The collected data of hospitalized patients with diabetes from June 2017 to January 2018 in Qingdao Municipal Hospital,Department of Endocrinology.Patients with T2 DM were divided into 4 groups: 1)Depression + Anxiety group: SD S of this group was higher than 50,and the anxiety scale(Salf-rating Anxiety Scale,SAS)scores was higher than 50;2)Depression group: SDS score of this group was ? 50,and SAS score of the group was lower than 50;3)Anxiety group: SAS score of the group was higher than 50,and SDS score of this group was lower than 50.At the same time,gender,age,smoking history,the way of taking hypoglycemic drugs,duration of disease,body mass index(BMI),systolic blood pressure,diastolic blood pressure,Hb A1 c,Fasting plasma glucose,postprandial 2h plasma glucose(2h PG),total cholesterol(TC),trimyristate(TG),alanine transaminase(ALT),urea nitrogen,estrogen and other indicators.To investigate the association with psychological status,estrogen level and DPN.The collected data were analyzed using SPSS 24.0 statistical software.For thenumerical variables in the data,we first test the homogeneity of the variance.If the two groups of samples are homogeneity of variance,we use the independent samplet test,otherwise,we use the nonparametric test.For the categorical variables,Using chi-square test method.Multivariate Logistic regression analysis was used to analyze the risk factors which may affect the occurrence of DPN.ROC curves were used to assess the cut-off value of DPN in depression and anxiety among different groups.Results:1.The data of DPN group and non-DPN group were compared and found that the differences of gender,age,duration of disease,systolic blood pressure,Hb A1 c and osteoporosis were statistically significant(p <0.05).Patients with DPN,the risk of cardiovascular disease and retinopathy are significantly higher than that of non-DPN group(p= 0.000).There was no significant difference in the incidence of diabetic nephropathy between the two groups.2.The data of DPN with depression + anxiety group,depression group,anxiety group and normal group were compared and found that the differences of Fasting plasma glucose,HBA1 c,estrogen,DR,DN were statistically significant(p < 0.05).DPN with depression and anxiety group,depression group,anxiety group,the incidence of DPN was significantly higher than the normal group(p <0.01).3.Mult-factor regression analysis showed that SDS scores and SAS scores were independent risk factors for DPN.Among them,SDS score and SAS score are closely related to the occurrence of DPN,and increase the risk of DPN by 1.723 and 1.0 23 times,respectiely.4.Receiveer-operating characteristic curve analysis revealed that the optimal cutoff point of SDS score to predict the incidence of diabetic peripheral neuropathy was 52.5,Jorden index=0.46 7,are a under the curve = 0.777,p = 0.000,95% CI =0.705-0.848;The sensitivitywas 61.6%;The specificity was 85.1%.And the optimal cutoff point of SAS score to predict the incidence of diabetic peripheral neuropathy was46.5,Jorden index=0.251,area under the curve(AUC)= 0.609,p = 0.0014,95% CI =0.524-0.695;The sensitivitywas 73.7%;The specificity was 74.9%.Conclusion: In the patients with type 2 diabetes mellitus,there is a close correlation between depression,anxiety and DPN.At the same time,low levels of estrogen can cause a significant increase in the risk of peripheral neuropathy.In addition,FPG,osteoporosis,DR,DN have the high risk of DPN. |
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