Study On The Relationship Between The Depression And Serum Non High Density Lipoprotein Cholesterol And Bilirubin In Patients With Diabetes Mellitus And Its Effect On Quality Of Life

Objectives To investigate the relationship between depression and non-high density lipoprotein-cholesterol(non-HDL-C)and bilirubin in patients with Type 2 Diabetes mellitus(T2DM),and its effect on quality of life.Methods Totally 259 patients with T2 DM treated in the endocrinology department of the Affiliated Hospital of North China University of Science and Technology and the Tangshan Gong Ren Hospital from october,2016 to october,2017 were selected.The Hamilton Depression Scale(HAMD)was used to evaluated the patients' s depression.The patients with T2 DM and depression were divided into case group(T2DM and depression group),and the patients with T2 DM but without depression were control group(T2DM and non-depressed group),and the levels of glycosylated hemoglobin A1c(Hb A1c),total bilirubin(TBil),direct bilirubin(DBil),indirect bilirubin(IBil),total cholesterol(TC),low density lipoprotein-cholesterol(LDL-C),high density lipoprotein-cholesterol(HDL-C)and triglyceride(TG)were measured respectively,and the Non-HDL-C was calculated.The self-made general situation questionnaire was used to investigate the patients' s general situation,and the quality of life and self-management behavior of the patients were evaluated by diabetes specific quality of life scale(DSQL)and the summary of diatbets self-care activities measure(SDSCA)respectively.Results 1 The incidence of depression in T2 DM patients was about 38.9%,mainly with mild depression(65.3%),followed by moderate depression(21.8%),and severe depression(12.9%).2 There were no statistically significant differences in gender,average age,marriage history,education level,occupation,course of disease,medical history,smoking history,drinking history,BMI and Hb A1 c between the case group and control group(P>0.05).3 The average levels of TBil,DBil,IBil,TC,HDL-C and Non-HDL-C in the case group were lower than control group,and the average levels of TG and LDL-C were higher than control group,and the differences were statistically significant(P<0.05).4 The high levels of Non-HDL-C,TBil,DBil and IBil in the case group were less than the control group,and the differences were statistically significant(P<0.05).5 Logistic regression analysis showed that Non-HDL-C,TBil and HDL-C were protective factors for T2 DM depression,and TG and LDL-C were risk factors.6 The high levels of Non-HDL-C,TBil,DBil and IBil in the moderate and severe depression groups were less than those in the mild depression group,and the differences were statistically significant(P<0.05).7 The average TC and HDL-C levels in the severe depression group were lower than those in the mild and moderate depression groups,while the average TG level was higher than that of the mild and moderate depression groups(P<0.05),and there was no statistically significant differences between mild and moderate depression groups(P>0.05).The average LDL-C was lower than the moderate and severe depression groups(P<0.05),and there was no statistically significant differences between the moderate and severe depression(P>0.05).8 The DSQL score of case group was higher than that of control group,and the difference was statistically significant(P<0.05),and the scores of patients with moderate and severe depression were higher than the mild depression patients(P<0.05)and there was no significan difference between moderate and severe depression groups.There was no significant difference in SDSCA score between the two groups(P>0.05).9 Pearson correlation analysis showed that the HAMD scale score of case group was negatively correlated with TBil,DBil,IBil,TC,and Non-HDL-C(r=-0.717;-0.283;-0.449;-0.234;-0.477;P<0.05),while positively correlated with TG(r=0.231,P<0.05)and LDL-C(r=0.508,P<0.001).10 TBi L,LDL-C,TG and Non-HDL-C were effective predictors of HAMD scale scores in patients with T2 DM,and their Beta coefficient were-0.527,0.175,-0.239,0.148 respectively.Conclusions 1 Depression in patients with type 2 diabetes was associated with the levels of Non-HDL-C and bilirubin,with low levels of Non-HDL-C and bilirubin,and high risk of depression.2 The degree of depression is related to the levels of Non-HDL-C and bilirubin,with low levels of Non-HDL-C and bilirubin,and high risk of moderate and severe depression.Non-HDL-C,TBil,DBil,and IBil can be used as reference indicators in early clinical screening.3 The quality of life of patients with type 2 diabetes was affected by depression,and the quality of life decreased with the increase of depression.We should pay attention to the effect of depression on the quality of life of type 2 diabetic patients.