The Study About The Correlation Between Anxiety,Depression As Well As Metabolic Factors And The Survival Quality Of Patients With Knee Osteoarthritis

Purpose: The research aims to analyze the correlation between the survival quality and mental health of patients with knee osteoarthritis(KOA)in Northeast Sichuan and investigate the influence of combined metabolic factors and inflammatory conditions on the survival quality and mental health of KOA patients.Method: 300 confirmed KOA patients from Outpatient Department and Inpatient Department of Rheumatology and Orthopedics in the Affiliated Hospital of North Sichuan Medical College from November 2017 to December 2018 are included in the research.(1)Collect patients' data like name,gender,age,menopausal status,physical exercise,marital status,average annual household income per capita,retirement,education background,sleep quality and medical history.Measure height and weight,then calculate body mass index(BMI=Weight/Height)for bone mineral density measurement.(2)Collect patients' medical history about knee osteoarthritis,give WOMAC marks on knee joints and assess SF-36 survival quality of the patients who are included in the research.Apply Hospital Anxiety and Depression Scale(HADS)for scoring.(3)Randomly select 30 patients whose were not treated after the first diagnosis.12 hours after fasting and water-deprivation,extract 5ml venous blood and detect erythrocyto sedimentation rate(ESR),fasting blood-glucose(FBG),glycated hemoglobin and blood fat respectively.Apply enzyme-linked immunosorbent assay(ELISA)to measure the inflammatory index level of blood plasma IL-1?,IL-6,IL-17,TNF-?and IL-10.(4)Divide cases into Group 0(No combined metabolic factor),Group 1(One combined metabolic factor),Group 2(Two combined metabolic factors)and Group 3(Three combined metabolic factors or more)based on the number of combined metabolic factors.Compare the difference in each group's severity of knee condition,survival quality,anxiety and depression.Order multivariate logistic regression model was used to analyze the factors associated with metabolic factors,and Spearman rank correlation test was used for correlation analysis.Results:(1)Total 300 KOA patients are included.10 unqualified cases are excluded.A total of 290 effective data are collected.The collection rate is 96.67%,among which there are 62 male patients,accounting for 21.38% and 228 female patients,accounting for 78.62%.Total 191 female patients suffer menopause,accounting for 82.46% of female patients.The patients' average age is 58.19±10.36,and the average disease course is 31.55±45.67 months.Marital status of the subjects: 0 cases were unmarried,accounting for 0%;244 cases were married,accounting for 84.14%;29 cases were divorced,accounting for 10.0%;17 cases were widowed,accounting for 5.86%.accounting for 35.17%,and 188 are dominated by mental labor,accounting for 64.83%.In terms of average annual household income per capita,22 patients' income is lower than 10,000 Yuan,131 patients' income is between 10,000 Yuan and 30,000 Yuan,103 between 30,000 Yuan and 50,000 Yuan and 34 between 50,000 Yuan and 100,000 Yuan,accounting for 7.59%,45.17%,35.52% and 11.72% respectively.Total 196 patients are retired,accounting for 67.59%,and 94 patients are not retired,accounting for 32.41%.In terms of education background,51 patients attended primary school or below,120 attended middle school,63 attended high school or technical secondary school and 56 attended the university,junior college or above,accounting for 6.90%,41.38%,21.72% and 19.31% respectively.In terms of inhabiting information,144 patients are living alone,73 living with their spouses and 73 living with their children,accounting for 49.66%,25.17% and 25.17%.In terms of sleep quality,80 patients' sleep quality is excellent,135 patients' sleep quality is moderate and 75 patients' sleep quality is poor,accounting for 27.59%,46.55% and 25.86%.Total 157 patients' BMI is equal to or more than 24(Overweight),accounting for 54.14%;62 patients ever suffered from high blood pressure,accounting for 21.38%;18 patients ever suffered from diabetes,accounting for 6.21%;29 patients ever suffered from lipid disorder,accounting for 10.0%;Total 100 patients ever suffered from osteoporosis,accounting for 34.48%.Total 70 patients have no combined metabolic factor,accounting for 24.14%;220 patients have more than one metabolic factor,accounting for 75.86%.(2)There are differences in the scores of each dimension of KOA patients' knee joint conditions in the groups of metabolic numbers(P<0.05),suggesting that the more combined metabolic factors,the more severe the patients' knee joint conditions will be;the scores of each dimension of KOA patients' survival quality are lower than regular models in Sichuan,suggesting KOA patients suffer lower survival possibility;there are differences in the scores of each dimension of KOA patients' survival quality in the groups of metabolic numbers(P<0.05),and the more combined metabolic factors,the lower patients' survival quality will be(P<0.05).(3)Total 99 patients suffer from anxiety and/or depression,accounting for 34.14%,among which 81 patients suffer from anxiety,accounting for 27.93%;and 95 from depression,accounting for 32.76%.77 patients suffer from both anxiety and depression,accounting for 26.55%.When anxiety and depression is combined,KOA patients' knee joint conditions will be more severe,their survival quality will be lower while combining more metabolic diseases(P<0.05).(4)TNF-? is positively correlated with the severity of knee joint condition(P<0.05);IL-6 and TNF-? make a positive influence on anxiety and depression(P<0.05);IL-1?,IL-17 A,TNF-?and IL-10 are positively correlated with the number of metabolic factors(P<0.05).The more metabolic diseases are combined,the more severe KOA patients' systemic inflammatory responses will be.IL-6,IL-17 A and TNF-? are positively correlated with fasting blood-sugar(P<0.05);IL-1?,IL-6,IL-17 A,TNF-?and IL-10 are positively correlated with glycated hemoglobin,average blood sugar and total glycated hemoglobin(P<0.05);IL-1?,IL-6,TNF-?and IL-10 are positively correlated with erythrocyto sedimentation rate(P<0.05);IL-6,IL-17 A,TNF-? and IL-10 are positively correlated with hypersensitive C-reactive protein(P<0.05);metabolic factors are positively correlated with bone mass changes(P<0.05);When metabolic syndrome is combined,bone mass changes will be more obvious.Conclusion:(1)The survival quality of KOA patients is lower than that of general population,which is positively correlated with the severity of knee joint condition,combined metabolic factor,anxiety and depression;(2)KOA patients' knee joint condition is positively impacted by metabolic factor.When metabolic diseases are combined,knee joint condition will be more severe.(3)When metabolic factors are combined,the biological and social functions as well as health changes of KOA patients will be obviously lower than those of non-combined metabolic factors.Besides,the survival quality of KOA patients who combine 3 kinds of metabolic factors or more obviously decreases.(4)Anxiety and depression is positively correlated with combined metabolic factors.When metabolism is in disorder,KOA patients may suffer more severe anxiety and depression.(5)KOA and osteoporosis are more common in postmenopausal women.Bone mass changes are positively correlated with the severity of knee joint condition,survival quality,anxiety and depression as well as combined metabolic factors.(6)KOA is a chronic low-grade inflammatory response.The inflammatory cytokines like IL-1?,IL-6,IL-17 A,TNF-? and IL-10 play a key role in the development of diseases,especially when combined blood sugar metabolism is in disorder,these inflammatory cytokines will obviously increase.