Depressive Symptoms are Associated with High Levels of Serum Low-Density Lipoprotein Cholesterol in Older Adults with Type 2 Diabetes Mellitus

Abstract Background Type 2 Diabetes Mellitus (T2DM) is common in older adults, who also present a high level of risk factors for cardiovascular disease (CVD), such as dyslipidemia. However, the role of depression in T2DM patients and its relationship with CVD risk factors are understudied. Objective The present study aimed to investigate the relationship between depressive symptoms (DS) and known cardiovascular risk factors in community dwelling older adults with T2DM. Methods This is a cross sectional study, in which 85 community-dwelling older adults with T2DM were assessed. DS was assessed using the Yesavage Geriatric Depression Scale - short version (GDS-15). The following cardiovascular risk factors were evaluated: systolic (SBP) and diastolic blood pressure (DBP), fasting plasma glucose (FPG), lipid profile (serum triglycerides - TG, serum total cholesterol - TC, serum low-density lipoprotein cholesterol - LDL-C, and serum high-density lipoprotein cholesterol - HDL-C) and body mass index (BMI). Poisson multiple regression was performed to test the association between DS and each cardiovascular risk factor adjusted by sex, age, time spent in moderate physical activity, and functional status. The significance level adopted for the analysis was 5%. Results Among all the analyzed risk factors, only high levels of LDL-C were related to high DS (PR=1.005, CI 95% 1.002-1.008). A significant association was observed between HDL-C levels (PR=0.99, CI 95% 0.98-0.99) and SBP (PR=1.009, CI 95% 1.004-1.014). Conclusion In older adults with T2DM, the presence of DS was associated with LDL-C, HDL-C levels and SBP, even after adjusting for sex, age, physical activity level and functional capacity. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

【研究背景】2型糖尿病（Type 2 Diabetes Mellitus, T2DM）在老年人群中高发，该群体同时也是心血管疾病（cardiovascular disease, CVD）危险因素的高发群体，例如血脂异常。然而，目前针对抑郁在2型糖尿病患者中的作用及其与心血管疾病危险因素的关联研究仍较为匮乏。
【研究目的】本研究旨在探讨社区居住的2型糖尿病老年人群中抑郁症状（depressive symptoms, DS）与已知心血管疾病危险因素之间的关联。
【研究方法】本研究为横断面研究（cross sectional study），共纳入85名社区居住的2型糖尿病老年人群进行评估。采用Yesavage老年抑郁量表简版（Yesavage Geriatric Depression Scale - short version, GDS-15）对抑郁症状进行评估。本研究评估的心血管疾病危险因素包括：收缩压（systolic blood pressure, SBP）、舒张压（diastolic blood pressure, DBP）、空腹血浆葡萄糖（fasting plasma glucose, FPG）、血脂谱[血清甘油三酯（serum triglycerides, TG）、血清总胆固醇（serum total cholesterol, TC）、血清低密度脂蛋白胆固醇（serum low-density lipoprotein cholesterol, LDL-C）及血清高密度脂蛋白胆固醇（serum high-density lipoprotein cholesterol, HDL-C）]以及体重指数（body mass index, BMI）。采用泊松多重回归（Poisson multiple regression）分析，检验抑郁症状与各心血管疾病危险因素之间的关联，并校正性别、年龄、中等强度体力活动时长及功能状态的混杂影响；本研究采用的检验水准为5%。
【研究结果】在所有分析的危险因素中，仅高水平低密度脂蛋白胆固醇（LDL-C）与抑郁症状评分升高存在关联（PR=1.005，95%置信区间CI：1.002~1.008）；此外，高密度脂蛋白胆固醇（HDL-C）水平（PR=0.99，95%CI：0.98~0.99）与收缩压（SBP）（PR=1.009，95%CI：1.004~1.014）亦与抑郁症状存在显著关联。
【研究结论】在2型糖尿病老年人群中，即便校正性别、年龄、体力活动水平及功能状态后，抑郁症状仍与低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平及收缩压存在显著关联。（Arq Bras Cardiol. 2020; [在线印刷预印版, 页码0-0]）