Sedentary Behavior and the Risk of Depression in Patients with Type 2 Diabetes Mellitus

doi:10.12114/j.issn.1007-9572.2019.00.684

Abstract

Abstract: Background　The adverse effects of sedentary behavior on physical health have been widely studied，but its impact on mental health is rarely reported. The prevalence of sedentary behavior in patients with type 2 diabetes mellitus（T2DM） is relatively high，so it is of great significance to explore the relationship between sedentary behavior level and depression risk in this group. Objective　To explore the correlation between sedentary behavior and depression risk in patients with T2DM，providing a theoretical basis for clinical delivery of health education intervention for such patients. Methods　From January to November 2018，a questionnaire survey was conducted in a convenience sample of 410 T2DM outpatients from the endocrine outpatient clinic of a grade A tertiary hospital in Nantong area，for collecting the data about socio-demographic information，history of disease，subjective assessment of sedentary behavior，depression risk assessed by the Beck Depression Inventory 2nd Edition（BDI-Ⅱ），and physical activity assessed by the International Physical Activity Questionnaire-Short Form（IPAQ-SF）. Correlation analysis and Logistic regression model were used to analyze the relationship between sedentary behavior level and depression risk. Results　A total of 402（98.1%） cases returned responsive questionnaires. The average daily time spent in sedentary behavior was （5.62±2.60）h in all the respondents，and was at least 5 hours in 265（65.9%） cases. The sedentary behavior level differed significantly by average personal monthly income，body mass index（BMI），the number of comorbidities，glycosylated hemoglobin（HbA1c），total cholesterol（TC），triacylglycerol（TG），low-density lipoprotein cholesterol（LDL-C），BDI-II score and physical activity level（P<0.05）. Correlation analysis showed that sedentary behavior level was positively correlated with the number of comorbidities，diastolic pressure，BMI，waist circumference and depression level，and negatively correlated with physical activity level（P<0.05）. After controlling for socio-demographic factors consisting of age，sex，marital status，employment status，prevalence of smoking，drinking，and medical insurance，educational level，average personal monthly income，course of T2DM，number of complications，number of comorbidities，family history of T2DM，depression history，types of drug therapies，insulin therapy，systolic blood pressure，diastolic blood pressure，BMI，waist circumference and physical activity level，partial correlation analysis showed that sedentary behavior level was still positively correlated with depression level（pratial correlation coefficient was 0.637，P<0.001）. Stepwise Logistic regression analysis showed that the OR（95%CI） of depression risk in sedentary group was 29.68（16.11，54.68），and was 64.55（28.40，146.72） after adjusting for the above-mentioned socio-demographic variables. Conclusion　There is a positive correlation between sedentary behavior level and depression risk in patients with T2DM. Clinical workers should pay attention to the health education for reducing sedentary behavior in such patients.

Key words: Diabetes mellitus, type 2；Sedentary lifestyle；Depression；Correlation

摘要： 背景　久坐行为于生理健康的不良影响已经得到了相对广泛的研究，但久坐行为对心理健康的影响却较少见报道。2型糖尿病（T2DM）患者的久坐行为水平相对较高，探究其久坐行为水平与抑郁风险之间的关系具有重要意义。目的　探讨T2DM患者久坐行为水平与其抑郁风险的相关性，为临床医务工作采取相应的健康教育干预措施提供理论依据。方法　于2018年1—11月，采用方便抽样法抽取南通地区某三级甲等医院内分泌门诊就诊的410例T2DM患者为研究对象，并对其进行问卷调查。问卷内容包括一般情况调查、患者疾病相关情况调查、久坐行为水平的评估、贝克抑郁量表第2版（BDI-Ⅱ）抑郁评估、国际体力活动短问卷（IPAQ-SF）调查。通过相关性分析和Logistic回归模型分析久坐行为水平与抑郁风险的关系。结果　402例（98.1%）T2DM患者的问卷被有效回收。T2DM患者日均久坐行为时间为（5.62±2.60）h，265例（65.9%）每日久坐行为时间≥5 h。不同久坐行为水平T2DM患者个人月收入、体质指数（BMI）、合并症个数、糖化血红蛋白（HbA1c）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、BDI-Ⅱ抑郁评分及体力活动水平比较，差异有统计学意义（P<0.05）。相关性分析结果显示，久坐行为水平与合并症个数、舒张压、BMI、腰围及抑郁水平呈正相关，与体力活动水平呈负相关（P<0.05）。控制社会人口学变量年龄、性别、婚姻状况、工作状态、吸烟、饮酒、医疗保险、文化程度、个人月收入、病程、并发症个数、合并症个数、家族史、抑郁史、药物治疗种类、胰岛素治疗、收缩压、舒张压、BMI、腰围和体力活动水平后进行偏相关分析，结果显示久坐行为水平仍与抑郁水平呈正相关（偏相关系数为0.637，P<0.001）。Logistic逐步回归分析结果显示久坐组发生抑郁风险的OR（95%CI）为29.68（16.11，54.68）；校正上述变量后，久坐组发生抑郁风险的OR（95%CI）为64.55（28.40，146.72）。结论　T2DM患者久坐行为水平与其抑郁风险呈正相关，临床工作者应重视减少T2DM患者久坐行为的健康宣教。

关键词: 糖尿病, 2型；久坐生活方式；抑郁；相关性

WANG Ya,SUN Juan,ZHANG Xiaoyi, et al. Sedentary Behavior and the Risk of Depression in Patients with Type 2 Diabetes Mellitus[J]. Chinese General Practice, 2020, 23(22): 2856-2862. DOI: 10.12114/j.issn.1007-9572.2019.00.684.
王娅,孙娟,张晓义等. 2型糖尿病患者久坐行为水平与抑郁风险的相关性研究[J]. 中国全科医学, 2020, 23(22): 2856-2862. DOI: 10.12114/j.issn.1007-9572.2019.00.684.

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