ABEM：抑郁治疗可改善糖尿病人体力活动

　　一项新的研究表明增强2型糖尿病患者独立性和治疗其抑郁症状可以促进患者体力活动能力提高。集体活动和来自看护人员与患者家庭的支持可能对依赖性较强的患者有益，也可促使平时体力活动较少的2型糖尿病患者参与到锻炼计划中。

　　为评估2型糖尿病患者体力活动、并发症、抑郁症状和健康相关生活质量之间的联系，研究者纳入200例2型糖尿病患者及50例对照者，所有受试者年龄均在40-60岁之间。通过国际体力活动量表（IPAQ）评估受试者体力活动，并以36项健康调查简表（SF-36）评估健康相关生活质量（HRQL），以Charlson合并症指数（CCI）评估并发症的严重程度，以Beck抑郁量表（BDI-II>16）评估抑郁症状。通过单因素和多因素回归分析评估独立变量对体力活动的影响。

　　结果显示，糖尿病患者抑郁症状与并发症都较更严重（P<0.005），体力活动水平（IPAQ）则优于对照组（P<0.005）。SF-36评测HRQL结果中，功能状态、总体健康状态和体力最受影响。体力活动较少的糖尿病患者腰围和腰臀比更高，抑郁症状更严重，健康相关生活质量较差。功能状态（P=0.000）以及总体健康状态（P=0.02）与身体活动独立相关的因素。

Associations among physical activity, comorbidities, depressive symptoms and health-related quality of life in type 2 diabetes

OBJECTIVE:

To investigate associations between physical activity, comorbidity severity, depressive symptoms, and health-related quality of life in type 2 diabetes mellitus.

SUBJECTS AND METHODS:

All individuals, 200 patients and 50 controls, aged from 40 to 60 years, were investigated by interview, and all variables were measured concurrently. Physical activity was evaluated by the International Physical Activity Questionnaire (IPAQ), Health-Related Quality of Life (HRQL) by the Short-Form Health Survey (SF-36), comorbidity severity by the Charlson Comorbidity Index (CCI), and depressive symptoms by the Beck Depression Inventory (BDI-II > 16). Single and multiple regression analysis evaluated the effects of independent variables on physical activity.

RESULTS:

The patients had more depressive symptoms and greater comorbidity severity (p < 0.005). Diabetic patients showed better activity levels (IPAQ) (p < 0.005). Functional Capacity, General State of Health, and Physical Limitation were the most affected subscales in the SF-36 evaluation of the HRQL. Sedentary diabetic patients had higher waist circumference, waist-to-hip ratios, more depressive symptoms, and worse HRQL. Functional capacity (p = 0.000), followed by General State of Health (p = 0.02), were the health status measure subscales independently associated with physical activity. Conclusions: The findings suggest that increasing patient independence and treating depressive symptoms can promote physical activity for type 2 diabetes mellitus patients. It is suggested that group activities and caregivers/family support might compensate for the patient dependence, and increase adherence to exercise programs in those that are less active.