Relativity study of thyroid hormone levels and depression mood in type 2 diabetes patients with insulin treatment

Abstract

Objective To observe the correlation of mood changes and serum levels of thyroid hormone in patients with diabetes and depression mood before and after intensive insulin therapy. Methods 340 patients with type 2 diabetes (T2DM) were enrolled, of which 187 cases were given intensive insulin therapy for 3 months and the other 153 cases were treated with oral hypoglycemic. All patients received depression measurement and tests of blood glucose, glycated hemoglobin (HbA1c), serum thyroid hormones before and after treatment. The data were analyzed statistically. During the treatment, fasting plasma glucose was controlled in ( 4.4 ～ 6. 1 )mmoL/L and 2-hour postprandial plasma glucose was controlled in (4.4 ～ 8.0) mmol/L. Results Thyroid hormone levels in the diabetic patients with depression mood ( T4 ( 6. 1 ± 1.4 ) μg/dl, T3 ( 0.98 ± 0.26) ng/ml ) were all lower than that in without depression mood ( T4 ( 8.4 ± 1.7 ) μg/dl, T3 ( 1.51 ± 0.29 ) ng/ml ) (P ＜ 0. 01 ), and TSH ( 4.5 ± 1. 1 ) were higher than that in without depression mood ( 1.9 ± 0.9 ) uIU/ml (P ＜ 0.01 ) before insulin treatment. After insulin therapy depression degree( 0.51 ± 0.12) were decreased significantly (0.68 ± 0. 21 )(P＜0.01 ) ,and thyroid hormone levels were significantly increased (T3 (1.38 ± 0. 28 )ng/ml,T4 (7.7 ±1.5 )μg/dl ),and TSH levels were significantly reduced( (2.1 ± 1.2 ) uIU/ml) (P ＜ 0. 01 ) than that before insulin therapy in the patients combined with depression mood. Depression degree was significantly negative correlated with T4 and T3 ( r= - 0.468, - 0.511, P ＜ 0.05 ) and significantly positive correlated with TSH ( r = 0.583, P＜ 0.01 ) before treatment. Decline of depression degree were significantly positive correlated with elevation of T3, T4 levels ( r =0. 395 ,0. 337, P＜0. 05 ) and were significantly negative correlated with decrease of TSH levels( r= -0. 239, P＜0.05 ) after insulin treatment. However, depression degree and thyroid hormone levels did not significantly change before and after in oral antihyperglycemic agents groups. Conclusion Improvement of depression was associated with thyroid hormone levels in type 2 diabetic patients after insulin therapy. Key words: Type 2 diabetes ; Insulin ; Depression ; Thyroid hormone levels ; Psychology measure ;