The Relationship Between HbA1c Level and Beck Depression Scale in Patients with Heart Failure with Type 2 Diabetes Mellitus

Abstract

Introduction: Multiple studies have shown the relationship between heart failure (HF) and development of depression. Several studies have demonstrated worse perception of quality of life among patients with type 2 diabetes mellitus (T2DM). We aimed to assess the association between glycated hemoglobin (HbA1c) levels and depression severity in patients with diabetic HF.

Patients and Methods: Between July 2015 and June 2016, 179 patients with HF (left ventricular ejection fraction < 35%) and T2DM were included in the study. Blood samples for HbA1c were obtained from patients with T2DM. The severity of depression was assessed using the Beck Depression Inventory (BDI). Patients with depression were classified as follows: minimal with score 0-13 (group I), mild with score 14-19 (group II), moderate with score 20-28 (group III), and severe with score 29-63 (group IV).

Results: The median age of the study population was 64 (57-75) years (98 females and 81 males). There was no significant difference between the groups regarding the frequency of hypertension and gender. There was a significant positive correlation between BDI and HbA1c levels in patients with HF (r= 0.488, p< 0.001). According to the analysis performed between the groups, HbA1c values were found to be significantly higher in group IV than in groups I, II, and III (6.0 ± 1.47, 6.4 ± 0.6, 7.03 ± 0.7, and 7.6 ± 1.23, respectively; p< 0.001), which indicate the association between severity of depression and HbA1c level.

Conclusion: We detected a significant association between BDI and HbA1c level in patients with chronic HF with T2DM. Therefore, more strict control of blood glucose level may improve quality of life and decrease depressive symptoms in patients with diabetic HF.

Keywords

• Beck depression scale,diabetes mellitus,HbA1c,heart failure

Tip 2 Diabetes Mellitusu Olan Kalp Yetmezlikli Hastalarda HbA1c Seviyesi ile Beck Depresyon Skalası Arasındaki İlişki

Abstract

Giriş: Birçok çalışma kalp yetmezliği ile depresyon gelişimi arasındaki ilişkiyi göstermiştir. Bazı çalışmalar tip 2 diabetes mellitus (DM) olanlarda yaşam kalitesinin bozulduğunu göstermiştir. Diyabetik kalp yetmezlikli hastalarda HbA1c düzeyleri ile depresyon arasındaki ilişkiyi değerlendirmeyi amaçladık. 

Hastalar ve Yöntem: Temmuz 2015 ve Haziran 2016 tarihleri arasında, 179 Tip 2 DM’li kalp yetmezliği olan (LV-EF < %35) hastalar çalışmaya dahil edildi. Tip 2 DM’li hastalardan HbA1c için kan örnekleri alındı. Depresyonun şiddeti Beck Depresyon Envanteri (BDE) kullanılarak değerlendirildi. Depresyonu olan hastalar aşağıdaki gibi sınıflandırıldı: minimal skor 0-13 (grup I), hafif skor 14-19 (grup II), orta skor 20-28 (grup III) ve şiddetli skor 29-63 (grup IV).

Bulgular: Çalışma popülasyonunun medyan yaşı 64 (57-75) idi (kadın: 98, erkek: 81). Hipertansiyon ve cinsiyet sıklığı açısından gruplar arasında anlamlı fark yoktu. BDE skorlama sistemine göre sınıflandırılan hastaların sayısı, I ila IV. gruplarda sırasıyla 42, 45, 46 ve 46 idi. Kalp yetmezliği olan hastalarda BDE ve HbA1c düzeyleri arasında anlamlı pozitif korelasyon vardı (r= 0.488, p< 0.001). Gruplar arasında yapılan analizlere göre HbA1c değerleri grup 4 te grup I, II ve III’e göre anlamlı olarak yüksek bulundu (6.0 ± 1.47, 6.4 ± 0.6, 7.03 ± 0.7, 7.6 ± 1.23, sırasıyla, p< 0.001).

Sonuç: Tip 2 DM’li kronik kalp yetmezlikli hastalarda BDE ve HbA1c düzeyleri arasında anlamlı ilişki saptadık. Bu nedenle, kan glukoz seviyesinin daha sıkı kontrolü, diyabetik kalp yetmezlikli hastalarda yaşam kalitesini artırabilir ve depresif belirtileri azaltabilir.

Keywords

• Beck depresyon skalası,diyabet hastalığı,HbA1c,kalp yetmezliği

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