Change of Serum Thyroid Hormone Level in Patients with Refractory Insomnia and Their Relationship with Depression
Objective:To explore the change of serum thyroid hormone level in patients with refractory insomnia and its relationship with depression.Methods:151 patients with refractory insomnia admitted to the hospital were selected as the study subjects and 151 health examinees in the same period were set as the control group.The levels of serum triiodothyronine(T3),tetraiodothyronine(T4),free triiodothyronine(FT3)and free tetraiodothyronine(FT4)were detected in both groups.In addition,the patients were divided into depression group[total score of Hamilton Depression Scale(HAMD)≥8 points]and non depression group(total score of HAMD＜8 points)according to the psychological evaluation results,and the serum thyroid hormone levels were compared.The correlation between serum thyroid hormone level and HAMD score in patients with refractory insomnia was analyzed by Pearson correlation coefficient,and the influencing factors of depression in patients was analyzed by multivariate logistic regression method.Results:The levels of serum T3,T4,FT3 and FT4 in the study group were lower than those of the control group(t=12.054,8.892,4.547,10.411;P＜0.05).And the serum FT3 level was lower than that in the non depression group(t=3.020,P＜0.05).The serum T3,T4 and FT4 levels in patients with refractory insomnia were not correlated with the total score of HAMD(r=0.316,0.304,0.285;P＞0.05),while the serum FT3 level was negatively correlated with the total score of HAMD(r=-0.738,P＜0.001).The course of disease and Pittsburgh Sleep Quality Index(PSQI)score were risk factors for depression in patients with refractory insomnia(OR=3.838,4.170;P＜0.05),while the serum FT3 level was a protective factor for it(OR=0.572,P＜0.05).Conclusion:The levels of serum T3,T4,FT3 and FT4 in patients with refractory insomnia are significantly reduced,and low expression of FT3 level can increase the risk of depression in patients.
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