Eur J Endocrinol:抑郁与1型糖尿病血糖控制不佳相关
2013-04-10 魏强 医学论坛网
瑞典一项研究表明,抑郁与1型糖尿病患者糖化血红蛋白(HbA1c)水平>8.6%独立相关。这种相关性与血糖控制不佳和糖尿病并发症的已知风险因素肥胖和吸烟的重要性具有可比性。抑郁与HbA1c水平>8.6%的相关性在女性当中尤其明显。述情障碍(alexithymia)是一种相对稳定的个性特征,与抑郁相关。今后,在糖尿病患者的护理中,为了使HbA1c达标,应将精神因素与人体测量学(anthr
瑞典一项研究表明,抑郁与1型糖尿病患者糖化血红蛋白(HbA1c)水平>8.6%独立相关。这种相关性与血糖控制不佳和糖尿病并发症的已知风险因素肥胖和吸烟的重要性具有可比性。抑郁与HbA1c水平>8.6%的相关性在女性当中尤其明显。述情障碍(alexithymia)是一种相对稳定的个性特征,与抑郁相关。今后,在糖尿病患者的护理中,为了使HbA1c达标,应将精神因素与人体测量学(anthropometrics)和生活方式一起考虑。该研究论文3月27日在线发表于《欧洲内分泌学杂志》(Eur J Endocrinol)。
该研究是一项横断面研究,纳入了292例年龄为18~59岁的1型糖尿病患者。精神状态数据采用自我报告工具、医院焦虑和抑郁量表和多伦多述情障碍量表-20来评估。人体测量学、血液分析和医疗记录采用瑞典国家糖尿病注册数据库的资料。
结果显示,自我报告的抑郁[校正后比值比(AOR)为4.8]、肥胖(AOR为4.3)和吸烟(AOR为3.0)与血糖控制不佳(HbA1c水平>8.6%)独立相关。性别分层分析显示,自我报告的女性抑郁(AOR为19.8)和肥胖(AOR为7.0)以及男性吸烟(AOR为4.2)与HbA1c>水平8.6%相关。述情障碍、抗抑郁药物治疗和运动不足仅在双变量分析中与HbA1c>水平8.6%相关。述情障碍、自我评定的焦虑运动不足和腹型肥胖与自我报告的抑郁相关。
与糖尿病相关的拓展阅读:
- Diabetes Care:NT-proBNP为老年糖尿病患者短期死亡强预测因子
- MD Consult:Invokana获准用于2型糖尿病
- 抑郁与1型糖尿病血糖控制不佳相关
- 抑郁与1型糖尿病血糖控制不佳相关
- Eur J Med Res:糖尿病患者需要口腔健康教育
- Diabetes Care:青少年期肥胖增高糖尿病风险 更多信息请点击:有关糖尿病更多资讯
Depression, Obesity and Smoking were Independently Associated with Inadequate Glycemic Control in Patients with Type 1 Diabetes
Objective
The aim of this study was to explore the associations between inadequate glycemic control of diabetes and psychological, anthropometric and life style variables in a population based cohort of type 1 diabetes patients.
Design
Cross-sectional study.
Methods
In this study 292 patients with type 1 diabetes participated, age 18-59 years. Psychological data were assessed by self-report instruments, Hospital Anxiety and Depression Scale and Toronto Alexithymia Scale-20. Anthropometrics, blood analyses, data from medical records and data from the Swedish National Diabetes Registry were collected.
Results
Self-reported depression (Adjusted Odds Ratio (AOR) 4.8), obesity (AOR 4.3) and smoking (AOR 3.0) were independently associated with inadequate glycemic control of diabetes (HbA1c >8.6%). Gender stratified analyses showed that self-reported depression (AOR 19.8) and obesity (AOR 7.0) in women; and smoking in men (AOR 4.2) were associated with HbA1c >8.6%. Alexithymia, antidepressant medication and physical inactivity were associated with HbA1c >8.6% only in bivariate analyses. Alexithymia, self-rated anxiety, physical inactivity and absence of abdominal obesity were associated with self-reported depression.
Conclusions
Depression was the only psychological factor independently associated with HbA1c >8.6%. The association was of comparable importance as obesity and smoking, well known risk factors for inadequate glycemic control and diabetes complications. The association between depression and HbA1c >8.6% was particularly strong for women. Alexithymia, which is a relatively stable personality trait, was associated with depression. In the future care of patients with diabetes, psychological aspects should be considered alongside anthropometrics and life style factors in order to achieve the goals for HbA1c.
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