Goodwin Renee D, Hoven Christina W, Spitzer Robert L
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.
Int J Eat Disord. 2003 Jan;33(1):85-91. doi: 10.1002/eat.10106.
To determine the relationship between diabetes and eating disorders among primary care patients.
Data on 3,000 patients were obtained from eight primary care and family practice settings, including the PRIME-MD Patient Health Questionnaire (PHQ), self-reported physical illness, and social functioning information. Multivariate logistic regression analyses were used to determine the association between diabetes and eating disorders.
Diabetes was associated with an increased likelihood of eating disorders [OR = 2.3 (1.4, 3.9)], after adjusting for differences in demographic characteristics and comorbid mental disorders. This effect was specific to diabetes. Eating disorder was the only mental disorder associated with a significantly increased risk of diabetes, odds ratio (OR) = 2.4 (1.4, 4.0), after adjusting for demographic characteristics and comorbid mental and physical disorders. Patients with both diabetes and eating disorders had significantly higher levels of comorbid anxiety, panic attacks, and alcohol use disorders, compared with those with one but not both.
Consistent with reports from community-based samples, these data suggest that diabetes may be associated with an increased likelihood of eating disorders among patients in primary care. Clinicians who treat patients with diabetes, a common condition in primary care, should screen for eating disorders. In addition, patients with eating disorders may be at risk for the development of diabetes. Further work is needed to determine the generalizability of these findings and to understand the mechanism of this association.
确定初级保健患者中糖尿病与饮食失调之间的关系。
从八个初级保健和家庭医疗场所获取了3000名患者的数据，包括PRIME-MD患者健康问卷（PHQ）、自我报告的身体疾病和社会功能信息。采用多因素逻辑回归分析来确定糖尿病与饮食失调之间的关联。
在调整了人口统计学特征和共病精神障碍的差异后，糖尿病与饮食失调的可能性增加相关[比值比（OR）=2.3（1.4，3.9）]。这种效应是糖尿病特有的。在调整了人口统计学特征以及共病的精神和身体疾病后，饮食失调是与糖尿病风险显著增加相关的唯一精神障碍，比值比（OR）=2.4（1.4，4.0）。与患有一种疾病而非两种疾病的患者相比，同时患有糖尿病和饮食失调的患者共病焦虑、惊恐发作和酒精使用障碍的水平显著更高。
与基于社区样本的报告一致，这些数据表明糖尿病可能与初级保健患者中饮食失调的可能性增加相关。治疗糖尿病患者（初级保健中的常见病症）的临床医生应筛查饮食失调情况。此外，饮食失调患者可能有患糖尿病的风险。需要进一步开展工作以确定这些发现的普遍性，并了解这种关联的机制。
