Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.
Diabetes Care. 2010 Aug;33(8):1771-7. doi: 10.2337/dc10-0296. Epub 2010 May 18.
Few prospective data exist on the risk of diabetes in individuals serving in the U.S. military. The objectives of this study were to determine whether military deployment, combat exposures, and mental health conditions were related to the risk of newly reported diabetes over 3 years.
Data were from Millennium Cohort Study participants who completed baseline (July 2001-June 2003) and follow-up (June 2004-February 2006) questionnaires (follow-up response rate = 71.4%). After exclusion criteria were applied, adjusted analyses included 44,754 participants (median age 36 years, range 18-68 years). Survey instruments collected demographics, height, weight, lifestyle, military service, clinician-diagnosed diabetes, and other physical and mental health conditions. Deployment was defined by U.S. Department of Defense databases, and combat exposure was assessed by self-report at follow-up. Odds of newly reported diabetes were estimated using logistic regression analysis.
Occurrence of diabetes during follow-up was 3 per 1,000 person-years. Individuals reporting diabetes at follow-up were significantly older, had greater baseline BMI, and were less likely to be Caucasian. After adjustment for age, sex, BMI, education, race/ethnicity, military service characteristics, and mental health conditions, only baseline posttraumatic stress disorder (PTSD) was significantly associated with risk of diabetes (odds ratio 2.07 [95% CI 1.31-3.29]). Deployments since September 2001 were not significantly related to higher diabetes risk, with or without combat exposure.
In this military cohort, PTSD symptoms at baseline but not other mental health symptoms or military deployment experience were significantly associated with future risk of self-reported diabetes.
针对曾在美国军队服役的个人罹患糖尿病的风险，目前仅有少量前瞻性数据。本研究旨在确定军事部署、战斗暴露和心理健康状况是否与 3 年内新发糖尿病报告风险相关。
数据来自千禧年队列研究参与者，他们完成了基线（2001 年 7 月至 2003 年 6 月）和随访（2004 年 6 月至 2006 年 2 月）问卷（随访应答率=71.4%）。在应用排除标准后，调整后的分析包括 44754 名参与者（中位年龄 36 岁，范围 18-68 岁）。调查问卷收集了人口统计学、身高、体重、生活方式、兵役、临床医生诊断的糖尿病和其他身体及心理健康状况等信息。美国国防部数据库定义了部署情况，随访时通过自我报告评估了战斗暴露情况。使用逻辑回归分析估计新发糖尿病的可能性。
随访期间糖尿病的发生率为每 1000 人年 3 例。随访时报告患有糖尿病的个体年龄明显更大，基线 BMI 更高，且更不可能为白种人。在校正年龄、性别、BMI、教育程度、种族/族裔、兵役特征和心理健康状况后，仅基线创伤后应激障碍（PTSD）与糖尿病风险显著相关（比值比 2.07 [95%CI 1.31-3.29]）。自 2001 年 9 月以来的部署与糖尿病风险升高无关，无论是否存在战斗暴露。
在这个军事队列中，基线时的 PTSD 症状，但不是其他心理健康症状或军事部署经历，与未来自我报告糖尿病的风险显著相关。
