Fujihara K, Saito A, Heianza Y, Gibo H, Suzuki H, Shimano H, Saito K, Kodama S, Yamada N, Sone H
Department of Endocrinology and Metabolism, University of Tsukuba Institute of Clinical Medicine, Ibaraki, Japan.
Exp Clin Endocrinol Diabetes. 2012 Oct;120(9):560-3. doi: 10.1055/s-0032-1314873. Epub 2012 Jul 31.
We examined the relationship between psychological stress and the worsening of glycemic control in diabetic patients at the time of the Great East Japan Earthquake. HbA1c levels in diabetic patients before and after the disaster were evaluated with the General Health Questionnaire (GHQ) and other questions including those on changes in diet, exercise, psychological stress and drug intake in 320 consecutive diabetic patients who had been followed in a diabetes clinic. Logistic regression analysis revealed that the total GHQ scores (odds ratio [OR] 1.03 [95% confidence interval 1.01-1.06]; p<0.01) and interruption of drug intake (OR 4.48 [1.57-12.7]; p=0.01) were independently associated with worsening of glycemic control defined as an increase in the HbA1c level equal to or greater than 0.5%. Among the scores on the GHQ, those for somatic symptoms (OR 1.18 [1.01-1.38]; p=0.03) and sleep disturbances or anxiety (OR 1.26 [1.08-1.46]; p<0.01) were independently associated with glycemic control. These results suggest that psychological stress during a disaster has independent effects on worsening of glycemic control.
我们研究了在东日本大地震发生时，糖尿病患者心理压力与血糖控制恶化之间的关系。在一家糖尿病诊所对320例连续随访的糖尿病患者进行了研究，通过一般健康问卷（GHQ）以及其他问题，包括饮食、运动、心理压力和药物摄入变化等问题，评估了灾难前后糖尿病患者的糖化血红蛋白（HbA1c）水平。逻辑回归分析显示，GHQ总分（优势比[OR]为1.03[95%置信区间为1.01 - 1.06]；p<0.01）和药物摄入中断（OR为4.48[1.57 - 12.7]；p = 0.01）与糖化血红蛋白水平升高等于或大于0.5%所定义的血糖控制恶化独立相关。在GHQ得分中，躯体症状得分（OR为1.18[1.01 - 1.38]；p = 0.03）以及睡眠障碍或焦虑得分（OR为1.26[1.08 - 1.46]；p<0.01）与血糖控制独立相关。这些结果表明，灾难期间的心理压力对血糖控制恶化具有独立影响。
