Feller Silke, Teucher Birgit, Kaaks Rudolf, Boeing Heiner, Vigl Matthaeus
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
PLoS One. 2013 Aug 20;8(8):e73462. doi: 10.1371/journal.pone.0073462. eCollection 2013.
The aim of the study was to examine the prospective association between life satisfaction and risk of type 2 diabetes mellitus, myocardial infarction, stroke, and cancer. Previous studies suggested that psychosocial factors may affect the development of chronic diseases but the impact of positive attitudes, in particular life satisfaction, is yet to be determined.
The analysis included 50,358 participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Germany study in Potsdam and Heidelberg. Life satisfaction was assessed in a baseline interview and incident cases of chronic diseases were identified and verified during follow-up. Hazard ratios were calculated using Cox proportional hazards regression models that were systematically multivariable-adjusted for established risk factors and prevalent diseases.
During an average of 8 years of follow-up 2,293 cases of cancer, 1,840 cases of type 2 diabetes mellitus, 440 cases of stroke, and 562 cases of myocardial infarction were observed. Women who were unsatisfied with life at baseline showed in all models a significantly increased risk of cancer (HR: 1.45; 95% CI: 1.18-1.78) and stroke (HR: 1.69; 95% CI: 1.05-2.73) as well as an increased risk of type 2 diabetes mellitus by trend across categories (p-trend=0.04) compared to women very satisfied with life. In men, a relationship between life satisfaction and stroke was found but did not persist after consideration of lifestyle factors and prevalent diseases. No significant association was observed between life satisfaction and risk of myocardial infarction.
The results of this study suggest that reduced life satisfaction is related to the development of chronic diseases--particularly in women and partly mediated by established risk factors.
本研究旨在探讨生活满意度与2型糖尿病、心肌梗死、中风和癌症风险之间的前瞻性关联。此前的研究表明，社会心理因素可能会影响慢性病的发展，但积极态度，尤其是生活满意度的影响尚未确定。
分析纳入了德国波茨坦和海德堡的欧洲癌症与营养前瞻性调查（EPIC）研究中的50358名参与者。在基线访谈中评估生活满意度，并在随访期间识别和核实慢性病的发病病例。使用Cox比例风险回归模型计算风险比，并对既定风险因素和常见疾病进行系统的多变量调整。
在平均8年的随访期间，观察到2293例癌症、1840例2型糖尿病、440例中风和562例心肌梗死病例。与对生活非常满意的女性相比，基线时对生活不满意的女性在所有模型中患癌症（风险比：1.45；95%置信区间：1.18 - 1.78）和中风（风险比：1.69；95%置信区间：1.05 - 2.73）的风险显著增加，并且患2型糖尿病的风险在各分类中呈上升趋势（P趋势 = 0.04）。在男性中，发现生活满意度与中风之间存在关联，但在考虑生活方式因素和常见疾病后这种关联不再持续。未观察到生活满意度与心肌梗死风险之间存在显著关联。
本研究结果表明，生活满意度降低与慢性病的发生有关——尤其是在女性中，部分由既定风险因素介导。
