Pisto Lauri, Vadén Atte, Sillanmäki Lauri, Mattila Kari
Department of General Practice, Medical School, University of Tampere, Lääkärinkatu 1, 33520 Tampere, Finland.
Health Centre of Tampere, Finland.
Int J Family Med. 2014;2014:864572. doi: 10.1155/2014/864572. Epub 2014 Apr 28.
Backgrounds. Research findings suggest that the mind can cause physical disease. To plan the best quality of care, general practitioner needs to understand an individual's health problems in physical, social, and psychological dimensions. This study sought to establish whether adverse life events occurring in childhood and adolescence are associated with diabetes. Methods. The cohort was collected from the health and social support (HeSSup) study-a postal follow-up survey of randomized working-aged Finns initiated in 1998. The response rate was 40.0% and the final cohort size 24057. Data on reimbursed diabetes medication during the years 1998-2006 were obtained from the Social Insurance Institute of Finland registers. Subjects were divided into insulin, tablet, combination therapy, and drug-naive groups together with a control group without diabetes. The prevalence of childhood adversities was assessed based on answers to six survey questions. Results. Childhood adversities showed predominant linkage to diabetes type 2 groups, especially to the combination therapy group requiring combined insulin and tablet treatment. No connection was found between childhood adversities and insulin use. Cumulative adversities did not markedly increase the association. Conclusions. Stressful events in childhood are associated with diabetes combination therapy in working age. The meaning of the relationship remains unsolved.
背景。研究结果表明,心理因素可导致身体疾病。为了规划最佳的护理质量,全科医生需要从身体、社会和心理层面了解个体的健康问题。本研究旨在确定童年和青少年时期发生的不良生活事件是否与糖尿病有关。方法。该队列来自健康与社会支持(HeSSup)研究——一项始于1998年的针对芬兰随机选取的工作年龄人群的邮政随访调查。回复率为40.0%,最终队列规模为24057人。1998年至2006年期间报销的糖尿病药物数据来自芬兰社会保险机构的登记册。受试者被分为胰岛素组、片剂组、联合治疗组和未用药组,以及一个无糖尿病的对照组。根据对六个调查问题的回答评估童年逆境的发生率。结果。童年逆境主要与2型糖尿病组相关,尤其是与需要胰岛素和片剂联合治疗的联合治疗组相关。未发现童年逆境与胰岛素使用之间存在关联。累积逆境并未显著增加这种关联。结论。童年时期的应激事件与工作年龄人群的糖尿病联合治疗有关。这种关系的意义仍未解决。