Demmer Ryan T, Gelb Sara, Suglia Shakira F, Keyes Katherine M, Aiello Allison E, Colombo Paolo C, Galea Sandro, Uddin Monica, Koenen Karestan C, Kubzansky Laura D
From the Department of Epidemiology (Demmer, Gelb, Suglia, Keyes, Galea, Koenen), Mailman School of Public Health, Columbia University, New York, New York; New York State Psychiatric Institute (Keyes), New York, New York; Gillings School of Global Public Health (Aiello), University of North Carolina, Chapel Hill, North Carolina; Department of Medicine (Colombo), College of Physician's and Surgeons, Columbia University, New York, New York; Department of Psychology and Institute for Genomic Biology (Uddin), University of Illinois Urbana-Champaign, Champaign, Illinois; Department of Social and Behavioral Sciences (Kubzansky), Harvard School of Public Health, Boston, Massachusetts.
Psychosom Med. 2015 May;77(4):467-77. doi: 10.1097/PSY.0000000000000169.
Depression and anxiety have been inconsistently associated with diabetes. Sex differences in the biological and behavioral correlates of these forms of distress could partially explain these inconsistencies. We investigated sex-specific associations between depression/anxiety symptoms and diabetes in two separate samples.
The First National Health and Nutrition Examination Survey enrolled 3233 participants aged 25 to 74 years from 1971 to 1974. Depression and anxiety symptoms were measured via General Well Being schedule subscales. Incident diabetes for 17 years was defined by the following: a) death certificate, b) participant self-report, or c) health care facility discharge. The Detroit Neighborhood Health Study enrolled 1054 participants 18 years or older from 2008 to 2010. The Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 assessed depression and anxiety. Participants' self-reported physician-diagnosed prevalent diabetes.
In the First National Health and Nutrition Examination Survey, the risk ratio (RR; 95% confidence interval) for incident diabetes among men with high versus low anxiety symptoms was 0.85 (0.56-1.29) and that among women was 2.19 (1.17-4.09; p for interaction = .005). RRs comparing high versus low depressive symptoms for men and women were 0.69 (0.43-1.100) and 2.11 (1.06-4.19); p for interaction = .007. In the Detroit Neighborhood Health Study, the RRs for prevalent diabetes comparing those with high versus low anxiety symptoms were 0.24 (0.02-2.42) for men and 1.62 (0.61-4.32) for women (p for interaction = < .001), whereas RRs for depression were 1.30 (0.46-3.68) for men and 2.32 (1.10-4.89) for women (p for interaction = .16).
In two separate samples, depressive symptoms were related to increased diabetes risk among women but not men. Although less robust, findings for anxiety were differentially associated with diabetes by sex.
抑郁症和焦虑症与糖尿病之间的关联并不一致。这些形式的痛苦在生物学和行为学方面的性别差异可能部分解释了这些不一致性。我们在两个独立样本中研究了抑郁/焦虑症状与糖尿病之间的性别特异性关联。
第一次全国健康与营养检查调查在1971年至1974年间招募了3233名年龄在25至74岁之间的参与者。抑郁和焦虑症状通过总体幸福感量表子量表进行测量。17年间的新发糖尿病定义如下：a）死亡证明，b）参与者自我报告，或c）医疗机构出院记录。底特律邻里健康研究在2008年至2010年间招募了1054名18岁及以上的参与者。采用患者健康问卷-9和广泛性焦虑障碍量表-7评估抑郁和焦虑。参与者自我报告医生诊断的糖尿病患病率。
在第一次全国健康与营养检查调查中，高焦虑症状男性与低焦虑症状男性相比，新发糖尿病的风险比（RR；95%置信区间）为0.85（0.56 - 1.29），女性为2.19（1.17 - 4.09；交互作用p值 = 0.005）。男性和女性中高抑郁症状与低抑郁症状相比的RR分别为0.69（0.43 - 1.10）和2.11（1.06 - 4.19）；交互作用p值 = 0.007。在底特律邻里健康研究中，高焦虑症状与低焦虑症状相比，男性患糖尿病的RR为0.24（0.02 - 2.42），女性为1.62（0.61 - 4.32）（交互作用p值 = < 0.001），而抑郁症状的RR男性为1.30（0.46 - 3.68），女性为2.32（1.10 - 4.89）（交互作用p值 = 0.16）。
在两个独立样本中，抑郁症状与女性而非男性的糖尿病风险增加有关。虽然焦虑的结果不太稳健，但按性别与糖尿病的关联存在差异。
