Li C, Liu J C, Xiao X, Chen X, Yue S, Yu H, Tian F S, Tang N J
Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.
Tongling University, Tongling, Anhui, China.
BMJ Open. 2017 Jan 27;7(1):e014235. doi: 10.1136/bmjopen-2016-014235.
This study investigated whether psychological distress predicts the development of type 2 diabetes mellitus (T2DM) and if the association differs between populations at a high or low diabetes risk level among Chinese police officers.
Prospective cohort study.
Single centre.
6559 participants underwent clinical measurements at the hospital in April 2007. 5811 police officers participated in the follow-up consisting of new-onset diabetes (NOD) events occurring annually between 2008 and 2011.
Baseline data were collected from policemen who completed the Symptom Checklist 90-Revised (SCL-90-R) questionnaire and a self-designed questionnaire. Psychological distress was measured by the SCL-90-R questionnaire. Hong Kong Chinese Diabetes Risk Score (HKCDRS) was used to evaluate the risk of T2DM, and the participants were divided into low-risk group and high-risk group based on the HKCDRS. Cox proportional hazards regression was used to calculate the HRs of the incidence of T2DM related to psychological distress and further stratified the analysis based on HKCDRS.
Among 5811 participants, 179 subjects developed NOD during the 4-year follow-up. 54 subjects (1.63%) with a HKCDRS 0-7 vs 125 subjects (4.98%) with a HKCDRS>7 developed NOD (p<0.05). There was a significant association between psychological distress and T2DM (HR=1.46; 95% CI 1.05 to 2.02). Among the participants with a high-risk score (HKCDRS>7), 7.07% of those with psychological distress developed T2DM compared with 4.43% of participants without psychological distress (p<0.05). The corresponding adjusted HR for psychological distress was 1.61 (95% CI 1.10 to 2.37).
Psychological distress is an independent risk factor for T2DM in this prospective cohort study. Stratification analysis indicated that psychological distress was associated with T2DM in a high-risk level population.
本研究调查了心理困扰是否可预测2型糖尿病（T2DM）的发生，以及在中国警察中，糖尿病风险高低不同的人群中这种关联是否存在差异。
前瞻性队列研究。
单中心。
2007年4月，6559名参与者在医院接受了临床测量。5811名警察参与了随访，随访内容包括2008年至2011年期间每年发生的新发糖尿病（NOD）事件。
从完成症状自评量表90修订版（SCL-90-R）问卷和一份自行设计问卷的警察中收集基线数据。心理困扰通过SCL-90-R问卷进行测量。采用香港华人糖尿病风险评分（HKCDRS）评估T2DM风险，并根据HKCDRS将参与者分为低风险组和高风险组。采用Cox比例风险回归计算心理困扰与T2DM发病相关的风险比（HR），并根据HKCDRS进一步进行分层分析。
在5811名参与者中，179名受试者在4年随访期间发生了NOD。HKCDRS为0 - 7的54名受试者（1.63%）与HKCDRS>7的125名受试者（4.98%）发生了NOD（p<0.05）。心理困扰与T2DM之间存在显著关联（HR = 1.46；95%可信区间1.05至2.02）。在高风险评分（HKCDRS>7）的参与者中，有心理困扰的参与者中有7.07%发生了T2DM，而没有心理困扰的参与者为4.43%（p<0.05）。心理困扰的相应调整后HR为1.61（95%可信区间1.10至2.37）。
在这项前瞻性队列研究中，心理困扰是T2DM的独立危险因素。分层分析表明，心理困扰与高风险水平人群的T2DM相关。
