Feng Xiaoqi, Astell-Burt Thomas
Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia; Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.
BMJ Open Diabetes Res Care. 2017 Feb 16;5(1):e000198. doi: 10.1136/bmjdrc-2016-000198. eCollection 2017.
The aim was to examine whether a type 2 diabetes mellitus (T2DM) diagnosis increases the odds of psychological distress, a worsening in overall quality of life, and a potential reduction in social contacts.
Longitudinal data were obtained from the 45 and Up Study (baseline 2006-2008; 3.4±0.95 years follow-up time). Fixed effects logistic and negative binomial regression models were fitted on a complete case on outcome sample that did not report T2DM at baseline (N=26 344), adjusted for time-varying confounders. The key exposure was doctor-diagnosed T2DM at follow-up. Outcome variables examined included the Kessler Psychological Distress Scale, self-rated quality of life, and four indicators of social contacts.
A modest increase in the odds of psychological distress associated with T2DM diagnosis (OR=1.30) was not statistically significant (95% CI 0.75 to 2.25). A T2DM diagnosis was associated with a fivefold increase in the odds of a participant reporting that their quality of life had become significantly poorer (OR 5.49, 95% CI 1.26 to 23.88). T2DM diagnosis was also associated with a reduction in times spent with friends and family (RR 0.88, 95% CI 0.82 to 0.95), contacts by telephone (RR 0.95, 95% CI 0.87 to 1.02), attendance at social clubs or religious groups (RR 0.82, 95% CI 0.73 to 0.91), and the number of people nearby but outside the home that participants felt they could rely on (RR 0.92, 95% CI 0.86 to 0.98).
A T2DM diagnosis can have important impacts on quality of life and on social contacts, which may have negative impacts on mental health and T2DM management in the longer term.
本研究旨在探讨2型糖尿病(T2DM)诊断是否会增加心理困扰的几率、导致总体生活质量恶化以及可能减少社交联系。
纵向数据取自45岁及以上研究(基线时间为2006 - 2008年;随访时间为3.4±0.95年)。对基线时未报告T2DM的完整病例结局样本(N = 26344)拟合固定效应逻辑回归和负二项回归模型,并对随时间变化的混杂因素进行调整。关键暴露因素为随访时医生诊断的T2DM。所检查的结局变量包括凯斯勒心理困扰量表、自评生活质量以及四个社交联系指标。
与T2DM诊断相关的心理困扰几率适度增加(OR = 1.30),但无统计学意义(95%CI 0.75至2.25)。T2DM诊断与参与者报告其生活质量显著变差的几率增加五倍相关(OR 5.49,95%CI 1.26至23.88)。T2DM诊断还与与朋友和家人相处时间减少(RR 0.88,95%CI 0.82至0.95)、电话联系减少(RR 0.95,95%CI 0.87至1.02)、参加社交俱乐部或宗教团体减少(RR 0.82,95%CI 0.73至0.91)以及参与者感觉可以依靠的家附近但不在家的人数减少(RR 0.92,95%CI 0.86至0.98)相关。
T2DM诊断可能对生活质量和社交联系产生重要影响,从长远来看,这可能对心理健康和T2DM管理产生负面影响。