Montgomery Joshua, Lu Juan, Ratliff Scott, Mezuk Briana
Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University School of Medicine, Richmond, Virginia (Mr Montgomery, Dr Lu, Mr Ratliff, Dr Mezuk).
Department of Epidemiology, University of Michigan, Ann Arbor, Michigan (Mr Ratliff, Dr Mezuk).
Diabetes Educ. 2017 Jun;43(3):260-271. doi: 10.1177/0145721717699890. Epub 2017 Apr 23.
Purpose While both food insecurity and depression have been linked to risk of type 2 diabetes, little is known about the relationship between food insecurity and depression among adults with diabetes. Research Design and Methods Cross-sectional analyses of the National Health and Nutrition Examination Survey (2011-2014), a nationally representative, population-based survey. Analytic sample was limited to adults aged ≥20 with diabetes determined by either fasting plasma glucose (≥126 mg/dL) or self-report (n = 1724) and adults age ≥20 with prediabetes determined by fasting plasma glucose (100-125 mg/dL) or self-report (n = 2004). Food insecurity was measured using the US Food Security Survey Module. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression was used to assess the relationship between food insecurity and depression while accounting for sociodemographic characteristics and health behaviors. Results Approximately 10% of individuals with diabetes and 8.5% of individuals with prediabetes had severe food insecurity in the past year; an additional 20.3% of individuals with diabetes and 14.3% of those with prediabetes had mild food insecurity. Among individuals with diabetes, both mild and severe food insecurity were associated with elevated odds of depression These relationships were similar in magnitude among individuals with prediabetes. Conclusions Food insecurity is significantly associated with depressive symptoms in people with diabetes and prediabetes. Results point to the need to address economic issues in conjunction with psychosocial issues for comprehensive diabetes care.
目的 虽然粮食不安全和抑郁症都与2型糖尿病风险相关，但对于糖尿病成年人中粮食不安全与抑郁症之间的关系知之甚少。研究设计与方法 对具有全国代表性的基于人群的调查——国家健康与营养检查调查（2011 - 2014年）进行横断面分析。分析样本限于年龄≥20岁、通过空腹血糖（≥126mg/dL）或自我报告确诊为糖尿病的成年人（n = 1724）以及年龄≥20岁、通过空腹血糖（100 - 125mg/dL）或自我报告确诊为糖尿病前期的成年人（n = 2004）。使用美国粮食安全调查模块测量粮食不安全状况。使用患者健康问卷 - 9（PHQ - 9）评估抑郁症。在考虑社会人口学特征和健康行为的同时，采用逻辑回归评估粮食不安全与抑郁症之间的关系。结果 在过去一年中，约10%的糖尿病患者和8.5%的糖尿病前期患者存在严重粮食不安全状况；另外，20.3%的糖尿病患者和14.3%的糖尿病前期患者存在轻度粮食不安全状况。在糖尿病患者中，轻度和严重粮食不安全状况均与抑郁症患病几率升高相关。在糖尿病前期患者中，这些关系的程度相似。结论 粮食不安全与糖尿病患者和糖尿病前期患者的抑郁症状显著相关。结果表明，在综合糖尿病护理中，需要同时解决经济问题和心理社会问题。
