Department of Internal Medicine, Mercer University School of Medicine, Macon, Georgia.
Department of Epidemiology and Biostatistics, College of Public Health, The University of Georgia, Athens.
J Gerontol B Psychol Sci Soc Sci. 2020 Feb 14;75(3):640-649. doi: 10.1093/geronb/gby040.
We evaluated the association between cumulative stressful life events (SLE) and type of stress (lifetime vs recent) and incident diabetes (Type 2 diabetes mellitus [T2DM]) in middle-aged U.S. adults.
Data from the 2006-2014 waves of the Health and Retirement Study (HRS) were analyzed (n = 7,956). Stress-related differences in age at T2DM diagnosis were estimated using Cox proportional hazards models.
The adjusted risk of T2DM significantly increased by 6% per unit increase in cumulative SLE (95% confidence interval [CI] = 1.03, 1.11), by 5% per unit increase in lifetime stress (95% CI = 1.00, 1.09), and by 23% per unit increase in recent stress (95% CI = 1.12, 1.36). Each level of cumulative SLE (1, 2, 3, and ≥4 events) and recent stress (1 and ≥2 events) compared to no stress was significantly associated with an increased risk of T2DM. Each level of lifetime stress compared to no stress was significantly associated with an elevated risk of T2DM except for 3 events.
Cumulative SLE and type of stress were associated with incident T2DM in middle-aged adults. Reducing the direct effect of stress with management interventions may reduce the indirect effect of developing T2DM and warrants further investigation.
我们评估了累积性生活应激事件（SLE）与应激类型（终生 vs 近期）与中年美国成年人发生 2 型糖尿病（2 型糖尿病[T2DM]）的关系。
对健康与退休研究（HRS）2006-2014 年各波次的数据进行了分析（n=7956）。采用 Cox 比例风险模型估计了 T2DM 诊断年龄与应激相关的差异。
校正累积 SLE 每增加一个单位，T2DM 的调整风险显著增加 6%（95%可信区间[CI]为 1.03，1.11），终生应激每增加一个单位，风险增加 5%（95%CI 为 1.00，1.09），近期应激每增加一个单位，风险增加 23%（95%CI 为 1.12，1.36）。与无应激相比，累积 SLE （1、2、3 和≥4 个事件）和近期应激（1 和≥2 个事件）的每个水平都与 T2DM 的风险增加显著相关。与无应激相比，终生应激的每个水平都与 T2DM 风险升高显著相关，但 3 个事件除外。
累积性 SLE 和应激类型与中年成年人的 T2DM 发生有关。通过管理干预减轻应激的直接作用可能会降低发生 T2DM 的间接作用，值得进一步研究。
