German Diabetes Center, Institute for Biometrics and Epidemiology, Düsseldorf, Germany; German Center for Diabetes Research, München-Neuherberg, Germany.
German Diabetes Center, Institute for Biometrics and Epidemiology, Düsseldorf, Germany; German Center for Diabetes Research, München-Neuherberg, Germany.
J Adolesc Health. 2019 Nov;65(5):681-689. doi: 10.1016/j.jadohealth.2019.05.016. Epub 2019 Aug 29.
The aims of this study were to analyze the prevalence and course of disordered eating behavior (DEB) in adolescents with intensively treated type I diabetes, describe differences in age-specific DEB symptoms, and identify predictors of current DEB.
Data were taken from 332/218 11- to 27-year-old participants (55.7% girls/women, mean age [SD] 17.8 [3.4] years, mean diabetes duration 14.9 [3.0] years) of two/three surveys of a Germany-wide longitudinal study on early-onset and long duration diabetes, respectively. A diabetes-adapted version of the SCOFF questionnaire was used to assess DEB. Both screening-based overall and age- and sex-specific prevalence of DEB and its symptoms were determined. To estimate transition probabilities between DEB states, first-order Markov transition models were implemented adjusting for previous sociodemographic, socioeconomic, and diabetes-specific covariates.
The overall screening-based DEB prevalence among all 1,318 observations was 10.8% (95% confidence interval [CI]: 9.2%, 12.6%) with age-specific differences in symptom prevalence. Transition probabilities for developing/persistent DEB were twofold higher among female than male participants (risk ratio [RR] 2.3 [1.4, 3.9]/2.1 [1.3, 3.4]). In multiple adjusted regression, previous DEB (odds ratio [OR] 2.8 [95% CI 1.4, 5.6]), follow-up time (OR 3.4 [1.4, 8.0]), and sex (OR 2.1 [1.1, 3.9]) were the most important predictors of current DEB with further weaker associations for previous age and HbA.
Our results contribute to better understanding the course of DEB in patients with early-onset diabetes and emphasize the relevance of regular DEB screenings including the age group of young adults.
本研究旨在分析强化治疗 I 型糖尿病青少年中饮食紊乱行为（DEB）的流行率和病程，描述特定年龄 DEB 症状的差异，并确定当前 DEB 的预测因素。
数据来自两个/三个德国全国性纵向研究中 332/218 名 11-27 岁参与者（55.7%为女孩/女性，平均年龄[标准差]17.8[3.4]岁，平均糖尿病病程 14.9[3.0]年），分别进行了早期发病和长期糖尿病的两次/三次调查。使用糖尿病适应版 SCOFF 问卷评估 DEB。确定基于筛查的总体和按年龄及性别划分的 DEB 及其症状的患病率。为了估计 DEB 状态之间的转移概率，实施了一阶马尔可夫转移模型，调整了先前的社会人口统计学、社会经济学和糖尿病特定的协变量。
在所有 1318 次观察中，基于筛查的总体 DEB 患病率为 10.8%（95%置信区间[CI]：9.2%，12.6%），且症状患病率存在年龄特异性差异。女性参与者发展/持续 DEB 的转移概率是男性参与者的两倍（风险比[RR]2.3[1.4, 3.9]/2.1[1.3, 3.4]）。在多因素调整回归中，先前的 DEB（比值比[OR]2.8[95%CI 1.4, 5.6]）、随访时间（OR 3.4[1.4, 8.0]）和性别（OR 2.1[1.1, 3.9]）是当前 DEB 的最重要预测因素，先前的年龄和 HbA 也有较弱的相关性。
我们的研究结果有助于更好地了解早期发病糖尿病患者中 DEB 的病程，并强调定期进行 DEB 筛查的重要性，包括青年人群。
