Troncone Alda, Cascella Crescenzo, Chianese Antonietta, Zanfardino Angela, Piscopo Alessia, Borriello Anna, Casaburo Francesca, Del Giudice Emanuele Miraglia, Iafusco Dario
Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Napoli, Italy.
Front Psychol. 2020 Sep 23;11:556520. doi: 10.3389/fpsyg.2020.556520. eCollection 2020.
To examine body image problems and their associations with disordered eating behavior in adolescents with type 1 diabetes and well-matched healthy peers.
Using a cross-sectional design, 183 adolescents with type 1 diabetes (13.02-18.05 years) were recruited from diabetes centers in southern Italy and compared to healthy peers matched for age and gender. Participants completed self-report measures of disordered eating behaviors (DEPS-r and EDI-3RF) and a gender-specific body image problem questionnaire (SATAQ-4R). Socio-demographic and clinical data (zBMI, HbA1c, and disease duration) were also collected. Hierarchical multiple linear regression analyses were computed to determine the relative importance of diabetes variables and body image problems on participants' disordered eating behaviors after controlling for demographic variables.
Adolescents with type 1 diabetes showed diabetes-specific eating problems in 37.7% of cases and had more eating problem symptoms (assessed as drive for thinness and bulimia) than healthy peers. Male adolescents with type 1 diabetes did not display more body image problems ( > 0.05); females with type 1 diabetes compared to females in the control group were found to be more pressured by family ( = 0.025) but less by media ( = 0.022) to improve their appearance and attain a thin body. zBMI and body image problems contributed to a significant increase in disordered eating behavior risk both in male and female adolescents with diabetes and in healthy peers (zBMI 0.213 < β < 0.426, < 0.05; body image 0.243 < β < 0.572, < 0.05). None of the variables analyzed were found to significantly predict male bulimic symptoms (all β < 0.296, > 0.05).
Since in adolescence type 1 diabetes and insulin therapy may increase the risk of weight gain and promote focus and attention on the body and thus contribute to the development of body image problems and disordered eating behaviors, continuity of medical, nutritional, and psychological care is needed.
研究1型糖尿病青少年及年龄和性别匹配的健康同龄人中的身体意象问题及其与饮食失调行为的关联。
采用横断面设计，从意大利南部的糖尿病中心招募了183名1型糖尿病青少年（年龄13.02 - 18.05岁），并与年龄和性别匹配的健康同龄人进行比较。参与者完成了饮食失调行为的自我报告测量（DEPS - r和EDI - 3RF）以及一份针对性别的身体意象问题问卷（SATAQ - 4R）。还收集了社会人口统计学和临床数据（zBMI、糖化血红蛋白和病程）。在控制人口统计学变量后，进行分层多元线性回归分析，以确定糖尿病变量和身体意象问题对参与者饮食失调行为的相对重要性。
37.7%的1型糖尿病青少年存在特定于糖尿病的饮食问题，且比健康同龄人有更多的饮食问题症状（以追求瘦身和贪食来评估）。1型糖尿病男性青少年未表现出更多的身体意象问题（P>0.05）；与对照组女性相比发现，1型糖尿病女性在改善外貌和达到瘦身方面受到家庭的压力更大（P = 0.025），但受到媒体的压力较小（P = 0.022）。zBMI和身体意象问题导致糖尿病青少年和健康同龄人中饮食失调行为风险显著增加（zBMI：0.213 <β< 0.426，P< 0.05；身体意象：0.243 <β< 0.572，P< 0.05）。未发现所分析的变量能显著预测男性的贪食症状（所有β< 0.296，P> 0.05）。
由于在青少年期1型糖尿病和胰岛素治疗可能增加体重增加的风险，并促使对身体的关注和重视，从而导致身体意象问题和饮食失调行为的发生，因此需要持续的医疗、营养和心理护理。
