Department of Psychosomatic Medicine and Psychotherapy, University of Gießen and Marburg, Germany; Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; German Center for Diabetes Research (DZD), Partner Helmholtz Zentrum München, Germany.
Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; German Center for Diabetes Research (DZD), Partner Helmholtz Zentrum München, Germany.
J Psychosom Res. 2021 Jun;145:110480. doi: 10.1016/j.jpsychores.2021.110480. Epub 2021 Mar 30.
To investigate the association of generalized anxiety disorder (GAD) symptomology on the incidence of type 2 diabetes.
RESEARCH DESIGN & METHODS: Participants from the prospective KORA F4/FF4 German cohort were followed for a mean of 6.5 years. Generalized Anxiety Disorder Scale-7 (GAD-7) was used to assess GAD symptoms and incident type 2 diabetes cases were confirmed using a standard oral glucose tolerance test. Multivariate logistic regression models were used to estimate the effect of GAD symptoms on the incidence of type 2 diabetes.
The present study included 1694 participants (51.8% women, 48.2% men) with a mean age of 51.2 years, among whom 113 (6.7%) had high GAD symptoms. During the follow-up period (11,102 person/years), 113 (6.5%) type 2 diabetes cases were confirmed. Participants with GAD symptoms had 2-fold higher incidence of type 2 diabetes than participants without GAD (17.7 vs. 8.7 cases/1000 person-years). Correspondingly, GAD symptoms independently increased the risk of type 2 diabetes by an odds ratio of 2.09 [95%CI 1.02-4.32, p = 0.04] after adjustment for concurrent sociodemographic, lifestyle and cardiometabolic risk factors, high sensitivity C-reactive protein, depression, and the use of antidepressant medications. Additionally, GAD symptoms had an even larger impact on the onset of type 2 diabetes incidence following additional adjustment for prediabetes at baseline (2.68 [1.23-5.88], p=0.01).
Participants with GAD symptoms had 2-times higher odds of type 2 diabetes incidence during 6.5 years of follow-up, highlighting the significant role of dysregulated stress mechanisms in the pathway to developing type 2 diabetes.
研究广泛性焦虑障碍（GAD）症状与 2 型糖尿病发病的关系。
前瞻性 KORA F4/FF4 德国队列的参与者随访平均 6.5 年。使用广泛性焦虑症量表-7（GAD-7）评估 GAD 症状，使用标准口服葡萄糖耐量试验确诊 2 型糖尿病病例。使用多变量逻辑回归模型估计 GAD 症状对 2 型糖尿病发病的影响。
本研究纳入 1694 名参与者（51.8%为女性，48.2%为男性），平均年龄为 51.2 岁，其中 113 人（6.7%）有高 GAD 症状。在随访期间（11102 人/年），确诊 113 例（6.5%）2 型糖尿病病例。有 GAD 症状的参与者 2 型糖尿病发病的发生率是无 GAD 症状的参与者的 2 倍（17.7 比 8.7 例/1000 人年）。相应地，在调整同期社会人口统计学、生活方式和心血管代谢危险因素、高敏 C 反应蛋白、抑郁和抗抑郁药物使用后，GAD 症状使 2 型糖尿病的发病风险独立增加 2.09 倍（95%CI 1.02-4.32，p=0.04）。此外，在进一步调整基线时的糖尿病前期后，GAD 症状对 2 型糖尿病发病的影响更大（2.68 [1.23-5.88]，p=0.01）。
在 6.5 年的随访中，有 GAD 症状的参与者发生 2 型糖尿病的几率增加了 2 倍，这突显了失调的应激机制在发展为 2 型糖尿病的过程中具有重要作用。
