Atasoy Seryan, Johar Hamimatunnisa, Fleischer Toni, Beutel Manfred, Binder Harald, Braehler Elmar, Schomerus Georg, Zöller Daniela, Kruse Johannes, Ladwig Karl-Heinz
Department of Psychosomatic Medicine and Psychotherapy, University of Giessen and Marburg, Giessen, Germany.
Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Front Psychiatry. 2022 Apr 6;13:825678. doi: 10.3389/fpsyt.2022.825678. eCollection 2022.
The dysregulation of glucose homeostasis mental health stress is increasingly acknowledged, whereby depression independently increases the risk of the onset of type 2 diabetes by up to 60%. Contributing mental health factors starting in early life have further been considered, indicating that exposure to childhood emotional abuse is associated with both depression and an increased onset of type 2 diabetes in adulthood. However, the potential role of depression within the emotional abuse and type 2 diabetes link remains unknown.
Data were derived from community-dwelling participants in southern and northeastern Germany who participated in the longitudinal KORA-F4 and SHIP-3 studies. Multivariable logistic regression analyses adjusted for lifestyle, somatic, and psychological risk factors were used to investigate the association between childhood emotional abuse, assessed retrospectively by the , and newly diagnosed type 2 diabetes cases, which were confirmed using a standard oral glucose tolerance test. The mediating role of depressive symptoms between childhood emotional abuse and type 2 diabetes was assessed by the and calculated by using the Sobel test for mediation.
A total of 2,973 (53.2% women, 46.8% men) participants with a mean age of 49.7 were included in the analyses, of whom 5.9% (7.1% women, 4.5% men) reported emotional abuse in childhood. Participants exposed to childhood emotional abuse had a 1.70 (1.12-2.56; = 0.02) times higher odds of depression in the fully adjusted model than unexposed participants. During the 6.5-year follow-up period, 104 (3.5%) participants developed type 2 diabetes. Participants who were exposed to childhood emotional abuse had a 2.56 (1.31-4.98, = 0.005) times higher odds of developing type 2 diabetes than unexposed participants. This association was significantly mediated by the increased odds of depression in participants with childhood emotional abuse (Sobel Test, 1.84, = 0.06; Goodman Test, 1.91, = 0.05).
The current results indicate that the increased likelihood of type 2 diabetes onset in participants who were exposed to childhood emotional abuse is significantly attributed to increased depression in adulthood.
血糖稳态与心理健康压力之间的失调日益受到关注，抑郁症会使2型糖尿病发病风险独立增加高达60%。人们进一步考虑了始于早年的心理健康影响因素，这表明童年期遭受情感虐待与成年期的抑郁症以及2型糖尿病发病率增加均有关联。然而，抑郁症在情感虐待与2型糖尿病之间联系中的潜在作用仍不明确。
数据来源于德国南部和东北部参与纵向KORA - F4和SHIP - 3研究的社区居民。采用多变量逻辑回归分析，对生活方式、躯体和心理风险因素进行调整，以研究童年期情感虐待（通过回顾性评估）与新诊断的2型糖尿病病例之间的关联，2型糖尿病病例通过标准口服葡萄糖耐量试验确诊。童年期情感虐待与2型糖尿病之间抑郁症状的中介作用通过[具体方法]评估，并使用Sobel中介检验进行计算。
共有2973名（53.2%为女性，46.8%为男性）平均年龄为49.7岁的参与者纳入分析，其中5.9%（女性7.1%，男性4.5%）报告童年期遭受情感虐待。在完全调整模型中，童年期遭受情感虐待的参与者患抑郁症的几率比未遭受情感虐待的参与者高1.70倍（1.12 - 2.56；P = 0.02）。在6.5年的随访期内，104名（3.5%）参与者患2型糖尿病。童年期遭受情感虐待的参与者患2型糖尿病的几率比未遭受情感虐待的参与者高2.56倍（1.31 - 4.98，P = 0.005）。童年期遭受情感虐待的参与者中抑郁症几率增加显著介导了这种关联（Sobel检验，1.84，P = 0.06；Goodman检验，1.91，P = 0.05）。
当前结果表明，童年期遭受情感虐待的参与者2型糖尿病发病可能性增加显著归因于成年期抑郁症增加。
