From the Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Psychosom Med. 2023 May 1;85(4):332-340. doi: 10.1097/PSY.0000000000001183. Epub 2023 Feb 27.
There is evidence that psychological distress increases the risk of type 2 diabetes (T2D), but implications for prevention remain elusive. We examined the association between chronic stress and the German Diabetes Risk Score (GDRS) among adults without diabetes in Germany.
The study population consisted of 4654 persons aged 18 to 64 years without known diabetes drawn from the German Health Interview and Examination Survey for Adults (2008-2011). The predicted 5-year T2D risk (in percent) was estimated using the GDRS. Perceived chronic stress was assessed by the Screening Scale of the Trier Inventory for the Assessment of Chronic Stress and categorized into "up to average," "above average," and "high." The cross-sectional association of chronic stress with log-transformed GDRS (expressed as geometric mean ratio [GMR]) was analyzed in multivariable linear regression models. Covariables included age, sex, community size, region, educational level, living alone, social support, depression, and alcohol use.
The mean predicted 5-year T2D risk rates were 2.7%, 2.9%, and 3.0% for chronic stress up to average, above average, and high chronic stress, respectively. Adjusted mean predicted 5-year risk was significantly higher among persons with chronic stress above average (GMR = 1.10, 95% confidence interval = 1.02-1.19) and high stress (GMR = 1.21, 95% CI = 1.06-1.39) compared with persons with chronic stress up to average. No interactions with sex or other covariables were found.
Perceived chronic stress is independently associated with an increased predicted T2D risk in cross-sectional analysis and should be considered as T2D risk factor in longitudinal studies.
有证据表明，心理困扰会增加 2 型糖尿病（T2D）的风险，但预防措施的影响仍难以捉摸。我们研究了德国无糖尿病成年人中慢性压力与德国糖尿病风险评分（GDRS）之间的关系。
研究人群由 4654 名年龄在 18 至 64 岁之间、无已知糖尿病的成年人组成，他们来自德国成年人健康访谈和体检调查（2008-2011 年）。使用 GDRS 估计预测的 5 年 T2D 风险（以百分比表示）。通过特里尔慢性压力评估量表（Trier Inventory for the Assessment of Chronic Stress）评估慢性压力，并将其分为“至平均水平”、“高于平均水平”和“高”。在多变量线性回归模型中，分析慢性压力与对数转换后的 GDRS（表示为几何均数比[GMR]）的横断面关联。协变量包括年龄、性别、社区规模、地区、教育水平、独居、社会支持、抑郁和饮酒。
慢性压力至平均水平、高于平均水平和高慢性压力的平均预测 5 年 T2D 风险率分别为 2.7%、2.9%和 3.0%。与慢性压力至平均水平的人相比，慢性压力高于平均水平（GMR=1.10，95%置信区间=1.02-1.19）和高压力（GMR=1.21，95%置信区间=1.06-1.39）的人调整后的平均预测 5 年风险显著更高。未发现性别或其他协变量的交互作用。
在横断面分析中，感知到的慢性压力与 T2D 风险增加独立相关，在纵向研究中应将其视为 T2D 风险因素。
