Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA.
The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD, USA.
Diabetes Res Clin Pract. 2023 Sep;203:110808. doi: 10.1016/j.diabres.2023.110808. Epub 2023 Jun 30.
People with type 2 diabetes (T2DM) have an increased risk of cardiovascular disease (CVD). We examined depressive symptoms (DS) and diabetes distress (DD) in relation to the estimated 10-year risk of CVD in adults with T2DM enrolled in the GRADE Emotional Distress Substudy.
Linear regression models examined the associations of baseline DS and DD with estimated 10-year risk of CVD using the Atherosclerotic Cardiovascular Disease (ASCVD) risk score, adjusting for age, sex, race/ethnicity, education, income, diabetes duration, diabetes-related complications, and HbA1c.
A total of 1,605 GRADE participants were included: 54% Non-Latino (NL) White, 18% Latino, 19% NL-Black, 66% male, mean age 57.5 (SD = 10.25) years, diabetes duration 4.2 (SD = 2.8) years, and HbA1c 7.5% (SD = 0.5%). After incorporating covariates, only DS, especially cognitive-affective symptoms, were associated with ASCVD risk (estimate = 0.15 [95% CI: 0.04, 0.025], p = 0.006). Higher DS remained significantly associated with higher ASCVD risk when adding DD to covariates (estimate = 0.19 [95% CI: 0.07, 0.30], p = 0.002). DD was not associated with ASCVD risk when accounting for covariates.
Depressive symptoms, particularly cognitive-affective symptoms, are associated with increased 10-year predicted ASCVD risk among adults with early T2DM. Diabetes distress is not significantly associated with the predicted ASCVD risk when accounting for covariates.
2 型糖尿病（T2DM）患者发生心血管疾病（CVD）的风险增加。我们研究了抑郁症状（DS）和糖尿病困扰（DD）与参加 GRADE 情绪困扰亚研究的 T2DM 成人的 CVD 10 年估计风险之间的关系。
使用动脉粥样硬化性心血管疾病（ASCVD）风险评分，线性回归模型检查了基线 DS 和 DD 与 CVD 10 年估计风险的关联，调整了年龄、性别、种族/民族、教育、收入、糖尿病病程、糖尿病相关并发症和 HbA1c。
共有 1605 名 GRADE 参与者入组：54%非拉丁裔（NL）白人、18%拉丁裔、19% NL 黑人、66%男性、平均年龄 57.5（SD=10.25）岁、糖尿病病程 4.2（SD=2.8）年，HbA1c 为 7.5%（SD=0.5%）。在纳入协变量后，只有 DS，尤其是认知情感症状，与 ASCVD 风险相关（估计值=0.15 [95%CI：0.04，0.025]，p=0.006）。当将 DD 添加到协变量中时，较高的 DS 与 ASCVD 风险仍显著相关（估计值=0.19 [95%CI：0.07，0.30]，p=0.002）。当考虑到协变量时，DD 与 ASCVD 风险无关。
抑郁症状，尤其是认知情感症状，与早期 T2DM 成人 ASCVD 10 年预测风险增加相关。当考虑到协变量时，糖尿病困扰与预测的 ASCVD 风险无显著相关性。
