特质冲动与成年人在 8 年以上的随访中患 2 型糖尿病的风险增加有关：NutriNet-Santé 队列研究的结果。

Trait impulsivity is associated with an increased risk of type 2 diabetes incidence in adults over 8 years of follow-up: results from the NutriNet-Santé cohort.

机构信息

Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentació, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM), Reus, Spain.

Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.

出版信息

BMC Med. 2024 Aug 15;22(1):332. doi: 10.1186/s12916-024-03540-7.

DOI:10.1186/s12916-024-03540-7

PMID:39148083

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11328429/

Abstract

BACKGROUND

Type 2 diabetes is one of the most prevalent and preventable diseases worldwide and impulsivity, a psychological trait characterized by making quick decisions without forethought, has been suggested as a key feature for health-related conditions. However, there have been no studies examining the relationships between impulsivity and the incidence of type 2 diabetes and our aim was to assess the prospective association between trait impulsivity and the risk of developing type 2 diabetes.

METHODS

A prospective observational study design was conducted between May 2014 and February 2023 within the NutriNet-Santé cohort. A web-based platform was used to collect data from the French adult population, with voluntary enrollment and participation. Of the 157,591 adults (≥ 18 years old) participating in the NutriNet-Santé study when impulsivity was assessed, 109,214 participants were excluded due to prevalent type 1 or 2 diabetes or missing data for impulsivity or follow-up data for type 2 diabetes. Trait impulsivity, and the attention, motor, and non-planning subfactors, were assessed at baseline using the Barratt Impulsiveness Scale 11. Incident type 2 diabetes was ascertained through follow-up. Medical information was reviewed by NutriNet-Santé physician experts to ascertain incident diabetes cases based on the ICD-10. Cox regression models, using hazard ratios and 95% confidence intervals (HR [95% CI]), were performed to evaluate associations between impulsivity per 1 standard deviation increment and type 2 diabetes risk, adjusting by recognized confounders.

RESULTS

Of the 48,377 individuals studied (women 77.6%; age at baseline = 50.6 year ± 14.5 years), 556 individuals developed type 2 diabetes over a median follow-up of 7.78 (IQR: 3.97-8.49) years. Baseline impulsivity was associated with an increased risk of type 2 diabetes incidence (HR = 1.10 [1.02, 1.20]). The motor impulsivity subfactor was positively associated with type 2 diabetes risk (HR = 1.14 [1.04, 1.24]), whereas no associations were found for attention and non-planning impulsivity subfactors.

CONCLUSIONS

Trait impulsivity was associated with an increased type 2 diabetes risk, mainly driven by the motor impulsivity subfactor. If these results are replicated in other populations and settings, trait impulsivity may become an important psychological risk factor to be considered in the prevention of type 2 diabetes.

COHORT REGISTRATION

Name of registry: The NutriNet-Santé Study. A Web-based Prospective Cohort Study of the Relationship Between Nutrition and Health and of Dietary Patterns and Nutritional Status Predictors. Cohort registration number: NCT03335644. Date of registration: October 11, 2017. URL: https://clinicaltrials.gov/ct2/show/NCT03335644.

摘要

背景

2 型糖尿病是全球最普遍和可预防的疾病之一，而冲动性是一种以不假思索地做出快速决策为特征的心理特征，被认为是与健康相关状况的关键特征。然而，目前还没有研究探讨冲动性与 2 型糖尿病发病之间的关系，我们的目的是评估特质冲动性与 2 型糖尿病发病风险之间的前瞻性关联。

方法

这是一项在 2014 年 5 月至 2023 年 2 月期间在 NutriNet-Santé 队列中进行的前瞻性观察性研究设计。该研究使用一个基于网络的平台从法国成年人群中收集数据，参与者自愿注册和参与。在评估冲动性时，共有 157591 名（≥18 岁）参加 NutriNet-Santé 研究的成年人中，有 109214 人因 1 型或 2 型糖尿病、冲动性或 2 型糖尿病随访数据缺失而被排除。在基线时使用巴雷特冲动量表 11 评估特质冲动性以及注意、运动和非计划子因素。使用 Cox 回归模型，采用风险比和 95%置信区间（HR [95%CI]），评估每增加 1 个标准差的冲动性与 2 型糖尿病风险之间的关联，同时调整公认的混杂因素。

结果

在 48377 名研究对象中（女性占 77.6%；基线年龄为 50.6 岁±14.5 岁），在中位数为 7.78 年（IQR：3.97-8.49）的随访期间，有 556 人患上了 2 型糖尿病。基线冲动性与 2 型糖尿病发病风险增加相关（HR=1.10 [1.02, 1.20]）。运动冲动性子因素与 2 型糖尿病风险呈正相关（HR=1.14 [1.04, 1.24]），而注意和非计划冲动性子因素则没有相关性。