Social Support, Social Network Size, Social Strain, Stressful Life Events, and Coronary Heart Disease in Women With Type 2 Diabetes: A Cohort Study Based on the Women's Health Initiative
Social Support, Social Network Size, Social Strain, Stressful Life Events, and Coronary Heart Disease in Women With Type 2 Diabetes: A Cohort Study Based on the Women's Health Initiative
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DOI：
10.2337/dc19-2065
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发表时间：
2020-08-01
期刊：
影响因子：
16.2
通讯作者：
Luo, Juhua
中科院分区：
文献类型：
--
作者：
Jonasson, Junmei Miao;Hendryx, Michael;Luo, Juhua
目的研究绝经后女性2型糖尿病患者的社会支持、社会网络规模、社会紧张或应激性生活事件与冠心病风险之间的关系。研究设计和方法来自妇女健康倡议，5,262名绝经后妇女在基线时患有2型糖尿病。考克斯比例风险回归模型校正人口统计学，抑郁症状，人体测量学变量，生活方式因素被用来检查社会因素和冠心病之间的关联。结果672例冠心病患者平均随访12.79年（SD 6.29）。随着应激性生活事件数量的增加，冠心病风险呈显著的线性趋势（趋势P = 0.01;第三和第四四个四分位数与第一个四分位数相比的风险比[HR] [95%CI]：1.27 [1.03-1.56]和1.30 [1.04-1.64]）。已婚或有亲密关系与冠心病风险降低相关（HR 0.82 [95%CI 0.69-0.97]）。结论：在绝经后2型糖尿病妇女中，高水平的应激性生活事件与冠心病的高风险相关。压力性生活事件的经历可能被认为是女性2型糖尿病患者冠心病的危险因素。
OBJECTIVE We studied associations between social support, social network size, social strain, or stressful life events and risk of coronary heart disease (CHD) in postmenopausal women with type 2 diabetes. RESEARCH DESIGN AND METHODS From the Women's Health Initiative, 5,262 postmenopausal women with type 2 diabetes at baseline were included. Cox proportional hazards regression models adjusted for demographics, depressive symptoms, anthropometric variables, and lifestyle factors were used to examine associations between social factors and CHD. RESULTS A total of 672 case subjects with CHD were observed during an average 12.79 (SD 6.29) years of follow-up. There was a significant linear trend toward higher risk of CHD as the number of stressful life events increased (Pfor trend = 0.01; hazard ratio [HR] [95% CI] for the third and fourth quartiles compared with first quartile: 1.27 [1.03-1.56] and 1.30 [1.04-1.64]). Being married or in an intimate relationship was related to decreased risk of CHD (HR 0.82 [95% CI 0.69-0.97]). CONCLUSIONS Among postmenopausal women with type 2 diabetes, higher levels of stressful life events were associated with higher risk of CHD. Experience of stressful life events might be considered as a risk factor for CHD among women with type 2 diabetes.