The Prospective Association Between Positive Psychological Well-Being and Diabetes
The Prospective Association Between Positive Psychological Well-Being and Diabetes
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DOI：
10.1037/hea0000200
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发表时间：
2015-10-01
影响因子：
4.2
通讯作者：
Kubzansky, Laura D.
中科院分区：
文献类型：
--
作者：
Boehm, Julia K.;Trudel-Fitzgerald, Claudia;Kubzansky, Laura D.
目的：积极的心理健康与心血管结局有保护性联系，但没有研究认为它与糖尿病有关。这项研究调查了幸福感和糖尿病之间的联系。研究方法：在研究基线（1991-1994），7,800名没有糖尿病的中年英国男性和女性表示他们的生活满意度，情感活力和乐观。糖尿病状态通过自我报告的医生诊断和口服葡萄糖耐量试验（筛查检测）在基线和2002-2004年确定。发病糖尿病的定义是由医生诊断和筛查发现的病例合并和单独。Logistic回归估计了控制相关协变量（例如，人口统计学、抑郁症状）。模型还按性别和体重状态分层。结果：在随访期间（长达13年），共有562例合并糖尿病事件。对于医生诊断和筛查发现的病例，幸福感与糖尿病事件无关。然而，当检查288名医生诊断的病例时，生活满意度和情绪活力与医生诊断的糖尿病的几率降低15%相关，控制人口统计学（结果与其他协变量相似）。乐观与医生诊断的糖尿病无关，没有健康指标与筛查出的糖尿病相关。性别和体重状况不是调节因素。结论：生活满意度和情绪活力，但不是乐观，与医生诊断的糖尿病的风险降低。这些发现表明，幸福感可能有助于降低流行和负担性疾病的风险，尽管需要干预研究来证实这一点。目前还不清楚为什么医生诊断的糖尿病与研究筛选的糖尿病的结果不同。
Objective: Positive psychological well-being has protective associations with cardiovascular outcomes, but no studies have considered its association with diabetes. This study investigated links between well-being and incident diabetes. Methods: At study baseline (1991-1994), 7,800 middle-aged British men and women without diabetes indicated their life satisfaction, emotional vitality, and optimism. Diabetes status was determined by self-reported physician diagnosis and oral glucose tolerance test (screen detection) at baseline and through 2002-2004. Incident diabetes was defined by physician-diagnosed and screen-detected cases combined and separately. Logistic regression estimated the odds of developing diabetes controlling for relevant covariates (e.g., demographics, depressive symptoms). Models were also stratified by gender and weight status. Results: There were 562 combined cases of incident diabetes during follow-up (up to 13 years). Well-being was not associated with incident diabetes for combined physician-diagnosed and screen-detected cases. However, when examining the 288 physician-diagnosed cases, life satisfaction and emotional vitality were associated with up to a 15% decrease in the odds of physician-diagnosed diabetes, controlling for demographics (results were similar with other covariates). Optimism was not associated with physician-diagnosed diabetes, and no wellbeing indicator was associated with screen-detected diabetes. Gender and weight status were not moderators. Conclusions: Life satisfaction and emotional vitality, but not optimism, were associated with reduced risk of physician-diagnosed diabetes. These findings suggest that well-being may contribute to reducing risk of a prevalent and burdensome condition, although intervention studies are needed to confirm this. It is unclear why findings differed for physician-diagnosed versus study-screened diabetes.