The role of health behaviors in mediating the relationship between depressive symptoms and glycemic control in type 2 diabetes: a structural equation modeling approach.
The role of health behaviors in mediating the relationship between depressive symptoms and glycemic control in type 2 diabetes: a structural equation modeling approach.
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DOI：
10.1007/s00127-009-0043-3
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发表时间：
2010-01
影响因子：
4.4
通讯作者：
Dominic, Oralia G.
中科院分区：
文献类型：
--
作者：
Chiu, Ching-Ju;Wray, Linda A.;Beverly, Elizabeth A.;Dominic, Oralia G.
我们调查了2型糖尿病成人患者抑郁症状与血糖控制（HbA 1c）之间的纵向关联，以及健康行为对这种关联的解释程度。这项研究评估了美国全国代表性健康和退休研究及其糖尿病特定邮件调查中998名成年人（51岁及以上）2型糖尿病患者的数据。参与者的抑郁症状和基线健康行为（锻炼，体重控制和吸烟状况）于1998年收集。随访健康行为和血糖控制结果分别以2年和5年为间隔进行测量。近四分之一的参与者（23%）在基线时报告中度或高度抑郁症状（CES-D评分≥3）。基线时抑郁症状水平较高的成年人在基线和随访健康行为方面的得分较低，在5年随访时HbA 1c水平较高。结构方程模型（SEM）显示，健康行为占抑郁症状和血糖控制之间联系的13%。本研究支持抑郁症状与血糖控制之间的长期关系。健康行为，包括锻炼、体重控制和吸烟状况，解释了抑郁症状和血糖控制之间的相当大的关联。更全面的糖尿病自我护理行为应与现有数据进行检查。这种联系的其他相互竞争的解释因素，如内分泌过程和抗抑郁作用，也需要进一步研究。
We investigated the longitudinal association between depressive symptoms and glycemic control (HbA1c) in adults with type 2 diabetes, and the extent to which that association was explained by health behaviors. This study assessed data on 998 adults (aged 51 and above) with type 2 diabetes in the US nationally representative Health and Retirement Study and its diabetes-specific mail survey. Participants’ depressive symptoms and baseline health behaviors (exercise, body weight control, and smoking status) were collected in 1998. Follow-up health behaviors and the glycemic control outcome were measured at a 2- and 5-year intervals, respectively. Nearly one in four of participants (23%) reported moderate or high levels of depressive symptoms at baseline (CES-D score ≥3). Adults with higher levels of depressive symptoms at baseline showed lower scores on baseline and follow-up health behaviors as well as higher HbA1c levels at a 5-year follow-up. Structural equation models (SEM) reveal that health behaviors accounted for 13% of the link between depressive symptoms and glycemic control. The long-term relationship between depressive symptoms and glycemic control was supported in the present study. Health behaviors, including exercise, body weight control, and smoking status, explained a sizable amount of the association between depressive symptoms and glycemic control. More comprehensive diabetes self-care behaviors should be examined with available data. Other competing explicators for the link, such as endocrinological process and antidepressant effects, also warrant further examination.
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影响因子：
7.6
作者：
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通讯作者：
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