Changes in negative affect and changes in heart rate variability among low-income latinos with type 2 diabetes in a randomized, controlled stress management trial.
Changes in negative affect and changes in heart rate variability among low-income latinos with type 2 diabetes in a randomized, controlled stress management trial.
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在一项随机对照压力管理试验中，患有 2 型糖尿病的低收入拉丁美洲人的负面影响和心率变异性的变化。
DOI：
10.1016/j.jpsychores.2019.109774
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发表时间：
2019
影响因子：
4.7
通讯作者：
Pérez-Escamilla,Rafael
中科院分区：
文献类型：
--
作者：
Wagner,JulieA;Feinn,Richard;Lampert,Rachel;Bermúdez-Millán,Angela;Pérez-Escamilla,Rafael
结构方程模型研究了121名拉美裔2型糖尿病患者的负性情绪变化(NA)和心率变异性(HRV)变化之间的关系。方法本研究利用社区卫生工作者协助拉美裔人管理压力和糖尿病(CALMSD)研究的数据，该研究比较了糖尿病教育和糖尿病教育+压力管理。参与者在基线时完成NA调查，并在8-10 周后再次完成NA调查。他们还在两个时间点佩戴7导联3通道动态心电监护仪24 h。潜在变量NA通过对抑郁、焦虑、糖尿病痛苦和幸福感的观察得分来建模(反转)。潜变量HRV通过在时间域(R-R间期的标准差[SDNN]和连续差值的均方根[RMSSD])和在频域(即对数变换的超低频、甚低频、低频和高频)的观察分数来建模。基线NA预测HRV的变化，而基线HRV不能预测NA的变化。控制空腹血糖和治疗分配并没有显著改变研究结果。压力管理改善了NA，但没有改善HRV。在随访中，NA的较大减少(改善)与HRV的较大增加(改善)相关，具有接近统计学意义的小到中型负相关。结论发现NA和HRV之间存在纵向关系，提示其中一个的改善可能与另一个的改善相关。
BackgroundStructural equation modeling examined the relationship between change in negative affect (NA) and change in heart rate variability (HRV) among 121 Latinos with type 2 diabetes.MethodsThis study leveraged data from the Community Health Workers Assisting Latinos Manage Stress and Diabetes (CALMSD) study which compared diabetes education vs diabetes education plus stress management. Participants completed surveys of NA at baseline and again 8–10 weeks later. They also wore 7‑lead, 3-channel ambulatory ECG monitors for 24 h at both time points. The latent variable NA was modeled by observed scores on symptoms of depression, anxiety, diabetes distress, and wellbeing (reversed). The latent variable HRV was modeled by observed scores in the time domain (the standard deviation of the R-R interval [SDNN] and the root mean square of the successive differences [RMSSD]) and in the frequency domain, i.e., log-transformed ultra-low frequency, very-low frequency, low frequency, and high frequency.ResultsAt baseline, there were strong, negative cross-sectional associations between NA and HRV. Baseline NA predicted change in HRV, whereas baseline HRV did not predict change in NA. Controlling for fasting glucose and treatment assignment did not meaningfully alter the findings. Stress management improved NA but not HRV. At followup, a greater reduction (improvement) in NA was associated with a larger increase (improvement) in HRV, with a small-to-medium negative association that approached statistical significance.ConclusionsFindings indicate a longitudinal relationship between NA and HRV, and suggest that improvement in one may be associated with improvement in the other.