Document Detail


Psychological distress, glycated hemoglobin, and mortality in adults with and without diabetes.
MedLine Citation:
PMID:  20884891     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine associations between psychological distress, glucose metabolism, and death. There is limited information about the long-term prognosis of diabetic patients with psychological distress.
METHODS: In a representative cohort of 11,546 adults (6.2% with high-risk/undiagnosed diabetes and 4.8% with physician-diagnosed diabetes), we measured glycated hemoglobin A1C as an indicator of glucose metabolism and psychological distress with the 12-item General Health Questionnaire (GHQ-12).
RESULTS: During the mean follow-up of 4.7 years, there were 682 deaths (93 among diabetic, 88 in high-risk/undiagnosed diabetic [A1C ≥6.0% without physician-diagnosed diabetes], and 501 in nondiabetic participants). Psychological distress was apparent in 18.9%, 16.5%, and 13.4% of diabetic, high-risk/undiagnosed diabetic, and nondiabetic participants, respectively. In participants with diabetes, a unit increase in GHQ-12 score was associated with higher risk of death at follow-up (multivariate adjusted hazard ratio, 1.16; 95% confidence interval, 1.09-1.24). Levels of A1C were also higher in diabetic participants with distress (GHQ-12 score of >3) compared with those without (7.86% versus 7.40%; p = .008), although adjustment for A1C did alter the association between distress and mortality. In the whole sample, the coexistence of diabetes and distress was associated with an elevated risk of death, beyond that due to having either diabetes or distress alone (multivariate adjusted hazard ratio, 3.64; 95% confidence interval, 2.21-5.98).
CONCLUSIONS: Psychological distress is an independent risk factor for death in diabetic patients, although impaired glucose metabolism did not explain the excess risk.
Authors:
Mark Hamer; Emmanuel Stamatakis; Mika Kivimäki; Andre Pascal Kengne; G David Batty
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-09-30
Journal Detail:
Title:  Psychosomatic medicine     Volume:  72     ISSN:  1534-7796     ISO Abbreviation:  Psychosom Med     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-10     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376505     Medline TA:  Psychosom Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  882-6     Citation Subset:  IM    
Affiliation:
Department of Epidemiology and Public Health,University College London, London, United Kingdom. m.hamer@ucl.ac.uk
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Blood Glucose / analysis,  metabolism*
Cardiovascular Diseases / mortality
Cause of Death
Comorbidity
Diabetes Mellitus / blood,  epidemiology,  mortality*
Diabetes Mellitus, Type 2 / blood,  epidemiology,  mortality
Female
Health Status
Hemoglobin A, Glycosylated / analysis*,  metabolism
Humans
International Classification of Diseases
Male
Middle Aged
Proportional Hazards Models
Questionnaires
Risk Factors
Stress, Psychological / blood,  epidemiology,  metabolism*
Grant Support
ID/Acronym/Agency:
R01AG034454/AG/NIA NIH HHS; R01HL036310/HL/NHLBI NIH HHS; RG 05/006//British Heart Foundation; WBS U.1300.00.006.00012.01//Wellcome Trust; //Chief Scientist Office; //Medical Research Council
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  VEGF??? differentially regulates neutrophil and T cell adhesion through ItgaL- and ItgaM-dependent m...
Next Document:  Preventing cervical cancer globally by acting locally: if not now, when?