| Psychological distress, glycated hemoglobin, and mortality in adults with and without diabetes. | |
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MedLine Citation:
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PMID: 20884891 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Mark Hamer; Emmanuel Stamatakis; Mika Kivimäki; Andre Pascal Kengne; G David Batty |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-09-30 |
Journal Detail:
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Title: Psychosomatic medicine Volume: 72 ISSN: 1534-7796 ISO Abbreviation: Psychosom Med Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-10 Completed Date: 2011-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376505 Medline TA: Psychosom Med Country: United States |
Other Details:
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Languages: eng Pagination: 882-6 Citation Subset: IM |
Affiliation:
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Department of Epidemiology and Public Health,University College London, London, United Kingdom. m.hamer@ucl.ac.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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:
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0/Blood Glucose; 0/Hemoglobin A, Glycosylated |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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