在退伍军人中,创伤后应激障碍和2型糖尿病的结果
Jeffrey F Scherrer1,2,3,4, Joanne Salas3,4, Wenjin Wang1
1Department of Family and Community Medicine, Saint Louis University School of Medicine, St Louis, Missouri.
JAMA network open
|August 13, 2024
概括
改善创伤后应激障碍 (PTSD) 症状可能会降低2型糖尿病并发症的风险. 这项研究表明,PTSD是糖尿病不良结果的可修改风险因素.
科学领域:
- 内分泌学和新陈代谢学
- 精神病学和心理健康 精神病学和心理健康
- 公共卫生和流行病学
背景情况:
- 创伤后应激障碍 (PTSD) 与患2型糖尿病 (T2D) 的风险较低有关.
- 然而,PTSD对现有的T2D结果的影响仍然在很大程度上是未知的.
- 调查PTSD作为T2D并发症的可修改风险因素至关重要.
研究的目的:
- 为了确定PTSD症状的缓解是否与T2D不良结果的风险降低有关.
- 为了比较患有创伤后应激障碍并得到改善的患者与持久性创伤后应激障碍患者的结果.
主要方法:
- 使用美国退伍军人卫生管理局数据 (2011-2022) 进行的回顾性队列研究.
- 包括18-80岁的患者,患有并发性PTSD和T2D.
- 分析了包括胰岛素启动,血糖控制,微血管并发症和使用生存和竞争风险模型的死亡率在内的结果.
主要成果:
- 在控制混因素后,PTSD的缓解与微血管并发症风险较低有关 (HR,0.92).
- 在年轻的退伍军人 (18-49岁) 中,PTSD缓解降低了胰岛素开始的风险 (HR,0.69) 和全因死亡率 (HR,0.39).
- 在没有抑郁症的患者中,PTSD缓解也降低了胰岛素启动的风险 (HR,0.73).
结论:
- 创伤后应激障碍 (PTSD) 似乎是2型糖尿病 (T2D) 的可修改风险因素.
- 创伤后应激障碍缓解与微血管并发症的适度减少有关.
- 需要进一步的研究来证实这些发现在不同的医疗保健机构.
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