目的:这项研究的目的是报告全国范围内1型糖尿病(T1D)青少年饮食紊乱行为(DEB)患病率的数据,并评估饮食问题的多维模型。分析精神病理学问题如何与DEB和代谢控制相关。
方法:本研究采用横断面设计,样本为1,562例T1D患者(812例男性),年龄11-19岁。参与者从位于北部的多个儿科糖尿病中心(N=30)招募,中央,意大利南部,他们分别完成了糖尿病饮食问题调查修订(DEPS-r)和青少年自我报告(YSR)。还收集了社会人口统计学和临床数据。多组结构方程模型用于研究内化/外化症状之间的关系,DEB,糖化血红蛋白(HbA1c)值。
结果:共有29.7%的参与者报告了DEB(DEPS-r评分≥20),42.4%报告胰岛素操纵(IM)。女性参与者的DEB患病率较高(p≤0.001)。该模型解释了37%的无序饮食差异,在IM中为12%,和21%的HbA1c值。身体质量指数,外化症状,内在化症状与DEB呈显著正相关,反过来与HbA1c值呈显著正相关(均p≤0.001)。外化(p≤.001)和内化(p≤.01)症状也与HbA1c值直接相关。
结论:鉴于DEB的相关患病率,他们与精神病理症状显著正相关,以及它们与更糟糕的糖尿病结局的关系,需要定期进行心理筛查和支持,以确保为患有T1D的青少年提供最佳护理.
The aim of this
study was to report nationwide data of the prevalence of disordered eating behaviors (DEBs) in adolescents with type 1 diabetes (T1D) and to evaluate a multidimensional model of eating problems, analyzing how psychopathological problems are associated with DEBs and with metabolic control.
This
study was carried out using a cross-sectional design with a sample of 1,562 patients with T1D (812 male), aged 11-19 years. Participants were recruited from multiple pediatric diabetes centers (N = 30) located in northern, central, and southern Italy, and they individually completed the Diabetes Eating Problem Survey-Revised (DEPS-r) and the Youth Self-Report (YSR). Sociodemographic and clinical data were also gathered. Multiple-group structural equation modeling was used to investigate the relationships between internalizing/externalizing symptoms, DEBs, and glycosylated hemoglobin (HbA1c) values.
A total of 29.7% of the participants reported DEBs (DEPS-r scores ≥20), 42.4% reported insulin manipulation (IM). The prevalence of DEBs was higher for female participants (p ≤ .001). The model explains 37% of the variance in disordered eating, 12% in IM, and 21% in HbA1c values. Body mass index, externalizing symptoms, and internalizing symptoms were significantly and positively associated with DEBs, which in turn were significantly and positively associated with HbA1c values (all p ≤ .001). Externalizing (p ≤ .001) and internalizing (p ≤ .01) symptoms were also directly associated with HbA1c values.
Given the relevant prevalence of DEBs, their significant positive association with psychopathological symptoms, and their relationship with worse diabetes outcomes, regular psychological screening and support is needed to ensure the best care of adolescents with T1D.