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Atasoy, S. ; Johar, H. ; Herder, C.* ; Rathmann, W.* ; Koenig, W.* ; Roden, M.* ; Peters, A. ; Kruse, J* ; Ladwig, K.-H.

Generalized anxiety disorder symptoms and type 2 diabetes onset: Findings from the Prospective Cooperative Health Research in the Region of Augsburg F4 and FF4 studies.

J. Psychosomat. Res. 145:110480 (2021)
Postprint DOI PMC
Open Access Green
OBJECTIVE: To investigate the association of generalized anxiety disorder (GAD) symptomology on the incidence of type 2 diabetes. RESEARCH DESIGN & METHODS: Participants from the prospective KORA F4/FF4 German cohort were followed for a mean of 6.5 years. Generalized Anxiety Disorder Scale-7 (GAD-7) was used to assess GAD symptoms and incident type 2 diabetes cases were confirmed using a standard oral glucose tolerance test. Multivariate logistic regression models were used to estimate the effect of GAD symptoms on the incidence of type 2 diabetes. RESULTS: The present study included 1694 participants (51.8% women, 48.2% men) with a mean age of 51.2 years, among whom 113 (6.7%) had high GAD symptoms. During the follow-up period (11,102 person/years), 113 (6.5%) type 2 diabetes cases were confirmed. Participants with GAD symptoms had 2-fold higher incidence of type 2 diabetes than participants without GAD (17.7 vs. 8.7 cases/1000 person-years). Correspondingly, GAD symptoms independently increased the risk of type 2 diabetes by an odds ratio of 2.09 [95%CI 1.02-4.32, p = 0.04] after adjustment for concurrent sociodemographic, lifestyle and cardiometabolic risk factors, high sensitivity C-reactive protein, depression, and the use of antidepressant medications. Additionally, GAD symptoms had an even larger impact on the onset of type 2 diabetes incidence following additional adjustment for prediabetes at baseline (2.68 [1.23-5.88], p=0.01). CONCLUSIONS: Participants with GAD symptoms had 2-times higher odds of type 2 diabetes incidence during 6.5 years of follow-up, highlighting the significant role of dysregulated stress mechanisms in the pathway to developing type 2 diabetes.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Anxiety ; Type 2 Diabetes Incidence; Heart-rate-variability; Insulin-resistance; Screener Gad-7; Stress; Risk; Mellitus
ISSN (print) / ISBN 0022-3999
e-ISSN 1879-1360
Journal Journal of Psychosomatic Research
Quellenangaben Volume: 145, Issue: , Pages: , Article Number: 110480 Supplement: ,
Publisher Elsevier
Publishing Place The Boulevard, Langford Lane, Kidlington, Oxford Ox5 1gb, England
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology II (EPI2)
Grants German Center for Diabetes Research (Deutsches Zentrum fur Diabetesforschung)
State of Bavaria
German Research Center for Environmental Health - German Federal Ministry of Education and Research (BMBF)
Helmholtz Zentrum Munchen