Fickley, Catherine; Lloyd, Cathy; Costacou, Tina; Miller, Rachel and Orchard, Trevor
(2013).
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| DOI (Digital Object Identifier) Link: | https://doi.org/10.2337/dc13-0266 |
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| Google Scholar: | Look up in Google Scholar |
Abstract
Objective To determine whether type A behavior predicts all cause mortality and incident coronary artery disease (CAD) in a type 1 diabetes population.
Research Design and Methods Twenty-two year follow-up data from the Pittsburgh Epidemiology of Diabetes Complications (EDC) study of childhood onset type 1 diabetes were analyzed for the 506 participants who completed the Bortner Rating Scale (measuring type A myocardial infarction as determined by hospital records/ Q waves on ECG, CAD death behavior) and Beck’s Depression Inventory (BDI) at baseline (1986-1988). CAD comprised (determined by a mortality classification committee), angiographic stenosis, ischemic ECG and angina.
Results There were 128 deaths (25.3%) during follow-up. Univariate analysis showed an inverse relationship between Bortner scores and all cause mortality (p=0.01) which remained significant after allowing for age, sex, duration, HbA1c, education, smoking, BMI, and physical activity (p=0.03). However, the addition of BDI scores attenuated the relationship (p=0.11) with a significant interaction (p=0.03) such that any protective effect against mortality was limited among individuals with lower BDI scores (bottom 3 quintiles) (p=0.07), while no effect was seen in those with higher BDI (p=0.97). Bortner scores showed only a borderline association with incident CAD (p=0.09).
Conclusions Those with higher type A behavior have lower all-cause mortality in our type 1 diabetes population, an effect that interacts with depressive symptomatology such that it is only operative in those with low BDI scores. Further research should focus on understanding this interaction.
| Item Type: | Journal Item |
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| Copyright Holders: | 2013 American Diabetes Association |
| ISSN: | 1935-5548 |
| Keywords: | type 1 diabetes; type A behaviour; mortality |
| Academic Unit/School: | Faculty of Wellbeing, Education and Language Studies (WELS) > Health, Wellbeing and Social Care Faculty of Wellbeing, Education and Language Studies (WELS) |
| Item ID: | 39155 |
| Depositing User: | Cathy Lloyd |
| Date Deposited: | 13 Dec 2013 10:06 |
| Last Modified: | 09 Dec 2018 01:47 |
| URI: | http://oro.open.ac.uk/id/eprint/39155 |
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