青年時抗壓差 成年後易患糖尿病

Men who have low resistance to psychological stress at age 18 may face considerably higher risk for type 2 diabetes in adulthood compared to those better able to handle stress, according to new research.

最新一項調查顯示，與那些擅長處理壓力情緒的人羣相比，那些年齡在18歲上下且不擅長應對心理壓力的人們更容易在成年後患有2型糖尿病。

"Other studies have found that stressful life experiences in mid-adulthood are linked with a higher risk of developing diabetes," said lead author Dr. Casey Crump of the Mount Sinai School of Medicine in New York.

紐約西奈山醫學院的首席作者凱西·克倫普醫生表示，“一些研究表明：若人在中年曾經歷過壓力較大的時期，那麼其患有糖尿病的風險也較大。”

But none have looked at whether responses to stress at a young age predict risk of diabetes much later in life, Crump and his colleagues write in Diabetologia.

克倫普與其同事在糖尿病學雜誌中提到：從未有人探索過一個人在青年時期對壓力的反應和處理態度是否與其人生後期患有糖尿病的風險大小有關。

"Stress resilience refers to the ability to properly adapt to or cope with stress and adversity," Crump, who was at Stanford University in California when he worked on the study, told Reuters Health by email. "Low resistance to stress (or low stress resilience) means difficulty coping with or rebounding from adversity."

克倫普曾在美國加州斯坦福大學進行這項研究，期間他向路透健康新聞專欄寫了一封郵件，上面寫道：“抗壓能力指一種能夠正確應對壓力以及挫折的能力，抗壓能力較弱則意味着遭受挫折後重新振作走出逆境的自我調節能力較差。”

The study team analyzed data on more than 1 million 18-year-old men who were conscripted into military service in Sweden between 1969 and 1997, when service was compulsory.

該研究團隊對一百多萬名18歲少年的數據進行了分析。這些少年都曾在1969至1997年間在瑞典應徵入伍，那段時期仍實行義務兵役制度。

The young men did not have diabetes at age 18 and all underwent standard psychological assessments of their stress resistance. In a 20 to 30 minute interview, a psychologist asked each man about adjustment problems and conflicts, successes, responsibilities taken on and initiatives shown or experienced in school, work, home or in leisure activities.

這些年輕人在18歲期間並未患有糖尿病，並且都曾進行過對自身抗壓能力的標準性心理評估。在短短二十到三十分鐘的採訪中，心理學家對這些人在學校、工作、家庭以及一些娛樂活動領域中存在的適應性問題、矛盾、取得的成功，肩負的責任以及展現的積極性等方面進行了相關詢問。

Crump’s team matched the participants to their later medical records to see who received an outpatient or inpatient diagnosis of diabetes between 1987 and 2012. About 34,000 of the men were diagnosed with type 2 diabetes.

克倫普團隊將這些參與採訪的人與其自身後來的病歷記錄進行了比對，並檢驗是否有人曾在1987至2012年間諮詢過糖尿病門診或被診斷患有糖尿病。

After accounting for body weight, family history of diabetes and individual and neighborhood socioeconomic factors, the researchers found that men with low stress resilience - that is, with a score between one and three on a nine-point scale - were 51 percent more likely to have a diabetes diagnosis than those with the highest scores, between seven and nine.

在對這些人的體重、家族病史、個人以及社區的社會經濟因素進行考量後，研究人員發現那些抗壓能力較低，也就是得分在1到3分之間（滿分是9分，1分代表抗壓能力最低，9分代表抗壓能力最高）的人，有51%的機率比那些得分在7到9分之間的人更容易患有糖尿病。

"Both the amount of stress and stress resilience may have important health effects," Crump said. "Common sources of stress include relationship, family, school, and workplace problems or worries."

“壓力大小以及抗壓能力都可能產生重大的健康效應，”克倫普說道，“生活中壓力通常來源於關係、家庭、學校、工作等領域的問題或煩惱。”

People who experience a lot of stress or have trouble resisting it may react with unhealthy behaviors like poor eating habits, little physical activity and smoking or heavier alcohol use, he said.

克倫普表示，那些經歷過重大壓力或者缺乏抗壓能力的人可能會逐漸形成不健康的生活方式，例如不規律的飲食習慣，缺乏體育運動，吸菸酗酒等等。

"Other stress-related physiologic changes may also be involved, such as higher levels of (the stress hormone) cortisol which can contribute to insulin resistance and diabetes," he said.

克倫普還表示，除此之外，還有可能產生一系列與壓力相關的心理變化，比如：較高水平的皮質醇（壓力激素），有助於產生抗胰島素性，並引發糖尿病。

"If you have low stress resilience, even some everyday experiences can be stressful," said Dr. Cecilia Bergh of Orebro University in Sweden, who was not part of the new study. "Very high levels of stress, such as being in a war zone, are damagingly stressful for almost everybody, even among those with high stress resilience," Bergh told Reuters Health by email.

瑞典奧萊布魯醫科大學的塞西莉亞·馬瑞醫生雖未參與此項新研究，但他表示，“如果你的抗壓能力較低，那麼日常生活中一些瑣碎的事情在你看來也可能讓你倍感壓力。”與此同時，馬瑞醫生向路透健康新聞專欄發郵件提到，“然而，諸如上戰場打仗這種事情對於每個人來說都屬於高壓事件，即使是對於那些抗壓能力較強的人來說也是如此。”

The general public, and especially those who are overweight or have a family history of diabetes, should know that stress management is an important part of maintaining long-term health and preventing diabetes, Crump said.

克倫普表示：普通大衆，尤其是那些超重或有糖尿病家族病史的人應該明白，抗壓處理對於保持長期健康以及預防糖尿病來說非常重要。