Advanced

Gender, alexithymia and physical inactivity associated with abdominal obesity in type 1 diabetes mellitus: a cross sectional study at a secondary care hospital diabetes clinic

Fürst Melin, Eva LU ; Svensson, Ralph; Thunander, Maria LU ; Hillman, Magnus LU ; Thulesius, Hans LU and Landin-Olsson, Mona LU (2017) In BMC Obesity 4(21). p.1-11
Abstract
Background
Obesity is linked to cardiovascular diseases and increasingly common in type 1 diabetes mellitus (T1DM) since the introduction of intensified insulin therapy. Our main aim was to explore associations between obesity and depression, anxiety, alexithymia and self-image measures and to control for lifestyle variables in a sample of persons with T1DM. Secondary aims were to explore associations between abdominal and general obesity and cardiovascular complications in T1DM.

Methods
Cross sectional study of 284 persons with T1DM (age 18–59 years, men 56%), consecutively recruited from one secondary care hospital diabetes clinic in Sweden. Assessments were performed with self-report instruments (Hospital Anxiety and... (More)
Background
Obesity is linked to cardiovascular diseases and increasingly common in type 1 diabetes mellitus (T1DM) since the introduction of intensified insulin therapy. Our main aim was to explore associations between obesity and depression, anxiety, alexithymia and self-image measures and to control for lifestyle variables in a sample of persons with T1DM. Secondary aims were to explore associations between abdominal and general obesity and cardiovascular complications in T1DM.

Methods
Cross sectional study of 284 persons with T1DM (age 18–59 years, men 56%), consecutively recruited from one secondary care hospital diabetes clinic in Sweden. Assessments were performed with self-report instruments (Hospital Anxiety and Depression Scale, Toronto Alexithymia Scale-20 items and Structural Analysis of Social Behavior). Anthropometrics and blood samples were collected for this study and supplemented with data from the patients’ medical records. Abdominal obesity was defined as waist circumference men/women (meters): ≥1.02/≥0.88, and general obesity as BMI ≥30 kg/m2 for both genders. Abdominal obesity was chosen in the analyses due to the high association with cardiovascular complications. Different explanatory logistic regression models were elaborated for the associations and calibrated and validated for goodness of fit with the data variables.

Results
The prevalence of abdominal obesity was 49/284 (17%), men/women: 8%/29% (P < 0.001). Abdominal obesity was associated with women (AOR 4.9), physical inactivity (AOR 3.1), alexithymia (AOR 2.6) and age (per year) (AOR 1.04). One of the three alexithymia sub factors, “difficulty identifying feelings” (AOR 3.1), was associated with abdominal obesity. Gender analyses showed that abdominal obesity in men was associated with “difficulty identifying feelings” (AOR 7.7), and in women with use of antidepressants (AOR 4.3) and physical inactivity (AOR 3.6). Cardiovascular complications were associated with abdominal obesity (AOR 5.2).

Conclusions
Alexithymia, particularly the alexithymia subfactor “difficulty identifying feelings”, physical inactivity, and women, as well as cardiovascular complications were associated with abdominal obesity. As abdominal obesity is detrimental in diabetes due to its association with cardiovascular complications, our results suggest two risk factor treatment targets: increased emotional awareness and increased physical activity. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Alexithymia, Anxiety, Cardiovascular complications, Depression, Emotions, Gender, Obesity, Physical activity, Self-image, Type 1 diabetes mellitus
in
BMC Obesity
volume
4
issue
21
pages
1 - 11
publisher
BioMed Central
ISSN
2052-9538
DOI
10.1186/s40608-017-0157-1
language
English
LU publication?
yes
id
430d1c94-c15a-465d-ada3-11aefd423e25
date added to LUP
2017-06-18 13:53:23
date last changed
2017-06-19 16:13:18
@article{430d1c94-c15a-465d-ada3-11aefd423e25,
  abstract     = {Background<br>
Obesity is linked to cardiovascular diseases and increasingly common in type 1 diabetes mellitus (T1DM) since the introduction of intensified insulin therapy. Our main aim was to explore associations between obesity and depression, anxiety, alexithymia and self-image measures and to control for lifestyle variables in a sample of persons with T1DM. Secondary aims were to explore associations between abdominal and general obesity and cardiovascular complications in T1DM.<br>
<br>
Methods<br>
Cross sectional study of 284 persons with T1DM (age 18–59 years, men 56%), consecutively recruited from one secondary care hospital diabetes clinic in Sweden. Assessments were performed with self-report instruments (Hospital Anxiety and Depression Scale, Toronto Alexithymia Scale-20 items and Structural Analysis of Social Behavior). Anthropometrics and blood samples were collected for this study and supplemented with data from the patients’ medical records. Abdominal obesity was defined as waist circumference men/women (meters): ≥1.02/≥0.88, and general obesity as BMI ≥30 kg/m2 for both genders. Abdominal obesity was chosen in the analyses due to the high association with cardiovascular complications. Different explanatory logistic regression models were elaborated for the associations and calibrated and validated for goodness of fit with the data variables.<br>
<br>
Results<br>
The prevalence of abdominal obesity was 49/284 (17%), men/women: 8%/29% (P &lt; 0.001). Abdominal obesity was associated with women (AOR 4.9), physical inactivity (AOR 3.1), alexithymia (AOR 2.6) and age (per year) (AOR 1.04). One of the three alexithymia sub factors, “difficulty identifying feelings” (AOR 3.1), was associated with abdominal obesity. Gender analyses showed that abdominal obesity in men was associated with “difficulty identifying feelings” (AOR 7.7), and in women with use of antidepressants (AOR 4.3) and physical inactivity (AOR 3.6). Cardiovascular complications were associated with abdominal obesity (AOR 5.2).<br>
<br>
Conclusions<br>
Alexithymia, particularly the alexithymia subfactor “difficulty identifying feelings”, physical inactivity, and women, as well as cardiovascular complications were associated with abdominal obesity. As abdominal obesity is detrimental in diabetes due to its association with cardiovascular complications, our results suggest two risk factor treatment targets: increased emotional awareness and increased physical activity.},
  articleno    = {28588898},
  author       = {Fürst Melin, Eva and Svensson, Ralph and Thunander, Maria and Hillman, Magnus and Thulesius, Hans and Landin-Olsson, Mona},
  issn         = {2052-9538},
  keyword      = {Alexithymia,Anxiety,Cardiovascular complications,Depression,Emotions,Gender,Obesity,Physical activity,Self-image,Type 1 diabetes mellitus },
  language     = {eng},
  month        = {06},
  number       = {21},
  pages        = {1--11},
  publisher    = {BioMed Central},
  series       = {BMC Obesity},
  title        = {Gender, alexithymia and physical inactivity associated with abdominal obesity in type 1 diabetes mellitus: a cross sectional study at a secondary care hospital diabetes clinic},
  url          = {http://dx.doi.org/10.1186/s40608-017-0157-1},
  volume       = {4},
  year         = {2017},
}