title: Alexithymia as a risk factor for type 2 diabetes mellitus in the metabolic syndrome: a cross-sectional study.
abstract: Alexithymia is a clinical trait consisting of diminished introspective and interoceptive capacities that has been shown to implicate elevated autonomic outflow and to bias for hypertension. To estimate relative risk associated with alexithymia in the metabolic syndrome (MetS), we conducted a cross-sectional analysis of patients with manifest type 2 diabetes mellitus (T2DM) or familial diabetes risk (N=101; 67 females; age 45.6±13.96) in a nationwide sampled treatment cohort for MetS in the Ukrainian governmental health care system. Laboratory data of single components of the MetS according to International Diabetes Federation Consensus were dependent measures in multivariable regression models with self-reported alexithymia severity (TAS-20) and socio-demographic data. TAS-20 as the sole surviving psychometric predictor for T2DM in the simplest regression equation provided the best model fit: OR 1.073, Z=19.04, (95%CIs 1.065-1.081). For microalbuminuria, the best fitting model was OR 1.030, Z=3.49 (95%CIs 1.013-1.048). TAS-20 predicted also triglyceride level at Wald-χ(2)=1299.27, Z=36.05 (95%CIs 0.052-0.058) and blood pressure maximum at Wald-χ(2)=2309.05, Z=48.05 (95%CIs 2.402-2.606). Our results show that alexithymia severity contributes to MetS by covarying with several of its single components, and that it may be a substantial concurrent indicator of T2DM and cardiovascular risks in MetS.
authors.affiliation: Department of Psychosomatic Medicine, Charité University Medicine Berlin, Germany.
authors.forename: Alexandra V
authors.initials: AV
authors.lastname: Lemche
authors.affiliation: Section of Neuroses and Somatoform Disorders, Bogolomets National Medical University, Kiev, Ukraine.
authors.forename: Oleg S
authors.initials: OS
authors.lastname: Chaban
authors.affiliation: Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King's College London, UK. Electronic address: erwin.lemche@kcl.ac.uk.
authors.forename: Erwin
authors.initials: E
authors.lastname: Lemche
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000150:complications* / Q000523:psychology; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology* / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000523:psychology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000523:psychology; D008875:Middle Aged; D012307:Risk Factors
keywords: Cardiovascular disease; Cross-sectional studies; Metabolic syndrome; National cohort; Relative risk; Toronto Alexithymia Scale; Type 2 diabetes mellitus