Association between poor psychosocial conditions and diabetic nephropathy in Japanese type 2 diabetes patients: A cross-sectional study.
OBJECTIVE
It is suggested that a positive psychosocial condition has a good effect on health and glycemic control. However, there has been no research to evaluate the association between positive psychosocial factors and diabetic nephropathy (DN). The aim of the present study was to evaluate the association between psychosocial factors and DN in patients with type 2 diabetes.


METHODS
To assess psychosocial condition, six indicators (happiness score, Life Orientation Test-revised score as an indicator of dispositional optimism, laughter frequency, self-awareness of stress, social network and social support) were assessed by a self-administered questionnaire, and associations between these psychosocial indicators and the presence of DN were examined.


RESULTS
A cross-sectional analysis of patients with (n = 123) and without DN (n = 220) showed that a high score for happiness (odds ratio [OR] per 1 standard deviation 0.71, 95% confidence interval [CI] 0.57-0.89, P = 0.003), high Life Orientation Test-revised score (OR per 1 standard deviation 0.77, 95% CI: 0.61-0.98, P = 0.035), less self-awareness of stress (OR 0.56, 95% CI: 0.34-0.90, P = 0.017), high connection of social network (OR 0.55, 95% CI: 0.35-0.87, P = 0.010) and high social support (OR 0.61, 95% CI: 0.38-0.96, P = 0.035) were associated with a reduced risk of prevalence of DN. Similar results were observed even after adjustment for the following conventional risk factors of DN: age, sex, duration of diabetes, hemoglobin A1c, hypertension, dyslipidemia and current smoking.


CONCLUSIONS
The present study showed that five out of six prespecified indicators of psychosocial condition were significantly associated with the presence of DN in Japanese patients with type 2 diabetes.
Department of Metabolic Medicine, Suita, Osaka, Japan.
Hiroyo
H
Ninomiya
Department of Metabolic Medicine, Suita, Osaka, Japan.|Department of Metabolism and Atherosclerosis, Suita, Osaka, Japan.
Naoto
http://orcid.org/0000-0001-9020-8320
N
Katakami
Department of Metabolic Medicine, Suita, Osaka, Japan.
Taka-Aki
TA
Matsuoka
Department of Metabolic Medicine, Suita, Osaka, Japan.|Department of Diabetes Care Medicine, Suita, Osaka, Japan.
Mitsuyoshi
M
Takahara
Department of Metabolic Medicine, Suita, Osaka, Japan.
Hitoshi
http://orcid.org/0000-0002-7845-9693
H
Nishizawa
Department of Metabolic Medicine, Suita, Osaka, Japan.
Norikazu
N
Maeda
Department of Metabolic Medicine, Suita, Osaka, Japan.
Michio
M
Otsuki
Department of Metabolic Medicine, Suita, Osaka, Japan.
Akihisa
A
Imagawa
Department of Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Hiroyasu
H
Iso
Department of Epidemiology, Fukushima Medical University, Fukushima, Japan.
Tetsuya
T
Ohira
Department of Metabolic Medicine, Suita, Osaka, Japan.
Iichiro
I
Shimomura
D000368:Aged; D044466:Asian People; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000523:psychology*; D003928:Diabetic Nephropathies / Q000150:complications / Q000523:psychology*; D005260:Female; D006240:Happiness; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012944:Social Support; D011795:Surveys and Questionnaires
Diabetic nephropathy; Psychosocial factors; Social support