August 2023
Loneliness linked with increased CVD risk in patients with diabetes
By Melanie Hinze
Loneliness is a potent risk factor for cardiovascular disease (CVD) in patients with diabetes, new research reveals.
Published in the European Heart Journal, the study included 18,509 participants from the UK Biobank database diagnosed with diabetes but without CVD at baseline. Researchers assessed the associations of loneliness and social isolation with CVD risk using questionnaires and evaluated the interactions of loneliness or isolation with the degree of risk-factor control in relation to CVD risk.
In total, a loneliness scale of 0, 1 and 2 was present in 61.1%, 29.6% and 9.3% of participants, respectively, where higher scores indicated higher loneliness levels. Social isolation scales of 0, 1 or 2 or above were found in 44.9%, 41.9% and 13.2% of participants, respectively, with higher scores indicating greater social isolation. Over a mean follow up of 10.7 years, 3247 CVD incidents were recorded, including coronary heart disease (n=2771) and stroke (n=701).
The study authors found that higher loneliness scales, but not social isolation scales, were significantly associated with a higher risk of CVD in patients with diabetes, with loneliness ranking higher in relative strength for predicting CVD than traditional lifestyle risk factors. They also found that the risk of CVD associated with a combination of loneliness and a low degree of traditional risk-factor control was greater than the addition of the risk associated with each of these factors. Specifically, the presence of both loneliness and low riskfactor control resulted in an additional 8.5% of cases of CVD.
The authors said these findings indicated that the public health consequences of a low degree of risk factor control were likely to be greater in patients with diabetes with loneliness.
Professor Elif Ekinci, Director of the Australian Centre for Accelerating Diabetes Innovations (ACADI) at the University of Melbourne, said this paper revealed an important novel cardiovascular risk factor that should be considered when caring for patients with diabetes.
‘The authors showed for the first time an independent association between loneliness, but not social isolation, and higher risk of cardiovascular disease,’ she told Medicine Today.
‘In fact, the higher risk of cardiovascular disease associated with higher degree of loneliness as a risk factor was more predictive than some of the traditional risk factors,’ she added. ‘It ranked after LDL cholesterol, BMI, albumin to creatinine ratio and estimated glomerular filtration rate.’
Professor Ekinci said that additional studies were needed to validate these findings in this highrisk population.
Eur Heart J 2023; 00: 1–9. https://doi.org/10.1093/eurheartj/ehad306.
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