title: Depressive symptoms and metabolic control in African-Americans with type 2 diabetes.
abstract: OBJECTIVE
  To determine the prevalence of depressive symptoms and the relationship between depressive symptoms and metabolic control.
  
  
  METHODS
  We conducted a cross-sectional study of 183 African-American adults aged 35-75 years with type 2 diabetes who were recruited from two primary care clinics in East Baltimore, Maryland. Depressive symptoms, using the Center for Epidemiological Studies Depression Scale (CES-D), HbA1c, fasting lipid profile, BMI, and blood pressure, were measured on each participant. Diabetes-related health behaviors were assessed by questionnaire.
  
  
  RESULTS
  The prevalence of depressive symptoms (CES-D > or =22) was 30%. After adjustment for age, sex, income, social support, and duration of diabetes in linear regression models, there were significant graded relationships between greater depressive symptoms and higher serum levels of cholesterol and triglycerides (P<0.050). Similar, albeit less statistically significant, relationships were found with higher levels of HbA1c (P = 0.104), diastolic blood pressure (P = 0.073), and LDL cholesterol (P = 0.176). Unexpectedly, individuals who reported more depressive symptoms also had higher serum levels of HDL cholesterol (P = 0.047). The associations were not explained by differences in diabetes-related health behaviors.
  
  
  CONCLUSIONS
  Depressive symptoms are marginally associated with suboptimal levels of HbA1c, diastolic blood pressure, and LDL cholesterol, and significantly associated with suboptimal levels of total cholesterol and triglyceride levels. Prospective studies are required to determine whether improved identification and management of depressive symptoms would enhance metabolic control in this population.
authors.affiliation: Department of Epidemiology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
authors.forename: T L
authors.initials: TL
authors.lastname: Gary
authors.forename: R M
authors.initials: RM
authors.lastname: Crum
authors.forename: L
authors.initials: L
authors.lastname: Cooper-Patrick
authors.forename: D
authors.initials: D
authors.lastname: Ford
authors.forename: F L
authors.initials: FL
authors.lastname: Brancati
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D015142:Baltimore / Q000453:epidemiology; D044383:Black People; D015190:Blood Glucose Self-Monitoring; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012907:Smoking; D012959:Socioeconomic Factors
chemical_list: D008055:Lipids