Depressive symptomatology and coronary heart disease in Type I diabetes mellitus: a study of possible mechanisms.
Recent evidence has suggested that depressive symptomatology is a risk factor for the development of coronary heart disease (CHD) in patients with diabetes mellitus, although little is understood about mechanisms that may explain this association. The Pittsburgh Epidemiology of Diabetes Complications (EDC) Study is a natural history study of 658 men and women with childhood-onset Type I diabetes. Participants from the EDC Study who reported the fewest depressive symptoms on the Beck Depression Inventory at baseline examination were least likely to develop CHD over 10 years. Differences in insulin resistance, autonomic dysregulation, inflammation, smoking, and complications associated with Type I diabetes appear to help explain this relationship. Future research should clarify causal pathways between depressive symptomatology, behavioral and physiological processes, and CHD.
Kinder
Leslie S
LS
Stanford Center for Research in Disease Prevention, School of Medicine, Stanford University, USA. lskinder@stanfordalumni.org
Kamarck
Thomas W
TW
Baum
Andrew
A
Orchard
Trevor J
TJ
D000328:Adult; D000787:Angina Pectoris / Q000453:epidemiology / Q000523:psychology; D003327:Coronary Disease / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D015994:Incidence; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology