Depression and type 2 diabetes mellitus: the multiethnic study of atherosclerosis.
OBJECTIVE
To assess the cross-sectional association between depression and glucose tolerance status.


METHODS
We conducted a study of 6754 White, Black, Hispanic, and Chinese men and women aged 45 to 84 years in the Multiethnic Study of Atherosclerosis (MESA). Depression was defined as Center for Epidemiologic Studies Depression scale score of > or =16 and/or antidepressant use. Glucose tolerance status was defined as normal, impaired fasting glucose (IFG) or Type 2 diabetes mellitus (untreated and treated).


RESULTS
In the minimally adjusted model, although depression was not associated with a greater odds of IFG (odds ratio (OR) = 1.01; 95% confidence interval (CI): 0.87-1.18) or untreated diabetes (OR = 1.03; 95% CI: 0.74-1.45), it was associated with a greater odds of treated diabetes (OR = 1.57; 95% CI: 1.27-1.96). This persisted following adjustment for body mass index (OR = 1.52; 95% CI: 1.22-1.90), metabolic (OR = 1.54; 95% CI: 1.23-1.93), and inflammatory (OR=1.53; 95% CI: 1.21-1.92) factors, daily caloric intake and smoking (OR = 1.48; 95% CI: 1.16-1.88), and socioeconomic markers (OR = 1.47; 95% CI: 1.17-1.85). Among individuals with treated diabetes, median depression scores were higher in those with microalbuminuria compared with those without microalbuminuria (median = 7; interquartile range: 3-13 versus median = 6; interquartile range: 2-11; p = .046). Depression scores were not associated with homeostatic model assessment of insulin resistance among individuals without diabetes.


CONCLUSIONS
In MESA, depression was significantly associated with treated diabetes. Further studies are needed to determine the temporality of this association.
Golden
Sherita Hill
SH
Department of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA. sahill@jhmi.edu
Lee
Hochang Benjamin
HB
Schreiner
Pamela J
PJ
Diez Roux
Ana
A
Fitzpatrick
Annette L
AL
Szklo
Moyses
M
Lyketsos
Constantine
C
D000284:Administration, Oral; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000208:ethnology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000188:drug therapy / Q000208:ethnology*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000208:ethnology / Q000209:etiology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000627:therapeutic use; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology
D007004:Hypoglycemic Agents; D007328:Insulin