title: Glycemia, insulin resistance, insulin secretion, and risk of depressive symptoms in middle age.
abstract: OBJECTIVE
  The extent to which abnormal glucose metabolism increases the risk of depression remains unclear. In this study, we investigated prospective associations of levels of fasting glucose and fasting insulin and indices of insulin resistance and secretion with subsequent new-onset depressive symptoms (DepS).
  
  
  METHODS
  In this prospective cohort study of 3,145 adults from the Whitehall II Study (23.5% women, aged 60.6 ± 5.9 years), baseline examination included fasting glucose and insulin level, the homeostasis model assessment of insulin resistance (HOMA2-%IR), and the homeostasis model assessment of β-cell insulin secretion (HOMA2-%B). DepS (Center for Epidemiologic Studies Depression Scale ≥16 or use of antidepressive drugs) were assessed at baseline and at 5-year follow-up.
  
  
  RESULTS
  Over the 5-year follow-up, DepS developed in 142 men and 84 women. Women in the lowest quintile of insulin secretion (HOMA2-%B ≤55.3%) had 2.18 (95% CI 1.25-3.78) times higher odds of developing DepS than those with higher insulin secretion. This association was not accounted for by inflammatory markers, cortisol secretion, or menopausal status and hormone replacement therapy. Fasting insulin measures were not associated with DepS in men, and fasting glucose measures were not associated with new-onset DepS in either sex.
  
  
  CONCLUSIONS
  Low insulin secretion appears to be a risk factor for DepS in middle-aged women, although further work is required to confirm this finding.
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK. tasnime.akbaraly@inserm.fr
authors.forename: Tasnime N
authors.initials: TN
authors.lastname: Akbaraly
authors.forename: Meena
authors.initials: M
authors.lastname: Kumari
authors.forename: Jenny
authors.initials: J
authors.lastname: Head
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Ancelin
authors.forename: Adam G
authors.initials: AG
authors.lastname: Tabák
authors.forename: Eric
authors.initials: E
authors.lastname: Brunner
authors.forename: Isabelle
authors.initials: I
authors.lastname: Chaudieu
authors.forename: Michael G
authors.initials: MG
authors.lastname: Marmot
authors.forename: Jane E
authors.initials: JE
authors.lastname: Ferrie
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Shipley
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003863:Depression / Q000097:blood* / Q000378:metabolism; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance / Q000502:physiology*; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D001786:Blood Glucose; D007328:Insulin