title: Associations of depression with impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in Chinese adults.
abstract: OBJECTIVE
  To examine the association between depression and impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in middle-aged and elderly Chinese people, and whether depression was associated with different treatment regimens or durations of diabetes.
  
  
  METHODS
  A cross-sectional study was performed among 229,047 adults living in the community aged ≥ 40 years from 25 centres in China. The self-reported depression rating scale Patient Health Questionnaire 9 (PHQ-9) was used to diagnose probable and sub-threshold depression. Glucose metabolism status was determined according to World Health Organization 1999 diagnostic criteria.
  
  
  RESULTS
  The numbers of participants with normal glucose regulation, impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes were 120,458, 59,512, 24,826 and 24,251, respectively. The prevalence of sub-threshold depression in the total sample of participants was 4.8% (4.8%, 4.8%, 4.4% and 5.6% from normal glucose regulation to previously diagnosed diabetes, respectively), and the prevalence of probable depression was 1.1% (1.1%, 1.0%, 0.9% and 1.8% from normal glucose regulation to previously diagnosed diabetes, respectively). Compared with participants with normal glucose regulation, those with previously diagnosed diabetes had increased odds of probable depression [odds ratio (OR) = 1.61, 95% confidence interval (CI) 1.39-1.87] and sub-threshold depression (OR = 1.14, 95% CI 1.06-1.24), after adjustment for multiple confounding factors. Newly diagnosed diabetes or impaired glucose regulation was not associated with depression. Among those with previously diagnosed diabetes, insulin treatment was associated with greater odds of depression compared with no treatment or oral anti-diabetic medicine.
  
  
  CONCLUSIONS
  Previously diagnosed diabetes, but not newly diagnosed diabetes or impaired glucose regulation, was associated with a higher prevalence of depression. Patients receiving insulin were more likely to have depression than those not receiving treatment or being treated with oral anti-diabetic medicine.
authors.affiliation: Laboratory of Endocrine and Metabolic Diseases, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, and Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: J C
authors.initials: JC
authors.lastname: Sun
authors.affiliation: Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: M
authors.initials: M
authors.lastname: Xu
authors.affiliation: Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: J L
authors.initials: JL
authors.lastname: Lu
authors.affiliation: Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Y F
authors.initials: YF
authors.lastname: Bi
authors.affiliation: People's Liberation Army General Hospital, Beijing, China.
authors.forename: Y M
authors.initials: YM
authors.lastname: Mu
authors.affiliation: Shandong Provincial Hospital, Jinan, China.
authors.forename: J J
authors.initials: JJ
authors.lastname: Zhao
authors.affiliation: Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China.
authors.forename: C
authors.initials: C
authors.lastname: Liu
authors.affiliation: Wuhan Xiehe Hospital, Huazhong University of Science and Technology School of Medicine, Wuhan, China.
authors.forename: L L
authors.initials: LL
authors.lastname: Chen
authors.affiliation: Affiliated Hospital of Guiyang Medical College, Guiyang, China.
authors.forename: L X
authors.initials: LX
authors.lastname: Shi
authors.affiliation: The Second Affilliated Hospital of Haerbin Medical University, Haerbin, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Li
authors.affiliation: The First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
authors.forename: T
authors.initials: T
authors.lastname: Yang
authors.affiliation: Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: L
authors.initials: L
authors.lastname: Yan
authors.affiliation: The Affiliated Hospital of Luzhou Medical College, Luzhou, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Wan
authors.affiliation: Xinjiang Kelamayi Peoples Hospital, Kelamayi, China.
authors.forename: S L
authors.initials: SL
authors.lastname: Wu
authors.affiliation: The First Hospital of Jilin University, Changchun, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.affiliation: The First Hospital of Jilin University, Changchun, China.
authors.forename: G X
authors.initials: GX
authors.lastname: Wang
authors.affiliation: The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Luo
authors.affiliation: The First Hospital of Lanzhou University, Lanzhou, China.
authors.forename: X L
authors.initials: XL
authors.lastname: Tang
authors.affiliation: Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: G
authors.initials: G
authors.lastname: Chen
authors.affiliation: Jiangxi Peoples Hospital, Nanchang, China.
authors.forename: Y N
authors.initials: YN
authors.lastname: Huo
authors.affiliation: Dalian Municipal Central Hospital, Dalian, China.
authors.forename: Z N
authors.initials: ZN
authors.lastname: Gao
authors.affiliation: Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Su
authors.affiliation: Zhejiang Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Ye
authors.affiliation: The First Affiliated Hospital of Anhui Medical University, Hefei, China.
authors.forename: Y M
authors.initials: YM
authors.lastname: Wang
authors.affiliation: The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: G J
authors.initials: GJ
authors.lastname: Qin
authors.affiliation: The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: H C
authors.initials: HC
authors.lastname: Deng
authors.affiliation: Wuhan Tongji Hospital, Huazhong University of Science and Technology School of Medicine, Wuhan, China.
authors.forename: X F
authors.initials: XF
authors.lastname: Yu
authors.affiliation: The First Affiliated Hospital of Wenzhou Medical University, The First Provincial Wenzhou Hospital of Zhejiang, Wenzhou, China.
authors.forename: F X
authors.initials: FX
authors.lastname: Shen
authors.affiliation: Qilu Hospital, University of Shandong School of Medicine, Jinan, China.
authors.forename: L
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: L B
authors.initials: LB
authors.lastname: Zhao
authors.affiliation: Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: T G
authors.initials: TG
authors.lastname: Wang
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Lai
authors.affiliation: Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, >TX, USA.
authors.forename: D H
authors.initials: DH
authors.lastname: Li
authors.affiliation: Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: W Q
authors.initials: WQ
authors.lastname: Wang
authors.affiliation: Laboratory of Endocrine and Metabolic Diseases, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, and Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: G
authors.initials: G
authors.lastname: Ning
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D018149:Glucose Intolerance / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015994:Incidence; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012306:Risk
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin