title: Depressive Symptoms Clusters and Insulin Resistance: Race/Ethnicity as a Moderator in 2005-2010 NHANES Data.
abstract: BACKGROUND
  Although depression has been linked to insulin resistance, few studies have examined depressive symptom clusters.
  
  
  OBJECTIVE
  We examined whether certain depressive symptom clusters are more strongly associated with insulin resistance in a nationally representative sample, and we evaluated potential moderators and mediators.
  
  
  METHODS
  Respondents were 4487 adults from NHANES 2005-2010. Depressive symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9), and insulin resistance was indexed by the homeostatic model assessment (HOMA) score.
  
  
  RESULTS
  Positive relationships between PHQ-9 total, somatic, and cognitive-affective scores and HOMA score were detected (ps <0.001). In a simultaneous model, the somatic (p = 0.017), but not the cognitive-affective (p = 0.071), score remained associated with HOMA score. We observed evidence of (a) moderation by race/ethnicity (relationships stronger in non-Hispanic Whites) and (b) mediation by body mass and inflammation.
  
  
  CONCLUSIONS
  The depressive symptoms-insulin resistance link may be strongest among non-Hispanic Whites and may be driven slightly more by the somatic symptoms.
authors: Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 100E, Indianapolis, IN, 46202, USA.
authors: Elizabeth A
authors: EA
authors: Vrany
authors: Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 100E, Indianapolis, IN, 46202, USA.
authors: Jessica M
authors: JM
authors: Berntson
authors: Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 100E, Indianapolis, IN, 46202, USA.
authors: Tasneem
authors: T
authors: Khambaty
authors: Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 100E, Indianapolis, IN, 46202, USA. jstew@iupui.edu.
authors: Jesse C
authors: JC
authors: Stewart
mesh_terms: D000328:Adult; D003863:Depression / Q000453:epidemiology* / Q000208:ethnology*; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D044465:White People / Q000706:statistics & numerical data
keywords: Depression; Depressive symptom clusters; Diabetes; Insulin resistance; NHANES; Race/ethnicity