title: Depression and risk of type 2 diabetes: the potential role of metabolic factors.
abstract: The aim of the present study was to evaluate the interaction between depressive symptoms and metabolic dysregulations as risk factors for type 2 diabetes. The sample comprised of 2525 adults who participated in a baseline and a follow-up assessment over a 4.5-year period in the Emotional Health and Wellbeing Study (EMHS) in Quebec, Canada. A two-way stratified sampling design was used, on the basis of the presence of depressive symptoms and metabolic dysregulation (obesity, elevated blood sugar, high blood pressure, high levels of triglycerides and decreased high-density lipoprotein). A total of 87 (3.5%) individuals developed diabetes. Participants with both depressive symptoms and metabolic dysregulation had the highest risk of diabetes (adjusted odds ratio=6.61, 95% confidence interval (CI): 4.86-9.01), compared with those without depressive symptoms and metabolic dysregulation (reference group). The risk of diabetes in individuals with depressive symptoms and without metabolic dysregulation did not differ from the reference group (adjusted odds ratio=1.28, 95% CI: 0.81-2.03), whereas the adjusted odds ratio for those with metabolic dysregulation and without depressive symptoms was 4.40 (95% CI: 3.42-5.67). The Synergy Index (SI=1.52; 95% CI: 1.07-2.17) suggested that the combined effect of depressive symptoms and metabolic dysregulation was greater than the sum of individual effects. An interaction between depression and metabolic dysregulation was also suggested by a structural equation model. Our study highlights the interaction between depressive symptoms and metabolic dysregulation as a risk factor for type 2 diabetes. Early identification, monitoring and a comprehensive management approach of both conditions might be an important diabetes prevention strategy.
authors.affiliation: Department of Psychiatry, McGill University, Montreal, QC, Canada.|Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.|Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada.|Montreal Diabetes Research Centre, Montreal, QC, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Schmitz
authors.affiliation: Department of Psychiatry, McGill University, Montreal, QC, Canada.|Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
authors.forename: S S
authors.initials: SS
authors.lastname: Deschênes
authors.affiliation: Department of Psychiatry, McGill University, Montreal, QC, Canada.|Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
authors.forename: R J
authors.initials: RJ
authors.lastname: Burns
authors.affiliation: Department of Life Sciences, Brunel University London, Uxbridge, UK.
authors.forename: K J
authors.initials: KJ
authors.lastname: Smith
authors.affiliation: Centre de Recherche Fernand Seguin, Hôpital Louis-H. Lafontaine, University of Montreal, Montreal, QC, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Lesage
authors.affiliation: Montreal Diabetes Research Centre, Montreal, QC, Canada.|Department of Nutrition, Faculty of Medicine, University of Montreal, and the Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada.
authors.forename: I
authors.initials: I
authors.lastname: Strychar
authors.affiliation: Montreal Diabetes Research Centre, Montreal, QC, Canada.|Department of Nutrition, Faculty of Medicine, University of Montreal, and the Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada.|Institut de Recherches Cliniques de Montréal, Montréal, QC, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Rabasa-Lhoret
authors.affiliation: Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.|Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Freitas
authors.affiliation: Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.|Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Graham
authors.affiliation: Department of Paediatrics, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Awadalla
authors.affiliation: Departments of Psychiatry and Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: J L
authors.initials: JL
authors.lastname: Wang
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002170:Canada; D003863:Depression / Q000150:complications / Q000378:metabolism*; D003866:Depressive Disorder / Q000150:complications / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000378:metabolism; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008660:Metabolism / Q000502:physiology; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D016017:Odds Ratio; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D014280:Triglycerides