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Diabetes Care. 2014 Aug;37(8):2211-7. doi: 10.2337/dc13-2642. Epub 2014 May 1.

Depressive symptoms, antidepressant use, and the incidence of diabetes in the Black Women's Health Study.

Author information

  • 1Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA varshav@bu.edu.
  • 2Slone Epidemiology Center, Boston University, Boston, MADepartment of Epidemiology, Boston University School of Public Health, Boston, MA.
  • 3Slone Epidemiology Center, Boston University, Boston, MADepartment of Biostatistics, Boston University School of Public Health, Boston, MA.
  • 4Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA.

Abstract

OBJECTIVE:

To assess the relationship of depressive symptoms and use of antidepressants with incident type 2 diabetes in prospective data from a large cohort of U.S. African American women.

RESEARCH DESIGN AND METHODS:

The Black Women's Health Study (BWHS) is an ongoing prospective cohort study. We followed 35,898 women from 1999 through 2011 who were without a diagnosis of diabetes and who had completed the Center for Epidemiologic Studies Depression Scale (CES-D) in 1999. CES-D scores were categorized as <16, 16-22, 23-32, and ≥33, which reflected increasingly more depressive symptoms. We estimated incidence rate ratios (IRRs) and 95% CIs for incident diabetes using Cox proportional hazards models. The basic multivariable model included age, time period, family history of diabetes, and education. In further models, we controlled for lifestyle factors and BMI. We also assessed the association of antidepressant use with incident diabetes.

RESULTS:

Over 12 years of follow-up, there were 3,372 incident diabetes cases. Relative to CES-D score <16, IRRs (95% CI) of diabetes for CES-D scores 16-22, 23-32, and ≥33 were 1.23 (1.12-1.35), 1.26 (1.12-1.41), and 1.45 (1.24-1.69), respectively, in the basic multivariate model. Multiple adjustment for lifestyle factors and BMI attenuated the IRRs to 1.11 (1.01-1.22), 1.08 (0.96-1.22), and 1.22 (1.04-1.43). The adjusted IRR for antidepressant use was 1.26 (1.11-1.43). Results were similar among obese women.

CONCLUSIONS:

Both depressive symptoms and antidepressant use are associated with incident diabetes among African American women. These associations are mediated in part, but not entirely, through lifestyle factors and BMI.

© 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

PMID:
24784829
[PubMed - in process]
PMCID:
PMC4113175
[Available on 2015/8/1]
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