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Mol Psychiatry. 2016 Dec;21(12):1726-1732. doi: 10.1038/mp.2016.7. Epub 2016 Feb 23.

Depression and risk of type 2 diabetes: the potential role of metabolic factors.

Author information

1
Department of Psychiatry, McGill University, Montreal, QC, Canada.
2
Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
3
Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada.
4
Montreal Diabetes Research Centre, Montreal, QC, Canada.
5
Department of Life Sciences, Brunel University London, Uxbridge, UK.
6
Centre de Recherche Fernand Seguin, Hôpital Louis-H. Lafontaine, University of Montreal, Montreal, QC, Canada.
7
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.
8
Institut de Recherches Cliniques de Montréal, Montréal, QC, Canada.
9
Department of Paediatrics, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.
10
Departments of Psychiatry and Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.

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.

PMID:
26903269
DOI:
10.1038/mp.2016.7
[Indexed for MEDLINE]

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