Depression and Type 2 Diabetes Mellitus: The Multiethnic Study of Atherosclerosis

Objective: To assess the cross-sectional association between depression and glucose tolerance status. Methods: We conducted a study of 6754 White, Black, Hispanic, and Chinese men and women aged 45 to 84 years in the Multiethnic Study of Atherosclerosis (MESA). Depression was defined as Center for Epidemiologic Studies Depression scale score of ≥16 and/or antidepressant use. Glucose tolerance status was defined as normal, impaired fasting glucose (IFG) or Type 2 diabetes mellitus (untreated and treated). Results: In the minimally adjusted model, although depression was not associated with a greater odds of IFG (odds ratio (OR) = 1.01; 95% confidence interval (CI): 0.87–1.18) or untreated diabetes (OR = 1.03; 95% CI: 0.74–1.45), it was associated with a greater odds of treated diabetes (OR = 1.57; 95% CI: 1.27–1.96). This persisted following adjustment for body mass index (OR = 1.52; 95% CI: 1.22–1.90), metabolic (OR = 1.54; 95% CI: 1.23–1.93), and inflammatory (OR=1.53; 95% CI: 1.21–1.92) factors, daily caloric intake and smoking (OR = 1.48; 95% CI: 1.16–1.88), and socioeconomic markers (OR = 1.47; 95% CI: 1.17–1.85). Among individuals with treated diabetes, median depression scores were higher in those with microalbuminuria compared with those without microalbuminuria (median = 7; interquartile range: 3–13 versus median = 6; interquartile range: 2–11; p = .046). Depression scores were not associated with homeostatic model assessment of insulin resistance among individuals without diabetes. Conclusions: In MESA, depression was significantly associated with treated diabetes. Further studies are needed to determine the temporality of this association. BMI = body mass index; CES-D = Center for Epidemiologic Studies Depression (CES-D) scale; CI = confidence interval; CRP = C-reactive protein; HOMA-IR = homeostatic model assessment of insulin resistance; IFG = impaired fasting glucose; IL-6 = interleukin-6; MESA = Multiethnic Study of Atherosclerosis; OR = odds ratio.

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