Fei Zhao1, An Pan2, Xue Yang1, Ruiwei Meng2, Yi Ye2, Yi Wang2, Yue Xie1, Xiong-Fei Pan3, Chun-Xia Yang4. 1. West China School of Public Health and West China Fourth Hospital, Sichuan University, China. 2. Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. 3. Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; The George Institute for Global Health, University of New South Wales, Sydney, Australia. Electronic address: pxiongfei@gmail.com. 4. West China School of Public Health and West China Fourth Hospital, Sichuan University, China. Electronic address: chunxia815@aliyun.com.
Abstract
OBJECTIVE: To prospectively examine the bidirectional relationship between depressive symptoms and type 2 diabetes mellitus (T2DM) among middle-aged and elderly Chinese. METHODS: Participants were enrolled in 2011-2012 (Wave 1) and followed up in 2013-2014 (Wave 2) and 2015-2016 (Wave 3) in the China Health and Retirement Longitudinal Study. Depressive symptoms were evaluated by the Chinese language version of 10-item Center for Epidemiological Studies Depression Scale (CESD-10) at three waves. T2DM was assessed by biochemical biomarkers at Wave 1 and reported physician-diagnosis at Wave 2 and 3. Cox proportional hazards regression was applied to calculate hazard ratio (HR) and 95% confidence intervals (CIs) for the bidirectional association. RESULTS: Participants with baseline depressive symptoms were 1.33 times as likely to develop T2DM (HR, 1.33; 95% CI: 1.06, 1.66), compared to their counterparts after adjusting for demographic characteristics and T2DM risk factors. The risk of T2DM increased linearly with higher severity of depression as determined by a higher CESD-10 score (P for trend ≪ 0.001). In addition, baseline T2DM was associated with increased risk of incident depressive symptoms (1.15; 1.00, 1.31) and persistent depressive symptoms (1.35; 1.03, 1.77). CONCLUSION: There is a positive bidirectional association between depressive symptoms and T2DM in middle-aged and elderly Chinese.
OBJECTIVE: To prospectively examine the bidirectional relationship between depressive symptoms and type 2 diabetes mellitus (T2DM) among middle-aged and elderly Chinese. METHODS:Participants were enrolled in 2011-2012 (Wave 1) and followed up in 2013-2014 (Wave 2) and 2015-2016 (Wave 3) in the China Health and Retirement Longitudinal Study. Depressive symptoms were evaluated by the Chinese language version of 10-item Center for Epidemiological Studies Depression Scale (CESD-10) at three waves. T2DM was assessed by biochemical biomarkers at Wave 1 and reported physician-diagnosis at Wave 2 and 3. Cox proportional hazards regression was applied to calculate hazard ratio (HR) and 95% confidence intervals (CIs) for the bidirectional association. RESULTS:Participants with baseline depressive symptoms were 1.33 times as likely to develop T2DM (HR, 1.33; 95% CI: 1.06, 1.66), compared to their counterparts after adjusting for demographic characteristics and T2DM risk factors. The risk of T2DM increased linearly with higher severity of depression as determined by a higher CESD-10 score (P for trend ≪ 0.001). In addition, baseline T2DM was associated with increased risk of incident depressive symptoms (1.15; 1.00, 1.31) and persistent depressive symptoms (1.35; 1.03, 1.77). CONCLUSION: There is a positive bidirectional association between depressive symptoms and T2DM in middle-aged and elderly Chinese.
Authors: Beata Dziedzic; Zofia Sienkiewicz; Anna Leńczuk-Gruba; Ewa Kobos; Wiesław Fidecki; Mariusz Wysokiski Journal: Int J Environ Res Public Health Date: 2020-05-19 Impact factor: 3.390