Depressive Symptoms, Insulin Resistance, and Risk of Diabetes in Women at Midlife

作者：Susan A. Everson‐Rose, Peter Meyer, Lynda H. Powell, Dilip Kumar Pandey, Javier I. Torréns, Howard M. Kravitz, Joyce T. Bromberger, Karen A. Matthews · 发表于：Diabetes Care · 年份：2004 · DOI：10.2337/diacare.27.12.2856 · 被引用次数：238 · 研究领域：Diabetes Management and Education、Cardiac Health and Mental Health、Diabetes, Cardiovascular Risks, and Lipoproteins

OBJECTIVE: To examine depression and 3-year change in insulin resistance and risk of diabetes and whether associations vary by race. RESEARCH DESIGN AND METHODS: We analyzed data from 2,662 Caucasian, African-American, Hispanic, Japanese-American, and Chinese-American women without a history of diabetes from the Study of Women's Health Across the Nation. We estimated regression coefficients and odds ratios to determine whether depression (Center for Epidemiological Studies Depression Scale score > or =16) predicted increases in homeostasis model assessment of insulin resistance (HOMA-IR) and greater risk of incident diabetes, respectively, over 3 years. RESULTS: Mean baseline HOMA-IR was 1.31 (SD 0.86) and increased 0.05 units per year for all women (P <0.0001). A total of 97 incident cases of diabetes occurred. Depression was associated with absolute levels of HOMA-IR (P <0.04) but was unrelated to changes in HOMA-IR; associations did not vary by race. The association between depression and HOMA-IR was eliminated after adjustment for central adiposity (P=0.85). Depression predicted a 1.66-fold greater risk of diabetes (P <0.03), which became nonsignificant after adjustment for central adiposity (P=0.12). We also observed a depression-by-race interaction (P <0.05) in analyses limited to Caucasians and African Americans, the only groups with enough diabetes cases to reliably test this interaction. Race-stratified models showed that depression predicted 2.56-fold greater risk o...