Bidirectional association between depressive symptoms and type 2 diabetes mellitus: The China Health and Retirement Longitudinal Study

Fei Zhao; An Pan; Xue Yang; Ruiwei Meng; Yi Ye; Yi Wang; Yue Xie; Xiong-Fei Pan; Chun-Xia Yang

doi:10.1016/j.jdiacomp.2019.05.018

Bidirectional association between depressive symptoms and type 2 diabetes mellitus: The China Health and Retirement Longitudinal Study

J Diabetes Complications. 2019 Oct;33(10):107387. doi: 10.1016/j.jdiacomp.2019.05.018. Epub 2019 May 29.

Authors

Fei Zhao¹, An Pan², Xue Yang¹, Ruiwei Meng², Yi Ye², Yi Wang², Yue Xie¹, Xiong-Fei Pan³, Chun-Xia Yang⁴

Affiliations

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.

PMID: 31331733
DOI: 10.1016/j.jdiacomp.2019.05.018

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.

Keywords: Association; Chinese; Depression symptoms; Risk; Type 2 diabetes mellitus.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Body Mass Index
China / epidemiology
Depression / epidemiology*
Diabetes Mellitus, Type 2 / epidemiology*
Diabetes Mellitus, Type 2 / psychology*
Educational Status
Female
Humans
Longitudinal Studies
Male
Middle Aged
Prospective Studies
Retirement
Risk Factors
Rural Population