High Bodyweight Variability Increases Depression Risk in Patients With Type 2 Diabetes Mellitus: A Nationwide Cohort Study in Korea

Ji Hyun An; Kyung-do Han; Jin-Hyung Jung; Juhwan Yoo; Maurizio Fava; David Mischoulon; Su-Min Jung; Dong Wook Shin; Kyu Yeon Hur; Hong Jin Jeon

doi:10.3389/fpsyt.2021.765129

High Bodyweight Variability Increases Depression Risk in Patients With Type 2 Diabetes Mellitus: A Nationwide Cohort Study in Korea

Front Psychiatry. 2021 Dec 10:12:765129. doi: 10.3389/fpsyt.2021.765129. eCollection 2021.

Authors

Ji Hyun An¹, Kyung-do Han², Jin-Hyung Jung³, Juhwan Yoo⁴, Maurizio Fava⁵, David Mischoulon⁵, Su-Min Jung⁶, Dong Wook Shin⁶, Kyu Yeon Hur⁷, Hong Jin Jeon^{1

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Affiliations

¹ Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
² Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea.
³ Department of Biomedicine and Health Science, The Catholic University of Korea, Seoul, South Korea.
⁴ Department of Biostatics, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
⁵ Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
⁶ Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Seoul, South Korea.
⁷ Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
⁸ Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
⁹ Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
¹⁰ Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.

Abstract

Objectives: Although obesity is associated with increased risk for depression in patients with type 2 diabetes mellitus (DM), the relationship between body weight variability (BWV) and depression remains poorly studied. This study was to investigate the incidence of depression in patients with type 2 DM according to their BWV. Methods: Intraindividual variation in body weight were measured in the nationwide, population-based retrospective cohort of 540,293 patients with type 2 DM from the Korean national health insurance system between 2009 and 2010. The diagnoses of new-onset depression occurring until the end of 2017 were ascertained. Risk of new-onset depression was examined using multivariate-adjusted Cox proportional hazards regression analysis by BWV quartile. Results: 93,149 (17.2%) patients developed new-onset depression for the follow up. BWV was significantly associated with an increased risk of depression after adjusting for confounding factors. The highest BWV quartile group had a hazard ratio (HR) of 1.17 (95% CI 1.15-1.19) compared to the lowest BWV quartile group as a reference. Obese patients in the highest BWV quartile group showed 12% increased risk of depression (HR 1.12, 95% CI 1.09-1.15) while non-obese patients in the highest BWV quartile group showed 20% increased risk of depression (HR: 1.20, 95% CI: 1.17-1.23) compared to their respective lowest BWV quartile groups. Conclusion: A higher BWV was significantly associated with an increased risk of depression in patients with type 2 DM. Thus, BWV may serve as an indicator for early detection of depression in type 2 DM patients.

Keywords: body weight; body weight variability; depression; diabetes mellitus; nationwide.