Joint Exposure to Positive Affect, Life Satisfaction, Depressive Symptoms, and Neuroticism and Incident Type 2 Diabetes

Abstract

Context: Whether the psychological wellbeing status could be a risk factor for type 2 diabetes is unclear.

Objective: We aimed to measure the association between combined psychological wellbeing factors and type 2 diabetes and investigate whether this association was modified by genetic predisposition.

Methods: Prospective cohort study from the UK Biobank. In total, 127 496 participants who completed a psychological wellbeing questionnaire and did not have type 2 diabetes at baseline (2006-2010) were included; among them, 88 584 (69.5%) were analyzed to determine their genetic predisposition. The main outcome measure was incident type 2 diabetes.

Results: During the median follow-up of 10.0 years, 2547 incident type 2 diabetes cases were documented. Moderate to extreme unhappiness, satisfaction score ≤3, presence of broad depression, and a neuroticism score ≥3 were all significantly and independently associated with an increased risk of diabetes. When considered as a combination indicator, compared with individuals in the highest quartile of the psychological wellbeing score, the fully adjusted hazard ratios (95% CI) of type 2 diabetes were 1.41 (1.21-1.65) in the third quartile, 1.45 (1.24-1.69) in the second quartile, and 1.73 (1.48-2.01) in the lowest quartile. In the stratified analysis, we observed significant interactions between age and physical activity, and type 2 diabetes (Pinteraction < .001 and 0.049, respectively). However, there was no significant interaction between the psychological wellbeing score and genetic susceptibility to diabetes (Pinteraction = .980).

Conclusion: Worse overall psychological wellbeing was associated with a significantly increased risk of type 2 diabetes in a dose-response fashion regardless of genetic predisposition.

Keywords: cohort study; genetics; psychological factors; type 2 diabetes.