Association between depression and diabetes mellitus and the impact of their comorbidity on mortality: Evidence from a nationally representative study

Cai, Jingda; Zhang, Songyan; Wu, Renrong; Huang, Jing

doi:10.1016/j.jad.2024.03.003

Cited by 6 publications

(1 citation statement)

References 63 publications

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“…Likewise, various chronic diseases are known to influence the onset of depression and cognitive decline. Evidence indicates that older adults with diabetes are at heightened risk for developing both depression and cognitive dysfunction ( 8 , 9 ). Clinically significant depression is observed in one out of every four individuals with type 2 diabetes mellitus ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Exploring the role of vitamin D in cognitive function: mediation by depression with diabetes modulation in older U.S. adults, a NHANES weighted analysis

Shu,

Zheng,

et al. 2024

Front. Nutr.

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BackgroundThe relationship between vitamin D levels, depressive symptoms, and cognitive function has yet to be definitively understood in the elderly, particularly when considering the impact of chronic diseases. This study focuses on how depression mediates the impact of 25-hydroxyvitamin D3 (25(OH)D3) on cognitive performance in older U.S. adults.MethodsWe analyzed data from 2,745 elderly individuals extracted from the NHANES 2011–2014 cycles, applying weighted processing to account for the complex multi-stage sampling design characteristic of NHANES data. Utilizing weighted data for covariate and model selection, we conducted mediation analyses on both the overall population and subgroup data. Significant mediation pathways were validated using a stratified weighted bootstrap approach. For significant subgroup pathways, we explored interactive mechanisms through interactive mediation analysis.ResultsMediation analyses, thoroughly accounting for the impact of chronic conditions, revealed significant pathways in both the weighted overall population and the weighted diabetes subgroup. After 1,000 stratified weighted bootstrap replications, the proportion of mediation effects were 10.6% [0.040, 0.268] and 20.9% [0.075, 0.663], respectively. Interactive mediation analysis for diabetes indicated that the interaction between diabetes and depression was not significant in the direct pathway (estimates = 0.050, p = 0.113) but was significant in the mediation pathway, yielding the largest effect size compared to other covariates (estimates = 0.981, p < 0.001).ConclusionThis study highlights the mediating role of depression in the relationship between vitamin D levels and cognitive function in the elderly, particularly emphasizing diabetes as a key moderator. Our findings suggest targeted interventions addressing both vitamin D sufficiency and depression could significantly benefit cognitive health, especially in diabetic individuals.

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Section: Introductionmentioning

confidence: 99%

Exploring the role of vitamin D in cognitive function: mediation by depression with diabetes modulation in older U.S. adults, a NHANES weighted analysis

Shu,

Zheng,

et al. 2024

Front. Nutr.

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Association between depression and diabetes among American adults using NHANES data from 2005 to 2020

Zheng,

Yin,

et al. 2024

Sci Rep

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Depression impairs self-management in diabetic patients, exacerbates insulin resistance, and elevates glycated hemoglobin (HbA1c) levels, thereby increasing diabetes risk. This study analyzed data from 30,386 participants in the National Health and Nutrition Examination Survey (NHANES), assessing depression severity using the 9-item Patient Health Questionnaire (PHQ-9) and evaluating diabetes status through clinical markers such as HbA1c, random blood glucose, and fasting blood glucose. Participants were stratified by depression severity and diabetes status to examine the relationship between depression and diabetes risk. We applied descriptive statistics, logistic regression models, subgroup analyses, and restricted cubic spline (RCS) modeling to explore this association. The results revealed that greater depression severity was significantly associated with increased diabetes incidence, elevated HbA1c, fasting glucose, and insulin levels. Multivariate regression analysis confirmed a consistent positive correlation between depression severity and diabetes risk. Subgroup analyses further identified significant relationships between depression and various demographic and behavioral factors, including gender, race, BMI, smoking status, and prediabetic conditions. Additionally, the RCS model demonstrated a clear increase in diabetes risk with rising PHQ-9 scores. In conclusion, our study demonstrates that the severity of depression is positively correlated with the risk of diabetes, and this association may be closely linked to various glycemic and lipid metabolic parameters.

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Metabolische unerwünschte Arzneimittelwirkungen von Psychopharmaka

Gahr

2024

Fortschr Neurol Psychiatr

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ZusammenfassungMetabolische unterwünschte Arzneimittelwirkungen (mUAW) von Psychopharmaka haben erhebliche gesundheitsbezogene und ökonomische Relevanz. Zu den mUAW gehören Gewichtszunahme, gestörte Glukosetoleranz, Diabetes mellitus und Dyslipidämie. Fast alle Antipsychotika (AP) und viele Antidepressiva (AD) sowie Stimmungsstabilisatoren können zu mUAW, insbesondere Gewichtszunahme führen. Die Gewichtsentwicklung in den ersten Wochen bis Monaten nach Initialisierung einer Therapie ist der stärkste Prädiktor für Gewichtszunahme assoziiert mit AP und AD. Die wichtigsten Risikofaktoren für mUAW sind antagonistische Effekte an H1-, 5-HT2C- und M3-Rezeptoren sowie antidopaminerge Effekte, wobei die Beeinflussung zahlreicher weiterer Systeme relevant ist. Ein systematisches Monitoring metabolischer Parameter sollte bei Therapie mit allen Substanzen durchgeführt werden, die mit einem erhöhten Risiko für mUAW assoziiert sind. Lebensstilverändernde und diätetische Maßnahmen, Bewegungstherapie, Dosisreduktion, Umstellung und Beendigung der Medikation sowie eine zusätzliche Therapie mit Metformin und Topiramat sind evidenzbasierte Therapieoptionen bei AP-assoziierter Gewichtszunahme, wobei auch die GLP-1-Rezeptoragonisten wie Liraglutid vielversprechend sind.

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Association between depression and diabetes mellitus and the impact of their comorbidity on mortality: Evidence from a nationally representative study

Cited by 6 publications

References 63 publications

Exploring the role of vitamin D in cognitive function: mediation by depression with diabetes modulation in older U.S. adults, a NHANES weighted analysis

Exploring the role of vitamin D in cognitive function: mediation by depression with diabetes modulation in older U.S. adults, a NHANES weighted analysis

Association between depression and diabetes among American adults using NHANES data from 2005 to 2020

Metabolische unerwünschte Arzneimittelwirkungen von Psychopharmaka

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