Depression was associated with younger age, female sex, obesity, smoking, and physical inactivity, in 1027 patients with newly diagnosed type 2 diabetes: a Swedish multicentre cross-sectional study

Abstract

Background Depression is a risk factor for type 2 diabetes (T2D) and cardiovascular disease (CVD). The aims were to explore the prevalence of depression, anxiety, antidepressant use, obesity, Hemoglobin A1c > 64 mmol/mol, life-style factors, pre-existing CVD, in patients with newly diagnosed T2D; to explore associations with depression; and to compare with Swedish general population data. Methods Multicentre, cross-sectional study. Inclusion criteria: adults with serologically verified newly diagnosed T2D. Included variables: age, sex, current depression and anxiety (Hospital Anxiety and Depression Scale), previous depression, antidepressant use, obesity (BMI ≥ 30 and ≥ 40 kg/m2), Hemoglobin A1c, pre-existing CVD. Logistic regression analyses were performed. Results In 1027 T2D patients, aged 18–94 years, depression was associated with age (per year) (inversely) (odds ratio (OR) 0.97), anxiety (OR 12.2), previous depression (OR 7.1), antidepressant use (OR 4.2), BMI ≥ 30 kg/m2 (OR 1.7), BMI ≥ 40 kg/m2 (OR 2.3), smoking (OR 1.9), physical inactivity (OR 1.8), and women (OR 1.6) (all p ≤ 0.013). Younger women (n = 113), ≤ 59 years, compared to younger men (n = 217) had higher prevalence of current depression (31% vs 12%), previous depression (43 vs 19%), anxiety (42% vs 25%), antidepressant use (37% vs 12%), BMI ≥ 30 kg/m2 (73% vs 60%) and BMI ≥ 40 kg/m2) (18% vs 9%), and smoking (26% vs 16%) (all p ≤ 0.029). Older women (n = 297), ≥ 60 years, compared to older men (n = 400) had higher prevalence of previous depression (45% vs 12%), anxiety (18% vs 10%), antidepressant use (20% vs 8%), BMI ≥ 30 kg/m2 (55% vs 47%), BMI ≥ 40 kg/m2 (7% vs 3%) (all p ≤ 0.048), but not of current depression (both 9%). Compared to the Swedish general population (depression (women 11.2%, men 12.3%) and antidepressant use (women 9.8%, men 5.3%)), the younger women had higher prevalence of current depression, and all patients had higher prevalence of antidepressant use. Conclusions In patients with newly diagnosed T2D, the younger women had the highest prevalence of depression, anxiety, and obesity. The prevalence of depression in young women and antidepressant use in all patients were higher than in the Swedish general population. Three risk factors for CVD, obesity, smoking, and physical inactivity, were associated with depression.

Mediating effect of depression on the association between cardiovascular disease and the risk of all‐cause mortality: NHANES in 2005−2018

“…Since the findings on the relationship between depression and CVD risk by sex are not consistent among studies, 28,29 and we similarly not find any difference of the mediating effect of depression on CVD and all‐cause mortality between women and men, more basic researched are required to explore the potential mechanism for sex‐related factors affecting depression's mediating influence. Melin et al 30 found that in patients with newly diagnosed type 2 diabetes (T2D), the younger women had the highest prevalence of depression, which was the risk factor for CVD. There mechanisms that could explain the association between depression and CVD events in patients with T2D induce the following alterations of autonomic nervous system activity, decrease of heart‐rate variability, the elevation of heart rate, catecholamine levels, and inflammatory activity, and the induction of endothelial and platelet dysfunction 31,32 .…”

A comparison in women with newly diagnosed diabetes between those with and without a history of gestational diabetes: a new perspective

“…This study included data from the Swedish observational study Diabetes in Kronoberg and Kalmar (DKK) that included patients with newly diagnosed adult-onset diabetes (ages 18–100 years) during 2016–2017, including 1248 patients [ 9 ]. Five hospitals (100%) and 55 (83%) Primary Health Care Centers (public and private) in Kronoberg and Kalmar counties, with together a population of 433 000 inhabitants, in southeastern Sweden, invited and included patients consecutively during routine care visits, acute, and scheduled.…”

“…Analyses of lipid levels (T-cholesterol, triglycerides, LDL and HDL, mmol/l), and venous HbA1c (mmol/mol) were performed according to clinical routine at the clinical chemistry laboratories of the participating hospitals, as were a venous p-glucose collected simultaneously with the C-peptide samples (random, for best estimate of beta-cell function) [ 9 , 10 ]. GADA (glutamic acid decarboxylase antibodies) IA-2A and ZnT8A were analyzed with enzyme-linked immunosorbent assay (ELISA) (RSR Ltd, Cardiff, UK) according to manufacturer’s instructions.…”

“…GADA (glutamic acid decarboxylase antibodies) IA-2A and ZnT8A were analyzed with enzyme-linked immunosorbent assay (ELISA) (RSR Ltd, Cardiff, UK) according to manufacturer’s instructions. C-peptide levels were analyzed with ELISA (Mercodia, Uppsala, Sweden) according to manufacturer’s instructions, detection limit 25 pmol/L [ 9 ].…”

Assessing the causal relationship between psychiatric disorders and obstructive sleep apnea: a bidirectional Mendelian randomization

“…However, accurately diagnosing PDs in OSA patients is challenging due to the overlap of symptoms such as excessive daytime sleepiness, cognitive impairment, and mood changes ( 7 ). Additionally, factors like alcohol consumption, smoking, and body mass index (BMI) can confound the relationship between OSA and PDs ( 20 , 21 ), leading to potential biases in observational studies. Therefore, the causality between OSA and PDs remains ambiguous and requires further exploration.…”