Depression As a Risk Factor for the Onset of Type 2 Diabetes Mellitus. A Meta-analysis

Overview

Journal Diabetologia

Specialty Endocrinology

Date 2006 Mar 8

PMID 16520921

Citations 345

Authors

M J Knol

J W R Twisk

A T F Beekman

R J Heine

F J Snoek

F Pouwer

Affiliations

Soon will be listed here.

Abstract

Aims/hypothesis: Evidence strongly suggests that depression and type 2 diabetes are associated, but the direction of the association is still unclear. Depression may occur as a consequence of having diabetes, but may also be a risk factor for the onset of type 2 diabetes. This study examined the latter association by reviewing the literature and conducting a meta-analysis of longitudinal studies on this topic.

Methods: Medline and PsycInfo were searched for articles published up to January 2005. All studies that examined the relationship between depression and the onset of type 2 diabetes were included. Pooled relative risks were calculated using fixed and random effects models. To explore sources of heterogeneity between studies, subgroup analyses and meta-regression analyses were performed.

Results: Nine studies met our inclusion criteria for this meta-analysis. The pooled relative risk was 1.26 (1.13-1.39) using the fixed effects model and 1.37 (1.14-1.63) using the random effects model. Heterogeneity between studies could not be explained by (1) whether studies controlled for undetected diabetes at baseline; (2) the method of diabetes assessment at follow-up; (3) the baseline overall risk of diabetes in the study population; and (4) follow-up duration.

Conclusions/interpretation: Depressed adults have a 37% increased risk of developing type 2 diabetes mellitus. The pathophysiological mechanisms underlying this relationship are still unclear and warrant further research. A randomised controlled study is needed to test whether effective prevention or treatment of depression can reduce the incidence of type 2 diabetes and its health consequences.

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References

Kumari M, Head J, Marmot M . Prospective study of social and other risk factors for incidence of type 2 diabetes in the Whitehall II study. Arch Intern Med. 2004; 164(17):1873-80. DOI: 10.1001/archinte.164.17.1873. View

Kessing L, Nilsson F, Siersma V, Andersen P . Increased risk of developing diabetes in depressive and bipolar disorders?. J Psychiatr Res. 2004; 38(4):395-402. DOI: 10.1016/j.jpsychires.2003.12.001. View

Maes M, Bosmans E, De Jongh R, Kenis G, Vandoolaeghe E, Neels H . Increased serum IL-6 and IL-1 receptor antagonist concentrations in major depression and treatment resistant depression. Cytokine. 1998; 9(11):853-8. DOI: 10.1006/cyto.1997.0238. View

Murray C, Lopez A . Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997; 349(9064):1498-504. DOI: 10.1016/S0140-6736(96)07492-2. View

Carnethon M, Kinder L, Fair J, Stafford R, Fortmann S . Symptoms of depression as a risk factor for incident diabetes: findings from the National Health and Nutrition Examination Epidemiologic Follow-up Study, 1971-1992. Am J Epidemiol. 2003; 158(5):416-23. DOI: 10.1093/aje/kwg172. View

Kaestner F, Hettich M, Peters M, Sibrowski W, Hetzel G, Ponath G . Different activation patterns of proinflammatory cytokines in melancholic and non-melancholic major depression are associated with HPA axis activity. J Affect Disord. 2005; 87(2-3):305-11. DOI: 10.1016/j.jad.2005.03.012. View

Maes M, Minner B, Suy E, Vandervorst C, Raus J . Coexisting dysregulations of both the sympathoadrenal system and hypothalamic-pituitary-adrenal-axis in melancholia. J Neural Transm Gen Sect. 1991; 85(3):195-210. DOI: 10.1007/BF01244945. View

Fleiss J, Gross A . Meta-analysis in epidemiology, with special reference to studies of the association between exposure to environmental tobacco smoke and lung cancer: a critique. J Clin Epidemiol. 1991; 44(2):127-39. DOI: 10.1016/0895-4356(91)90261-7. View

Kawakami N, Araki S, TAKATSUKA N, Shimizu H, Ishibashi H . Overtime, psychosocial working conditions, and occurrence of non-insulin dependent diabetes mellitus in Japanese men. J Epidemiol Community Health. 1999; 53(6):359-63. PMC: 1756890. DOI: 10.1136/jech.53.6.359. View

10.

Dentino A, Pieper C, Rao M, Currie M, Harris T, Blazer D . Association of interleukin-6 and other biologic variables with depression in older people living in the community. J Am Geriatr Soc. 1999; 47(1):6-11. DOI: 10.1111/j.1532-5415.1999.tb01894.x. View

11.

Schmidt M, Duncan B, Sharrett A, Lindberg G, Savage P, Offenbacher S . Markers of inflammation and prediction of diabetes mellitus in adults (Atherosclerosis Risk in Communities study): a cohort study. Lancet. 1999; 353(9165):1649-52. DOI: 10.1016/s0140-6736(99)01046-6. View

12.

Pouwer F, Nijpels G, Beekman A, Dekker J, van Dam R, Heine R . Fat food for a bad mood. Could we treat and prevent depression in Type 2 diabetes by means of omega-3 polyunsaturated fatty acids? A review of the evidence. Diabet Med. 2005; 22(11):1465-75. DOI: 10.1111/j.1464-5491.2005.01661.x. View

13.

Bjorntorp P . Do stress reactions cause abdominal obesity and comorbidities?. Obes Rev. 2002; 2(2):73-86. DOI: 10.1046/j.1467-789x.2001.00027.x. View

14.

Buckley T, Schatzberg A . On the interactions of the hypothalamic-pituitary-adrenal (HPA) axis and sleep: normal HPA axis activity and circadian rhythm, exemplary sleep disorders. J Clin Endocrinol Metab. 2005; 90(5):3106-14. DOI: 10.1210/jc.2004-1056. View

15.

Ryan M, Collins P, Thakore J . Impaired fasting glucose tolerance in first-episode, drug-naive patients with schizophrenia. Am J Psychiatry. 2003; 160(2):284-9. DOI: 10.1176/appi.ajp.160.2.284. View

16.

DerSimonian R, Laird N . Meta-analysis in clinical trials. Control Clin Trials. 1986; 7(3):177-88. DOI: 10.1016/0197-2456(86)90046-2. View

17.

Colditz G, Willett W, Rotnitzky A, Manson J . Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med. 1995; 122(7):481-6. DOI: 10.7326/0003-4819-122-7-199504010-00001. View

18.

Eaton W, Armenian H, Gallo J, Pratt L, Ford D . Depression and risk for onset of type II diabetes. A prospective population-based study. Diabetes Care. 1996; 19(10):1097-102. DOI: 10.2337/diacare.19.10.1097. View

19.

Eliasson B . Cigarette smoking and diabetes. Prog Cardiovasc Dis. 2003; 45(5):405-13. DOI: 10.1053/pcad.2003.00103. View

20.

Weber-Hamann B, Hentschel F, Kniest A, Deuschle M, Colla M, Lederbogen F . Hypercortisolemic depression is associated with increased intra-abdominal fat. Psychosom Med. 2002; 64(2):274-7. DOI: 10.1097/00006842-200203000-00010. View