AUTHOR=An Ji Hyun , Han Kyung-do , Jeon Hong Jin 

TITLE=Higher metabolic variability increases the risk of depressive disorder in type 2 diabetes mellitus: a longitudinal nationwide cohort study

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1217104

DOI=10.3389/fpsyt.2023.1217104

ISSN=1664-0640

ABSTRACT=Background and Objectives: While variabilities in metabolic parameters (METv) have been linked to adverse health outcomes in type 2 DM, their association with depression has yet to be studied. This research aimed to investigate the association between METv and depressive disorder in patients with type 2 DM.
Methods: The study involved a nationwide-cohort of 1,119,631 type 2 DM patients who had undergone three or more serial health examinations between 2005 and 2012.  At each visit, body mass index (BMI), fasting glucose (FG), systolic blood pressure (BP) and total cholesterol (TC) were measured and stratified into quartiles, with Q4 being the highest and Q1 the lowest. The risk of depressive disorder was evaluated using Cox proportional hazard regression models, which accounted for METs in the indexes, after adjusting for sex, income status, lifestyle habits, medical comorbidities, DM severity, and baseline levels of BMI, FG, BP, and TC.
Results: During a mean follow-up period of 6.00 ± 2.42 years, 239,477 (21.4%) cases of type 2 DM patients developed depressive disorder. The risk of developing depressive disorder was incrementally increased as the number of METv increased. (HR 1.18; 95% CI 1.13, 1.23 for the group with the highest METv in all parameters compared to those with lowest METv in all parameters). In the subgroup analysis, the risk of developing depressive disorder was 43% higher in males (HR 1.43; 95% CI 1.34, 1.51), and 31% higher in those younger than 65 years of age (HR 1.31; 95% CI 1.23, 1.39) in the group with the highest number of METv compared to the group with the lowest number of METv.
Conclusion: In type 2 DM, higher METv was an independent risk factor for depressive disorder.  This risk is notably elevated in males and individuals under the age of 65.