Metabolic and Inflammatory Links to Depression in Youth With Diabetes

Department of Pediatrics, University of California, San Francisco, San Francisco, California.
Diabetes care (Impact Factor: 8.42). 10/2012; 35(12). DOI: 10.2337/dc11-2329
Source: PubMed


Youth with diabetes are at increased risk for depression. The objectives of this study were to provide preliminary evidence that this at-risk status for depression is associated with metabolic and inflammatory markers and to inform future, more stringent examinations of the directionality of these associations.RESEARCH DESIGN AND METHODS
Data from SEARCH for Diabetes in Youth Study Group (SEARCH), an observational study of U.S. children diagnosed with diabetes at <20 years of age, were used for these analyses. SEARCH participants were drawn from four geographically defined populations in Ohio, Washington, South Carolina, and Colorado; health plan enrollees in Hawaii and California; and Indian Health Service beneficiaries from four Native American populations. Participants were 2,359 youth with diabetes from the 2001 prevalent and 2002-2004 incident SEARCH cohorts. Depression was measured with the Center for Epidemiologic Studies Depression scale. Eight metabolic and inflammatory markers were measured: adiponectin, leptin, C-reactive protein, serum amyloid A, apolipoprotein B (apoB), lipoprotein A, interleukin-6, and LDL.RESULTSSix of eight markers were significantly (P < 0.006) associated with depression in youth with diabetes in bivariate analyses. In general, higher levels of depression were associated with indicators of worse metabolic or inflammatory functioning. In regression models stratified by diabetes type and accounting for demographic and clinical characteristics, only higher levels of apoB remained associated with higher levels of depression in youth with type 1 diabetes.CONCLUSIONS
These data suggest that depression reported by youth with diabetes is partially associated with metabolic abnormalities and systemic inflammation.

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Available from: Dana Dabelea, Apr 10, 2014
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    • "Moreover, the majority of studies evaluate depressive population, in contrast with the present investigation which evaluated depressive symptoms in an obese population. Hood et al. [22] showed that greater metabolic abnormalities , such as leptin, are associated with higher depressive categories in adolescents with diabetes, however, this was also a cross-sectional study and they did not test for gender differences. "
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    • "Moreover, in several studies, hyperleptinemia and insulin resistance, which can be present in obesity, MetS, and DM2 have been also linked to endothelial dysfunction or inflammation processes [46,47], conditions also present in depression. Not only metabolic disturbances but also inflammatory markers have been recently associated with depressive symptoms in participants with diabetes from the SEARCH for Diabetes in Youth cohort study [48]. "
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    • "p = .01). Higher CRP levels remained 6 months after depressive episode had abated in those subjects exposed to higher levels of childhood adversity Hood et al., 2012 1. To provide preliminary evidence that the increased risk for depression in youth with diabetes is associated with metabolic and inflammatory markers 2. To inform future examinations of the directionality of these associations 2,359 youths with diabetes from the SEARCH study – an observational study of US children diagnosed with diabetes at <20 years of age. "
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