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Diabetes Care Publish Ahead of Print published online ahead of print July 13, 2007
DOI: 10.2337/dc07-0258
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Original Research

Depressive symptoms, race and glucose concentrations: the role of cortisol as mediator

Stephen H. Boyle, PhD, Richard S. Surwit, PhD, Anastasia Georgiades, PhD, Beverly H. Brummett, PhD, Michael J. Helms, BS, Redford B. Williams, MD and John C. Barefoot, PhD

Department of Psychiatry and Behavioral Medicine, Duke University Medical Center, Durham NC, USA

shboyle{at}duke.edu

ABSTRACT

Objective -: This study examined the associations of depressive symptoms with glucose concentrations and morning cortisol levels in 665 African American and 4216 Caucasian Vietnam era veterans.

Research Design and Methods -: Glucose level was measured as a three level variable (Diabetes, impaired glucose, normal). Depressive symptoms were measured by the obvious depression (OBD) scale from the MMPI.

Results -: Regression models showed significant race X OBD scale interactions in relation to glucose concentration (p < .0001) and cortisol (p < .0001). The OBD scale was positively associated with glucose concentration and cortisol in both racial groups. However, the magnitude of those associations was larger for African Americans. Further analyses suggested that cortisol partially mediated the race difference in the relation of depressive symptoms to glucose concentrations.

Conclusions -: These results suggest that enhanced hypothalamic pituitary adrenal activity plays an important role in the relation of depressive symptoms to dysregulated glucose metabolism and may partially explain the differential effects of depressive symptoms on glucose levels in African Americans and Caucasian males.


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Copyright © 2007 by the American Diabetes Association.