Metabolic and Inflammatory Links to Depression in Youth With Diabetes
- Korey K. Hood, PHD1⇓,
- Jean M. Lawrence, SCD, MPH, MSSA2,
- Andrea Anderson, MS3,
- Ronny Bell, PHD3,
- Dana Dabelea, MD, PHD4,
- Stephen Daniels, MD, PHD5,
- Beatriz Rodriguez, MD6,
- Lawrence M. Dolan, MD7,
- for the SEARCH for Diabetes in Youth Study Group
- 1Department of Pediatrics, University of California, San Francisco, San Francisco, California
- 2Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
- 3Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston Salem, North Carolina
- 4Department of Epidemiology, Colorado School of Public Health, University of Colorado, Denver, Colorado
- 5Department of Pediatrics, The Children’s Hospital, University of Colorado, Denver, Colorado
- 6Public Health Sciences and Epidemiology, University of Hawaii at Manoa, Manoa, Hawaii
- 7Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Corresponding author: Korey K. Hood, .
OBJECTIVE 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 (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.
RESULTS Six 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.
The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention and the National Institute of Diabetes and Digestive and Kidney Diseases.
- Received December 1, 2011.
- Accepted May 24, 2012.
- © 2012 by the American Diabetes Association.
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