Association between depression and the prevalence and prognosis of prediabetes: a population-based study

Abstract

AbstractBackgroundDiagnosis and intervention of prediabetes is an emerging approach to preventing the progression and complications of diabetes. It has been reported that inflammatory factors and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis may be potential pathogenesis mechanisms of diabetes and depression. However, the relationship between depression levels and the prevalence of prediabetes and its prognosis remains elusive. This study aimed to explore the relationship between depression and the prevalence of prediabetes and to further explore the all-cause mortality of different levels of depression in patients with prediabetes.MethodsOur study used a data set from the National Health and Nutrition Examination Survey (NHANES). Participants were divided into two groups (with or without depression) and further divided into subgroups based on different levels of depression status to analyze the relationship between depression and prediabetes prevalence. We then analyzed the relationship between all-cause mortality and depressive status in patients with prediabetes. This study used a weighted multiple logistic/Cox regression model.ResultsA total of 4384 participants were included, divided into depression group (n=1379) and non-depression group (n=3005). Results showed that people with depression were at higher risk of developing prediabetes. After adjusting for covariates, moderate to severe depression was positively associated with prediabetes (moderate to severe depression vs no depression: OR=1.834, 95%CI: 0.713–4.721; severe depression vs no depression: OR= 1.004, 95% CI 0.429–2.351). In addition, we explored the relationship between all-cause mortality and depressive status in patients diagnosed with prediabetes (n=2240) and found that moderate to severe depression (HR=2.109, 95%CI 0.952-4.670) was associated with higher mortality in patients with prediabetes. Associated with increased all-cause mortality.ConclusionsOverall, findings suggest that depression is positively associated with prediabetes prevalence and mortality. These results suggest that good management of mental health conditions may be a potential strategy to reduce the occurrence and progression of prediabetes.