Abstract
The longitudinal association between glycated hemoglobin (HbA1c) and different courses of depressive symptoms is understudied. This study aimed to identify different trajectories of depressive symptoms and investigate the relation of HbA1c with the risk of increasing and high-stable depressive symptoms. In the China Health and Retirement Longitudinal Study, depressive symptoms were measured using the 10-item Center for Epidemiological Studies-Depression scale in three visits (years: 2011, 2013 and 2015) among 9804 participants (mean age 60.0 ± 9.0 years). Group-based trajectory modeling was used to identify trajectories of depressive symptoms. HbA1c was measured at baseline and categorized five groups according to the respective quintile. Multinomial logistic regression was fitted to examine this relationship. Four distinct trajectories of depressive symptoms were identified: low symptoms (n=6401, 65.29%); decreasing symptoms (n=1362, 13.89%); increasing symptoms (n=1452, 14.81%); and high symptoms (n=1452, 14.81%). Adjusting for demographic, health-related, and cognitive factors, the risk ratio (95% confidence interval) pertaining to the highest HbA1c (Quintile 5) for decreasing, increasing, and high symptoms of depression versus low symptoms was 1.01 (0.82-1.25), 1.12 (0.92-1.36), and 1.39 (1.04-1.86) compared with the lowest HbA1c (Quintile 1), respectively. We observed a J-shaped relationship between HbA1c and high depressive symptoms, with the lowest risk at a HbA1c concentration of 5.0%. In summary, in this large population-based cohort, high levels of glycated hemoglobin concentrations were associated with a higher risk of increasing and high-stable symptoms of depression.
Highlights
Depression symptoms are highly prevalent and impact the quality of life of those struggling from them [1]
We explored the relationship between glycated hemoglobin and incidence of depressive symptoms at visit 3
Prospective cohort studies had demonstrated that individuals with increasing or high-stable symptoms of depression had a higher risk of dementia [5, 28]
Summary
Depression symptoms are highly prevalent and impact the quality of life of those struggling from them [1]. Glycated Hemoglobin and Trajectories of Depressive Symptoms associated with a high risk of diabetes mellitus. A recent meta-analysis shows that diabetes mellitus increased the risk of depression by 25% [13]. This suggests that the association between depressive symptoms and diabetes mellitus is more complex and may be bidirectional[8]. In most studies, depressive symptoms are assessed at a single point time (at baseline), and these studies may not have fully captured the longitudinal pattern of depressive symptoms. Previous studies found HbA1c is associated with depressive symptoms [15, 16]. Very few studies have provided information that describes the relationship between HbA1c and the longitudinal pattern of depressive symptoms in the Chinese population. We hypothesize that high levels of HbA1c is associated with increasing and high-stable depressive symptoms
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