Dynamic relationships between depressive symptoms and insulin resistance over 20 years of adulthood

Che Yuan Wu, Hugo Cogo-Moreira, Bradley J. Macintosh, Jodi D. Edwards, Saffire H. Krance, Michael Eid, Pamela J. Schreiner, Lenore J. Launer, Walter Swardfager

Research output: Contribution to journalArticlepeer-review

Abstract

Background Bidirectional longitudinal relationships between depression and diabetes have been observed, but the dominant direction of their temporal relationships remains controversial. Methods The random-intercept cross-lagged panel model decomposes observed variables into a latent intercept representing the traits, and occasion-specific latent 'state' variables. This permits correlations to be assessed between the traits, while longitudinal 'cross-lagged' associations and cross-sectional correlations can be assessed between occasion-specific latent variables. We examined dynamic relationships between depressive symptoms and insulin resistance across five visits over 20 years of adulthood in the population-based Coronary Artery Risk Development in Young Adults (CARDIA) study. Possible differences based on population group (Black v. White participants), sex and years of education were tested. Depressive symptoms and insulin resistance were quantified using the Center for Epidemiologic Studies Depression (CES-D) scale and the homeostatic model assessment for insulin resistance (HOMA-IR), respectively. Results Among 4044 participants (baseline mean age 34.9 ± 3.7 years, 53% women, 51% Black participants), HOMA-IR and CES-D traits were weakly correlated (r = 0.081, p = 0.002). Some occasion-specific correlations, but no cross-lagged associations were observed overall. Longitudinal dynamics of these relationships differed by population groups such that HOMA-IR at age 50 was associated with CES-D score at age 55 (β = 0.076, p = 0.038) in White participants only. Longitudinal dynamics were consistent between sexes and based on education. Conclusions The relationship between depressive symptoms and insulin resistance was best characterized by weak correlations between occasion-specific states and enduring traits, with weak evidence that insulin resistance might be temporally associated with subsequent depressive symptoms among White participants later in adulthood.

Original languageEnglish (US)
JournalPsychological medicine
DOIs
StatePublished - Sep 7 2021

Bibliographical note

Funding Information:
The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201800005I and HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). This manuscript has been reviewed by CARDIA for scientific content. CW acknowledges gratefully financial support from the University of Toronto Banting & Best Diabetes Centre (Tamarack Graduate Award in Diabetes Research). WS acknowledges gratefully funding from the Canadian Institutes of Health Research (PJT-159711), the Natural Sciences and Engineering Research Council of Canada (RGPIN-2017-06962), and from the National Institute of Diabetes and Digestive and Kidney Diseases Diabetic Complications Consortium (DiaComp, www.diacomp.org grant DK076169) (16GRU3711).

Funding Information:
CW is supported by the University of Toronto Banting & Best Diabetes Centre (Tamarack Graduate Award in Diabetes Research). WS receives funding from the Canadian Institutes of Health Research (PJT-159711), the Natural Sciences and Engineering Research Council of Canada (RGPIN-2017-06962), National Institute of Diabetes and Digestive and Kidney Diseases Diabetic Complications Consortium (DiaComp, www.diacomp.org grant DK076169) (16GRU3711).

Publisher Copyright:
Copyright © The Author(s), 2021. Published by Cambridge University Press.

Keywords

  • Cross-lagged panel model
  • depression
  • depressive symptoms
  • diabetes
  • insulin resistance

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