Introduction
Methods
Results
Characteristic | No depressive symptoms at baseline and follow-up (n = 2583) | Incident depressive symptoms (PHQ-9 ≥10) (n = 265) | p value |
---|---|---|---|
Demographics | |||
Age (years) | 59.9 ± 8.1 | 59.8 ± 8.2 | 0.768 |
Sex, n (% female) | 1263 (48.9) | 127 (47.9) | 0.796 |
Educational level, low/medium/high, n (%) | 766/723/1048 (30.2/28.5/41.3) | 114/79/69 (43.5/30.2/26.3) | <0.001 |
Partner status, n (%) (partner) | 2187 (85.8) | 218 (82.9) | |
Depression | |||
Depressive symptoms (PHQ-9 score) | 2.0 ± 2.1 | 4.5 ± 2.8 | <0.001 |
MDD (MINI), n (%) | 23 (1.0) | 18 (7.1) | <0.001 |
Anti-depressive medication, n (%) | 124 (4.8) | 40 (15.1) | <0.001 |
Cardiovascular risk factors | |||
BMI (kg/m2) | 26.7 ± 4.3 | 28.5 ± 5.2 | <0.001 |
Waist circumference (cm) | 94.7 ± 13.1 | 100.0 ± 15.2 | <0.001 |
Office systolic BP (mmHg) | 134.6 ± 17.9 | 135.6 ± 19.5 | 0.397 |
Office diastolic BP (mmHg) | 76.1 ± 9.7 | 76.6 ± 11.2 | 0.480 |
Antihypertensive medication, n (%) | 953 (37.0) | 133 (50.2) | <0.001 |
Hypertension, n (%) | 1405 (54.5) | 165 (62.3) | 0.016 |
Total-to-HDL-cholesterol ratio | 3.6 ± 1.1 | 3.9 ± 1.3 | 0.003 |
Triacylglycerols (mmol/l) | 1.4 ± 0.8 | 1.7 ± 1.3 | <0.001 |
Lipid-modifying medication, n (%) | 860 (33.4) | 109 (41.1) | 0.012 |
eGFR (ml min−1 1.73 m−2) | 88.3 ± 14.3 | 86.6 ± 16.6 | 0.124 |
Albuminuria, normal/micro/macro, n (%) | 2238/157/15 (92.9/6.5/0.6) | 214/29/4 (86.6/11.7/1.6) | <0.001 |
History of CVD, n (%) | 376 (15.0) | 66 (25.4) | <0.001 |
Type 2 diabetes mellitus, n (%) | 612 (23.7) | 110 (41.5) | <0.001 |
Diabetes medication (all types), n (%) | 456 (17.7) | 92 (34.7) | <0.001 |
Diabetes medication (insulin), n (%) | 102 (3.9) | 32 (12.1) | <0.001 |
Lifestyle factors | |||
Smoking, never/former/current, n (%) | 929/1340/278 (36.5/52.6/10.9) | 77/129/56 (29.4/49.2/21.4) | <0.001 |
Alcohol use, none/low/high, n (%) | 399/1443/702 (15.7/56.7/27.6) | 68/144/49 (26.1/55.2/18.8) | <0.001 |
Physical activity (h/week) | 14.4 ± 8.0 | 13.0 ± 8.8 | 0.008 |
Mediterranean diet score | 4.5 ± 1.7 | 4.2 ± 1.6 | 0.008 |
Markers of hyperglycaemia and insulin resistance | |||
Fasting plasma glucose (mmol/l) | 5.9 ± 1.4 | 6.6 ± 2.2 | <0.001 |
2 h post-load glucose (mmol/l) | 7.6 ± 4.0 | 8.9 ± 4.9 | <0.001 |
HbA1c (mmol/mol) | 39.9 ± 8.5 | 44.4 ± 11.5 | <0.001 |
HbA1c (%) | 5.8 ± 0.8 | 6.2 ± 1.1 | <0.001 |
SAF (AU) | 2.4 ± 0.5 | 2.5 ± 0.6 | 0.010 |
HOMA-IR | 1.7 ± 1.1 | 1.9 ± 1.2 | 0.021 |
ISI | 4.1 ± 2.7 | 3.6 ± 2.4 | 0.008 |
Model | Prevalent depressive symptoms Rate ratio (95% CI) | p value | Prevalent clinically relevant depressive symptoms (PHQ-9 ≥10) OR (95% CI) | p value |
---|---|---|---|---|
Markers of hyperglycaemia | ||||
Fasting plasma glucose (per 1 SD) | ||||
Model 1 | 1.08 (1.04, 1.12) | <0.001 | 1.30 (1.15, 1.46) | <0.001 |
Model 2 | 1.15 (1.10, 1.20) | <0.001 | 1.41 (1.25, 1.60) | <0.001 |
Model 3 | 1.08 (1.03, 1.13) | 0.001 | 1.17 (1.00, 1.36) | 0.045 |
Model 4 | 1.07 (1.02, 1.12) | 0.008 | 1.13 (0.97, 1.32) | 0.130 |
2 h post-load glucose (per 1 SD) | ||||
Model 1 | 1.04 (1.00, 1.08) | 0.074 | 1.19 (1.01, 1.41) | 0.042 |
Model 2 | 1.10 (1.05, 1.15) | <0.001 | 1.35 (1.13, 1.61) | 0.001 |
Model 3 | 1.03 (0.98, 1.09) | 0.298 | 1.06 (0.84, 1.33) | 0.619 |
Model 4 | 1.02 (0.97, 1.08) | 0.407 | 1.05 (0.84, 1.33) | 0.656 |
HbA1c (per 1 SD) | ||||
Model 1 | 1.12 (1.07, 1.16) | <0.001 | 1.42 (1.26, 1.61) | <0.001 |
Model 2 | 1.18 (1.13, 1.23) | <0.001 | 1.54 (1.35, 1.75) | <0.001 |
Model 3 | 1.11 (1.06, 1.16) | <0.001 | 1.30 (1.11, 1.52) | 0.001 |
Model 4 | 1.08 (1.03, 1.13) | 0.002 | 1.21 (1.03, 1.42) | 0.022 |
SAF (per 1 SD) | ||||
Model 1 | 1.03 (0.99, 1.08) | 0.122 | 1.18 (1.00, 1.39) | 0.051 |
Model 2 | 1.11 (1.06, 1.16) | <0.001 | 1.43 (1.19, 1.72) | <0.001 |
Model 3 | 1.07 (1.02, 1.13) | 0.004 | 1.31 (1.07, 1.60) | 0.009 |
Model 4 | 1.04 (0.99, 1.09) | 0.152 | 1.18 (0.95, 1.45) | 0.129 |
Markers of insulin resistance | ||||
ISI (per SD)a | ||||
Model 1 | 1.04 (1.00, 1.09) | 0.056 | 1.16 (0.93, 1.45) | 0.182 |
Model 2 | 1.10 (1.05, 1.15) | <0.001 | 1.29 (1.02, 1.63) | 0.033 |
Model 3 | 1.02 (0.96, 1.07) | 0.598 | 0.89 (0.69, 1.15) | 0.363 |
Model 4 | 1.01 (0.96, 1.07) | 0.621 | 0.88 (0.68, 1.14) | 0.323 |
HOMA-IR (per SD) | ||||
Model 1 | 1.07 (1.02, 1.12) | 0.004 | 1.20 (1.02, 1.42) | 0.032 |
Model 2 | 1.12 (1.07, 1.17) | <0.001 | 1.28 (1.08, 1.53) | 0.005 |
Model 3 | 1.03 (0.97, 1.09) | 0.345 | 0.95 (0.75, 1.20) | 0.665 |
Model 4 | 1.02 (0.96, 1.08) | 0.485 | 0.93 (0.73, 1.18) | 0.561 |
Model | Incident depressive symptoms (PHQ-9 ≥10) HR (95% CI) | p value |
---|---|---|
Markers of hyperglycaemia | ||
Fasting plasma glucose (per 1 SD) | ||
Model 1 | 1.35 (1.25, 1.46) | <0.001 |
Model 2 | 1.33 (1.22, 1.45) | <0.001 |
Model 3 | 1.21 (1.09, 1.34) | <0.001 |
Model 4 | 1.20 (1.08, 1.33) | 0.001 |
2 h post-load glucose (per 1 SD) | ||
Model 1 | 1.32 (1.18, 1.47) | <0.001 |
Model 2 | 1.29 (1.14, 1.45) | <0.001 |
Model 3 | 1.26 (1.09, 1.46) | 0.002 |
Model 4 | 1.25 (1.08, 1.44) | 0.003 |
HbA1c (per 1 SD) | ||
Model 1 | 1.44 (1.32, 1.57) | <0.001 |
Model 2 | 1.40 (1.27, 1.53) | <0.001 |
Model 3 | 1.28 (1.15, 1.43) | <0.001 |
Model 4 | 1.22 (1.09, 1.37) | 0.001 |
SAF (per 1 SD) | ||
Model 1 | 1.15 (1.02, 1.30) | 0.019 |
Model 2 | 1.12 (0.99, 1.28) | 0.075 |
Model 3 | 1.06 (0.93, 1.22) | 0.401 |
Model 4 | 0.99 (0.86, 1.13) | 0.831 |
Markers of insulin resistance | ||
ISI (per SD)a | ||
Model 1 | 1.22 (1.05, 1.43) | 0.010 |
Model 2 | 1.21 (1.03, 1.42) | 0.018 |
Model 3 | 1.03 (0.86, 1.23) | 0.748 |
Model 4 | 1.03 (0.86, 1.23) | 0.783 |
HOMA-IR (per SD) | ||
Model 1 | 1.19 (1.06, 1.34) | 0.003 |
Model 2 | 1.19 (1.05, 1.34) | 0.006 |
Model 3 | 0.99 (0.84, 1.17) | 0.962 |
Model 4 | 0.98 (0.83, 1.15) | 0.766 |
Model | Incident clinically relevant depressive symptoms (PHQ-9 ≥10) HR (95% CI) | p value |
---|---|---|
Fasting plasma glucose (per 1 SD) | ||
Model 4 | 1.20 (1.08, 1.33) | 0.001 |
Model 5: model 4 + type 2 diabetes | 1.12 (0.99, 1.27) | 0.085 |
Model 6: model 4 excl. type 2 diabetes (excluded data n = 683) | 1.35 (0.81, 2.25) | 0.255 |
Model 7: model 4 + antidepressant medication | 1.20 (1.08, 1.33) | 0.001 |
Model 8: model 4 excl. antidepressant users (missing data n = 152) | 1.18 (1.05, 1.33) | 0.006 |
Model 9: model 4 excl. baseline MDD (excluded data n = 150) | 1.19 (1.06, 1.33) | 0.003 |
Model 10: model 4 excl. lifetime MDD (excluded data n = 897) | 1.06 (0.87, 1.29) | 0.580 |
Model 11: model 4 + physical activity (missing data n = 160) | 1.19 (1.07, 1.33) | 0.002 |
Model 12: model 4 + Mediterranean diet (missing data n = 123) | 1.18 (1.06, 1.32) | 0.002 |
Model 13: model 4 replacing office SBP for 24 h SBP (missing data n = 294) | 1.19 (1.06, 1.33) | 0.003 |
Model 14: model 4 replacing waist circumference for BMI | 1.21 (1.09, 1.34) | <0.001 |
Model 15: model 4 replacing total-to-HDL-cholesterol ratio for triacylglycerols | 1.17 (1.05, 1.30) | 0.004 |
2 h post-load glucose (per 1 SD) | ||
Model 4 | 1.25 (1.08, 1.44) | 0.003 |
Model 5: model 4 + type 2 diabetes | 1.16 (0.93, 1.45) | 0.192 |
Model 6: model 4 excl. type 2 diabetes (excluded data n = 539) | 1.19 (0.78, 1.83) | 0.419 |
Model 7: model 4 + antidepressant medication | 1.27 (1.10, 1.47) | 0.001 |
Model 8: model 4 excl. antidepressant users (missing data n = 132) | 1.26 (1.08, 1.47) | 0.003 |
Model 9: model 4 excl. baseline MDD (excluded data n = 143) | 1.23 (1.05, 1.44) | 0.009 |
Model 10: model 4 excl. lifetime MDD (excluded data n = 840) | 1.18 (0.94, 1.49) | 0.163 |
Model 11: model 4 + physical activity (missing data n = 153) | 1.22 (1.04, 1.42) | 0.014 |
Model 12: model 4 + Mediterranean diet (missing data n = 116) | 1.24 (1.06, 1.44) | 0.006 |
Model 13: model 4 replacing office SBP for 24 h SBP (missing data n = 274) | 1.23 (1.05, 1.44) | 0.008 |
Model 14: model 4 replacing waist circumference for BMI | 1.25 (1.08, 1.44) | 0.002 |
Model 15: model 4 replacing total-to-HDL-cholesterol ratio for triacylglycerols | 1.21 (1.04, 1.40) | 0.015 |
HbA1c (per 1 SD) | ||
Model 4 | 1.22 (1.09, 1.37) | 0.001 |
Model 5: model 4 + type-2 diabetes | 1.14 (1.00, 1.31) | 0.057 |
Model 6: model 4 excl. type-2 diabetes (excluded data n = 684) | 1.23 (0.82, 1.83) | 0.318 |
Model 7: model 4 + antidepressant medication | 1.23 (1.10, 1.38) | <0.001 |
Model 8: model 4 excl. antidepressant users (missing data n = 152) | 1.18 (1.03, 1.34) | 0.017 |
Model 9: model 4 excl. baseline MDD (excluded data n = 150) | 1.21 (1.07, 1.37) | 0.003 |
Model 10: model 4 excl. lifetime MDD (excluded data n = 894) | 1.08 (0.87, 1.33) | 0.486 |
Model 11: model 4 + physical activity (missing data n = 160) | 1.25 (1.11, 1.41) | <0.001 |
Model 12: model 4 + Mediterranean diet (missing data n = 123) | 1.20 (1.06, 1.35) | 0.004 |
Model 13: model 4 replacing office SBP for 24 h SBP (missing data n = 294) | 1.23 (1.08, 1.41) | 0.002 |
Model 14: model 4 replacing waist circumference for BMI | 1.23 (1.10, 1.38) | <0.001 |
Model 15: model 4 replacing total-to-HDL-cholesterol ratio for triacylglycerols | 1.20 (1.07, 1.35) | 0.002 |
SAF (per 1 SD) | ||
Model 4 | 0.99 (0.86, 1.13) | 0.831 |
Model 5: model 4 + type-2 diabetes | 0.94 (0.85, 1.11) | 0.606 |
Model 6: model 4 excl. type-2 diabetes (excluded data n = 658) | 0.87 (0.72, 1.05) | 0.154 |
Model 7: model 4 + antidepressant medication | 1.00 (0.87, 1.15) | 0.975 |
Model 8: model 4 excl. antidepressant users (missing data n = 147) | 1.01 (0.87, 1.18) | 0.852 |
Model 9: model 4 excl. baseline MDD (excluded data n = 145) | 1.01 (0.87, 1.17) | 0.876 |
Model 10: model 4 excl. lifetime MDD (excluded data n = 854) | 1.00 (0.81, 1.25) | 0.985 |
Model 11: model 4 + physical activity (missing data n = 150) | 1.03 (0.89, 1.19) | 0.696 |
Model 12: model 4 + Mediterranean diet (missing data n = 117) | 1.00 (0.87, 1.16) | 0.986 |
Model 13: model 4 replacing office SBP for 24 h SBP (missing data n = 280) | 0.93 (0.81, 1.08) | 0.353 |
Model 14: model 4 replacing waist circumference for BMI | 0.99 (0.86, 1.14) | 0.897 |
Model 15: model 4 replacing total-to-HDL-cholesterol ratio for triacylglycerols | 0.98 (0.86, 1.13) | 0.800 |