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Published in: Current Psychiatry Reports 1/2012

01-02-2012 | MEDICOPSYCHIATRIC DISORDERS (WJ KATON, SECTION EDITOR)

A Review of the Association Between Depression and Insulin Resistance: Pitfalls of Secondary Analyses or a Promising New Approach to Prevention of Type 2 Diabetes?

Authors: Naomi Silva, Evan Atlantis, Khalida Ismail

Published in: Current Psychiatry Reports | Issue 1/2012

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Abstract

We review the validity of the evidence for an association between depression and the risk of insulin resistance (IR). We describe the potentially plausible biological and behavioral mechanisms that explain how depression increases the risk of IR and consequent overt diabetes. We have identified gaps in the literature to guide future research. Evidence for bidirectional associations between depression and IR is inconsistent. Results showing positive associations between depression and IR are derived from cross-sectional studies, whereas negative findings are typically reported in cohort studies. On the other hand, tentative trial evidence suggests that the effective treatment of depression can improve IR, and that lifestyle programs improve IR and reduce depressive symptoms. These emerging themes could lead to potential new multidisciplinary approaches to preventing diabetes.
Literature
1.
go back to reference World Health Organization. The global burden of disease: 2004 Update. WHO Press; 2008. World Health Organization. The global burden of disease: 2004 Update. WHO Press; 2008.
2.
go back to reference Egede LE, Zheng D, Simpson K. Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care. 2002;25(3):464–70.PubMedCrossRef Egede LE, Zheng D, Simpson K. Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care. 2002;25(3):464–70.PubMedCrossRef
3.
go back to reference Abdul-Ghani MA, Tripathy D, DeFronzo RA. Contributions of beta-cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose. Diabetes Care. 2006;29(5):1130–9.PubMedCrossRef Abdul-Ghani MA, Tripathy D, DeFronzo RA. Contributions of beta-cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose. Diabetes Care. 2006;29(5):1130–9.PubMedCrossRef
4.
go back to reference ••Nouwen A, Nefs G, Caramlau I, et al. Prevalence of depression in individuals with impaired glucose metabolism or undiagnosed diabetes. Diabetes Care. 2011;34(3):752–762. This review shows that the prevalence of depression is similar in people with pre-diabetes compared with those with normal fasting plasma glucose and undiagnosed diabetes, but higher in people with known diabetes.PubMedCrossRef ••Nouwen A, Nefs G, Caramlau I, et al. Prevalence of depression in individuals with impaired glucose metabolism or undiagnosed diabetes. Diabetes Care. 2011;34(3):752–762. This review shows that the prevalence of depression is similar in people with pre-diabetes compared with those with normal fasting plasma glucose and undiagnosed diabetes, but higher in people with known diabetes.PubMedCrossRef
5.
go back to reference Knol MJ, Twisk JW, Beekman AT, et al. Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis. Diabetologia. 2006;49(5):837–45.PubMedCrossRef Knol MJ, Twisk JW, Beekman AT, et al. Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis. Diabetologia. 2006;49(5):837–45.PubMedCrossRef
6.
go back to reference Mezuk B, Eaton WW, Albrecht S, Golden SH. Depression and type 2 diabetes over the lifespan: a meta-analysis. Diabetes Care. 2008;31(12):2383–90.PubMedCrossRef Mezuk B, Eaton WW, Albrecht S, Golden SH. Depression and type 2 diabetes over the lifespan: a meta-analysis. Diabetes Care. 2008;31(12):2383–90.PubMedCrossRef
7.
go back to reference Lawlor DA, Smith GD, Ebrahim S. British Women’s Heart and Health study: association of insulin resistance with depression: cross sectional findings from the British Women’s Heart and Health study. BMJ. 2003;327(7428):1383–4.PubMedCrossRef Lawlor DA, Smith GD, Ebrahim S. British Women’s Heart and Health study: association of insulin resistance with depression: cross sectional findings from the British Women’s Heart and Health study. BMJ. 2003;327(7428):1383–4.PubMedCrossRef
8.
go back to reference Timonen M, Rajala U, Jokelainen J, et al. Depressive symptoms and insulin resistance in young adult males: results from the Northern Finland 1966 birth cohort. Mol Psychiatry. 2006;11(10):929–33.PubMedCrossRef Timonen M, Rajala U, Jokelainen J, et al. Depressive symptoms and insulin resistance in young adult males: results from the Northern Finland 1966 birth cohort. Mol Psychiatry. 2006;11(10):929–33.PubMedCrossRef
9.
go back to reference Timonen M, Salmenkaita I, Jokelainen J, et al. Insulin resistance and depressive symptoms in young adult males: findings from Finnish military conscripts. Psychosom Med. 2007;69(8):723–8.PubMedCrossRef Timonen M, Salmenkaita I, Jokelainen J, et al. Insulin resistance and depressive symptoms in young adult males: findings from Finnish military conscripts. Psychosom Med. 2007;69(8):723–8.PubMedCrossRef
10.
go back to reference Adriaanse MC, Dekker JM, Nijpels G, et al. Associations between depressive symptoms and insulin resistance: the Hoorn study. Diabetologia. 2006;49(12):2874–7.PubMedCrossRef Adriaanse MC, Dekker JM, Nijpels G, et al. Associations between depressive symptoms and insulin resistance: the Hoorn study. Diabetologia. 2006;49(12):2874–7.PubMedCrossRef
11.
go back to reference Pan A, Ye X, Franco OH, et al. Insulin resistance and depressive symptoms in middle-aged and elderly Chinese: findings from the Nutrition and Health of Aging Population in China Study. J Affect Disord. 2008;109(1–2):75–82.PubMedCrossRef Pan A, Ye X, Franco OH, et al. Insulin resistance and depressive symptoms in middle-aged and elderly Chinese: findings from the Nutrition and Health of Aging Population in China Study. J Affect Disord. 2008;109(1–2):75–82.PubMedCrossRef
12.
go back to reference Holt RI, Phillips DI, Jameson KA, et al. The relationship between depression and diabetes mellitus: findings from the Hertfordshire cohort study. Diabet Med. 2009;26(6):641–8.PubMedCrossRef Holt RI, Phillips DI, Jameson KA, et al. The relationship between depression and diabetes mellitus: findings from the Hertfordshire cohort study. Diabet Med. 2009;26(6):641–8.PubMedCrossRef
13.
go back to reference Pearson S, Schmidt M, Patton G, et al. Depression and insulin resistance: cross sectional associations in young adults. Diabetes Care. 2010;33(5):1128–33.PubMedCrossRef Pearson S, Schmidt M, Patton G, et al. Depression and insulin resistance: cross sectional associations in young adults. Diabetes Care. 2010;33(5):1128–33.PubMedCrossRef
14.
go back to reference Golden SH, Lee HB, Schreiner PJ, et al. Depression and type 2 diabetes mellitus: the multiethnic study of atherosclerosis. Psychosom Med. 2007;69(6):529–36.PubMedCrossRef Golden SH, Lee HB, Schreiner PJ, et al. Depression and type 2 diabetes mellitus: the multiethnic study of atherosclerosis. Psychosom Med. 2007;69(6):529–36.PubMedCrossRef
15.
go back to reference Roos C, Lidfeldt J, Agardh CD, et al. Insulin resistance and self-rated symptoms of depression in Swedish women with risk factors for diabetes: the Women’s Health in the Lund Area study. Metab Clin Exp. 2007;56(6):825–9.PubMedCrossRef Roos C, Lidfeldt J, Agardh CD, et al. Insulin resistance and self-rated symptoms of depression in Swedish women with risk factors for diabetes: the Women’s Health in the Lund Area study. Metab Clin Exp. 2007;56(6):825–9.PubMedCrossRef
16.
go back to reference Shen Q, Bergquist-Beringer S, Sousa VD. Major depressive disorder and insulin resistance in nondiabetic young adults in the United States: the National Health and Nutrition Examination Survey, 1999–2002. Biological Research for Nursing 2010. [Epub ahead of print]. Shen Q, Bergquist-Beringer S, Sousa VD. Major depressive disorder and insulin resistance in nondiabetic young adults in the United States: the National Health and Nutrition Examination Survey, 1999–2002. Biological Research for Nursing 2010. [Epub ahead of print].
17.
go back to reference Lawlor DA, Ben-Shlomo Y, Ebrahim S, et al. Insulin resistance and depressive symptoms in middle aged men: findings from the Caerphilly prospective cohort study. BMJ. 2005;330(7493):705–6.PubMedCrossRef Lawlor DA, Ben-Shlomo Y, Ebrahim S, et al. Insulin resistance and depressive symptoms in middle aged men: findings from the Caerphilly prospective cohort study. BMJ. 2005;330(7493):705–6.PubMedCrossRef
18.
go back to reference Everson-Rose SA, Meyer PM, Powell LH, et al. Depressive symptoms, insulin resistance, and risk of diabetes in women at midlife. Diabetes Care. 2004;27(12):2856–62.PubMedCrossRef Everson-Rose SA, Meyer PM, Powell LH, et al. Depressive symptoms, insulin resistance, and risk of diabetes in women at midlife. Diabetes Care. 2004;27(12):2856–62.PubMedCrossRef
19.
go back to reference Chiba M, Suzuki S, Hinokio Y, et al. Tyrosine hydroxylase gene microsatellite polymorphism associated with insulin resistance in depressive disorder. Metab Clin Exp. 2000;49(9):1145–9.PubMedCrossRef Chiba M, Suzuki S, Hinokio Y, et al. Tyrosine hydroxylase gene microsatellite polymorphism associated with insulin resistance in depressive disorder. Metab Clin Exp. 2000;49(9):1145–9.PubMedCrossRef
20.
go back to reference Hung YJ, Hsieh CH, Chen YJ, et al. Insulin sensitivity, proinflammatory markers and adiponectin in young males with different subtypes of depressive disorder. Clin Endocrinol. 2007;67(5):784–9.CrossRef Hung YJ, Hsieh CH, Chen YJ, et al. Insulin sensitivity, proinflammatory markers and adiponectin in young males with different subtypes of depressive disorder. Clin Endocrinol. 2007;67(5):784–9.CrossRef
21.
go back to reference Okamura F, Tashiro A, Utumi A, et al. Insulin resistance in patients with depression and its changes during the clinical course of depression: minimal model analysis. Metabolism. 2000;49(10):1255–160.PubMedCrossRef Okamura F, Tashiro A, Utumi A, et al. Insulin resistance in patients with depression and its changes during the clinical course of depression: minimal model analysis. Metabolism. 2000;49(10):1255–160.PubMedCrossRef
22.
go back to reference Kauffman RP, Castracane VD, White DL, et al. Impact of the selective serotonin reuptake inhibitor citalopram on insulin sensitivity, leptin and basal cortisol secretion in depressed and non-depressed euglycemic women of reproductive age. Gynecol Endocrinol. 2005;21(3):129–37.PubMedCrossRef Kauffman RP, Castracane VD, White DL, et al. Impact of the selective serotonin reuptake inhibitor citalopram on insulin sensitivity, leptin and basal cortisol secretion in depressed and non-depressed euglycemic women of reproductive age. Gynecol Endocrinol. 2005;21(3):129–37.PubMedCrossRef
23.
go back to reference Weber-Hamann B, Gilles M, Lederbogen F, et al. Improved insulin sensitivity in 80 nondiabetic patients with MDD after clinical remission in a double-blind, randomized trial of amitriptyline and paroxetine. J Clin Psychiatry. 2006;67(12):1856–61.PubMedCrossRef Weber-Hamann B, Gilles M, Lederbogen F, et al. Improved insulin sensitivity in 80 nondiabetic patients with MDD after clinical remission in a double-blind, randomized trial of amitriptyline and paroxetine. J Clin Psychiatry. 2006;67(12):1856–61.PubMedCrossRef
24.
go back to reference Chen YC, Lin WW, Chen YJ, et al. Antidepressant effects on insulin sensitivity and proinflammatory cytokines in the depressed males. Mediators of Inflammation; 2010. [Epub 2010 May 18]. Chen YC, Lin WW, Chen YJ, et al. Antidepressant effects on insulin sensitivity and proinflammatory cytokines in the depressed males. Mediators of Inflammation; 2010. [Epub 2010 May 18].
25.
go back to reference Atlantis E, Lange K, Goldney RD, et al. Specific medical conditions associated with clinically significant depressive symptoms in men. Soc Psychiatry Psychiatr Epidemiol 2010. Atlantis E, Lange K, Goldney RD, et al. Specific medical conditions associated with clinically significant depressive symptoms in men. Soc Psychiatry Psychiatr Epidemiol 2010.
26.
go back to reference Barton DA, Dawood T, Lambert EA, et al. Sympathetic activity in major depressive disorder: identifying those at increased cardiac risk? J Hypertens. 2007;25:2117–24.PubMedCrossRef Barton DA, Dawood T, Lambert EA, et al. Sympathetic activity in major depressive disorder: identifying those at increased cardiac risk? J Hypertens. 2007;25:2117–24.PubMedCrossRef
27.
go back to reference Bao AM, Meynen G, Swaab DF. The stress system in depression and neurodegeneration: focus on the human hypothalamus. Brain Res Rev. 2008;57:531–53.PubMedCrossRef Bao AM, Meynen G, Swaab DF. The stress system in depression and neurodegeneration: focus on the human hypothalamus. Brain Res Rev. 2008;57:531–53.PubMedCrossRef
28.
go back to reference Pizzi C, Manzoli L, Mancini S, Costa GM. Analysis of potential predictors of depression among coronary heart disease risk factors including heart rate variability, markers of inflammation, and endothelial function. Eur Heart J. 2008;29:1110-a–1117.CrossRef Pizzi C, Manzoli L, Mancini S, Costa GM. Analysis of potential predictors of depression among coronary heart disease risk factors including heart rate variability, markers of inflammation, and endothelial function. Eur Heart J. 2008;29:1110-a–1117.CrossRef
29.
go back to reference Champeri Wand GS, Malhotra SS, et al. Biological basis of depression in adults with diabetes. Curr Diabetes Rep. 2010;10(6):396–405.CrossRef Champeri Wand GS, Malhotra SS, et al. Biological basis of depression in adults with diabetes. Curr Diabetes Rep. 2010;10(6):396–405.CrossRef
30.
go back to reference Pizzi C, Mancini S, Angeloni L, et al. Effects of selective serotonin reuptake inhibitor therapy on endothelial function and inflammatory markers in patients with coronary heart disease. Clin Pharmacol Ther. 2009;86:527–32.PubMedCrossRef Pizzi C, Mancini S, Angeloni L, et al. Effects of selective serotonin reuptake inhibitor therapy on endothelial function and inflammatory markers in patients with coronary heart disease. Clin Pharmacol Ther. 2009;86:527–32.PubMedCrossRef
31.
go back to reference Buhl ES, Jensen TK, Jessen N, et al. Treatment with an SSRI antidepressant restores hippocampo-hypothalamic corticosteroid feedback and reverses insulin resistance in low-birth-weight rats. Am J Physiol Endocrinol Metab. 2010;298:E920–9.PubMedCrossRef Buhl ES, Jensen TK, Jessen N, et al. Treatment with an SSRI antidepressant restores hippocampo-hypothalamic corticosteroid feedback and reverses insulin resistance in low-birth-weight rats. Am J Physiol Endocrinol Metab. 2010;298:E920–9.PubMedCrossRef
32.
go back to reference Danese A, Pariante CM, Caspi A, et al. Childhood maltreatment predicts adult inflammation in a life-course study. Proc Natl Acad Sci USA. 2007;104(4):1319–24.PubMedCrossRef Danese A, Pariante CM, Caspi A, et al. Childhood maltreatment predicts adult inflammation in a life-course study. Proc Natl Acad Sci USA. 2007;104(4):1319–24.PubMedCrossRef
33.
go back to reference Ismail K, Sloggett A, De Stavola B. Do common mental disorders increase cigarette smoking? Results from five waves of a population-based panel cohort study. Am J Epidemiol. 2000;152(7):651–7.PubMedCrossRef Ismail K, Sloggett A, De Stavola B. Do common mental disorders increase cigarette smoking? Results from five waves of a population-based panel cohort study. Am J Epidemiol. 2000;152(7):651–7.PubMedCrossRef
34.
go back to reference •Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67:220–229. This systematic review showed for the first time bidirectional associations between obesity and depression, and provides support for the hypothesis that lifestyle behaviors (unhealthy eating and physical inactivity) mediate the association between depression and diabetes.PubMedCrossRef •Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67:220–229. This systematic review showed for the first time bidirectional associations between obesity and depression, and provides support for the hypothesis that lifestyle behaviors (unhealthy eating and physical inactivity) mediate the association between depression and diabetes.PubMedCrossRef
35.
go back to reference Patton GC, Carlin JB, Coffey C, et al. Depression, anxiety, and smoking initiation: a prospective study over 3 years. Am J Public Health. 1998;88:1518–22.PubMedCrossRef Patton GC, Carlin JB, Coffey C, et al. Depression, anxiety, and smoking initiation: a prospective study over 3 years. Am J Public Health. 1998;88:1518–22.PubMedCrossRef
36.
go back to reference van Gool CH, Kempen GIJM, Penninx BWJH, et al. Relationship between changes in depressive symptoms and unhealthy lifestyles in late middle aged and older persons: results from the Longitudinal Aging Study Amsterdam. Age Ageing. 2003;32:81–7.PubMedCrossRef van Gool CH, Kempen GIJM, Penninx BWJH, et al. Relationship between changes in depressive symptoms and unhealthy lifestyles in late middle aged and older persons: results from the Longitudinal Aging Study Amsterdam. Age Ageing. 2003;32:81–7.PubMedCrossRef
37.
go back to reference Patten SB, Williams JVA, Lavorato DH, Eliasziw M: A longitudinal community study of major depression and physical activity. General Hospital Psychiatry; 2009;31:571–575. Patten SB, Williams JVA, Lavorato DH, Eliasziw M: A longitudinal community study of major depression and physical activity. General Hospital Psychiatry; 2009;31:571–575.
38.
go back to reference Matza LS, Revicki DA, Davidson JR, Stewart JW. Depression with atypical features in the National Comorbidity Survey: classification, description, and consequences. Arch Gen Psychiatry. 2003;60:817–26.PubMedCrossRef Matza LS, Revicki DA, Davidson JR, Stewart JW. Depression with atypical features in the National Comorbidity Survey: classification, description, and consequences. Arch Gen Psychiatry. 2003;60:817–26.PubMedCrossRef
39.
go back to reference Di Marzo V. The endocannabinoid system in obesity and type 2 diabetes. Diabetologia. 2008;51:1356–67.PubMedCrossRef Di Marzo V. The endocannabinoid system in obesity and type 2 diabetes. Diabetologia. 2008;51:1356–67.PubMedCrossRef
40.
go back to reference Drewnowski A. The real contribution of added sugars and fats to obesity. Epidemiol Rev. 2007;29:160–71.PubMedCrossRef Drewnowski A. The real contribution of added sugars and fats to obesity. Epidemiol Rev. 2007;29:160–71.PubMedCrossRef
41.
go back to reference Alberti KG, Zimmet P, Shaw J. International Diabetes Federation: a consensus on type 2 diabetes prevention. Diabet Med. 2007;24:451–63.PubMedCrossRef Alberti KG, Zimmet P, Shaw J. International Diabetes Federation: a consensus on type 2 diabetes prevention. Diabet Med. 2007;24:451–63.PubMedCrossRef
42.
go back to reference The Diabetes Prevention Program. Design and methods for a clinical trial in the prevention of type 2 diabetes. Diabetes Care. 1999;22:623–34.CrossRef The Diabetes Prevention Program. Design and methods for a clinical trial in the prevention of type 2 diabetes. Diabetes Care. 1999;22:623–34.CrossRef
43.
go back to reference Gonzalez JS, Peyrot M, McCarl LA, et al. Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care. 2008;31:2398–403.PubMedCrossRef Gonzalez JS, Peyrot M, McCarl LA, et al. Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care. 2008;31:2398–403.PubMedCrossRef
44.
go back to reference Gilbody S, Bower P, Fletcher J, et al. Collaborative care for depression: a cumulative meta-analysis and review of longer-term outcomes. Arch Intern Med. 2006;166:2314–21.PubMedCrossRef Gilbody S, Bower P, Fletcher J, et al. Collaborative care for depression: a cumulative meta-analysis and review of longer-term outcomes. Arch Intern Med. 2006;166:2314–21.PubMedCrossRef
45.
go back to reference Roy-Byrne P, Craske MG, Sullivan G, et al. Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial. JAMA. 2010;303:1921–8.PubMedCrossRef Roy-Byrne P, Craske MG, Sullivan G, et al. Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial. JAMA. 2010;303:1921–8.PubMedCrossRef
46.
go back to reference Gilbody S, Bower P, Whitty P. Costs and consequences of enhanced primary care for depression: systematic review of randomised economic evaluations. Br J Psychiatry. 2006;189:297–308.PubMedCrossRef Gilbody S, Bower P, Whitty P. Costs and consequences of enhanced primary care for depression: systematic review of randomised economic evaluations. Br J Psychiatry. 2006;189:297–308.PubMedCrossRef
47.
go back to reference Katon WJ, Lin EH, Von Korff M, et al. Collaborative care for patients with depression and chronic illnesses. N Engl J Med. 2010;363(27):2611–20.PubMedCrossRef Katon WJ, Lin EH, Von Korff M, et al. Collaborative care for patients with depression and chronic illnesses. N Engl J Med. 2010;363(27):2611–20.PubMedCrossRef
48.
go back to reference Simon GE, Rohde P, Ludman EJ, et al. Association between change in depression and change in weight among women enrolled in weight loss treatment. Gen Hosp Psychiatry. 2010;32:583–9.PubMedCrossRef Simon GE, Rohde P, Ludman EJ, et al. Association between change in depression and change in weight among women enrolled in weight loss treatment. Gen Hosp Psychiatry. 2010;32:583–9.PubMedCrossRef
49.
go back to reference •Ye Z, Chen L, Yang Z, et al. Metabolic effects of fluoxetine in adults with type 2 diabetes mellitus: a meta-analysis of randomized placebo-controlled trials. PLoS One. 2011;6:e21551. This systematic review shows significant treatment effects of fluoxetine on reducing weight, triglyceride, and glycated hemoglobin levels in obese people with type 2 diabetes mellitus, which should be taken into account in the pharmacologic management of depression in individuals with excess body weight and diabetes.PubMedCrossRef •Ye Z, Chen L, Yang Z, et al. Metabolic effects of fluoxetine in adults with type 2 diabetes mellitus: a meta-analysis of randomized placebo-controlled trials. PLoS One. 2011;6:e21551. This systematic review shows significant treatment effects of fluoxetine on reducing weight, triglyceride, and glycated hemoglobin levels in obese people with type 2 diabetes mellitus, which should be taken into account in the pharmacologic management of depression in individuals with excess body weight and diabetes.PubMedCrossRef
50.
Metadata
Title
A Review of the Association Between Depression and Insulin Resistance: Pitfalls of Secondary Analyses or a Promising New Approach to Prevention of Type 2 Diabetes?
Authors
Naomi Silva
Evan Atlantis
Khalida Ismail
Publication date
01-02-2012
Publisher
Current Science Inc.
Published in
Current Psychiatry Reports / Issue 1/2012
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-011-0245-8

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