The Clinical Study Of Combined Association Of Abdominal Obesity And Depressive Symptoms With Risk Of Diabetes

BackgroundWith the world population aging and changing its lifestyle,the incidence rates of diabetes mellitus are on the rise.Diabetes causes not only multiple health complications which directly influence the patients’ quality of life,but also prolongs hospital stays.It has brought heavy economic burden both to families and society.Prediabetes is an intermediate stage,when the blood glucose level is between normal and diabetes.Early interventions on prediabetes can reduce the risk of diabetes occurring,and thus also the risk of all-cause mortality and medical insurance expenditure.Therefore,it is important to explore the risk factors of diabetes in prediabetes and normal population and propose preventative measures informed by the findings.Abdominal obesity is a common chronic metabolic disease characterized by an increased quantity of abdominal fat.Depressive symptoms are common mental illnesses that can increase the risk of diabetes.Interestingly,many studies showed that abdominal obesity often co-occurs with depressive symptoms.The co-existence of abdominal obesity and depressive symptoms inflicts harms on human health.Diabetes is a multifactorial disease,but whether or not the co-existence of abdominal obesity and depressive symptoms increases its risk,especially in the middle-aged and elderly people who are already at a higher risk for diabetes,has not been fully studied.Compared with the normal people,those with pre-diabetes has their own characteristics,because their glucose metabolism has been partly damaged.It is important to investigate whether abdominal obesity and depressive symptoms have different effects on the onset of diabetes in pre-diabetic population,as well as the interaction between them.Abdominal obesity and depressive symptoms are greatly affected by gender.Exploring the influence and interaction of them on the incidence of diabetes in different genders will provide personalized guidance for the prevention of diabetes.Objectives1.Exploring the combined association of abdominal obesity and depressive symptoms with risk of diabetes and the question whether there is an interaction between them.2.Exploring the combined association of abdominal obesity and depressive symptoms with risk of diabetes and the question whether different glycemic statuses and gender have influenced this association.MethodsData is acquired from the China Health and Retirement Longitudinal Study.The non-diabetic population at baseline was included and followed up for 7 years to calculate the incidence of diabetes.Participants were divided into four groups:neither have abdominal obesity nor depressive symptoms(AO-/DS-),only have depressive symptoms(AO-/DS+),only have abdominal obesity(AO+/DS-),and have both abdominal obesity and depressive symptoms(AO+/DS+).Stratified analyses differentiating the glycemic statuses and gender of the participants were also carried out.The additive model was used to analyze the interaction between abdominal obesity and depressive symptoms on the incidence of diabetes.Results1.A total of 5949 participants were involved in our study,and 598 of them developed diabetes,with a cumulative incidence of 10.05%.After adjusting for potential confounding factors by logistic regression analysis,the AO-/DS+,AO+/DS-and AO+/DS+phenotypes were all associated with the risk of diabetes independently in overall population(OR＝1.38,95%CI:1.06-1.79;OR=2.07,95%CI:1.63-2.63;OR=2.38,95%CI:1.83-3.11,respectively).2.To analyze whether glycemic status and gender influences the incidence of diabetes within different phenotypes,we performed a stratified analysis of different glycemic status(normoglycemia and prediabetes)and gender at baseline.For normoglycemia and females,the AO-/DS+,AO+/DS-and AO+/DS+phenotypes were associated with the risk of diabetes,compared with AO-/DS-phenotypes.For prediabetes and males,the AO+/DS-and AO+/DS+ phenotypes are risk factors for diabetes compared with the AO-/DS-phenotype,but not AO-/DS+.3.The additive interaction analysis showed no significant interaction between abdominal obesity and depressive symptoms on the incidence of diabetes in either the overall population or stratified analysis with different glycemic status and gender.Conclusion1.Abdominal obesity and depressive symptoms are risk factors for diabetes in normoglycemic individuals.In prediabetes,only abdominal obesity is risk factor for diabetes.2.For females,the incidence of diabetes was significantly higher in patients with abdominal obesity and depressive symptoms.For males,the incidence of diabetes was significantly higher in those with abdominal obesity.3.Regardless of glycemic status and gender,there was no interaction between abdominal obesity and depressive symptoms on the incidence of diabetes.4.Depressive symptoms were independent risk factors for diabetes only in normoglycemic individuals and females.