Longitudinal study of depressive symptoms and progression of insulin resistance in youth at risk for adult obesity

Lauren B Shomaker, Marian Tanofsky-Kraff, Elizabeth A Stern, Rachel Miller, Jaclyn M Zocca, Sara E Field, Susan Z Yanovski, Van S Hubbard, Jack A Yanovski, Lauren B Shomaker, Marian Tanofsky-Kraff, Elizabeth A Stern, Rachel Miller, Jaclyn M Zocca, Sara E Field, Susan Z Yanovski, Van S Hubbard, Jack A Yanovski

Abstract

OBJECTIVE The purpose of this study was to determine whether having childhood depressive symptoms is a risk factor that prospectively predicts impairment in glucose homeostasis. RESEARCH DESIGN AND METHODS A non-treatment-seeking sample of 115 children (aged 5-13 years), oversampled for being at risk for adult obesity, was assessed at baseline and again ~6 years later. Children self-reported depressive symptoms using the Children's Depression Inventory at baseline. Insulin resistance was assessed at baseline and follow-up with the homeostasis model assessment of insulin resistance index (HOMA-IR). RESULTS Children's depressive symptoms were a significant predictor of follow-up HOMA-IR, fasting insulin, and fasting glucose in models accounting for baseline HOMA-IR, insulin, or glucose values; sex; race; baseline age; baseline BMI; change in BMI at follow-up; family history of type 2 diabetes; and time in the study (P < 0.01). CONCLUSIONS In this study, depressive symptomatology at baseline predicted the progression of insulin resistance during child and adolescent development independent of changes in BMI. Research is needed to determine whether early intervention to decrease elevated depressive symptoms in youth ameliorates later development of insulin resistance and lessens the risk of type 2 diabetes.

Trial registration: ClinicalTrials.gov NCT00001522.

Figures

Figure 1
Figure 1
Compared with children with lower depressive symptoms at baseline (n = 97; CDI total score <13), youth with elevated depressive symptoms at baseline (n = 18; CDI total score ≥13) had greater follow-up: insulin resistance (HOMA-IR: [means ± SE] 2.8 ± 0.2 vs. 4.3 ± 0.4, P < 0.001) (A), fasting insulin (13.2 ± 0.8 µU/L vs. 19.4 ± 1.7 µU/L, P = 0.001) (B), and fasting glucose (85.3 ± 0.8 mg/dL vs. 92.9 ± 1.7 mg/dL, P < 0.001) (C), adjusting for the respective baseline values, sex, race, family history of type 2 diabetes, baseline age, baseline BMI, BMI change, and time in study.

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Source: PubMed

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