Sex-specific associations of depressive symptom trajectories with type 2 diabetes mellitus in middle-aged and older adults: Findings from a nationwide cohort in China.
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Abstract
Objectives: This study aimed to investigate the sex-specific associations between depressive symptom trajectories and the risk of Type 2 diabetes mellitus (T2DM).
Method: This longitudinal study was based on the China Health and Retirement Longitudinal Study. Chinese residents aged ≥45 years with sufficient information were included in 2011-2015 and followed up in 2018. The sex-specific associations between depressive symptom trajectories and T2DM were calculated by Multivariable Cox frailty models. The population attributable fractions were used to quantify the risk of T2DM associated with trajectories of depressive symptoms.
Results: Of the 2,949 males and 3,407 females included, 99 and 122 developed T2DM, respectively. We identified four depressive symptom trajectories in both sexes: maintained-low, decreasing, increasing, and maintained-high. Compared to those in maintained-low trajectory, females in all other trajectories had higher risks of T2DM (hazard ratios [HRs] ranged from 2.01 to 3.93). In comparison, only maintained-high (HR = 2.86, 95% confidence interval [CI] [1.42, 5.77]) and decreasing depressive symptom trajectories were associated with increased risk of T2DM (1.82, [1.10, 3.00]) in males. The T2DM risks attributable to maintained-high, increasing, and decreasing trajectories were 16.35%-23.75% in females. In males, maintained-high and decreasing trajectories accounted for 9.14% and 11.98% of T2DM risks.
Conclusion: The sex-specific analysis revealed the trajectories with initially high levels of depressive symptoms were associated with T2DM in both sexes. Additionally, females exhibited an extra risk of T2DM associated with the increasing depressive symptoms trajectory. The findings necessitate monitoring and addressing depressive symptoms in preventing T2DM in both males and females. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
期刊介绍：
Health Psychology publishes articles on psychological, biobehavioral, social, and environmental factors in physical health and medical illness, and other issues in health psychology.
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