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Risk of depression and anxiety disorders according to long-term glycemic variability

Authors
 Manjae Kwon  ;  Myeongjee Lee  ;  Eun Hwa Kim  ;  Dong-Woo Choi  ;  Eunjin Jung  ;  Keun You Kim  ;  Inkyung Jung  ;  Junghee Ha 
Citation
 JOURNAL OF AFFECTIVE DISORDERS, Vol.343 : 50-58, 2023-12 
Journal Title
JOURNAL OF AFFECTIVE DISORDERS
ISSN
 0165-0327 
Issue Date
2023-12
Keywords
Anxiety disorder ; Depression ; Glycemic variability ; Hyperglycemia ; Psychiatric disorder
Abstract
Background: Poor glycemic control has been linked to psychiatric symptoms. However, studies investigating the relationship between glycemic variability (GV) and depression and anxiety disorders are limited. We investigated the association of GV with depression and anxiety disorders. In addition, the relationship between trends in fasting plasma glucose (FPG) levels and these disorders were explored.

Methods: We analyzed the National Health Insurance Service-National Sample Cohort database (2002-2013) with 151,814 participants who had at least three health screenings between 2002 and 2010. Visit-to-visit FPG variability was measured as variability independent of the mean (VIM). Depression and anxiety disorders were diagnosed using ICD-10 codes (F41 for anxiety and F32 or F33 for depression) after index date. We analyzed the association between GV and incidences of these disorders using Kaplan-Meier and Cox proportional hazards methods. Trajectory analysis was conducted to explore the relationship between FPG trends and these disorders.

Results: During follow-up, 7166 and 14,149 patients were newly diagnosed with depression and anxiety disorders, respectively. The highest quartile group of FPG-VIM had a greater incidence of depression and anxiety than the lowest quartile group, with adjusted hazard ratios of 1.09 (95 % confidence interval [CI]: 1.02-1.17) and 1.08 (95 % CI: 1.03-1.14). Group with persistent hyperglycemia, identified through trajectory clustering of FPG levels, had a 1.43-fold increased risk of depression compared to those with consistently low FPG levels.

Limitations: Potential selection bias by including participants with at least three health screenings.

Conclusions: High GV and persistent hyperglycemia are associated with increased incidence of depression and anxiety disorders.
Full Text
https://www.sciencedirect.com/science/article/pii/S0165032723011515
DOI
10.1016/j.jad.2023.09.017
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Manjae(권만재)
Kim, Keun You(김근유) ORCID logo https://orcid.org/0000-0001-7192-2828
Lee, Myeongjee(이명지)
Jung, Inkyung(정인경) ORCID logo https://orcid.org/0000-0003-3780-3213
Ha, Junghee(하정희) ORCID logo https://orcid.org/0000-0002-4217-3570
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/196728
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