Depressive symptoms and metabolic markers of risk for type 2 diabetes in obese adolescents

Abstract

Objective: Although higher rates of depression are found among individuals with type 2 diabetes, it remains unknown if the presence of depressive symptoms is associated with heightened metabolic risk for the development of type 2 diabetes among youth. The objective of this study was to evaluate whether depressive symptoms in obese adolescents are associated with impaired β-cell function relative to insulin sensitivity [oral disposition index (oDI)] and/or dysglycemia or prediabetes, predictors of type 2 diabetes development.

Research design and methods: Fasting and oral glucose tolerance test (OGTT)-derived indices of glucose tolerance, insulin sensitivity, secretion, and oDI were evaluated in obese youth (n = 56, age 15.0 ± 1.6 yr, 68% female). The Children's Depression Inventory was utilized to determine depressive symptomatology.

Results: Despite no association between depressive symptoms and measures of adiposity, youth with higher depressive symptoms had (i) significantly higher fasting and stimulated glucose levels (13% higher glucose area under the OGTT curve), (ii) ∼50% lower oDI, and (iii) a 50% frequency of prediabetes.

Conclusions: These data point to an important relationship between depressive symptoms and a heightened metabolic risk for type 2 diabetes in obese adolescents, including prediabetes and impairment in β-cell function relative to insulin sensitivity. While the directionality of these relationships is unknown, it should be determined if treating one disorder improves the other or vice versa.

Keywords: IGT; depression; insulin secretion; insulin sensitivity; obesity; prediabetes; type 2 diabetes.

Figure I

The correlation between log-transformed CDI score and (A) fasting glucose, (B) OGTT 2-hr glucose, (C) OGTT glucose AUC and (D) oral disposition index (oDI). Subjects with CDI total score < 13 are represented by empty circles and CDI total score ≥ 13 are represented by filled circles.