Table 2.
Associations of major depressive disorder and depressive symptoms with the risk of total and individual vascular complications and death among individuals with type 2 diabetes mellitus.
| Incidence (per 1000 person-years) | Cases/deaths | Major depressive disorder |
PAF, % | Depressive symptoms |
PAF, % | |||
|---|---|---|---|---|---|---|---|---|
| HR1 (95% CI) | HR2 (95% CI) | HR1 (95% CI) | HR2 (95% CI) | |||||
| ASCVD | 18.00 | 2927 | 1.21 (1.08–1.37) | 1.17 (1.03–1.32) | 1.1 | 1.37 (1.21–1.55) | 1.25 (1.10–1.42) | 1.4 |
| CAD | 13.26 | 2205 | 1.30 (1.13–1.49) | 1.26 (1.10–1.45) | 1.9 | 1.39 (1.20–1.60) | 1.27 (1.10–1.47) | 1.7 |
| PAD | 3.52 | 615 | 1.19 (0.91–1.55) | 1.07 (0.82–1.40) | – | 1.47 (1.13–1.92) | 1.30 (0.99–1.69) | – |
| IS | 3.26 | 570 | 0.93 (0.67–1.27) | 0.90 (0.66–1.23) | – | 1.10 (0.80–1.50) | 0.97 (0.71–1.34) | – |
| HF | 6.16 | 1070 | 1.43 (1.18–1.74) | 1.32 (1.09–1.61) | 2.5 | 1.69 (1.39–2.06) | 1.47 (1.20–1.79) | 3.1 |
| Microvascular complications | ||||||||
| Overall | 15.42 | 2579 | 1.30 (1.15–1.47) | 1.29 (1.14–1.46) | 2.0 | 1.31 (1.15–1.50) | 1.20 (1.05–1.37) | 1.2 |
| DKD | 6.42 | 1114 | 1.36 (1.13–1.65) | 1.31 (1.09–1.59) | 2.3 | 1.22 (0.99–1.51) | 1.09 (0.88–1.36) | – |
| DN | 3.33 | 582 | 2.06 (1.66–2.57) | 1.96 (1.57–2.45) | 7.8 | 1.62 (1.26–2.09) | 1.49 (1.16–1.93) | 3.8 |
| DR | 8.10 | 1393 | 0.96 (0.80–1.16) | 0.99 (0.83–1.20) | – | 1.25 (1.04–1.49) | 1.13 (0.94–1.35) | – |
| All-cause death | 12.16 | 2157 | 1.39 (1.21–1.59) | 1.26 (1.09–1.44) | 2.0 | 1.38 (1.18–1.60) | 1.26 (1.08–1.47) | 1.6 |
| CVD-specific death | 2.62 | 465 | 1.36 (1.01–1.83) | 1.26 (0.93–1.70) | – | 1.12 (0.79–1.59) | 1.01 (0.71–1.44) | – |
HR1 (95% CI): adjusted for age and sex.
HR2 (95% CI): adjusted for age, sex, ethnicity, Townsend deprivation index, smoking status, alcohol intake, body mass index, family history of cardiovascular disease, family history of diabetes, diabetes duration, use of hypoglycemic agents, and use of lipid-lowing medication.
Major depressive disorder determined based on hospital inpatient admission records and self-report, and depressive symptoms assessed using the Patient Health Questionnaire-2.
ASCVD, atherosclerotic cardiovascular disease; CAD, coronary artery disease; DKD, diabetic kidney disease; DN, diabetic neuropathy; DR, diabetic retinopathy; HF, heart failure; HR, hazard ratio; IS, ischemic stroke; PAD, peripheral artery disease; PAF, population attributable fraction.