Diabetes and depression in atherosclerosis individuals at high cardiovascular risk


Diabetes mellitus is a major cause of death and disability worldwide and is a strong risk factor for stroke and independently predicts coronary atherosclerosis. The projective of this study is to analyze whether depression may influence the control of diabetes individuals at high cardiovascular risk. It is apparent that a variety of adaptations/alterations in cardiac structure and function occur as excessive uncontrol diabetes, even in the absence of comorbidities. PubMed MEDLINE was systematically searched for prospective population-based cohort studies published between on January 1, 2001 and January 1, 2013, of 4628 diabetes patients with high cardiovascular risk factor profiles. The relationship between diabetes and depression was analyzed. A multivariate analysis (logistic and log-linear regression), adjusting for potential confounders (socio-demographic factors, body mass index, lifestyle, diabetes, dyslipidemia), was performed. The pooled maximal-adjusted RR of stroke associated with diabetes was 2.32 (95% confidence interval [CI]:1.94, 2.86) in depression and 1.62 (1.51, 2.02) in non-depression. Together with these results the excess risk of cardiovascular risk associated with diabetes is significantly higher in depressant patients and need for further work to clarify the behavioral mechanisms that are involved.

Keywords: Diabetes Mellitus; Coronary atherosclerosis; Cardiovascular risk; Depression

Copyright © 2014 by The American Society for BioMedicine and BM-Publisher, Inc.

Article citationReferencesFull-Text/PDFFeedback
The citation data is computed by the following citation measuring services:

Cited by (CrossRef)
Google Scholar

  1. Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998; 339:229-234. https://doi.org/10.1056/NEJM199807233390404
  2. Scognamiglio R, Negut C, Ramondo A, Tiengo A, Avogaro A: Detection of coronary artery disease in asymptomatic patients with type 2 diabetes mellitus. J Am Coll cardiol 2006; 47:65-71. https://doi.org/10.1016/j.jacc.2005.10.008
  3. Frye RL, August P, Brooks MM, Hardison RM, Kelsey SF, MacGregor JM, Orchard TJ, Chaitman BR, Genuth SM, Goldberg SH, et al. A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med 2009; 360: 2503-2515. https://doi.org/10.1056/NEJMoa0805796
    PMid:19502645 PMCid:PMC2863990
  4. American Diabetes Association: Standards of medical care in diabetes-2012. Diabetes Care 2012; 35(Suppl 1):S11-S63. https://doi.org/10.2337/dc12-s011
    PMid:22187469 PMCid:PMC3632172
  5. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735-2752.
  6. Weiner DA, Ryan TJ, Parsons L, Fisher LD, Chaitman BR, Sheffield LT, Tristani FE. Significance of silent myocardial ischemia during exercise testing in patients with diabetes mellitus: a report from the Coronary Artery Surgery Study (CASS) Registry. Am J Cardiol 1991; 68:729-734.
  7. Elkeles RS, Godsland IF, Feher MD, Rubens MB, Roughton M, Nugara F, Humphries SE, Richmond W, Flather MD: Coronary calcium measurement improves prediction of cardiovascular events in asymptomatic patients with type 2 diabetes. the PREDICT study. Eur Heart J 2008; 29: 2244-2251.
  8. Hadamitzky M, Hein F, Meyer T, Bischoff B, Martinoff S, Schomig A, Hausleiter J. Prognostic value of coronary computed tomographic angiography in diabetic patients without known coronary artery disease. Diabetes Care 2010; 33:1358-1363.
    PMid:20200300 PMCid:PMC2875454
  9. Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med 2008; 358: 580-591.
  10. Wilson  PWCupples  LAKannel  WB Is hyperglycemia associated with cardiovascular disease? the Framingham Study. Am Heart J. 1991;121(2, pt 1)586- 590.
  11. Wong  TYKlein  RSharrett  AR  et al.  Cerebral white matter lesions, retinopathy, and incident clinical stroke. JAMA 2002; 28867- 74.
  12. Arad Y, Goodman KJ, Roth M, Newstein D, Guerci AD. Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events: The St Francis Heart Study. J Am Coll Cardiol 2005;46:158-165. https://doi.org/10.1016/j.jacc.2005.02.088
  13. Bax JJ, Inzucchi SE, Bonow RO, Schuijf JD, Freeman MR, Barrett EJ. For the Global Dialogue Group for the Evaluation of Cardiovascular Risk in Patients with Diabetes. Cardiac imaging for risk stratification in diabetes. Cardiac imaging for risk stratification in diabetes. Diab Care 2007;30:1295-1304. https://doi.org/10.2337/dc06-2094
  14. Budoff MJ, Shaw LJ, Liu ST, Weinstein SR, Mosler TP, Tseng PH, Flores FR, Callister TQ, Raggi P, Berman DS. Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 2007;49:1860-1870.  https://doi.org/10.1016/j.jacc.2006.10.079
  15. Carstensen B, Kristensen JK, Ottosen P, Borch-Johnsen K, Steering Group of the National Diabetes Register The Danish National Diabetes Register: trends in incidence, prevalence and mortality. Diabetologia 2008;51:2187–2196. https://doi.org/10.1007/s00125-008-1156-z
  16. Boyle JP, Thompson TJ, Gregg EW, Barker LE, Williamson DF. Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. Popul Health Metr 2010;8:29. https://doi.org/10.1186/1478-7954-8-29
    PMid:20969750 PMCid:PMC2984379
  17. Cowie CC, Rust KF, Byrd-Holt DD, et al. Prevalence of diabetes and high risk for diabetes using A1c criteria in the U.S. population in 1988–2006. Diabetes Care 2010;33:562–568.
    PMid:20067953 PMCid:PMC2827508
  18. Burrows NR, Li Y, Geiss LS. Incidence of treatment for end-stage renal disease among individuals with diabetes in the U.S. continues to decline. Diabetes Care 2010;33:73–77.
    PMid:20040673 PMCid:PMC2797989
  19. Hoehner CM, Williams DE, Sievers ML, Knowler WC, Bennett PH, Nelson RG. Trends in heart disease death rates in diabetic and nondiabetic Pima Indians. J Diabetes Complications 2006;20:8–13. https://doi.org/10.1016/j.jdiacomp.2005.06.003
  20. Ford ES, Ajani UA, Croft JB, et al. Explaining the decrease in U.S. deaths from coronary disease, 1980–2000. N Engl J Med 2007;356:2388–2398.
  21. Centers for Disease Control and Prevention Design and estimation for the National Health Interview Survey, 1995–2004. Vital Health Stat 2 2000;130:1–31.
    22. Preis SR, Hwang SJ, Coady S, et al. Trends in all-cause and cardiovascular disease mortality among women and men with and without diabetes mellitus in the Framingham Heart Study, 1950 to 2005. Circulation 2009;119:1728–1735. https://doi.org/10.1161/CIRCULATIONAHA.108.829176
    PMid:19307472 PMCid:PMC2789419
  22. Thomas RJ, Palumbo PJ, Melton LJ, 3rd, et al. Trends in the mortality burden associated with diabetes mellitus: a population-based study in Rochester, Minn, 1970–1994. Arch Intern Med 2003;163:445–451.


For any technique error please contact us and will be response to sending purchase article by email.

Who Can Become a Reviewer?
Any expert in the article's research field can become a reviewer with American Journal of BioMedicine. Editors might ask you to look at a specific aspect of an article.

Find out more

Thank you for visiting American Journal of BioMedicine. * = Required fields

Error: Contact form not found.

Research Article
DOI: http://dx.doi.org/10.18081/2333-5106/014-2/952-963
American Journal of BioMedicine Volume 2, Issue 8, pages 93-109
Received September 30, 2015; Accepted January 30, 2016; Published March 21, 2016

How to cite this article
Gregg LN, Ford L, Gerstein E. Diabetes and depression in atherosclerosis individuals at high cardiovascular risk. American Journal of BioMedcine 2016;4(1):93-109.
Case report outline
1. Abstract
2. Keywords
3. Introduction
4. Methods
5. Results
6. Discussion
7. References

Explore PlumX Metrics