摘要：Objectives. We investigated whether depressive symptoms and antidepressant use are associated with biomarkers for glucose dysregulation and inflammation, body mass index (BMI), and waist circumference. Methods. Postmenopausal women were recruited into the Women’s Health Initiative from 1993 to 1998, and data were collected at regular intervals through 2005. We used multiple linear regression models to examine whether depressive symptoms and antidepressant use are associated with BMI, waist circumference, and biomarkers. Results. Analysis of data from 71 809 women who completed all relevant baseline and year 3 assessments showed that both elevated depressive symptoms and antidepressant use were significantly associated with higher BMI and waist circumference. Among 1950 women, elevated depressive symptoms were significantly associated with increased insulin levels and measures of insulin resistance. Analyses of baseline data from 2242 women showed that both elevated depressive symptoms and antidepressant use were associated with higher C-reactive protein levels. Conclusions. Monitoring body habitus and other biomarkers among women with elevated depression symptoms or taking antidepressant medication may be prudent to prevent diabetes and cardiovascular disease. Postmenopausal women have been identified as being at elevated risk for both depression and diabetes. 1 Depression has been well documented to be associated with increased risk of diabetes. 2–9 Using data on postmenopausal women from the Women’s Health Initiative (WHI), we previously observed that depressive symptoms and antidepressant use were independently associated with diabetes risk and cardiovascular disease. 10,11 Recent studies 12–15 have suggested that this relationship may be prospective and independent of traditional risk factors for type 2 diabetes such as family history of diabetes, body weight, diet, physical activity, and smoking, although 1 study found no association between depressive symptoms and unrecognized diabetes. 16 Few studies have examined the association of body mass index (BMI; defined as weight in kilograms divided by height in meters squared), waist circumference, and biomarkers of glucose dysregulation and inflammation with depression, antidepressant medication use, or both. However, identifying these markers is important for diabetes prevention because they can be monitored for possible action before progression to full-blown diabetes. We therefore investigated the associations of elevated depressive symptoms and antidepressant use with body habitus, glucose dysregulation, and inflammatory biomarkers using longitudinal data from the WHI. In particular, we examined these hypotheses: (1) elevated depressive symptoms and antidepressant use are independently associated with increased BMI and waist circumference; (2) elevated depressive symptoms and antidepressant use are independently associated with increased levels of fasting glucose and insulin, insulin resistance, blood pressure, and triglycerides and reduced high-density lipoprotein (HDL) cholesterol; and (3) elevated depressive symptoms and antidepressant use are independently associated with increased levels of high-sensitivity C-reactive protein (CRP), tumor-necrosis factor-α receptor 2 (TNF-α R2), and interleukin-6 (IL-6) as markers of systemic inflammation.
