The relationship between diabetes and depressive symptoms in men with or at risk of HIV infection

R. C. Basil; T. T. Brown; S. Haberlen; L. H. Rubin; M. Plankey; J. T. Becker; J. E. Lake; F. J. Palella; S. Sarkar

doi:10.1111/hiv.12958

The relationship between diabetes and depressive symptoms in men with or at risk of HIV infection

R. C. Basil, T. T. Brown, S. Haberlen, L. H. Rubin, M. Plankey, J. T. Becker, J. E. Lake, F. J. Palella, S. Sarkar^*

^*Corresponding author for this work

Medicine, Infectious Diseases Division

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Objectives: The aim of the study was to compare the prevalence of comorbid diabetes and depressive symptoms in men living with HIV (MLWH) with that in men without HIV infection and to determine associations between glycaemic control and depressive symptoms. Methods: Participants included 920 MLWH and 840 men without HIV infection from the Multicenter AIDS Cohort Study (MACS) with available data regarding glycaemic status [categorized as normal for fasting blood glucose (FBG) < 100 mg/dL, prediabetes for FBG 100–125 mg/dL, and diabetes, defined by self-report, diabetes medication use or FBG ≥ 126 mg/dL on at least two consecutive visits, with diabetes classified as controlled if Hemoglobin A1c (HbA1C) < 7.5% and uncontrolled if HbA1C ≥ 7.5%]. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) score, with CES-D ≥ 16 scores classified as elevated depressive symptoms. A modified Poisson regression model with robust variance was used and adjusted for covariates including HIV serostatus. Results: Compared to men without HIV infection, MLWH had a higher mean CES-D score, but a similar prevalence of diabetes (11.3% versus 12.8%, respectively; P = 0.33). The concomitant prevalence of diabetes and elevated depressive symptoms did not differ by HIV serostatus (P = 0.215). In an adjusted analysis, men with uncontrolled diabetes had a greater prevalence of depressive symptoms compared to men with normoglycaemia (prevalence ratio = 1.43; 95% confidence interval 1.11, 1.84). The association between glycaemic status and depressive symptoms did not differ by HIV serostatus (P = 0.22 for interaction). Conclusions: Both controlled and uncontrolled diabetes were independently associated with a greater prevalence of depressive symptoms, regardless of HIV serostatus. These results highlight the importance of identifying depression in people with diabetes.

Original language	English (US)
Pages (from-to)	37-46
Number of pages	10
Journal	HIV Medicine
Volume	22
Issue number	1
DOIs	https://doi.org/10.1111/hiv.12958
State	Published - Jan 2021

Funding

: TTB has served as a consultant to Gilead Sciences, ViiV Healthcare, Merck, and Theratechnologies. JEL has served as a consultant to Merck and Gilead consultancy and has received research funding from Gilead Sciences. The remaining authors do not report any conflicts of interest. Conflicts of interest : SS was funded by a grant (K12HL143957) from the National Heart, Lung, and Blood Institute. TTB was funded by grants (K24AI120834 and U01‐AI35042) from the National Institutes of Health. Financial disclosure Data in this manuscript were collected by the Multicenter AIDS Cohort Study (MACS). MACS (Principal Investigators): Johns Hopkins University Bloomberg School of Public Health (Joseph Margolick and Todd Brown), U01‐AI35042; Northwestern University (Steven Wolinsky), U01‐AI35039; University of California, Los Angeles (Roger Detels), U01‐AI35040; University of Pittsburgh (Charles Rinaldo and Jeremy Martinson), U01‐AI35041; the Center for Analysis and Management of MACS, Johns Hopkins University Bloomberg School of Public Health (Lisa Jacobson and Gypsyamber D’Souza), UM1‐AI35043. The MACS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co‐funding from the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH). Targeted supplemental funding for specific projects was also provided by the National Heart, Lung, and Blood Institute (NHLBI), and the National Institute on Deafness and Communication Disorders (NIDCD). MACS data collection is also supported by UL1‐TR001079 (JHU ICTR) from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH), Johns Hopkins ICTR, or NCATS. The MACS website is located at http://aidscohortstudy.org/ .

Keywords

HIV
depressive symptoms
diabetes

ASJC Scopus subject areas

Health Policy
Infectious Diseases
Pharmacology (medical)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/hiv.12958

Cite this

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title = "The relationship between diabetes and depressive symptoms in men with or at risk of HIV infection",

abstract = "Objectives: The aim of the study was to compare the prevalence of comorbid diabetes and depressive symptoms in men living with HIV (MLWH) with that in men without HIV infection and to determine associations between glycaemic control and depressive symptoms. Methods: Participants included 920 MLWH and 840 men without HIV infection from the Multicenter AIDS Cohort Study (MACS) with available data regarding glycaemic status [categorized as normal for fasting blood glucose (FBG) < 100 mg/dL, prediabetes for FBG 100–125 mg/dL, and diabetes, defined by self-report, diabetes medication use or FBG ≥ 126 mg/dL on at least two consecutive visits, with diabetes classified as controlled if Hemoglobin A1c (HbA1C) < 7.5% and uncontrolled if HbA1C ≥ 7.5%]. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) score, with CES-D ≥ 16 scores classified as elevated depressive symptoms. A modified Poisson regression model with robust variance was used and adjusted for covariates including HIV serostatus. Results: Compared to men without HIV infection, MLWH had a higher mean CES-D score, but a similar prevalence of diabetes (11.3% versus 12.8%, respectively; P = 0.33). The concomitant prevalence of diabetes and elevated depressive symptoms did not differ by HIV serostatus (P = 0.215). In an adjusted analysis, men with uncontrolled diabetes had a greater prevalence of depressive symptoms compared to men with normoglycaemia (prevalence ratio = 1.43; 95% confidence interval 1.11, 1.84). The association between glycaemic status and depressive symptoms did not differ by HIV serostatus (P = 0.22 for interaction). Conclusions: Both controlled and uncontrolled diabetes were independently associated with a greater prevalence of depressive symptoms, regardless of HIV serostatus. These results highlight the importance of identifying depression in people with diabetes.",

keywords = "HIV, depressive symptoms, diabetes",

author = "Basil, {R. C.} and Brown, {T. T.} and S. Haberlen and Rubin, {L. H.} and M. Plankey and Becker, {J. T.} and Lake, {J. E.} and Palella, {F. J.} and S. Sarkar",

note = "Funding Information: : TTB has served as a consultant to Gilead Sciences, ViiV Healthcare, Merck, and Theratechnologies. JEL has served as a consultant to Merck and Gilead consultancy and has received research funding from Gilead Sciences. The remaining authors do not report any conflicts of interest. Conflicts of interest Funding Information: : SS was funded by a grant (K12HL143957) from the National Heart, Lung, and Blood Institute. TTB was funded by grants (K24AI120834 and U01‐AI35042) from the National Institutes of Health. Financial disclosure Funding Information: Data in this manuscript were collected by the Multicenter AIDS Cohort Study (MACS). MACS (Principal Investigators): Johns Hopkins University Bloomberg School of Public Health (Joseph Margolick and Todd Brown), U01‐AI35042; Northwestern University (Steven Wolinsky), U01‐AI35039; University of California, Los Angeles (Roger Detels), U01‐AI35040; University of Pittsburgh (Charles Rinaldo and Jeremy Martinson), U01‐AI35041; the Center for Analysis and Management of MACS, Johns Hopkins University Bloomberg School of Public Health (Lisa Jacobson and Gypsyamber D{\textquoteright}Souza), UM1‐AI35043. The MACS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co‐funding from the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH). Targeted supplemental funding for specific projects was also provided by the National Heart, Lung, and Blood Institute (NHLBI), and the National Institute on Deafness and Communication Disorders (NIDCD). MACS data collection is also supported by UL1‐TR001079 (JHU ICTR) from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH), Johns Hopkins ICTR, or NCATS. The MACS website is located at http://aidscohortstudy.org/ . Publisher Copyright: {\textcopyright} 2020 British HIV Association",

year = "2021",

month = jan,

doi = "10.1111/hiv.12958",

language = "English (US)",

volume = "22",

pages = "37--46",

journal = "HIV Medicine",

issn = "1464-2662",

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TY - JOUR

T1 - The relationship between diabetes and depressive symptoms in men with or at risk of HIV infection

AU - Basil, R. C.

AU - Brown, T. T.

AU - Haberlen, S.

AU - Rubin, L. H.

AU - Plankey, M.

AU - Becker, J. T.

AU - Lake, J. E.

AU - Palella, F. J.

AU - Sarkar, S.

N1 - Funding Information: : TTB has served as a consultant to Gilead Sciences, ViiV Healthcare, Merck, and Theratechnologies. JEL has served as a consultant to Merck and Gilead consultancy and has received research funding from Gilead Sciences. The remaining authors do not report any conflicts of interest. Conflicts of interest Funding Information: : SS was funded by a grant (K12HL143957) from the National Heart, Lung, and Blood Institute. TTB was funded by grants (K24AI120834 and U01‐AI35042) from the National Institutes of Health. Financial disclosure Funding Information: Data in this manuscript were collected by the Multicenter AIDS Cohort Study (MACS). MACS (Principal Investigators): Johns Hopkins University Bloomberg School of Public Health (Joseph Margolick and Todd Brown), U01‐AI35042; Northwestern University (Steven Wolinsky), U01‐AI35039; University of California, Los Angeles (Roger Detels), U01‐AI35040; University of Pittsburgh (Charles Rinaldo and Jeremy Martinson), U01‐AI35041; the Center for Analysis and Management of MACS, Johns Hopkins University Bloomberg School of Public Health (Lisa Jacobson and Gypsyamber D’Souza), UM1‐AI35043. The MACS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co‐funding from the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH). Targeted supplemental funding for specific projects was also provided by the National Heart, Lung, and Blood Institute (NHLBI), and the National Institute on Deafness and Communication Disorders (NIDCD). MACS data collection is also supported by UL1‐TR001079 (JHU ICTR) from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH), Johns Hopkins ICTR, or NCATS. The MACS website is located at http://aidscohortstudy.org/ . Publisher Copyright: © 2020 British HIV Association

PY - 2021/1

Y1 - 2021/1

N2 - Objectives: The aim of the study was to compare the prevalence of comorbid diabetes and depressive symptoms in men living with HIV (MLWH) with that in men without HIV infection and to determine associations between glycaemic control and depressive symptoms. Methods: Participants included 920 MLWH and 840 men without HIV infection from the Multicenter AIDS Cohort Study (MACS) with available data regarding glycaemic status [categorized as normal for fasting blood glucose (FBG) < 100 mg/dL, prediabetes for FBG 100–125 mg/dL, and diabetes, defined by self-report, diabetes medication use or FBG ≥ 126 mg/dL on at least two consecutive visits, with diabetes classified as controlled if Hemoglobin A1c (HbA1C) < 7.5% and uncontrolled if HbA1C ≥ 7.5%]. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) score, with CES-D ≥ 16 scores classified as elevated depressive symptoms. A modified Poisson regression model with robust variance was used and adjusted for covariates including HIV serostatus. Results: Compared to men without HIV infection, MLWH had a higher mean CES-D score, but a similar prevalence of diabetes (11.3% versus 12.8%, respectively; P = 0.33). The concomitant prevalence of diabetes and elevated depressive symptoms did not differ by HIV serostatus (P = 0.215). In an adjusted analysis, men with uncontrolled diabetes had a greater prevalence of depressive symptoms compared to men with normoglycaemia (prevalence ratio = 1.43; 95% confidence interval 1.11, 1.84). The association between glycaemic status and depressive symptoms did not differ by HIV serostatus (P = 0.22 for interaction). Conclusions: Both controlled and uncontrolled diabetes were independently associated with a greater prevalence of depressive symptoms, regardless of HIV serostatus. These results highlight the importance of identifying depression in people with diabetes.

AB - Objectives: The aim of the study was to compare the prevalence of comorbid diabetes and depressive symptoms in men living with HIV (MLWH) with that in men without HIV infection and to determine associations between glycaemic control and depressive symptoms. Methods: Participants included 920 MLWH and 840 men without HIV infection from the Multicenter AIDS Cohort Study (MACS) with available data regarding glycaemic status [categorized as normal for fasting blood glucose (FBG) < 100 mg/dL, prediabetes for FBG 100–125 mg/dL, and diabetes, defined by self-report, diabetes medication use or FBG ≥ 126 mg/dL on at least two consecutive visits, with diabetes classified as controlled if Hemoglobin A1c (HbA1C) < 7.5% and uncontrolled if HbA1C ≥ 7.5%]. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) score, with CES-D ≥ 16 scores classified as elevated depressive symptoms. A modified Poisson regression model with robust variance was used and adjusted for covariates including HIV serostatus. Results: Compared to men without HIV infection, MLWH had a higher mean CES-D score, but a similar prevalence of diabetes (11.3% versus 12.8%, respectively; P = 0.33). The concomitant prevalence of diabetes and elevated depressive symptoms did not differ by HIV serostatus (P = 0.215). In an adjusted analysis, men with uncontrolled diabetes had a greater prevalence of depressive symptoms compared to men with normoglycaemia (prevalence ratio = 1.43; 95% confidence interval 1.11, 1.84). The association between glycaemic status and depressive symptoms did not differ by HIV serostatus (P = 0.22 for interaction). Conclusions: Both controlled and uncontrolled diabetes were independently associated with a greater prevalence of depressive symptoms, regardless of HIV serostatus. These results highlight the importance of identifying depression in people with diabetes.

KW - HIV

KW - depressive symptoms

KW - diabetes

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The relationship between diabetes and depressive symptoms in men with or at risk of HIV infection

Abstract

Funding

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UN SDGs

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