The bidirectional longitudinal association between depressive symptoms and HbA1c : a systematic review and meta‐analysis

Article

Beran, M., Muzambi, R., Geraets, A., Albertorio-Diaz, J., Adriaanse, M., Iversen, M., Kokoszka, A., Nefs, G., Nouwen, A., Pouwer, F., Huber, J., Schmitt, A. and Schram, M. 2022. The bidirectional longitudinal association between depressive symptoms and HbA1c : a systematic review and meta‐analysis. Diabetic Medicine. 39 (2), pp. 1-11. https://doi.org/10.1111/dme.14671
TypeArticle
TitleThe bidirectional longitudinal association between depressive symptoms and HbA1c : a systematic review and meta‐analysis
AuthorsBeran, M., Muzambi, R., Geraets, A., Albertorio-Diaz, J., Adriaanse, M., Iversen, M., Kokoszka, A., Nefs, G., Nouwen, A., Pouwer, F., Huber, J., Schmitt, A. and Schram, M.
Abstract

Aim
To investigate whether there is a bidirectional longitudinal association of depression with HbA1c.
Methods
We conducted a systematic literature search in PubMed, PsycINFO, CINAHL and EMBASE for observational, longitudinal studies published from January 2000 to September 2020, assessing the association between depression and HbA1c in adults. We assessed study quality with the Newcastle-Ottawa-Scale. Pooled effect estimates were reported as partial correlation coefficients (rp) or odds ratios (OR).
Results
We retrieved 1,642 studies; 26 studies were included in the systematic review and eleven in the meta-analysis. Most studies (16/26) focused on type 2 diabetes. Study quality was rated as good (n=19), fair (n=2) and poor (n=5). Of the meta-analysed studies, six investigated the longitudinal association between self-reported depressive symptoms and HbA1c and five the reverse longitudinal association, with a combined sample size of n=48,793 and a mean follow-up of 2 years. Higher levels of baseline depressive symptoms were associated with subsequent higher levels of HbA1c (partial r=0.07;[95%CI0.03,0.12]; I238%). Higher baseline HbA1c values were also associated with 18% increased risk of (probable) depression (OR=1.18;[95%CI1.12,1.25]; I20.0%).
Conclusions
Our findings support a bidirectional longitudinal association between depressive symptoms and HbA1c. However, the observed effect sizes were small and future research in large-scale longitudinal studies is needed to confirm this association. Future studies should investigate the role of type of diabetes and depression, diabetes distress and diabetes self-management behaviours. Our results may have clinical implications, as depressive symptoms and HbA1c levels could be targeted concurrently in the prevention and treatment of diabetes and depression.

Keywordsdepression; diabetes mellitus; glycated haemoglobin A; longitudinal studies; meta‐analysis; systematic review
PublisherWiley
JournalDiabetic Medicine
ISSN0742-3071
Electronic1464-5491
Publication dates
Online05 Sep 2021
Print11 Jan 2022
Publication process dates
Deposited27 Aug 2021
Accepted16 Aug 2021
Submitted08 Jan 2021
Output statusPublished
Publisher's version
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Copyright Statement

© 2021 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Digital Object Identifier (DOI)https://doi.org/10.1111/dme.14671
Web of Science identifierWOS:000693930900001
LanguageEnglish
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