Khambaty, TasneemStewart, Jesse C.Muldoon, Matthew F.Kamarck, Thomas W.2016-03-312016-03-312014-06Khambaty, T., Stewart, J. C., Muldoon, M. F., & Kamarck, T. W. (2014). Depressive Symptom Clusters as Predictors of 6-Year Increases in Insulin Resistance: Data from the Pittsburgh Healthy Heart Project. Psychosomatic Medicine, 76(5), 363–369. http://doi.org/10.1097/PSY.00000000000000631534-7796https://hdl.handle.net/1805/9119OBJECTIVE: To examine longitudinal bidirectional associations between two depressive symptom clusters-the cognitive-affective and somatic-vegetative clusters--and insulin resistance, a marker of prediabetes. METHODS: Participants were 269 adults aged 50 to 70 years without diabetes enrolled in the Pittsburgh Healthy Heart Project, a prospective cohort study. At baseline and 6-year visits, participants completed the Beck Depression Inventory-II (BDI-II) and underwent a blood draw to quantify fasting insulin and glucose. We examined baseline BDI-II total, cognitive-affective, and somatic-vegetative scores as predictors of 6-year change in the homeostatic model of assessment (HOMA) score, an estimate of insulin resistance computed from fasting insulin and glucose. We also examined baseline HOMA score as a predictor of 6-year change in BDI-II total and subscale scores. RESULTS: Regression analyses, adjusted for demographic factors and baseline HOMA score, revealed that the baseline BDI-II somatic-vegetative score (β = 0.14, p = .025), but not the cognitive-affective (β = 0.001, p = .98) or total (β = 0.10, p = .11) scores, predicted 6-year HOMA change. This result persisted in models controlling for anxiety symptoms and hostility. Several factors were examined as candidate mediators; however, only change in body mass index was a significant mediator (p = .042), accounting for 23% of the observed association. Baseline HOMA score did not predict 6-year change in BDI-II total or subscale scores (all p values >.56). CONCLUSIONS: Among adults aged 50 to 70 years, the somatic-vegetative symptoms of depression (e.g., fatigue, sleep disturbance, and appetite changes) may worsen insulin resistance and increase diabetes risk, partly, by increasing body mass index.en-USPublisher PolicyDepressionepidemiologyDepressive symptom clusters as predictors of 6-year increases in insulin resistance: data from the Pittsburgh Healthy Heart ProjectArticle