Associations between depressive trajectories and progression to type 2 diabetes mellitus in postmenopausal women with prediabetes: Findings from a national ten-year follow-up study

BACKGROUND: Whether the depressive symptoms contributed to the progression from prediabetes to type 2 diabetes mellitus (T2DM) in postmenpausal women is still unknown. METHODS: 938 postmenopausal women with prediabetes from China Health and Retirement Longitudinal Study (CHARLS) were included. The Centre for Epidemiologic Studies-Depression scale (CESD-10) was used to measure depression symptoms. 938 CHARLS data of baseline survey in 2011-2012 (wave 1), 2013-2014 (wave 2), and 2015-2016 (wave 3) were used as the timescales to conduct the depressive trajectory analysis. And the data of survey in 2017-2018 (wave 4) and survey in 2019-2020 (wave 5) were used as the outcomes of new onset T2DM. Odds ratios (OR) and 95 % confidence intervals (CI) were reported. RESULTS: Among 938 individuals, 537 of them who had a CES-D10 score of less than 10 were categorized as no presence of depressive symptom while the other 401 individuals with a score of 10 or higher were classified as presence of depressive symptoms. Depressive trajectories were labelled as None-Stable (n = 167, 17.8 %), Minimal-Stable (n = 345, 36.8 %), Mild-Stable (n = 389, 41.5 %) and Moderate/Severe-Stable (n = 37, 3.9 %). The moderate/severe depressive trajectory was an independent predictor of the progression to T2DM from prediabetes (OR:1.152, 95 %CI (1.013, 1.310), P = 0.031). The stratified regression analyses showed that trajectory of moderate/severe depression contributed to developing T2DM in normal weight, age ≤ 60, and with education level of high school and above. CONCLUSIONS: These findings indicated that moderate/severe depressive symptoms accelerate the progression from prediabetes to T2DM which appeal for healthier aging for women.