Key result
Higher baseline levels of multiple inflammatory biomarkers were associated with greater reductions in depressive symptoms in type 2 diabetes (β=0.128 to 0.255) but lower reductions in type 1 diabetes (β=-0.189 to -0.094).
Why the study?
People with diabetes and depression show large heterogeneity in their response to depression treatment, prompting the search for biomarkers of subclinical inflammation associated with symptom improvement.
Do baseline biomarkers of inflammation predict 1-year changes in depressive symptoms in people with type 1 and type 2 diabetes?
Cohort (n=521)
No
Do baseline biomarkers of inflammation predict 1-year changes in depressive symptoms in people with type 1 and type 2 diabetes?
Effect estimate: β=0.128 to 0.255 (T2D); β=-0.189 to -0.094 (T1D)
p-value: p=<0.05
Higher baseline levels of multiple inflammatory biomarkers predict greater depression reduction in type 2 diabetes but lower depression reduction in type 1 diabetes, suggesting different inflammation-related pathways for treatment response.
Subclinical inflammation markers may aid depression response prediction in diabetes; leaves open whether targeting them improves outcomes.
Aims/hypothesis People with diabetes and depression show large heterogeneity in their response to depression treatment. This study aimed to identify biomarkers of subclinical inflammation that were associated with improvement of depressive symptoms in people with type 1 diabetes and type 2 diabetes. Methods The prospective analysis combined data from three studies (DIAMOS, ECCE HOMO and DDCT). A total of 332 people with type 1 diabetes and 189 people with type 2 diabetes completed both the baseline and 1 year follow-up examinations. Depressive symptoms were assessed using the Center for Epidemiological Studies depression scale (CES-D). Associations between baseline serum levels of 76 biomarkers of inflammation and 1 year changes in depressive symptoms were estimated using multiple linear regression. Results In people with type 2 diabetes, higher levels of 26 biomarkers were associated with greater reductions in depressive symptoms ( β =0.128 to 0.255; p <0.05), whereas in people with type 1 diabetes, higher levels of 13 biomarkers were linked with lower reductions in depressive symptoms ( β =−0.189 to −0.094; p <0.05). A significant effect modification was observed for 33 biomarkers ( p interaction <0.05). The positive associations in type 2 diabetes were strongest for improvements in cognitive-affective and anhedonia symptoms, while the inverse associations in type 1 diabetes were strongest for improvements in somatic symptoms. Conclusions/interpretation Higher baseline levels of multiple biomarkers of inflammation were associated with greater depression reduction in type 2 diabetes but lower depression reduction in type 1 diabetes. There were also diabetes type-specific differences in the associations with symptom clusters of depression. This suggests that different inflammation-related pathways may be relevant for the response to depression treatment in people with type 1 diabetes or type 2 diabetes.
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Herder et al. (2025) conducted a cohort in Type 1 and Type 2 diabetes with elevated depressive symptoms (n=521). Baseline serum levels of biomarkers of inflammation vs. Lower baseline levels was evaluated on 1-year changes in depressive symptoms assessed by CES-D score (β=0.128 to 0.255 (T2D); β=-0.189 to -0.094 (T1D), p=<0.05). Higher baseline levels of multiple inflammatory biomarkers were associated with greater reductions in depressive symptoms in type 2 diabetes (β=0.128 to 0.255) but lower reductions in type 1 diabetes (β=-0.189 to -0.094).
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