1Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Biostatistics, Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea
3Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
Copyright © 2021 Korean Diabetes Association
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS
Conception or design: I.J.
Acquisition, analysis, or interpretation of data: H.K., S.E.P., K.D.H, Y.G.P., Y.H.K.
Drafting the work or revising: I.J., H.K., S.E.P.
Final approval of the manuscript: I.J., H.K., S.E.P., K.D.H, Y. G.P., Y.H.K., E.J.R., W.Y.L.
FUNDING
None
Variable | ND (n=2,166,979) | TD (n=42,124) | PD (n=19,340) |
---|---|---|---|
Proportion, % | 97.2 | 1.9 | 0.9 |
|
|||
Male sex | 1,358,838 (62.7) | 18,125 (43.0) | 7,236 (37.4) |
|
|||
Smoking status | |||
Never smoker | 1,160,719 (53.6) | 28,704 (68.1) | 13,925 (72.0) |
Former smoker | 407,553 (18.8) | 6,008 (14.3) | 2,460 (12.7) |
Current smoker | 598,707 (27.6) | 7,412 (17.6) | 2,955 (15.3) |
|
|||
Alcohol drinking, g/day | |||
None | 1,165,870 (53.8) | 29,884 (70.9) | 15,159 (78.4) |
Mild (<30) | 795,488 (36.7) | 9,863 (23.4) | 3,410 (17.6) |
Heavy (≥30) | 205,621 (9.5) | 2,377 (5.6) | 771 (4.0) |
|
|||
Exercisea | 1,070,288 (49.4) | 17,987 (42.7) | 7,559 (39.1) |
|
|||
Income, lower | 20% 476,661 (22.0) | 9,895 (23.5) | 4,755 (24.6) |
|
|||
CKD | 212,160 (9.8) | 5,859 (13.9) | 3,455 (17.9) |
|
|||
Hypertension | 1,171,049 (54.0) | 25,584 (60.7) | 12,814 (66.3) |
|
|||
Dyslipidemia | 864,572 (39.9) | 20,042 (47.6) | 9,979 (51.6) |
|
|||
Antidiabetic agent ≥2b | 767,738 (35.4) | 18,786 (44.6) | 9,446 (48.8) |
|
|||
Use of insulinb | 125,707 (5.8) | 5,689 (13.5) | 3,193 (16.5) |
|
|||
Treatment for diabetes ≥5 yr | 631,998 (29.2) | 15,121 (35.9) | 8,009 (41.4) |
|
|||
Age, yr | 56.5±11.8 | 61.0±11.1 | 63.3±10.6 |
|
|||
BMI, kg/m2 | 25.1±3.3 | 24.8±3.3 | 24.8±3.4 |
|
|||
Total cholesterol, mg/dL | 198.8±41.7 | 196.5±42.9 | 194.9±43.6 |
|
|||
SBP, mm Hg | 129.1±15.6 | 128.2±15.6 | 128.1±15.9 |
|
|||
DBP, mm Hg | 79.3±10.1 | 78.1±10.0 | 77.8±10.1 |
|
|||
Fasting blood glucose, mg/dL | 145.7±43.6 | 137.7±42.0 | 135.6±43.1 |
|
|||
HDL-C, mg/dL | 51.8±19.9 | 52.3±20.8 | 52.4±23.1 |
|
|||
LDL-C, mg/dL | 112.6±43.4 | 112.3±44.3 | 111.2±45.9 |
|
|||
Triglyceride, mg/dL | 151.9 (151.8–152.0) | 143.8 (143.0–144.6) | 142.4 (141.3–143.5) |
Values are presented as number (%), mean±standard deviation, or geometric means (range). P values were <0.0001 for all variables.
ND, no depression; TD, transient depression; PD, persistent depression; CKD, chronic kidney disease; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; HDL-C, high density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol.
a Regular exercise was defined as performing >30 minutes of moderate physical activity at least 5 times per week or >20 minutes of strenuous physical activity at least 3 times per week,
b Within 1 year before the index date.
Model 1: unadjusted; Model 2: adjusted for age and sex; Model 3: adjusted for model 2+current smoking, alcohol and regular exercise; Model 4: adjusted for model 3+body mass index, hypertension, dyslipidemia, chronic kidney disease, fasting blood glucose, use of insulin, prescription of 2 or more antidiabetic agents.
HR, hazard ratio; CI, confidence interval; ND, no depression; TD, transient depression; PD, persistent depression.
Variable | ND (n=2,166,979) | TD (n=42,124) | PD (n=19,340) |
---|---|---|---|
Proportion, % | 97.2 | 1.9 | 0.9 |
| |||
Male sex | 1,358,838 (62.7) | 18,125 (43.0) | 7,236 (37.4) |
| |||
Smoking status | |||
Never smoker | 1,160,719 (53.6) | 28,704 (68.1) | 13,925 (72.0) |
Former smoker | 407,553 (18.8) | 6,008 (14.3) | 2,460 (12.7) |
Current smoker | 598,707 (27.6) | 7,412 (17.6) | 2,955 (15.3) |
| |||
Alcohol drinking, g/day | |||
None | 1,165,870 (53.8) | 29,884 (70.9) | 15,159 (78.4) |
Mild (<30) | 795,488 (36.7) | 9,863 (23.4) | 3,410 (17.6) |
Heavy (≥30) | 205,621 (9.5) | 2,377 (5.6) | 771 (4.0) |
| |||
Exercise |
1,070,288 (49.4) | 17,987 (42.7) | 7,559 (39.1) |
| |||
Income, lower | 20% 476,661 (22.0) | 9,895 (23.5) | 4,755 (24.6) |
| |||
CKD | 212,160 (9.8) | 5,859 (13.9) | 3,455 (17.9) |
| |||
Hypertension | 1,171,049 (54.0) | 25,584 (60.7) | 12,814 (66.3) |
| |||
Dyslipidemia | 864,572 (39.9) | 20,042 (47.6) | 9,979 (51.6) |
| |||
Antidiabetic agent ≥2 |
767,738 (35.4) | 18,786 (44.6) | 9,446 (48.8) |
| |||
Use of insulin |
125,707 (5.8) | 5,689 (13.5) | 3,193 (16.5) |
| |||
Treatment for diabetes ≥5 yr | 631,998 (29.2) | 15,121 (35.9) | 8,009 (41.4) |
| |||
Age, yr | 56.5±11.8 | 61.0±11.1 | 63.3±10.6 |
| |||
BMI, kg/m2 | 25.1±3.3 | 24.8±3.3 | 24.8±3.4 |
| |||
Total cholesterol, mg/dL | 198.8±41.7 | 196.5±42.9 | 194.9±43.6 |
| |||
SBP, mm Hg | 129.1±15.6 | 128.2±15.6 | 128.1±15.9 |
| |||
DBP, mm Hg | 79.3±10.1 | 78.1±10.0 | 77.8±10.1 |
| |||
Fasting blood glucose, mg/dL | 145.7±43.6 | 137.7±42.0 | 135.6±43.1 |
| |||
HDL-C, mg/dL | 51.8±19.9 | 52.3±20.8 | 52.4±23.1 |
| |||
LDL-C, mg/dL | 112.6±43.4 | 112.3±44.3 | 111.2±45.9 |
| |||
Triglyceride, mg/dL | 151.9 (151.8–152.0) | 143.8 (143.0–144.6) | 142.4 (141.3–143.5) |
Variable | No. of event | Incidence rate,/1,000 person-yr | HR (95% CI) | |||
---|---|---|---|---|---|---|
| ||||||
Model 1 | Model 2 | Model 3 | Model 4 | |||
Stroke | ||||||
ND | 70,736 | 5.5 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
TD | 1,990 | 8.1 | 1.47 (1.41–1.54) | 1.29 (1.23–1.35) | 1.28 (1.22–1.33) | 1.20 (1.15–1.26) |
PD | 1,308 | 11.7 | 2.12 (2.01–2.24) | 1.72 (1.62–1.81) | 1.68 (1.59–1.78) | 1.54 (1.46–1.63) |
| ||||||
Myocardial infarction | ||||||
ND | 44,688 | 3.5 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
TD | 1,295 | 5.2 | 1.51 (1.43–1.60) | 1.34 (1.27–1.42) | 1.32 (1.25–1.40) | 1.25 (1.18–1.32) |
PD | 743 | 6.5 | 1.88 (1.75–2.03) | 1.56 (1.45–1.68) | 1.51 (1.41–1.63) | 1.38 (1.29–1.49) |
| ||||||
All cause mortality | ||||||
ND | 141,985 | 10.9 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
TD | 4,151 | 16.5 | 1.52 (1.47–1.57) | 1.42 (1.38–1.47) | 1.39 (1.35–1.43) | 1.27 (1.23–1.31) |
PD | 2,791 | 24.2 | 2.21 (2.13–2.30) | 1.94 (1.87–2.01) | 1.86 (1.80–1.93) | 1.66 (1.60–1.72) |
Values are presented as number (%), mean±standard deviation, or geometric means (range). ND, no depression; TD, transient depression; PD, persistent depression; CKD, chronic kidney disease; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; HDL-C, high density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol. Regular exercise was defined as performing >30 minutes of moderate physical activity at least 5 times per week or >20 minutes of strenuous physical activity at least 3 times per week, Within 1 year before the index date.
Model 1: unadjusted; Model 2: adjusted for age and sex; Model 3: adjusted for model 2+current smoking, alcohol and regular exercise; Model 4: adjusted for model 3+body mass index, hypertension, dyslipidemia, chronic kidney disease, fasting blood glucose, use of insulin, prescription of 2 or more antidiabetic agents. HR, hazard ratio; CI, confidence interval; ND, no depression; TD, transient depression; PD, persistent depression.