Background: Recently, it has been shown that increasing body mass index (BMI) in asthma is associated with reduced exhaled NO. Our objective in this study was to determine if the BMIrelated changes in exhaled NO differ across asthmatics and controls, and to determine if these changes are related to increased airway oxidative stress and systemic levels of leptin and adiponectin.

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OBJECTIVE -The purpose of this study was to assess the history of previous depression in people with incident diabetes compared with people without diabetes. RESEARCH DESIGN AND METHODS -We conducted a population-based nested case-control study using the administrative databases of Saskatchewan Health to assess the study objective. We identified cases of type 2 diabetes based on diagnostics codes and prescription records for individuals over the age of 20 years. For each case subject, two control subjects were randomly selected from the nondiabetic population during the same index year. History of depression, based on diagnostic codes and antidepressant prescription, was ascertained up to 3 years before index date. Simple and multivariate logistic regression analysis was used to estimate the odds ratio (OR) and 95% CIs, after adjusting for age, sex, and frequency of physician visits.RESULTS -Individuals with newly diagnosed diabetes (1,622 of 33,257; 4.9%) were 30% more likely to have had a previous history of depression compared with people without diabetes (2,279 of 59,420; 3.8%). This increased risk remained after controlling for sex and number of physician visits but was limited to subjects 20 -50 years of age (adjusted OR 1.23 [95% CI 1.10 -1.37]) and not in those aged Ն51 years (0.92 [0.84 -1.00]).CONCLUSIONS -Depression appears to increase the risk of developing diabetes by ϳ23% in younger adults. This provides information regarding the temporality of the relationship between diabetes and depression. Diabetes Care 28:1063-1067, 2005D epression is a highly prevalent disease associated with substantial morbidity and mortality (1-6) and is recognized as an important comorbidity for a number of chronic medical conditions (7-10). Diabetes is among many chronic medical conditions that appear to be adversely affected by comorbid depression. Numerous reports have indicated that patients with diabetes are 1.5-2 times more likely to have depression compared with people without diabetes (11)(12)(13)(14). In the most recent estimates using large administrative databases from the U.S. (13,14), adjustment for age, sex, and cardiovascular disease tends to reduce the previous prevalence estimates from metaanalyses of published studies (11).The majority of this literature, however, has reported only cross-sectional assessments of comorbid diabetes and depression. Little information is available on the temporal association between diabetes and depression. Onset of depression may result in increased weight gain (as a result of the disorder or in relation to antidepressant treatment) and decreased self-care measures such as exercise. Also, people with depression are more likely to abuse alcohol and smoke cigarettes compared with individuals without depression. These behaviors can potentially increase the risk of developing type 2 diabetes. However, the literature evaluating depression as a risk factor for diabetes is quite inconsistent.Nine prospective observational studies (15-23) suggest that depression and depressive symp...

Research I ncreasing prevalences of chronic medical conditions are a growing health and economic burden. Type 2 diabetes, for example, shortens life, mostly through comorbid cardiovascular disease.1-4 Another comorbidity associated with diabetes that is increasingly recognized is depression. Several investigations [5][6][7][8] have documented that people with diabetes experience depression from 1.3 to 3 times as often as those without the disorder. Many of these studies are limited by their cross-sectional design, however, and have not addressed the temporal relation between the onsets of these 2 conditions. Depression itself is a disabling illness leading to considerable illness and early death.9,10 When associated with diabetes, depression increases the risks of work loss, 11 functional disability, 11,12 and micro-13 and macrovascular complications, 14and adds to health care costs. 13,15 Diabetes with comorbid depression is also linked with poorer adherence to medications and self-care activities such as self-monitoring of blood glucose levels and adhering to a proper diet and exercise program.16-19 Perhaps most importantly, depressed patients with diabetes die earlier than other people, irrespective of their sociodemographic variables, lifestyle or health status. 20Several prospective studies have evaluated the risk of diabetes in those with previous depression. [21][22][23][24][25][26][27][28][29][30][31] Most reported an increased risk of diabetes associated with a history of depression or depressive symptoms, but often only in selected subpopulations. [21][22][23][24][26][27][28]30,31 Carnethon and colleagues, 28 for example, found that the increased risk was limited to those with less education; Arroyo's group 22 studied only women; and Palinkas and associates 26 evaluated middle-class individuals aged 50 years and older. We recently conducted a large, population-based, nested case-control study 21 that suggested an association between a history of depression and the onset of type 2 diabetes, but this increased risk was limited to people no older than 50 years.Little information is currently available on the obverse of that temporal chain: the incidence of depression among people who have diabetes. Such knowledge could influence clinical practice by suggesting who would most effectively be screened for depression and by evaluating ways to prevent people with diabetes from becoming depressed, in order to decrease both the patients' risk of complications and the cost of the ensuing treatments. We therefore conducted a population-based retrospective cohort study to evaluate the incidence of new-onset depression among people with diabetes, compared with those who do not have diabetes. MethodsEthics approval to conduct this study was granted from the Health Research Ethics Board at the University of Alberta.Saskatchewan Health databases include information on most residents (99%) of the province of Saskatchewan (pop- Type 2 diabetes does not increase risk of depressionBackground: Although diabetes mellitus ha...