The association of depression and perceived stress with beta cell function between African and Haitian Americans with and without type 2 diabetes

Abstract

Background: Diabetes and diabetes-related complications are major causes of morbidity and mortality in the United States. Depressive symptoms and perceived stress have been identified as possible risk factors for beta cell dysfunction and diabetes. The purpose of this study was to assess associations between depression symptoms and perceived stress with beta cell function between African and Haitian Americans with and without type 2 diabetes. Participants and Methods: Informed consent and data were available for 462 participants (231 African Americans and 231 Haitian Americans) for this cross-sectional study. A demographic questionnaire developed by the Primary Investigator was used to collect information regarding age, gender, smoking, and ethnicity. Diabetes status was determined by self-report and confirmed by fasting blood glucose. Anthropometrics (weight, and height and waist circumference) and vital signs (blood pressure) were taken. Blood samples were drawn after 8 – 10 hours over-night fasting to measure lipid panel, fasting plasma glucose and serum insulin concentrations. The homeostatic model assessment, version 2 (HOMA2) computer model was used to calculate beta cell function. Depression was assessed using the Beck Depression Inventory-II (BDI-II) and stress levels were assessed using the Perceived Stress Scale (PSS). Results: Moderate to severe depressive symptoms were more likely for persons with diabetes (p = 0.030). There were no differences in perceived stress between ethnicity and diabetes status (p = 0.283). General linear models for participants with and without type 2 diabetes using beta cell function as the dependent variable showed no association with depressive symptoms and perceived stress; however, Haitian Americans had significantly lower beta cell function than African Americans both with and without diabetes and adjusting for age, gender, waist circumference and smoking. Further research is needed to compare these risk factors in other race/ethnic groups.

Implications for Self-Management among African Caribbean Adults with Noncommunicable Diseases and Mental Health Disorders: A Systematic Review

“…Comparably, Huffman and associates [ 24 ] identified that African Caribbeans with type 2 diabetes had a depression score 3.2 points higher than those without type 2 diabetes. de Caluwé et al showed diabetes prevalence to be 7.6% higher in patients with significant mental illness than in the general population [ 25 ].…”

“…Three synthesized themes were identified: (1) prevalence of comorbid mental health problems and chronic NCDs ( n = 10); [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]; (2) factors that mitigate or mediate the association between mental health problems and chronic NCDs ( n = 11) [ 23 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 32 , 33 , 34 ]; —(2a) factors influencing self-management ( n = 4); [ 26 , 27 , 29 , 30 ]; (2b) association between mental health and NCD outcomes—studies focused on (2b1) risk factors ( n = 9) [ 23 , 24 , 25 , 26 , 27 , 28 , 31 , 32 , 33 ]; and (2b2) protective factors ( n = 3); [ 24 , 31 , 33 ]; and (3) varied results ( n = 3) [ 27 , 28 , 29 ]. The results are summarized in Table 4 .…”

“…Comorbid poor mental health and chronic NCDs were reported throughout the literature, with 7 out of 14 studies reporting a statistically significant association between mental health problems (e.g., depression) and comorbid NCDs in African Caribbeans [ 21 , 22 , 23 , 24 , 25 , 26 , 30 ]. Stewart et al reported a strong association between depression and physical illness and subsequent disability (e.g., stroke) in the African Caribbean population (OR = 2.48) [ 20 ].…”

“…Protective Factors-Some biological measures were proposed to aid NCD management [ 24 , 31 , 33 ]. Overall, Fuster’s team reported Haitian-born residents in Chile to be generally healthy, with a lower prevalence of obesity and cardiovascular risk than other residents of Chile [ 31 ].…”

“…Fuster and colleagues found African Caribbeans to have low levels of alcohol use, with 7.3% of individuals drinking more than once a week and 4.2% of individuals smoking [ 31 ]. Huffman et al reported African Americans to have a 40% prevalence of smoking, while African Caribbeans had a 6% prevalence [ 24 ].…”