The relationship of life-course patterns of adiposity with type 2 diabetes, depression, and their comorbidity in the Northern Finland Birth Cohort 1966

Abstract

Objectives Type 2 diabetes (T2D) and comorbid depression challenges clinical management particularly in individuals with overweight. We aim to explore the shared etiology, via lifecourse adiposity, between T2D and depression. Methods We used data from birth until 46years from Northern Finland Birth Cohort 1966 (n = 6,372; 53.8% females). We conducted multivariate analyses on three outcomes: T2D (4.2%), depression (19.2%) and as comorbidity (1.8%). We conducted (i) Path analysis to clarify time-dependent body mass index (BMI) related pathways, including BMI polygenic risk scores (PRS); and (ii) Cox regression models to assess whether reduction of overweight between 7years and 31years influence T2D, depression and/or comorbidity. The models were tested for covariation with sex, education, smoking, physical activity, and diet score. Results The odd ratios (OR) of T2D in individuals with depression was 1.68 [95% confidence interval (CI): 1.34–2.11], and no change in estimate was observed when adjusted for covariates. T2D and comorbidity showed similar patterns of relationships in the path analyses (P < 0.001). The genetic risk for obesity (PRS BMI) did not show direct effect on T2D or comorbidity in adulthood but indirectly through measures of adiposity in early childhood and mid-adulthood in the path analysis (P < 0.001). Having early-onset of overweight at 7years and 31years showed highest risk of T2D (OR 3.8, 95%CI 2.4–6.1) and comorbidity (OR 5.0, 95%CI 2.7–9.5), with mild-to-moderate attenuation with adjustments. Depression showed no significant associations. Conclusions We found evidence for overweight since childhood as a risk factor for T2D and co-morbidity between T2D and depression, influenced moderately by lifestyle factors in later life. However, no shared early life adiposity related risk factors were observed between T2D and depression when assessed independently in this Finnish setting.

The effects of weight change from childhood to adulthood on depression and anxiety risk in adulthood: A systematic review

“…Eleven 13,16,21,31,35,41,44–46,48,50,53 defined weight change between two time points, and the remaining six 23,25,27,29,37,39 defined trajectories of weight change based on three or more repeated measures of weight. Two 29,37 of these articles modelled population‐average trajectories using generalized estimating equations, and four 23,25,27,39 articles modelled heterogenous person‐centered trajectories using growth mixture modelling 25 or group‐based trajectory modelling 23,27,39 …”

“…Conflicting results were reported in the two articles from the 1966 Northern Finland Birth cohort, which assessed weight change between different time points. Both studies were rated moderate quality, with one 48 using a combination of self‐report and measured BMI data and the other 21 defining depression using three heterogenous methods. The first study ( n = 8451) 48 showed females, but not males, with persistent overweight (including obesity) from age 14 to 31 years were at greater risk of depression at age 31 than the reference group comprising (1) women who were never overweight and (2) women with overweight confined to adolescence (OR: 1.4, 95% CI: 1.1, 1.9).…”

“…The first study ( n = 8451) 48 showed females, but not males, with persistent overweight (including obesity) from age 14 to 31 years were at greater risk of depression at age 31 than the reference group comprising (1) women who were never overweight and (2) women with overweight confined to adolescence (OR: 1.4, 95% CI: 1.1, 1.9). The other study ( n = 6372) 21 excluded those with depression at age 31 and explored weight change from age 7 to 46 years. However, this study observed no evidence of an association with depression onset at age 46, in the total sample or by sex.…”

“…Participants were sampled from 14 different cohorts, with the Northern Finland 1966 Birth Cohort, 21,48 the National Longitudinal Study of Adolescent Health cohort 41,45 and the Cardiovascular Risk in Young Finns cohort, 16,29 generating two publications each. Cohorts were from the United States (n = 3), 35,41,45 the United Kingdom (n = 3), 25,31,50 Finland (n = 4), 16,21,29,48 Spain (n = 1), 27 Canada (n = 1), 44 Australia (n = 2), 13,46 France (n = 1), 39 and Iran (n = 1). 23 Most articles studied both men and women, except for three which exclusively sampled females.…”

Developmental origins of psycho-cardiometabolic multimorbidity in adolescence and their underlying pathways through methylation markers: A two cohort’s study

“…The risk is posited to spiral from one generation to another, arising from adverse biological and environmental factors during gestation. Various in-utero adversities together have immediate consequences on birth outcomes and are also known to in uence the future burden of psycho-cardiometabolic disorders [5][6][7]. Along these lines our previous study identi ed four in-utero biopsychosocial latent factors that were, when combined, adversely associated with lower birth weight [8], which is a known risk factor for numerous diseases across the lifespan [9].…”