Objectives Type 2 diabetes mellitus (T2DM) patients are four times more prone to develop depression. Common subjective tool to evaluate depression is Patient Health Questionnaire-9 (PHQ-9). Depression in T2DM remains unaddressed because of lack of objective tools resulting in poor treatment compliance. Both obesity and metabolic disturbances could influence mental health status. Therefore, this study was designed to determine the better adiposity index to predict depression in T2DM.

Subjects and Methods In this clinic-based cross-sectional study, 400 individuals (260 = T2DM and 140 = healthy) were recruited. Based on PHQ-9, T2DM patients were divided into T2DM + Dep (PHQ-9 ≥ 10) and T2DM-Dep (PHQ-9 < 10). The relationship between the PHQ-9 score and adiposity indices was examined by Pearson's/ Spearman's correlation. The receiver-operating characteristic curve analysis was used to identify the cutoff value.

Results Female diabetic patients showed significant correlation only in lipid accumulation product index (LAPI) and visceral adiposity index (VAI) (r = 0.206 and r = 0.0.237, respectively), while male diabetic patients did not show any significant association. Interestingly, T2DM + Dep group showed significant association between LAPI (r = 0.248) with PHQ-9 score, while T2DM-Dep group did not show significant association. VAI had maximum area under the curve in T2DM patients (0.619, p = 0.002) as well as in female diabetic patients (0.684, p = 0.002). The cutoff value for identifying depression among diabetic individuals was 5.60, with 70.3% sensitivity and 48.2% specificity, while in diabetic females, it was 6.612, with 70% sensitivity and 61.4% specificity.

Conclusion VAI might be the best adiposity index to predict depression among diabetic individuals.

PKS and JS wrote manuscript, collected samples, and performed tests; RN was involved in literature review; RK and AD helped in selection of patients; AAM was involved in editing of manuscript; SS was involved in conceptualization, data collection, statistics, and editing of the manuscript. All authors have read and approved the manuscript.

The study was approved by the Institutional Research Ethics Committee (IEC approval letter no: AIIMS/IEC/19/1169, dated 29/11/2019), All India Institute of Medical Sciences, Rishikesh. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent was obtained from all participants.

Consent for Publication: Not applicable.

#These authors contributed equally.

Received: 25 April 2023

Accepted: 27 June 2023

Article published online:
28 July 2023

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