The Association of the Prevalence of Depression in Type 2 Diabetes Mellitus with Visual-Related Quality of Life and Social Support

Figures & data

Table 1 Demographic, Clinical Characteristics of Subjects Included in Study

	Subjects Included (n=1618)
Age (years)	61.69±8.72
Duration of diabetes (years)	7.65±5.93
FPG (mmol/L)	9.39±3.52
HbAlc (%)	7.79±2.00
Cholesterol (mmol/L)	5.50±1.18
BMI (kg/m^2)	26.47±3.47
Binocular visual acuity (LogMar)	0.14±0.22
Sex (%)
Male	632(39.06)
Female	986(60.94)
Education (%)
Less than high school	997(61.66)
High school and technical school	387(23.93)
More than high school	233(14.41)
Religion (%)
No	1390(85.91)
Yes	228(14.09)
Dwelling status (%)
Alone	135(8.34)
With partner	1483(91.66)
Marital status (%)
Married	1350(83.44)
Divorced	39(2.41)
Widowed	225(13.91)
Spinsterhood	4(0.25)
Employment status (%)
Employed	191(11.80)
Retired	1306(80.72)
Unemployed	121(7.48)
Smoking (%)
No	1276(78.86)
Yes	342(21.14)
Income levels (%)
Low	617(38.35)
Middle	915(56.87)
High	77(4.79)
Treatment regimen of diabetes (%)
Diet alone	175(11.24)
Oral hypoglycemic agents	1005(64.55)
Insulin dependent or with oral hypoglycemic agents	377(24.21)
Severity of DR (%)
No DR	858(54.75)
Mild NPDR	488(31.14)
Moderate NPDR	92(5.87)
Severe NPDR	69(4.40)
PDR	60(3.83)
AMD (%)
No	1418(97.66)
Yes	34(2.34)
Cataract (%)
No	1239(84.80)
Yes	222(15.20)
Glaucoma (%)
No	1432(97.48)
Yes	37(2.52)
Nephropathy (%)
No	1174(74.30)
Yes	406(25.70)
Cardiovascular disease (%)
No	721(46.61)
Yes	826(53.39)
Stroke (%)
No	1286(81.34)
Yes	295(18.66)
Hyperlipidemia (%)
No	583(48.58)
Yes	617(51.42)
Hypertension (%)
No	912(58.31)
Yes	652(41.69)

Notes: Duration of diabetes is defined by the period from the date of diagnosis to the date of the study examination, Religion is defined by if having any kind of religious belief, Smoking is defined by if smoke at the time of study, family income status is defined accordance with the perceptions of the patients, other ocular disease and systemic diseases is defined by self-report history at the time of study.

Abbreviations: AMD, age-related macular degeneration; BCVA, best corrected visual acuity; BMI, Body Mass Index; DR, diabetic retinopathy; FPG, fasting plasma glucose; HbA1c, glycated hemoglobin; NPDR, non proliferative diabetic retinopathy; PDR, proliferative diabetic retinopathy; PRP, panretinal photocoagulation.

Table 2 The Individual Effects of VFQ Composite Score (Quartile) and SSRS Score (Quartile) on the Risk of Depression in T2DM Patients

Variable	N	Cases (%)	Crude		Adjusted
			OR(95%CI)	P	OR(95%CI)	P
Age(years)
<60	649	165(25.4)	Ref		Ref
≥60	969	213(22.0)	0.8(0.7,1.0)	0.109	0.6(0.4,0.9)	0.006
Cardiovascular disease
No	721	121(16.8)	Ref		Ref
Yes	826	237(28.7)	2.0(1.6,2.6)	<0.001	1.7(1.1,2.5)	0.009
VFQCS ^a
5.8~	403	195(48.4)	Ref		Ref
81.4~	410	88(21.5)	0.3(0.2,0.4)	<0.001	0.3(0.2,0.5)	<0.001
91.3~	401	58(14.5)	0.2(0.1,0.3)	<0.001	0.2(0.1,0.3)	<0.001
95.6~100.0	402	35(8.7)	0.1(0.1,0.2)	<0.001	0.1(0.1,0.2)	<0.001
Trend test				<0.001		<0.001
Per IQR=14.1			0.5(0.4,0.5)	<0.001	0.5(0.4,0.6)	<0.001
SSRSS^b
12.0~	467	172(36.8)	Ref		Ref
32.0~	448	109(24.3)	0.6(0.4,0.7)	<0.001	0.6(0.4,0.9)	0.019
38.0~	356	67(18.8)	0.4(0.3,0.6)	<0.001	0.5(0.3,0.8)	0.009
43.0~60.0	346	30(8.7)	0.2(0.1,0.2)	<0.001	0.2(0.1,0.3)	<0.001
Trend test				<0.001		<0.001
Per IQR=11.0			0.6(0.5,0.6)	<0.001	0.6(0.5,0.7)	<0.001

Notes: Adjusted for age, sex, body mass index, education, religion, dwelling state, marital status, employment status, family income status, binocular visual acuity, cataract, glaucoma, severity of diabetes retinopathy, cardiovascular disease, nephropathy, stroke, hyperlipidemia, hypertension. ^aAdditional adjusted for SSRSS. ^bAdditional adjusted VFQCS.

Abbreviation: IQR, interquartile range.

Table 3 Combined Effects of VFQ Composite Score and SSRS Score on the Risk of Depression in T2DM Patients

VFQCS <91.3	SSRSS <38.0	N	Cases (%)	Crude		Adjusted
				OR(95% CI)	P	OR(95% CI)	P
No	No	505	47(9.3)	Ref		Ref
No	Yes	305	49(16.1)	1.9(1.2, 2.9)	0.004	1.5(0.9, 2.7)	0.002
Yes	No	403	102(25.3)	3.3(2.3, 4.8)	<0.001	2.6(1.6, 4.3)	<0.001
Yes	Yes	405	180(44.4)	7.8(5.4, 11.2)	<0.001	5.9(3.6, 9.7)	<0.001
Interaction					0.376		0.275

Notes: Adjusted for age, sex, body mass index, education, religion, dwelling state, marital status, employment status, family income status, binocular visual acuity, cataract, glaucoma, severity of diabetes retinopathy, cardiovascular disease, nephropathy, stroke, hyperlipidemia, hypertension.

Abbreviations: OR, odds ratio; CI, confidence interval.

Figure 1 Association of VFQ composite score and SSRS score with the risk of depression in type 2 diabetes mellitus patients based on spline regression model.

Abbreviations: OR, odds ratio; CI, confidence interval.