Mediating Role of Depressive Symptoms on the Association Between Neighborhood Social Cohesion and Quality of Life in Individuals with Type 2 Diabetes Mellitus

Figures & data

Table 1 Demographic Characteristics of Patients

	Total (n=1747)
Age, mean (SD), years	58.6 (12.1)
Gender, male, n (%)	958 (54.8)
Ethnicity, Han, n (%)	1284 (73.5)
Residence, urban, n (%)	1095 (62.7)
Marital status, married, n (%)	1630 (93.3)
Education level, n (%)
Illiterate	348 (19.9)
Primary	392 (22.4)
Junior and Senior	616 (35.3)
College degree or above	391 (22.4)
Occupation, farmer, n (%)	701 (40.1)
FPCMI, <2000, n (%)	680 (38.9)
Smoking, yes, n (%)	393 (22.5)
Alcohol use, yes, n (%)	365 (20.9)
Physical exercise, yes, n (%)	1169 (66.9)
BMI, mean (SD), kg/m2	24.9 (6.0)
New cases of diabetes, yes, n (%)	273 (15.6)
Other chronic diseases, yes, n (%)	1149 (65.8)
Disease duration, mean (SD), years	8.3 (7.5)
T2DM complications, yes, n (%)	1048 (60.0)
Take medicine, yes, n (%)	1457 (83.4)
NSC, mean (SD)	15.2 (3.1)
Depressive symptoms, mean (SD)	11.1 (7.3)
DSQL, mean (SD)	55.4 (12.0)

Abbreviations: FPCMI, family per capita monthly income; NSC, neighborhood social cohesion; SD, standard deviation; BMI, body mass index; T2DM, type 2 diabetes mellitus.

Table 2 Correlation Matrix (n=1747)

	Mean	SD	Neighborhood Social Cohesion	Depressive Symptoms	DSQL
NSC	15.2	3.1	1
Depressive symptoms	11.1	7.3	−0.24**	1
DSQL	55.4	12.0	−0.20**	0.46**	1

Notes: **p<0.01, *p<0.05, After controlling for age, gender, ethnicity, marital status, education, occupation, economic condition, residence, smoking, alcohol use, physical exercise, BMI, New cases of diabetes, other chronic diseases, disease duration, T2DM complications, take medicine.

Abbreviations: SD, standard deviation; NSC, neighborhood social cohesion; DSQL, diabetes specific quality of life.

Table 3 Linear Regression Model for Interaction Between NSC and Depressive Symptoms on DSQL (n=1747)

Variables	Model 1		Model 2		Model 3
	P value	β (95% CI)	P value	β (95% CI)	P value	β (95% CI)
NSC	<0.001	−0.57 (−0.75, −0.38)	<0.001	−0.37 (−0.53, −0.20)	0.011	−0.35 (−0.63, −0.08)
Depressive symptoms	<0.001	0.81 (0.74, 0.88)	<0.001	0.73 (0.65, 0.79)	<0.001	0.74 (0.43, 1.04)
Age	NA	NA	0.314	0.02 (−0.02, 0.07)	0.321	0.02 (−0.02,0.07)
Gender (reference=female)	NA	NA	0.903	−0.07 (−1.26, 1.12)	0.900	−0.08 (−1.93,0.38)
Ethnicity (reference=minority)	NA	NA	0.187	−0.78 (−1.93, 0.38)	0.187	−0.78 (−1.93, 0.38)
Residence (reference=rural)	NA	NA	0.003	−2.02 (−3.35, −0.70)	0.003	−2.02 (−3.35, −0.70)
Marital status (reference=married)	NA	NA	0.009	−2.60 (−4.56, −0.64)	0.010	−2.60 (−4.56, −0.63)
Education (reference=Illiterate)	NA	NA	0.001	−1.18 (−1.86, −0.49)	0.001	−1.18 (−1.86, −0.49)
Occupation (reference=non-farmers)	NA	NA	0.761	−0.22 (−1.67, 1.22)	0.763	−0.22 (−1.67, 1.22)
FPCMI	NA	NA	<0.001	1.17 (0.72, 1.63)	<0.001	1.17 (0.72, 1.63)
Smoking (reference=no)	NA	NA	0.994	0.05 (−1.35, 1.45)	0.941	0.05 (−1.35, 1.45)
Alcohol use (reference=no)	NA	NA	0.091	1.23 (−0.19, 2.65)	0.090	1.23 (−0.19, 2.65)
Physical exercise (reference=no)	NA	NA	0.119	0.83 (−0.21, 1.88)	0.120	0.83 (−0.22, 1.88)
BMI	NA	NA	0.101	−0.07 (−0.15, 0.01)	0.101	−0.07 (−0.15, 0.01)
New cases of diabetes (reference=no)	NA	NA	0.002	−2.56 (−4.17, −0.96)	0.002	−2.57 (−4.17, −0.96)
Other chronic diseases (reference=no)	NA	NA	0.019	1.31 (0.21, 2.41)	0.019	1.31 (0.21, 2.41)
T2DM complications (reference=no)	NA	NA	<0.001	2.96 (1.88, 4.04)	<0.001	2.96 (1.88, 4.04)
Disease duration	NA	NA	<0.001	0.24 (0.16, 0.32)	<0.001	0.24 (0.16, 0.32)
Take medicine (reference=no)	NA	NA	0.239	−0.83 (−2.22, 0.55)	0.239	−0.83 (−2.22, 0.55)
NSC× Depressive symptoms	NA	NA	NA	NA	0.928	−0.01 (−0.02, 0.02)

Notes: Model l = social cohesion or depressive symptoms separately; Model 2 = Model l + covariates (age, gender, ethnicity, marital status, education, occupation, economic condition, residence, smoking, alcohol use, physical exercise, BMI, new cases of diabetes, other chronic diseases, disease duration, T2DM complications, take medicine); Model 3 = Model 2 + interaction between social cohesion and depressive symptoms.

Abbreviations: NSC, neighborhood social cohesion; DSQL, diabetes specific quality of life; FPCMI, family per capita monthly income; β, βvalue; 95% CI, 95% confidence interval; NA, not apply.

Table 4 The Mediating Effect of Depressive Symptoms on the Relationship Between Neighborhood Social Cohesion and DSQL*

Effect				Bias-Corrected 95% CI
	β	SE	P value	Lower	Upper
Total effect	−0.754	0.088	<0.001	−0.926	−0.582
Indirect Effects	−0.382	0.047	<0.001	−0.477	−0.294
Direct Effects	−0.372	0.082	<0.001	−0.533	−0.212

Notes: *After controlling for age, gender, ethnicity, marital status, education, occupation, economic condition, residence, smoking, alcohol use, physical exercise, BMI, new cases of diabetes, other chronic diseases, disease duration, T2DM complications, take medicine.