Hypercortisolemic Depression is Associated with the Metabolic Syndrome in Late-life

Overview

Journal Psychoneuroendocrinology

Specialties Endocrinology
Neurology
Psychiatry

Date 2007 Jan 17

PMID 17224244

Citations 80

Authors

Nicole Vogelzangs

Kristen Suthers

Luigi Ferrucci

Eleanor M Simonsick

Alessandro Ble

Matthew Schrager

Stefania Bandinelli

Fulvio Lauretani

Sandra V Giannelli

Brenda W Penninx

Affiliations

Soon will be listed here.

Abstract

Introduction: Depression has been hypothesized to be associated with metabolic abnormalities which increase the risk of cardiovascular disease (CVD) and diabetes. Such a link could be due to increased HPA-axis activity. This study investigates the cross-sectional relationship between depression, urinary cortisol and metabolic syndrome in an older population.

Methods: Data are from 867 participants of the InChianti Study, aged 65 years. Depressive symptoms were assessed using the CES-D scale; cortisol levels were determined in 24-h urine samples. Metabolic syndrome was defined as three or more of the following: abdominal obesity, high triglycerides, low HDL cholesterol, high blood pressure, and high fasting glucose.

Results: Clinically relevant depressed mood (CES-D20) was present in 20.6% of the sample, and 24.5% had the metabolic syndrome. After adjustment for sociodemographics and health indicators, depression score (per SD increase: OR=1.20, 95% CI=1.02-1.41) and urinary cortisol level (per SD increase: OR=1.23, 95% CI=1.01-1.51) were significantly associated with presence of metabolic syndrome. There was, however, a significant interaction (p=0.003) between depressed mood and urinary cortisol in the probability of having metabolic syndrome. The odds of metabolic syndrome in persons with both depressed mood and urinary cortisol excretion in the highest tertile was 1.84 (95% CI=1.02-3.34) compared to persons with neither condition.

Discussion: This study suggests a synergistic relationship between depression, cortisol and metabolic syndrome. Hypercortisolemic depression may constitute a specific risk group for the metabolic syndrome.

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References

Bjorntorp P . Do stress reactions cause abdominal obesity and comorbidities?. Obes Rev. 2002; 2(2):73-86. DOI: 10.1046/j.1467-789x.2001.00027.x. View

. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002; 106(25):3143-421. View

Raikkonen K, Matthews K, Kuller L . The relationship between psychological risk attributes and the metabolic syndrome in healthy women: antecedent or consequence?. Metabolism. 2002; 51(12):1573-7. DOI: 10.1053/meta.2002.36301. View

Shen B, Todaro J, Niaura R, McCaffery J, Zhang J, Spiro 3rd A . Are metabolic risk factors one unified syndrome? Modeling the structure of the metabolic syndrome X. Am J Epidemiol. 2003; 157(8):701-11. DOI: 10.1093/aje/kwg045. View

McCaffery J, Niaura R, Todaro J, Swan G, Carmelli D . Depressive symptoms and metabolic risk in adult male twins enrolled in the National Heart, Lung, and Blood Institute twin study. Psychosom Med. 2003; 65(3):490-7. DOI: 10.1097/01.psy.0000041545.52924.82. View

Penninx B, Kritchevsky S, Yaffe K, Newman A, Simonsick E, Rubin S . Inflammatory markers and depressed mood in older persons: results from the Health, Aging and Body Composition study. Biol Psychiatry. 2003; 54(5):566-72. DOI: 10.1016/s0006-3223(02)01811-5. View

Gur A, Cevik R, Nas K, Colpan L, Sarac S . Cortisol and hypothalamic-pituitary-gonadal axis hormones in follicular-phase women with fibromyalgia and chronic fatigue syndrome and effect of depressive symptoms on these hormones. Arthritis Res Ther. 2004; 6(3):R232-8. PMC: 416440. DOI: 10.1186/ar1163. View

Kinder L, Carnethon M, Palaniappan L, King A, Fortmann S . Depression and the metabolic syndrome in young adults: findings from the Third National Health and Nutrition Examination Survey. Psychosom Med. 2004; 66(3):316-22. DOI: 10.1097/01.psy.0000124755.91880.f4. View

Otte C, Marmar C, Pipkin S, Moos R, Browner W, Whooley M . Depression and 24-hour urinary cortisol in medical outpatients with coronary heart disease: The Heart and Soul Study. Biol Psychiatry. 2004; 56(4):241-7. PMC: 2776670. DOI: 10.1016/j.biopsych.2004.06.003. View

10.

Kopf D, Westphal S, Luley C, Ritter S, Gilles M, Weber-Hamann B . Lipid metabolism and insulin resistance in depressed patients: significance of weight, hypercortisolism, and antidepressant treatment. J Clin Psychopharmacol. 2004; 24(5):527-31. DOI: 10.1097/01.jcp.0000138762.23482.63. View

11.

Rosmond R . Role of stress in the pathogenesis of the metabolic syndrome. Psychoneuroendocrinology. 2004; 30(1):1-10. DOI: 10.1016/j.psyneuen.2004.05.007. View

12.

Fava G . Assessing depressive symptoms across cultures: Italian validation of the CES-D self-rating scale. J Clin Psychol. 1983; 39(2):249-51. DOI: 10.1002/1097-4679(198303)39:2<249::aid-jclp2270390218>3.0.co;2-y. View

13.

. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA. 1991; 265(24):3255-64. View

14.

Sternberg E, Chrousos G, Wilder R, Gold P . The stress response and the regulation of inflammatory disease. Ann Intern Med. 1992; 117(10):854-66. DOI: 10.7326/0003-4819-117-10-854. View

15.

Raikkonen K, Keltikangas-Jarvinen L, Adlercreutz H, Hautanen A . Psychosocial stress and the insulin resistance syndrome. Metabolism. 1996; 45(12):1533-8. DOI: 10.1016/s0026-0495(96)90184-5. View

16.

Beekman A, Deeg D, van Limbeek J, Braam A, De Vries M, van Tilburg W . Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D): results from a community-based sample of older subjects in The Netherlands. Psychol Med. 1997; 27(1):231-5. DOI: 10.1017/s0033291796003510. View

17.

Nelson J, Davis J . DST studies in psychotic depression: a meta-analysis. Am J Psychiatry. 1997; 154(11):1497-503. DOI: 10.1176/ajp.154.11.1497. View

18.

Ferrucci L, Guralnik J, Pahor M, Harris T, Corti M, Hyman B . Apolipoprotein E epsilon 2 allele and risk of stroke in the older population. Stroke. 1997; 28(12):2410-6. DOI: 10.1161/01.str.28.12.2410. View

19.

Penninx B, Guralnik J, Mendes de Leon C, Pahor M, Visser M, Corti M . Cardiovascular events and mortality in newly and chronically depressed persons > 70 years of age. Am J Cardiol. 1998; 81(8):988-94. DOI: 10.1016/s0002-9149(98)00077-0. View

20.

Penninx B, Guralnik J, Ferrucci L, Simonsick E, Deeg D, Wallace R . Depressive symptoms and physical decline in community-dwelling older persons. JAMA. 1998; 279(21):1720-6. DOI: 10.1001/jama.279.21.1720. View