Depression: an Important Comorbidity with Metabolic Syndrome in a General Population

Overview

Journal Diabetes Care

Specialty Endocrinology

Date 2008 Oct 7

PMID 18835951

Citations 94

Authors

James A Dunbar

Prasuna Reddy

Nathalie Davis-Lameloise

Benjamin Philpot

Tiina Laatikainen

Annamari Kilkkinen

Stephen J Bunker

James D Best

Erkki Vartiainen

Sing Kai Lo

Edward D Janus

Affiliations

Soon will be listed here.

Abstract

Objective: There is a recognized association among depression, diabetes, and cardiovascular disease. The aim of this study was to examine in a sample representative of the general population whether depression, anxiety, and psychological distress are associated with metabolic syndrome and its components.

Research Design And Methods: Three cross-sectional surveys including clinical health measures were completed in rural regions of Australia during 2004-2006. A stratified random sample (n = 1,690, response rate 48%) of men and women aged 25-84 years was selected from the electoral roll. Metabolic syndrome was defined by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, Adult Treatment Panel III (NCEP ATP III), and International Diabetes Federation (IDF) criteria. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale and psychological distress by the Kessler 10 measure.

Results: Metabolic syndrome was associated with depression but not psychological distress or anxiety. Participants with the metabolic syndrome had higher scores for depression (n = 409, mean score 3.41, 95% CI 3.12-3.70) than individuals without the metabolic syndrome (n = 936, mean 2.95, 95% CI 2.76-3.13). This association was also present in 338 participants with the metabolic syndrome and without diabetes (mean score 3.37, 95% CI 3.06-3.68). Large waist circumference and low HDL cholesterol showed significant and independent associations with depression.

Conclusions: Our results show an association between metabolic syndrome and depression in a heterogeneous sample. The presence of depression in individuals with the metabolic syndrome has implications for clinical management.

Citing Articles

Metabolic Syndrome in Patients with Depressive Disorder: A Cross-sectional Study.

Moorthy R, A J, Annamalai M Indian J Psychol Med. 2025; 02537176241309032.

PMID: 39839149 PMC: 11744599. DOI: 10.1177/02537176241309032.

The evaluation of depression prevalence and its association with obesity phenotypes in a community-dwelling aged population.

Abbasloo F, Ebrahimi P, Ghadimi D, Sharifi F, Ayati A, Moodi M Aging Clin Exp Res. 2024; 37(1):2.

PMID: 39708254 PMC: 11663182. DOI: 10.1007/s40520-024-02904-6.

Investigating the prevalence and associated factors of depression, anxiety, and loneliness among people with type-2 diabetes in Bangladesh: a community-based study.

Pardhan S, Siddique A, Motahara U, Islam M Sci Rep. 2024; 14(1):25129.

PMID: 39448658 PMC: 11502699. DOI: 10.1038/s41598-024-75144-3.

Understanding the experiences of ketogenic metabolic therapy for people living with varying levels of depressive symptoms: a thematic analysis.

Bellamy E, Hadjiefthyvoulou F, Walsh J, Brown J, Turner J Front Nutr. 2024; 11:1397546.

PMID: 38903620 PMC: 11188922. DOI: 10.3389/fnut.2024.1397546.

Changes in Social, Economic, and Health Risk Factors Across the Lifespan during the COVID-19 Pandemic: A Latent Transition Analysis.

Jackson A, Weaver R, Weybright E, Lanigan J, Parker L, Iniguez A J Prev Health Promot. 2024; 3(4):539-562.

PMID: 38603389 PMC: 9510955. DOI: 10.1177/26320770221096839.

References

Yudkin J, Kumari M, Humphries S, Mohamed-Ali V . Inflammation, obesity, stress and coronary heart disease: is interleukin-6 the link?. Atherosclerosis. 2000; 148(2):209-14. DOI: 10.1016/s0021-9150(99)00463-3. View

Skilton M, Moulin P, Terra J, Bonnet F . Associations between anxiety, depression, and the metabolic syndrome. Biol Psychiatry. 2007; 62(11):1251-7. DOI: 10.1016/j.biopsych.2007.01.012. View

Yirmiya R, Pollak Y, Morag M, Reichenberg A, Barak O, Avitsur R . Illness, cytokines, and depression. Ann N Y Acad Sci. 2001; 917:478-87. DOI: 10.1111/j.1749-6632.2000.tb05412.x. View

Andrews G, Slade T . Interpreting scores on the Kessler Psychological Distress Scale (K10). Aust N Z J Public Health. 2002; 25(6):494-7. DOI: 10.1111/j.1467-842x.2001.tb00310.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

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

Miller G, Freedland K, Carney R, Stetler C, Banks W . Pathways linking depression, adiposity, and inflammatory markers in healthy young adults. Brain Behav Immun. 2003; 17(4):276-85. DOI: 10.1016/s0889-1591(03)00057-6. View

Xu H, Barnes G, Yang Q, Tan G, Yang D, Chou C . Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest. 2003; 112(12):1821-30. PMC: 296998. DOI: 10.1172/JCI19451. View

10.

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

11.

Ford E, Giles W, Mokdad A . Increasing prevalence of the metabolic syndrome among u.s. Adults. Diabetes Care. 2004; 27(10):2444-9. DOI: 10.2337/diacare.27.10.2444. View

12.

Reaven G . Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988; 37(12):1595-607. DOI: 10.2337/diab.37.12.1595. View

13.

Bjorntorp P . Visceral fat accumulation: the missing link between psychosocial factors and cardiovascular disease?. J Intern Med. 1991; 230(3):195-201. DOI: 10.1111/j.1365-2796.1991.tb00431.x. View

14.

Hotamisligil G, Shargill N, Spiegelman B . Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science. 1993; 259(5091):87-91. DOI: 10.1126/science.7678183. View

15.

Chrousos G . The hypothalamic-pituitary-adrenal axis and immune-mediated inflammation. N Engl J Med. 1995; 332(20):1351-62. DOI: 10.1056/NEJM199505183322008. View

16.

Maes M, Smith R, Christophe A, Vandoolaeghe E, Van Gastel A, Neels H . Lower serum high-density lipoprotein cholesterol (HDL-C) in major depression and in depressed men with serious suicidal attempts: relationship with immune-inflammatory markers. Acta Psychiatr Scand. 1997; 95(3):212-21. DOI: 10.1111/j.1600-0447.1997.tb09622.x. View

17.

Lustman P, Clouse R . Depression in diabetic patients: the relationship between mood and glycemic control. J Diabetes Complications. 2005; 19(2):113-22. DOI: 10.1016/j.jdiacomp.2004.01.002. View

18.

Herva A, Rasanen P, Miettunen J, Timonen M, Laksy K, Veijola J . Co-occurrence of metabolic syndrome with depression and anxiety in young adults: the Northern Finland 1966 Birth Cohort Study. Psychosom Med. 2006; 68(2):213-6. DOI: 10.1097/01.psy.0000203172.02305.ea. View

19.

Alberti K, Zimmet P, Shaw J . Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006; 23(5):469-80. DOI: 10.1111/j.1464-5491.2006.01858.x. View

20.

Vogelzangs N, Suthers K, Ferrucci L, Simonsick E, Ble A, Schrager M . Hypercortisolemic depression is associated with the metabolic syndrome in late-life. Psychoneuroendocrinology. 2007; 32(2):151-9. PMC: 1868465. DOI: 10.1016/j.psyneuen.2006.11.009. View