Top

European Archives of Psychiatry and Clinical Neuroscience

Published in:

01-06-2012 | Original Paper

Prevalence of the metabolic syndrome in unipolar major depression

Authors: Kai G. Kahl, Wiebke Greggersen, Ulrich Schweiger, Joachim Cordes, Chakrapani Balijepalli, Christian Lösch, Susanne Moebus

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 4/2012

Abstract

Previous studies on the association between affective disorders and the metabolic syndrome yielded inconclusive results. Therefore, we examined the prevalence of the metabolic syndrome in 230 men and women with unipolar major depressive disorder during inpatient treatment and compared it to 1,673 subjects from primary care from a similar region in northern Germany. We used the AHA/NHBLI criteria to determine the rate of metabolic syndrome (MetS) and each single criterion of MetS in both groups. The age-standardized prevalence of MetS was 2.4× as high in patients with major depressive disorder (MDD) compared with data from comparison subjects (41.0% vs. 17.0%). With respect to the single criteria, elevations were found in MDD patients for fasting glucose and triglycerides in both genders, and waist circumference in women. Men in the patient and the comparison groups were found to have higher rates of increased fasting glucose and triglycerides than women in the respective groups. Factors associated with the MetS in MDD patients comprise body mass index and the severity of depression. Our results demonstrate an increased prevalence of the MetS in men and women with MDD. Interventions for the frequently untreated metabolic abnormalities and careful screening for physical health conditions among people with MDD are warranted.

Adriaanse MC, Dekker JM, Nijpels G, Heine RJ, Snoek FJ, Pouwer F (2006) Associations between depressive symptoms and insulin resistance: the Hoorn Study. Diabetologia 49:2874–2877PubMedCrossRef

Agyemang C, van Valkengoed I, Hosper K, Nicolaou M, van den Born BJ, Stronks K (2010) Educational inequalities in metabolic syndrome vary by ethnic group: evidence from the SUNSET study. Int J Cardiol 141:266–274

Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, de Girolamo G, Graaf R, Demyttenaere K, Gasquet I, Haro JM, Katz SJ, Kessler RC, Kovess V, Lepine JP, Ormel J, Polidori G, Russo LJ, Vilagut G, Almansa J, Arbabzadeh-Bouchez S, Autonell J, Bernal M, Buist-Bouwman MA, Codony M, Domingo-Salvany A, Ferrer M, Joo SS, Martinez-Alonso M, Matschinger H, Mazzi F, Morgan Z, Morosini P, Palacin C, Romera B, Taub N, Vollebergh WA (2004) Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl:21–27

Boissonnet C, Schargrodsky H, Pellegrini F, Macchia A, Champagne BM, Wilson E, Tognoni G (2011) Educational inequalities in obesity, abdominal obesity, and metabolic syndrome in seven Latin American cities: the CARMELA Study. Eur J Cardiovasc Prev Rehabil

Brown ES, Varghese FP, McEwen BS (2004) Association of depression with medical illness: does cortisol play a role? Biol Psychiatry 55:1–9PubMedCrossRef

Cohn T, Prud’homme D, Streiner D, Kameh H, Remington G (2004) Characterizing coronary heart disease risk in chronic schizophrenia: high prevalence of the metabolic syndrome. Can J Psychiatry 49:753–760PubMed

Cuppett M, Latin RW (2002) A survey of physical activity levels of certified athletic trainers. J Athl Train 37:281–285PubMed

De Hert M, Dekker JM, Wood D, Kahl KG, Holt RI, Moller HJ (2009) Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). Eur Psychiatry 24:412–424PubMedCrossRef

DiBello JR, McGarvey ST, Kraft P, Goldberg R, Campos H, Quested C, Laumoli TS, Baylin A (2009) Dietary patterns are associated with metabolic syndrome in adult Samoans. J Nutr 139:1933–1943PubMedCrossRef

10.

Fagiolini A, Frank E, Scott JA, Turkin S, Kupfer DJ (2005) Metabolic syndrome in bipolar disorder: findings from the Bipolar Disorder Center for Pennsylvanians. Bipolar Disord 7:424–430PubMedCrossRef

11.

Goldbacher EM, Bromberger J, Matthews KA (2009) Lifetime history of major depression predicts the development of the metabolic syndrome in middle-aged women. Psychosom Med 71:266–272PubMedCrossRef

12.

Greggersen W, Rudolf S, Fassbinder E, Dibbelt L, Stoeckelhuber BM, Hohagen F, Oltmanns KM, Kahl KG, Schweiger U (2011) Major depression, borderline personality disorder, and visceral fat content in women. Eur Arch Psychiatry Clin Neurosci 261(8):551–557

13.

Grundy SM, Abate N, Chandalia M (2002) Diet composition and the metabolic syndrome: what is the optimal fat intake? Am J Med 113(Suppl 9B):25S–29SPubMedCrossRef

14.

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112:2735–2752PubMedCrossRef

15.

Gustafsson PE, Persson M, Hammarstrom A (2011) Life course origins of the metabolic syndrome in middle-aged women and men: the role of socioeconomic status and metabolic risk factors in adolescence and early adulthood. Ann Epidemiol 21:103–110

16.

Hamada A, Mori M, Mori H, Muhihi A, Njelekela M, Masesa Z, Mtabaji J, Yamori Y (2010) Deterioration of traditional dietary custom increases the risk of lifestyle-related diseases in young male Africans. J Biomed Sci 17(Suppl 1):S34

17.

Hanley AJ, Wagenknecht LE, Norris JM, Bryer-Ash M, Chen YI, Anderson AM, Bergman R, Haffner SM (2009) Insulin resistance, beta cell dysfunction and visceral adiposity as predictors of incident diabetes: the Insulin Resistance Atherosclerosis Study (IRAS) Family study. Diabetologia 52:2079–2086PubMedCrossRef

18.

Hauner H, Hanisch J, Bramlage P, Steinhagen-Thiessen E, Schunkert H, Jockel KH, Wasem J, Moebus S (2008) Prevalence of undiagnosed Type-2-diabetes mellitus and impaired fasting glucose in German primary care: data from the German Metabolic and Cardiovascular Risk Project (GEMCAS). Exp Clin Endocrinol Diabetes 116:18–25PubMedCrossRef

19.

Heiskanen T, Niskanen L, Lyytikainen R, Saarinen PI, Hintikka J (2003) Metabolic syndrome in patients with schizophrenia. J Clin Psychiatry 64:575–579PubMedCrossRef

20.

Heiskanen TH, Niskanen LK, Hintikka JJ, Koivumaa-Honkanen HT, Honkalampi KM, Haatainen KM, Viinamaki HT (2006) Metabolic syndrome and depression: a cross-sectional analysis. J Clin Psychiatry 67:1422–1427PubMedCrossRef

21.

Herva A, Rasanen P, Miettunen J, Timonen M, Laksy K, Veijola J, Laitinen J, Ruokonen A, Joukamaa M (2006) Co-occurrence of metabolic syndrome with depression and anxiety in young adults: the Northern Finland 1966 Birth Cohort Study. Psychosom Med 68:213–216PubMedCrossRef

22.

Hildrum B, Mykletun A, Midthjell K, Ismail K, Dahl AA (2009) No association of depression and anxiety with the metabolic syndrome: the Norwegian HUNT study. Acta Psychiatr Scand 120:14–22PubMedCrossRef

23.

Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, Taskinen MR, Groop L (2001) Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 24:683–689PubMedCrossRef

24.

Kahl KG, Bester M, Greggersen W, Rudolf S, Dibbelt L, Stoeckelhuber BM, Gehl HB, Sipos V, Hohagen F, Schweiger U (2005) Visceral fat deposition and insulin sensitivity in depressed women with and without comorbid borderline personality disorder. Psychosom Med 67:407–412PubMedCrossRef

25.

Kapczinski F, Vieta E, Andreazza AC, Frey BN, Gomes FA, Tramontina J, Kauer-Sant’anna M, Grassi-Oliveira R, Post RM (2008) Allostatic load in bipolar disorder: implications for pathophysiology and treatment. Neurosci Biobehav Rev 32:675–692PubMedCrossRef

26.

Karlamangla AS, Merkin SS, Crimmins EM, Seeman TE (2010) Socioeconomic and ethnic disparities in cardiovascular risk in the United States, 2001–2006. Ann Epidemiol 20:617–628

27.

Kinder LS, Carnethon MR, Palaniappan LP, King AC, Fortmann SP (2004) Depression and the metabolic syndrome in young adults: findings from the Third National Health and Nutrition Examination Survey. Psychosom Med 66:316–322PubMedCrossRef

28.

Laaksonen DE, Lakka HM, Niskanen LK, Kaplan GA, Salonen JT, Lakka TA (2002) Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol 156:1070–1077PubMedCrossRef

29.

Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT (2002) The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 288:2709–2716PubMedCrossRef

30.

Lapidus L, Bengtsson C, Larsson B, Pennert K, Rybo E, Sjostrom L (1984) Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden. Br Med J (Clin Res Ed) 289:1257–1261CrossRef

31.

Lopez-Duran NL, Kovacs M, George CJ (2009) Hypothalamic-pituitary-adrenal axis dysregulation in depressed children and adolescents: a meta-analysis. Psychoneuroendocrinology 34:1272–1283PubMedCrossRef

32.

McIntyre RS, Konarski JZ, Wilkins K, Soczynska JK, Kennedy SH (2006) Obesity in bipolar disorder and major depressive disorder: results from a national community health survey on mental health and well-being. Can J Psychiatry 51:274–280PubMed

33.

Mezuk B, Eaton WW, Albrecht S, Golden SH (2008) Depression and type 2 diabetes over the lifespan: a meta-analysis. Diabetes Care 31:2383–2390PubMedCrossRef

34.

Miettola J, Niskanen LK, Viinamaki H, Kumpusalo E (2008) Metabolic syndrome is associated with self-perceived depression. Scand J Prim Health Care 26:203–210PubMedCrossRef

35.

Moebus S, Hanisch JU, Neuhauser M, Aidelsburger P, Wasem J, Jockel KH (2006) Assessing the prevalence of the metabolic syndrome according to NCEP ATP III in Germany: feasibility and quality aspects of a two step approach in 1550 randomly selected primary health care practices. Ger Med Sci 4:Doc07PubMed

36.

Pjrek E, Winkler D, Abramson DW, Konstantinidis A, Stastny J, Willeit M, Praschak-Rieder N, Kasper S (2007) Serum lipid levels in seasonal affective disorder. Eur Arch Psychiatry Clin Neurosci 257:197–202PubMedCrossRef

37.

Raikkonen K, Matthews KA, Kuller LH (2002) The relationship between psychological risk attributes and the metabolic syndrome in healthy women: antecedent or consequence? Metabolism 51:1573–1577PubMedCrossRef

38.

Richter N, Juckel G, Assion HJ (2010) Metabolic syndrome: a follow-up study of acute depressive inpatients. Eur Arch Psychiatry Clin Neurosci 260:41–49

39.

Saari KM, Lindeman SM, Viilo KM, Isohanni MK, Jarvelin MR, Lauren LH, Savolainen MJ, Koponen HJ (2005) A 4-fold risk of metabolic syndrome in patients with schizophrenia: the Northern Finland 1966 Birth Cohort study. J Clin Psychiatry 66:559–563PubMedCrossRef

40.

Sarandol A, Sarandol E, Eker SS, Karaagac EU, Hizli BZ, Dirican M, Kirli S (2006) Oxidation of apolipoprotein B-containing lipoproteins and serum paraoxonase/arylesterase activities in major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 30:1103–1108PubMedCrossRef

41.

Shin A, Lim SY, Sung J, Shin HR, Kim J (2009) Dietary intake, eating habits, and metabolic syndrome in Korean men. J Am Diet Assoc 109:633–640PubMedCrossRef

42.

Skilton MR, Moulin P, Terra JL, Bonnet F (2007) Associations between anxiety, depression, and the metabolic syndrome. Biol Psychiatry 62:1251–1257PubMedCrossRef

43.

Timonen M, Laakso M, Jokelainen J, Rajala U, Meyer-Rochow VB, Keinanen-Kiukaanniemi S (2005) Insulin resistance and depression: cross sectional study. BMJ 330:17–18PubMedCrossRef

44.

Toker S, Shirom A, Melamed S (2008) Depression and the metabolic syndrome: gender-dependent associations. Depress Anxiety 25:661–669PubMedCrossRef

45.

Vaccarino V, McClure C, Johnson BD, Sheps DS, Bittner V, Rutledge T, Shaw LJ, Sopko G, Olson MB, Krantz DS, Parashar S, Marroquin OC, Merz CN (2008) Depression, the metabolic syndrome and cardiovascular risk. Psychosom Med 70:40–48PubMedCrossRef

46.

Vanhala M, Jokelainen J, Keinanen-Kiukaanniemi S, Kumpusalo E, Koponen H (2009) Depressive symptoms predispose females to metabolic syndrome: a 7-year follow-up study. Acta Psychiatr Scand 119:137–142PubMedCrossRef

47.

Viinamaki H, Heiskanen T, Lehto SM, Niskanen L, Koivumaa-Honkanen H, Tolmunen T, Honkalampi K, Saharinen T, Haatainen K, Hintikka J (2009) Association of depressive symptoms and metabolic syndrome in men. Acta Psychiatr Scand 120:23–29PubMedCrossRef

48.

Vogelzangs N, Suthers K, Ferrucci L, Simonsick EM, Ble A, Schrager M, Bandinelli S, Lauretani F, Giannelli SV, Penninx BW (2007) Hypercortisolemic depression is associated with the metabolic syndrome in late-life. Psychoneuroendocrinology 32:151–159PubMedCrossRef

49.

Young E, Korszun A (2011) Sex, trauma, stress hormones and depression. Mol Psychiatry 15:23–28

Title: Prevalence of the metabolic syndrome in unipolar major depression
Authors: Kai G. Kahl
Wiebke Greggersen
Ulrich Schweiger
Joachim Cordes
Chakrapani Balijepalli
Christian Lösch
Susanne Moebus
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: European Archives of Psychiatry and Clinical Neuroscience / Issue 4/2012
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI: https://doi.org/10.1007/s00406-011-0277-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prevalence of the metabolic syndrome in unipolar major depression

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2012

Cholinergic blockade under working memory demands encountered by increased rehearsal strategies: evidence from fMRI in healthy subjects

Correlation with statistical significance and its explanation rate: comment on Minelli et al., “BDNF serum levels, but not BDNF Val66Met genotype, are correlated with personality traits in healthy subjects.” (Eur Arch Psychiatry Clin Neurosci doi:10.1007/s00406-011-0189-3)

How close is evidence to truth in evidence-based treatment of mental disorders?

Depression is associated with low levels of 25-hydroxyvitamin D among Jordanian adults: results from a national population survey

Influence of GRIA1, GRIA2 and GRIA4 polymorphisms on diagnosis and response to treatment in patients with major depressive disorder

Sensitivity to changes during antidepressant treatment: a comparison of unidimensional subscales of the Inventory of Depressive Symptomatology (IDS-C) and the Hamilton Depression Rating Scale (HAMD) in patients with mild major, minor or subsyndromal depression