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Central or overall obesity: which one is a better predictor of depressive symptoms in children, adolescents, and youths? Eat Weight Disord 2018; 23:117-123. [PMID: 27653851 DOI: 10.1007/s40519-016-0320-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 09/08/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND PURPOSE Despite the strong effect of central obesity on individuals' physical health outcomes, there is little evidence underlying the relationship between central obesity and mental disorders such as depression, especially in children, adolescents, and youths of the developing countries. This study explores the relationship between depressive symptoms (DS) with central and overall obesity in a sample of Iranian children, adolescents, and youths. METHODS One thousand and fifty-two male participants ranging from 7 to 24 years old underwent standard anthropometry, and filled the DS questionnaire. RESULTS Having controlled the potential confounders (e.g., age, socioeconomic status, pubertal maturation status, and physical activity), we found waist circumference (WC) significantly related to DS in the children (standardized β = 0.14; P < 0.05) and adolescents (standardized β = 0.13; P < 0.05). No significant relationship was observed between WC and DS in the youths (standardized β = 0.09; P = 0.22). In addition, no significant relationship was observed between DS and the percentage of fat in the sampled children (standardized β = 0.085; P = 0.13), adolescents (standardized β = 0.10; P = 0.10), and youths (standardized β = -0.02; P = 0.75). CONCLUSION Central obesity (but not overall obesity) was a significant predictor of DS in the children and adolescents (7-18 years). However, DS in the youths (19-24 years) were not significantly associated with both the central and overall body obesity indices.
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Milaneschi Y, Lamers F, Peyrot WJ, Baune BT, Breen G, Dehghan A, Forstner AJ, Grabe HJ, Homuth G, Kan C, Lewis C, Mullins N, Nauck M, Pistis G, Preisig M, Rivera M, Rietschel M, Streit F, Strohmaier J, Teumer A, Van der Auwera S, Wray NR, Boomsma DI, Penninx BWJH. Genetic Association of Major Depression With Atypical Features and Obesity-Related Immunometabolic Dysregulations. JAMA Psychiatry 2017; 74:1214-1225. [PMID: 29049554 PMCID: PMC6396812 DOI: 10.1001/jamapsychiatry.2017.3016] [Citation(s) in RCA: 138] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
IMPORTANCE The association between major depressive disorder (MDD) and obesity may stem from shared immunometabolic mechanisms particularly evident in MDD with atypical features, characterized by increased appetite and/or weight (A/W) during an active episode. OBJECTIVE To determine whether subgroups of patients with MDD stratified according to the A/W criterion had a different degree of genetic overlap with obesity-related traits (body mass index [BMI] and levels of C-reactive protein [CRP] and leptin). DESIGN, SETTING, AND PATIENTS This multicenter study assembled genome-wide genotypic and phenotypic measures from 14 data sets of the Psychiatric Genomics Consortium. Data sets were drawn from case-control, cohort, and population-based studies, including 26 628 participants with established psychiatric diagnoses and genome-wide genotype data. Data on BMI were available for 15 237 participants. Data were retrieved and analyzed from September 28, 2015, through May 20, 2017. MAIN OUTCOMES AND MEASURES Lifetime DSM-IV MDD was diagnosed using structured diagnostic instruments. Patients with MDD were stratified into subgroups according to change in the DSM-IV A/W symptoms as decreased or increased. RESULTS Data included 11 837 participants with MDD and 14 791 control individuals, for a total of 26 628 participants (59.1% female and 40.9% male). Among participants with MDD, 5347 (45.2%) were classified in the decreased A/W and 1871 (15.8%) in the increased A/W subgroups. Common genetic variants explained approximately 10% of the heritability in the 2 subgroups. The increased A/W subgroup showed a strong and positive genetic correlation (SE) with BMI (0.53 [0.15]; P = 6.3 × 10-4), whereas the decreased A/W subgroup showed an inverse correlation (-0.28 [0.14]; P = .06). Furthermore, the decreased A/W subgroup had a higher polygenic risk for increased BMI (odds ratio [OR], 1.18; 95% CI, 1.12-1.25; P = 1.6 × 10-10) and levels of CRP (OR, 1.08; 95% CI, 1.02-1.13; P = 7.3 × 10-3) and leptin (OR, 1.09; 95% CI, 1.06-1.12; P = 1.7 × 10-3). CONCLUSIONS AND RELEVANCE The phenotypic associations between atypical depressive symptoms and obesity-related traits may arise from shared pathophysiologic mechanisms in patients with MDD. Development of treatments effectively targeting immunometabolic dysregulations may benefit patients with depression and obesity, both syndromes with important disability.
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Affiliation(s)
- Yuri Milaneschi
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Vrije Universiteit Medical Center and GGZ inGeest, Amsterdam, the Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Vrije Universiteit Medical Center and GGZ inGeest, Amsterdam, the Netherlands
| | - Wouter J. Peyrot
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Vrije Universiteit Medical Center and GGZ inGeest, Amsterdam, the Netherlands
| | - Bernhard T. Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Gerome Breen
- Medical Research Council Social Genetic and Developmental Psychiatry Centre, King’s College London, London, England,National Institute for Health Research Biomedical Research Centre for Mental Health, King’s College London, London, England
| | - Abbas Dehghan
- Department of Epidemiology and Biostatistics, Imperial College London, London, England
| | - Andreas J. Forstner
- Institute of Human Genetics, University of Bonn, Bonn, Germany,Life Brain Center, Department of Genomics, University of Bonn, Bonn, Germany,Department of Psychiatry, University of Basel, Basel, Switzerland,Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland,Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine and Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - Carol Kan
- Department of Psychological Medicine, King’s College London, London, England,South London and Maudsley National Health Service Foundation, London, England
| | - Cathryn Lewis
- Medical Research Council Social Genetic and Developmental Psychiatry Centre, King’s College London, London, England
| | - Niamh Mullins
- Medical Research Council Social Genetic and Developmental Psychiatry Centre, King’s College London, London, England
| | - Matthias Nauck
- German Centre for Cardiovascular Research, Partner Site Greifswald, University Medicine, University Medicine Greifswald, Greifswald, Germany,Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Giorgio Pistis
- Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland
| | - Margarita Rivera
- Medical Research Council Social Genetic and Developmental Psychiatry Centre, King’s College London, London, England,Department of Biochemistry and Molecular Biology II, Institute of Neurosciences, Center for Biomedical Research, University of Granada, Granada, Spain
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jana Strohmaier
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Naomi R. Wray
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia,Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Dorret I. Boomsma
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, the Netherlands
| | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Vrije Universiteit Medical Center and GGZ inGeest, Amsterdam, the Netherlands
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Simmons WK, DeVille DC. Interoceptive contributions to healthy eating and obesity. Curr Opin Psychol 2017; 17:106-112. [PMID: 28950955 PMCID: PMC5657601 DOI: 10.1016/j.copsyc.2017.07.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 06/26/2017] [Accepted: 07/03/2017] [Indexed: 12/12/2022]
Abstract
Obesity results from persistent failure by the brain to balance food intake with energy needs, resulting in a state of chronic energy surplus. Although there are many factors that predispose individuals to weight gain and obesity, the current review focuses on two ways eating behavior may be influenced by sensitivity to interoceptive signals of hunger, satiety, and metabolic energy reserves. First, obesity may be related to hypersensitivity to interoceptive signals of hunger, leading to positive alliesthesia for food cues that undermine attempts to change unhealthy eating behaviors. Second, overeating and obesity may arise from an inability to accurately detect interoceptive signals of satiety and positive energy balance. The findings reviewed herein demonstrate that obesity may be related to altered interoception, and warrant the continued development of novel obesity interventions aimed at promoting interoceptive awareness.
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Affiliation(s)
- W Kyle Simmons
- Laureate Institute for Brain Research, 6655 South Yale Ave., Tulsa, OK 74136-3326, United States; School of Community Medicine, University of Tulsa, Tulsa, OK, United States.
| | - Danielle C DeVille
- Laureate Institute for Brain Research, 6655 South Yale Ave., Tulsa, OK 74136-3326, United States; Department of Psychology, University of Tulsa, Tulsa, OK, United States
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Irandoust K, Taheri M. The Effect of Vitamin D supplement and Indoor Vs Outdoor Physical Activity on Depression of Obese Depressed Women. Asian J Sports Med 2017; In Press. [DOI: 10.5812/asjsm.13311] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
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Assari S, Caldwell CH, Zimmerman MA. Depressive Symptoms During Adolescence Predict Adulthood Obesity Among Black Females. J Racial Ethn Health Disparities 2017; 5:774-781. [PMID: 28840545 DOI: 10.1007/s40615-017-0422-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 07/27/2017] [Accepted: 08/03/2017] [Indexed: 01/29/2023]
Abstract
AIM This study aimed to investigate gender differences in the association between baseline depressive symptoms and subsequent changes in obesity in a sample of urban Black youth in the USA. METHODS The current study followed 681 Black youth (335 male and 346 female) for up to 18 years from 1994 to 2012. All youth were selected from an economically disadvantaged urban area in MI, USA. The main independent variable was baseline depressive symptoms measured in 1994. The main outcome was change in body mass index (BMI) from 1999 to 2012, calculated based on self-reported height and weight. Scio-demographics (age, number of parents in the household, and parental employment) were covariates. Gender was the focal moderator. We used linear regressions to test the predictive role of baseline depressive symptoms on change in BMI (from 1999 to 2012) in the pooled sample, and also based on gender. RESULTS Among Black females, but not Black males, baseline depressive symptoms predicted the BMI change from 1999 to 2012. The association remained significant for Black females after controlling for covariates. CONCLUSION High depressive symptoms at baseline better predict BMI change over the next decade for female than male Black youth. As a result, detection and reduction of depressive symptoms may be a vital element of obesity prevention programs for Black females. Policies and programs that address determinants of psychological distress as a strategy to prevent obesity among female Black youth in disadvantaged neighborhoods may be especially useful.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI, 48109-2700, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Cleopatra Howard Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 2846 SPH I, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Marc A Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 2846 SPH I, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
- Prevention Research Center, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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The effects of a lifestyle intervention program on physical outcomes, depression, and quality of life in adults with metabolic syndrome: A randomized clinical trial. Int J Cardiol 2017; 230:461-467. [DOI: 10.1016/j.ijcard.2016.12.084] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 11/25/2016] [Accepted: 12/16/2016] [Indexed: 01/22/2023]
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Hofmann T, Weibert E, Ahnis A, Elbelt U, Rose M, Klapp BF, Stengel A. Phoenixin is negatively associated with anxiety in obese men. Peptides 2017; 88:32-36. [PMID: 27989611 DOI: 10.1016/j.peptides.2016.12.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 12/03/2016] [Accepted: 12/14/2016] [Indexed: 11/30/2022]
Abstract
Phoenixin was recently identified in the rat hypothalamus and initially implicated in reproductive functions. A subsequent study described an anxiolytic effect of the peptide. The aim of the study was to investigate a possible association of circulating phoenixin with anxiety in humans. We therefore enrolled 68 inpatients with a broad spectrum of psychometrically measured anxiety (GAD-7). We investigated men since a menstrual cycle dependency of phoenixin has been assumed. Obese subjects were enrolled since they often report psychological comorbidities. In addition, we also assessed depressiveness (PHQ-9) and perceived stress (PSQ-20). Plasma phoenixin levels were measured using a commercial ELISA. First, we validated the ELISA kit performing a spike-and-recovery experiment showing a variance of 6.7±8.8% compared to the expected concentrations over the whole range of concentrations assessed, while a lower variation of 1.6±0.8% was observed in the linear range of the assay (0.07-2.1ng/ml). We detected phoenixin in the circulation of obese men at levels of 0.68±0.50ng/ml. These levels showed a negative association with anxiety scores (r=-0.259, p=0.043), while no additional associations with other psychometric parameters were observed. In summary, phoenixin is present in the human circulation and negatively associated with anxiety in obese men, a population often to report comorbid anxiety.
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Affiliation(s)
- Tobias Hofmann
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine; Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Elena Weibert
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine; Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Anne Ahnis
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine; Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ulf Elbelt
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine; Charité-Universitätsmedizin Berlin, Berlin, Germany; Charité Center for Internal Medicine with Gastroenterology and Nephrology, Department for Endocrinology, Diabetes and Nutrition, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Rose
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine; Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Burghard F Klapp
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine; Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Stengel
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine; Charité-Universitätsmedizin Berlin, Berlin, Germany.
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Immunometabolic dysregulation is associated with reduced cortical thickness of the anterior cingulate cortex. Brain Behav Immun 2017; 60:361-368. [PMID: 27989860 DOI: 10.1016/j.bbi.2016.10.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/10/2016] [Accepted: 10/25/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Immunometabolic dysregulation (low-grade inflammation and metabolic dysregulation) has been associated with the onset and more severe course of multiple psychiatric disorders, partly due to neuroanatomical changes and impaired neuroplasticity. We examined the effect of multiple markers of immunometabolic dysregulation on hippocampal and amygdala volume and anterior cingulate cortex thickness in a large sample of patients with depression and/or anxiety and healthy subjects (N=283). METHODS Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-a), c-reactive protein (CRP), triglyceride levels and HDL-cholesterol and genomic profile risk scores (GPRS) for immunometabolic dysregulation were determined in peripheral blood and T1 MRI scans were acquired at 3T. Regional brain volume and cortical thickness was assessed using FreeSurfer. Covariate-adjusted linear regression analyses were performed to examine the relationship between immunometabolic dysregulation and brain volume/thickness across all subjects. RESULTS Multiple immunometabolic dysregulation markers (i.e. triglyceride levels and inflammation) were associated with lower rostral ACC thickness across all subjects. IL-6 was inversely associated with hippocampal and amygdala volume in healthy subjects only. GPRS for immunometabolic dysregulation were not associated with brain volume or cortical thickness. CONCLUSIONS Multiple serum, but not genetic immunometabolic dysregulation markers were found to relate to rostral ACC structure, suggesting that inflammation and metabolic dysregulation may impact the ACC through similar mechanisms.
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de Montigny F, Cloutier L, Meunier S, Cyr C, Coulombe S, Tremblay G, Auger N, Roy B, Gaboury I, Lavoie B, Dion H, Houle J. Association between weight status and men's positive mental health: The influence of marital status. Obes Res Clin Pract 2016; 11:389-397. [PMID: 28007535 DOI: 10.1016/j.orcp.2016.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 10/25/2016] [Accepted: 12/02/2016] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to (1) examine the association between weight status and men's positive mental health, defined as the presence of symptoms of emotional, psychological, and social well-being, and (2) evaluate the moderating effect of marital status. A total of 645 men aged between 19 and 71 years self-reported their height and weight and answered a questionnaire measuring their emotional, psychological, and social well-being. Analysis of variance revealed that mean levels of emotional, psychological, and social well-being did not significantly differ according to men's weight status. Moderation analyses indicated that, for men in a relationship (married or living common-law), there were no significant associations between overweight, obesity, and the three components of positive mental health. However, for single men, overweight was marginally associated with higher emotional well-being, while obesity was associated with lower psychological well-being and marginally associated with lower social well-being. Results of the present study suggest that health professionals and researchers should take the characteristics (such as marital status) of men with obesity and overweight into account when working with them. Mental health researchers may need to examine men in each weight category separately (e.g. obesity vs. overweight), since the association with positive mental health can differ from one category to another.
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Affiliation(s)
| | - Lyne Cloutier
- Department of Nursing, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.
| | - Sophie Meunier
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada.
| | - Caroline Cyr
- Department of Psychology and Psychoeducation, Université du Québec en Outaouais, Gatineau, Canada.
| | - Simon Coulombe
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada.
| | - Gilles Tremblay
- School of Social Work, Université Laval, Québec City, Canada.
| | - Nathalie Auger
- Institut national de santé publique du Québec, Montréal, Canada.
| | - Bernard Roy
- Faculty of Nursing, Université Laval, Québec City, Canada.
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Canada.
| | | | - Harold Dion
- Clinique médicale l'Actuel, Montréal, Canada.
| | - Janie Houle
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada.
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Ye D, Cai S, Jiang X, Ding Y, Chen K, Fan C, Jin M. Associations of polymorphisms in circadian genes with abdominal obesity in Chinese adult population. Obes Res Clin Pract 2016; 10 Suppl 1:S133-S141. [DOI: 10.1016/j.orcp.2016.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 01/07/2016] [Accepted: 02/02/2016] [Indexed: 11/25/2022]
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Agarwal A, Agarwal M, Garg K, Dalal PK, Trivedi JK, Srivastava JS. Metabolic syndrome and central obesity in depression: A cross-sectional study. Indian J Psychiatry 2016; 58:281-286. [PMID: 28066005 PMCID: PMC5100119 DOI: 10.4103/0019-5545.192021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The current epidemiological data and meta-analyses indicate a bidirectional association between depression and metabolic syndrome (MetS). AIMS To assess the prevalence of metabolic syndrome and obesity in drug naïve patients (in current episode) having Recurrent Major Depressive Disorder and Bipolar Depression. METHOD This was a single point cross sectional observational study that involved administration of diagnostic and assessment tools and blood investigations. Recruitment for the study was done from a period of September 2008 to august 2009. RESULTS The prevalence of MetS was significantly more in the depression group when compared to healthy controls. The Bipolar depression group had 24% prevalence and recurrent depression group had 26% prevalence as opposed to none in the control group. The prevalence of MetS did not differ significantly amongst the both depression groups. Presence of central obesity was significantly more in the recurrent depression (30%) and Bipolar depression (24%) as compared to controls (8%). There was no statistically significant difference between the two depression subgroups. DISCUSSION Our study adds to the mounting evidence that links the presence of depression and metabolic syndrome. As we had ensured a drug free period of at least 3 months, the findings in our study indicate that the metabolic syndrome observed in our study is independent of drug exposure. CONCLUSIONS This study demonstrated significantly more incidence of metabolic syndrome and central obesity in patients of depression than age and sex matched controls.
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Affiliation(s)
- Anju Agarwal
- Department of Psychiatry, Era's Lucknow Medical College, Lucknow, Uttar Pradesh, India
| | - Manu Agarwal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Kabir Garg
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Pronob Kumar Dalal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Jitendra Kumar Trivedi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - J S Srivastava
- (Retd.) Senior Scientist, Central Drug Research Institute, Lucknow, Uttar Pradesh, India
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Davillas A, Benzeval M, Kumari M. Association of Adiposity and Mental Health Functioning across the Lifespan: Findings from Understanding Society (The UK Household Longitudinal Study). PLoS One 2016; 11:e0148561. [PMID: 26849046 PMCID: PMC4744034 DOI: 10.1371/journal.pone.0148561] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 01/19/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Evidence on the adiposity-mental health associations is mixed, with studies finding positive, negative or no associations, and less is known about how these associations may vary by age. OBJECTIVE To examine the association of adiposity -body mass index (BMI), waist circumference (WC) and percentage body fat (BF%)- with mental health functioning across the adult lifespan. METHODS Data from 11,257 participants (aged 18+) of Understanding Society: the UK Household Longitudinal Study (waves 2 and 3, 5/2010-7/2013) were employed. Regressions of mental health functioning, assessed by the Mental Component Summary (MCS-12) and the General Health Questionnaire (GHQ-12), on adiposity measures (continuous or dichotomous indicators) were estimated adjusted for covariates. Polynomial age-adiposity interactions were estimated. RESULTS Higher adiposity was associated with poorer mental health functioning. This emerged in the 30s, increased up to mid-40s (all central adiposity and obesity-BF% measures) or early 50s (all BMI measures) and then decreased with age. Underlying physical health generally accounted for these associations except for central adiposity, where associations remained statistically significant from the mid-30s to 50s. Cardiovascular, followed by arthritis and endocrine, conditions played the greatest role in attenuating the associations under investigation. CONCLUSIONS We found strong age-specific patterns in the adiposity-mental health functioning association that varied across adiposity measures. Underlying physical health had the dominant role in attenuating these associations. Policy makers and health professionals should target increased adiposity, mainly central adiposity, as it is a risk factor for poor mental health functioning in those aged between mid-30s to 50 years.
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Affiliation(s)
- Apostolos Davillas
- Institute for Social and Economic Research (ISER), University of Essex, Colchester, United Kingdom
| | - Michaela Benzeval
- Institute for Social and Economic Research (ISER), University of Essex, Colchester, United Kingdom
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Meena Kumari
- Institute for Social and Economic Research (ISER), University of Essex, Colchester, United Kingdom
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Dressler H, Smith C. Depression Affects Emotional Eating and Dietary Intake and Is Related to Food Insecurity in a Group of Multiethnic, Low-income Women. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2015. [DOI: 10.1080/19320248.2015.1045666] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Park AE, Huynh P, Schell AM, Baker LA. Relationship between obesity, negative affect and basal heart rate in predicting heart rate reactivity to psychological stress among adolescents. Int J Psychophysiol 2015; 97:139-44. [PMID: 26049136 PMCID: PMC4685043 DOI: 10.1016/j.ijpsycho.2015.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 05/20/2015] [Accepted: 05/27/2015] [Indexed: 11/29/2022]
Abstract
Reduced cardiovascular responses to psychological stressors have been found to be associated with both obesity and negative affect in adults, but have been less well studied in children and adolescent populations. These findings have most often been interpreted as reflecting reduced sympathetic nervous system response, perhaps associated with heightened baseline sympathetic activation among the obese and those manifesting negative affect. However, obesity and negative affect may themselves be correlated, raising the question of whether they both independently affect cardiovascular reactivity. The present study thus examined the separate effects of obesity and negative affect on both cardiovascular and skin conductance responses to stress (e.g., during a serial subtraction math task) in adolescents, while controlling for baseline levels of autonomic activity during rest. Both obesity and negative affect had independent and negative associations with cardiovascular reactivity, such that reduced stress responses were apparent for obese adolescents and those with high levels of negative affect. In contrast, neither obesity nor negative affect was related to skin conductance responses to stress, implicating specifically noradrenergic mechanisms rather than sympathetic mechanisms generally as being deficient. Moreover, baseline heart rate was unrelated to obesity in this sample, which suggests that heightened baseline of sympathetic activity is not necessary for the reduced cardiovascular reactivity to stress.
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Affiliation(s)
- Andres E Park
- Department of Psychology, Seeley G. Mudd Building Room 501, University of Southern California, 3620 South McClintock Ave., Los Angeles, CA 90007, United States
| | - Pauline Huynh
- Department of Psychology, Seeley G. Mudd Building Room 501, University of Southern California, 3620 South McClintock Ave., Los Angeles, CA 90007, United States
| | - Anne M Schell
- Department of Psychology, Occidental College, 1600 Campus Rd, Los Angeles, CA 90041, United States.
| | - Laura A Baker
- Department of Psychology, Seeley G. Mudd Building Room 501, University of Southern California, 3620 South McClintock Ave., Los Angeles, CA 90007, United States
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Snoek FJ, Bremmer MA, Hermanns N. Constructs of depression and distress in diabetes: time for an appraisal. Lancet Diabetes Endocrinol 2015; 3:450-460. [PMID: 25995123 DOI: 10.1016/s2213-8587(15)00135-7] [Citation(s) in RCA: 266] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 01/20/2015] [Accepted: 01/20/2015] [Indexed: 01/04/2023]
Abstract
Depression presents in roughly 20% of people with diabetes worldwide, and adversely affects quality of life and treatment outcomes. The causes of depression in diabetes are poorly understood, but research suggests a bi-directional association, at least for type 2 diabetes. Inconsistent findings regarding prevalence and depression treatment outcomes in patients with diabetes seem partly attributable to inconsistencies in the definition and measurement of depression and in distinguishing it from diabetes-distress, a psychological concept related to depression. We review evidence suggesting that diabetes-distress and depression are correlated and overlapping constructs, but are not interchangeable. Importantly, diabetes-distress seems to mediate the association between depression and glycaemic control. We propose a model to explain the direct and indirect effects of depression and diabetes-distress on glycaemic control. Additionally, using emerging insights from data-driven approaches, we suggest three distinct symptom profiles to define depression in patients with diabetes that could help explain differential associations between depression and metabolic abnormalities, and to tailor interventions for depression. Future research should focus on further refining depression profiles in patients with diabetes, taking into account the natural history of diabetes and depression, clinical characteristics, and diabetes-distress. The assessment of diabetes-distress and depression in research and clinical practice will be essential to identify high-risk patients with different mental health needs.
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Affiliation(s)
- Frank J Snoek
- Department of Medical Psychology, VU University Medical Center (VUMC) and Academic Medical Center (AMC)/University of Amsterdam, Amsterdam, Netherlands.
| | - Marijke A Bremmer
- Department of Psychiatry, VU University Medical Center, Amsterdam, Netherlands
| | - Norbert Hermanns
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
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von Känel R, Margani A, Stauber S, Meyer FA, Demarmels Biasiutti F, Vökt F, Wissmann T, Lämmle B, Lukas PS. Depressive symptoms as a novel risk factor for recurrent venous thromboembolism: a longitudinal observational study in patients referred for thrombophilia investigation. PLoS One 2015; 10:e0125858. [PMID: 25938663 PMCID: PMC4418654 DOI: 10.1371/journal.pone.0125858] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 03/23/2015] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Increasing evidence suggests that psychosocial factors, including depression predict incident venous thromboembolism (VTE) against a background of genetic and acquired risk factors. The role of psychosocial factors for the risk of recurrent VTE has not previously been examined. We hypothesized that depressive symptoms in patients with prior VTE are associated with an increased risk of recurrent VTE. METHODS In this longitudinal observational study, we investigated 271 consecutive patients, aged 18 years or older, referred for thrombophilia investigation with an objectively diagnosed episode of VTE. Patients completed the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). During the observation period, they were contacted by phone and information on recurrent VTE, anticoagulation therapy, and thromboprophylaxis in risk situations was collected. RESULTS Clinically relevant depressive symptoms (HADS-D score ≥ 8) were present in 10% of patients. During a median observation period of 13 months (range 5-48), 27 (10%) patients experienced recurrent VTE. After controlling for sociodemographic and clinical factors, a 3-point increase on the HADS-D score was associated with a 44% greater risk of recurrent VTE (OR 1.44, 95% CI 1.02, 2.06). Compared to patients with lower levels of depressive symptoms (HADS-D score: range 0-2), those with higher levels (HADS-D score: range 3-16) had a 4.1-times greater risk of recurrent VTE (OR 4.07, 95% CI 1.55, 10.66). CONCLUSIONS The findings suggest that depressive symptoms might contribute to an increased risk of recurrent VTE independent of other prognostic factors. An increased risk might already be present at subclinical levels of depressive symptoms.
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Affiliation(s)
- Roland von Känel
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
- Department of Clinical Research, University of Bern, Bern, Switzerland
- Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland
- * E-mail:
| | - Angelina Margani
- Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Stefanie Stauber
- Department of Cardiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, and University of Bern, Bern Switzerland
| | - Fiorenza A. Meyer
- Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Franziska Demarmels Biasiutti
- University Clinic of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Franziska Vökt
- Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Thomas Wissmann
- Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Bernhard Lämmle
- University Clinic of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
- Center for Thrombosis and Hemostasis, University Medical Center, Mainz, Germany
| | - Paul S. Lukas
- Department of Clinical Research, University of Bern, Bern, Switzerland
- Privatklinik für Psychiatrie und Psychotherapie, Sanatorium Kilchberg, Kilchberg, Switzerland
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Anderson G, Maes M. The gut–brain axis: The role of melatonin in linking psychiatric, inflammatory and neurodegenerative conditions. ADVANCES IN INTEGRATIVE MEDICINE 2015. [DOI: 10.1016/j.aimed.2014.12.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Gender and Ethnic Differences in the Association Between Obesity and Depression Among Black Adolescents. J Racial Ethn Health Disparities 2015; 2:481-93. [PMID: 26863554 DOI: 10.1007/s40615-015-0096-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 01/31/2015] [Accepted: 02/27/2015] [Indexed: 11/27/2022]
Abstract
AIM This study aimed to investigate the association between obesity and major depression disorder (MDD) in a nationally representative sample of Black adolescents in the USA. The study also tested the effects of ethnicity and gender as possible moderators. METHOD Data came from the National Survey of American Life (NSAL)-Adolescents, a representative household mental health survey of Black adolescents in the USA. Participants consisted of 1170 Black adolescents (810 African Americans and 360 Caribbean Blacks). Obesity was defined determined by the cutoff points based on the body mass index (BMI) appropriate for age and gender. Twelve-month MDD was measured using the World Mental Health Composite International Diagnostic Interview (CIDI). In the first step, the association between obesity and MDD in the pooled sample, controlling for the main effects of gender and ethnicity. In the next steps, two interactions were tested: (1) obesity and ethnicity and (2) obesity and gender. RESULTS Although any associations between obesity and MDD in the pooled sample of Blacks were not found, there was a significant interaction between ethnicity and obesity on MDD. Upon testing the associations across intersections of ethnicity and gender, a positive association was found among Caribbean Black females but not Caribbean Black males, African American males, or African American female. CONCLUSION The link between BMI and MDD among Blacks depends on ethnicity and gender, and risk of comorbid depression among Black youth with obesity is highest among Caribbean Black females.
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Abou Abbas L, Salameh P, Nasser W, Nasser Z, Godin I. Obesity and symptoms of depression among adults in selected countries of the Middle East: a systematic review and meta-analysis. Clin Obes 2015; 5:2-11. [PMID: 25504829 DOI: 10.1111/cob.12082] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 09/28/2014] [Accepted: 10/15/2014] [Indexed: 01/22/2023]
Abstract
Although obesity has been widely recognized for its consequences on physical health, its psychological burden in the adult populations in the Middle East remains unclear. This meta-analysis synthesized data from observational studies to investigate the association between obesity and depression among adult populations in Middle Eastern countries. Five bibliographical electronic databases were searched for studies published up to April 2014. Pooled meta-analytic estimates were derived using the random-effect models. Three case-control studies and five cross-sectional studies were identified. Meta-analysis showed significant positive associations between obesity and depression across study designs, with an overall effect of odds ratio 1.27 (95% confidence interval 1.11-1.44). The association between obesity and depression was more marked in women than men although that difference was not statistically significant. Other subgroup analysis showed that none of the potential factors including the assessment for obesity or depression, confounder control and study quality had a modification effect on the studied association. Meta-analysis of eight observational studies from five countries in the Middle East suggests an evidence of a positive association between obesity and depression among adult populations, which appeared to be more marked among women. Future research should examine the causal pathways between obesity and depression.
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Affiliation(s)
- L Abou Abbas
- School of Public Health, Free University of Brussels, Brussels, Belgium; Clinical and Epidemiological Research Laboratory (LCER), Doctoral School of Sciences and Technology, Lebanese University, Beirut, Lebanon
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Au B, Smith KJ, Gariépy G, Schmitz N. C-reactive protein, depressive symptoms, and risk of diabetes: results from the English Longitudinal Study of Ageing (ELSA). J Psychosom Res 2014; 77:180-6. [PMID: 25128285 DOI: 10.1016/j.jpsychores.2014.07.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 07/11/2014] [Accepted: 07/14/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Raised levels of C-reactive protein (CRP), an inflammatory biomarker, and depressive symptoms are both independently linked to risk of diabetes. The purpose of this study was to assess the joint association of CRP and depressive symptomatology with diabetes incidence in a representative sample of English people ≥50 years old. METHOD Data were from the English Longitudinal Study of Ageing, a prospective study of community-dwelling older adults. The sample was comprised of 4955 participants without self-reported doctor-diagnosed diabetes at baseline. High CRP level was dichotomized as >3 mg/L. Elevated depressive symptomatology was defined as ≥4 using the 8-item Center for Epidemiologic Studies Depression Scale. Incident diabetes was determined based on newly self-reported doctor-diagnosed diabetes. Cox proportional hazard regressions were used to examine the association between CRP and depressive symptoms with incidence of type 2 diabetes. RESULTS During approximately 63.2 months of follow-up, 194 participants reported diabetes diagnosis. After adjustment for socio-demographics, lifestyle behaviors, clinical factors, and BMI, the hazard ratio for diabetes was 1.63 (95% CI 0.88-3.01) for people with elevated depressive symptoms only, 1.43 (95% CI 0.99-2.07) for people with high CRP only, and 2.03 (95% CI 1.14-3.61) for people with both high CRP and elevated depressive symptoms. CONCLUSION The presence of both high CRP levels and elevated depressive symptoms was associated with risk of diabetes. Further investigation into this relationship could aid in understanding the mechanisms underlying inflammation, depression, and diabetes.
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Affiliation(s)
- Bonnie Au
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
| | - Kimberley J Smith
- Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Geneviève Gariépy
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Norbert Schmitz
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Montreal Diabetes Research Center, Montreal, Quebec, Canada
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Vogelzangs N, Beekman ATF, van Reedt Dortland AKB, Schoevers RA, Giltay EJ, de Jonge P, Penninx BWJH. Inflammatory and metabolic dysregulation and the 2-year course of depressive disorders in antidepressant users. Neuropsychopharmacology 2014; 39:1624-34. [PMID: 24442097 PMCID: PMC4023159 DOI: 10.1038/npp.2014.9] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 11/27/2013] [Accepted: 12/16/2013] [Indexed: 01/15/2023]
Abstract
Scarce evidence suggests that inflammatory and metabolic dysregulation predicts poor response to antidepressants, which could result in worse depression outcome. This study prospectively examined whether inflammatory and metabolic dysregulation predicted the 2-year course of depressive disorders among antidepressant users. Data were from the Netherlands Study of Depression and Anxiety, including 315 persons (18-65 years) with a current depressive disorder (major depressive disorder, dysthymia) at baseline according to the DSM-IV criteria and using antidepressants. Inflammatory (C-reactive protein, interleukin-6 (IL-6), tumor-necrosis factor-α) and metabolic (waist circumference, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, fasting glucose) factors were measured at baseline. Primary outcome for course of depression was indicated by whether or not a DSM-IV depressive disorder diagnosis was still/again present at 2-year follow-up, indicating chronicity of depression. Elevated IL-6, low HDL cholesterol, hypertriglyceridemia, and hyperglycemia were associated with chronicity of depression in antidepressant users. Persons showing ⩾ 4 inflammatory or metabolic dysregulations had a 1.90 increased odds of depression chronicity (95% CI = 1.12-3.23). Among persons who recently (ie, at most 3 months) started antidepressant medication (N = 103), having ⩾ 4 dysregulations was associated with a 6.85 increased odds of depression chronicity (95% CI = 1.95-24.06). In conclusion, inflammatory and metabolic dysregulations were found to predict a more chronic course of depressive disorders among patients using antidepressants. This could suggest that inflammatory and metabolic dysregulation worsens depression course owing to reduced antidepressant treatment response and that alternative intervention treatments may be needed for depressed persons with inflammatory and metabolic dysregulation.
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Affiliation(s)
- Nicole Vogelzangs
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands,Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands,Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands, Tel: +31 20 788 4521, Fax: +31 20 788 5664, E-mail: /
| | - Aartjan TF Beekman
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Arianne KB van Reedt Dortland
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter de Jonge
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Brenda WJH Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands,Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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Ul-Haq Z, Smith DJ, Nicholl BI, Cullen B, Martin D, Gill JMR, Evans J, Roberts B, Deary IJ, Gallacher J, Hotopf M, Craddock N, Mackay DF, Pell JP. Gender differences in the association between adiposity and probable major depression: a cross-sectional study of 140,564 UK Biobank participants. BMC Psychiatry 2014; 14:153. [PMID: 24884621 PMCID: PMC4050096 DOI: 10.1186/1471-244x-14-153] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 05/20/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies on the association between adiposity and mood disorder have produced contradictory results, and few have used measurements other than body mass index (BMI). We examined the association between probable major depression and several measurements of adiposity: BMI, waist circumference (WC), waist-hip-ratio (WHR), and body fat percentage (BF%). METHODS We conducted a cross-sectional study using baseline data on the sub-group of UK Biobank participants who were assessed for mood disorder. Multivariate logistic regression models were used, adjusting for potential confounders including: demographic and life-style factors, comorbidity and psychotropic medication. RESULTS Of the 140,564 eligible participants, evidence of probable major depression was reported by 30,145 (21.5%). The fully adjusted odds ratios (OR) for obese participants were 1.16 (95% confidence interval (CI) 1.12, 1.20) using BMI, 1.15 (95% CI 1.11, 1.19) using WC, 1.09 (95% CI 1.05, 1.13) using WHR and 1.18 (95% CI 1.12, 1.25) using BF% (all p < 0.001). There was a significant interaction between adiposity and gender (p = 0.001). Overweight women were at increased risk of depression with a dose response relationship across the overweight (25.0-29.9 kg/m2), obese I (30.0-34.9 kg/m2), II (35.0-39.9 kg/m2) and III (≥40.0 kg/m2) categories; fully adjusted ORs 1.14, 1.20, 1.29 and 1.48, respectively (all p < 0.001). In contrast, only obese III men had significantly increased risk of depression (OR 1.29, 95% CI 1.08, 1.54, p = 0.006). CONCLUSION Adiposity was associated with probable major depression, irrespective of the measurement used. The association was stronger in women than men. Physicians managing overweight and obese women should be alert to this increased risk.
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Affiliation(s)
- Zia Ul-Haq
- Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK,Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Daniel J Smith
- Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK
| | - Barbara I Nicholl
- Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK
| | - Breda Cullen
- Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK
| | - Daniel Martin
- Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK
| | - Jason MR Gill
- Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK
| | - Jonathan Evans
- Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK
| | | | | | | | | | | | - Daniel F Mackay
- Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK
| | - Jill P Pell
- Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK.
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Kornhuber J, Müller CP, Becker KA, Reichel M, Gulbins E. The ceramide system as a novel antidepressant target. Trends Pharmacol Sci 2014; 35:293-304. [PMID: 24793541 DOI: 10.1016/j.tips.2014.04.003] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 03/28/2014] [Accepted: 04/03/2014] [Indexed: 01/01/2023]
Abstract
Major depression is a systems disorder which impairs not only central nervous system aspects of mood and behavior but also peripheral organ systems. Current views on the pathogenesis and treatment of depression are predominantly based on proteins and transmitters and thus are difficult to reconcile central with peripheral pathomechanisms. Recent research showed that there is also a lipid-based pathway involved in the pathology of depression, which is activated by psychosocial stress, oxidative stress, or inflammation. Inducible dysfunction of the ceramide pathway, which is abundant in the brain as well as in peripheral organs, may account for mood disorder, behavioral symptoms, and further promote inflammation and oxidative stress in peripheral systems. As such, the lipid ceramide pathway may provide the missing link between brain dysfunction and somatic symptoms of depression. Pharmacological interventions that reduce ceramide abundance also show antidepressant action and may promise a better treatment of major depression.
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Affiliation(s)
- Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany.
| | - Christian P Müller
- Department of Psychiatry and Psychotherapy, University Hospital, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
| | - Katrin Anne Becker
- Department of Molecular Biology, University of Duisburg-Essen, Essen, Germany
| | - Martin Reichel
- Department of Psychiatry and Psychotherapy, University Hospital, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
| | - Erich Gulbins
- Department of Molecular Biology, University of Duisburg-Essen, Essen, Germany
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Milaneschi Y, Sutin AR, Terracciano A, Canepa M, Gravenstein KS, Egan JM, Vogelzangs N, Guralnik JM, Bandinelli S, Penninx BWJH, Ferrucci L. The association between leptin and depressive symptoms is modulated by abdominal adiposity. Psychoneuroendocrinology 2014; 42:1-10. [PMID: 24636496 PMCID: PMC4214922 DOI: 10.1016/j.psyneuen.2013.12.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 12/05/2013] [Accepted: 12/23/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND Evidence for a role of leptin in depression is limited and conflicting. Inconclusive findings may be explained by the complex effect of obesity on leptin signaling. In particular, both hyperleptinemia due to leptin resistance in obese persons as well as low leptin in lean persons can imply that low leptin biological signaling is associated with an increased risk of significant depressive symptoms. We tested whether the relationship between leptin and depressive symptoms is modulated by abdominal adiposity in two population-based studies. METHODS Data were from 851 participants (65-94 years) of the InCHIANTI Study and 1064 (26-93 years) of the Baltimore Longitudinal Study of Aging (BLSA). Plasma concentrations of leptin, waist circumference and depressive symptoms via the Center for Epidemiological Studies-Depression scale (CES-D) were assessed. In longitudinal InCHIANTI analyses onset of depressed mood (CES-D≥20) was evaluated over a 9-year follow-up. RESULTS In pooled cross-sectional analyses the interaction between leptin and waist circumference was significantly associated with CES-D scores ((log)leptin-by-waist interaction p=0.01). Also in longitudinal analyses, the (log)leptin-by-waist interaction term significantly (p=0.04) predicted depressed mood onset over time; depressed mood risk was especially increased for high levels of both leptin and waist circumference. CONCLUSIONS The present findings suggest that low leptin signaling rather than low leptin concentration is a risk factor for depression. Future studies should develop proxy measures of leptin signaling by combining information on abdominal adiposity and leptin level to be used for clinical and research applications.
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Affiliation(s)
- Yuri Milaneschi
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center/GGZ inGeest, Amsterdam, The Netherlands; Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA.
| | - Angelina R Sutin
- Department of Medical Humanities and Social Sciences, Florida State University College of Medicine, Tallahassee, FL, USA; Laboratory of Population Science, National Institute on Aging, Baltimore, MD, USA
| | - Antonio Terracciano
- Department of Geriatrics Florida State University College of Medicine, Tallahassee, FL, USA
| | - Marco Canepa
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA; Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute on Aging, Baltimore, MD, USA; Department of Internal Medicine, University of Genova, Genova, Italy
| | - Kristofer S Gravenstein
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Josephine M Egan
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA; Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, MD, USA
| | - Nicole Vogelzangs
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center/GGZ inGeest, Amsterdam, The Netherlands
| | - Jack M Guralnik
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Brenda W J H Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center/GGZ inGeest, Amsterdam, The Netherlands
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
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Depression-related differences in lean body mass distribution from National Health and Nutrition Examination Survey 2005-2006. J Affect Disord 2014; 157:1-7. [PMID: 24581820 DOI: 10.1016/j.jad.2013.12.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 12/20/2013] [Accepted: 12/22/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Although the association between depression and body composition has been widely discussed, the effects of depression on lean body mass (LBM) are unclear. The present study aimed to investigate the association of depression with LBM. METHODS The study included 2406 participants aged 18-69 years. The sex and body mass index (BMI) stratified analysis of covariance was performed to compare total LBM and percentage LBM (%LBM) in subjects with different depression score levels. Multiple linear regression analysis was conducted to estimate the association between depression score and serum albumin level. RESULTS An analysis of covariance stratified by sex showed that participants with moderate-to-severe depression had significantly decreased total LBM and total and regional %LBM in men, except for total LBM and percentage gynoid LBM, which was observed in women. In the BMI stratified analysis of covariance, depression was significantly associated with decreased total and regional %LBM and with increased total and regional percentage fat body mass. In people with BMI≥25kg/m(2), the associations between depression or depressive syndrome and LBM, and total and regional %LBM are stronger compared to those with BMI<25kg/m(2). Multiple linear regression analysis showed that depression score was significantly negatively associated with serum albumin level. LIMITATIONS This is a cross-sectional study based on a general population, some information about clinical diagnosis and medication use is not available. CONCLUSIONS Depression had a significant negative association with LBM and serum albumin level.
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Rosa Fortin MM, Brown C, Ball GDC, Chanoine JP, Langlois MF. Weight management in Canada: an environmental scan of health services for adults with obesity. BMC Health Serv Res 2014; 14:69. [PMID: 24521300 PMCID: PMC3927222 DOI: 10.1186/1472-6963-14-69] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 02/05/2014] [Indexed: 11/10/2022] Open
Abstract
Background Obesity in Canada is a growing concern, but little is known about the available services for managing obesity in adults. Our objectives were to (a) survey and describe programs dedicated to weight management and (b) evaluate program adherence to established recommendations for care. Methods We conducted an online environmental scan in 2011 to identify adult weight management services throughout Canada. We examined the degree to which programs adhered to the 2006 Canadian Clinical Practice Guidelines on the Management and Prevention of Obesity in Adults and Children (CCPGO) and the analysis criteria developed by the Association pour la Santé Publique du Québec (ASPQ). Results A total of 83 non-surgical (34 community-based, 42 primary care-based, 7 hospital-based) and 33 surgical programs were identified. All programs encouraged patient self-management. However, few non-surgical programs adhered to the CCPGO recommendations for assessment and intervention, and there was a general lack of screening for eating disorders, depression and other psychiatric diseases across all programs. Concordance with the ASPQ criteria was best among primary care-based programs, but less common in other settings with deficits most frequently revealed in multidisciplinary health assessment/management and physical activity counselling. Conclusions With more than 60% of Canadians overweight or obese, our findings highlight that availability of weight management services is far outstripped by need. Our observation that evidence-based recommendations are applied inconsistently across the country validates the need for knowledge translation of effective health services for managing obesity in adults.
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Affiliation(s)
| | | | | | | | - Marie-France Langlois
- Centre de recherche clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Québec, Canada.
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Assari S. Association Between Obesity and Depression Among American Blacks: Role of Ethnicity and Gender. J Racial Ethn Health Disparities 2014. [DOI: 10.1007/s40615-014-0007-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Perquier F, Lasfargues A, Mesrine S, Clavel-Chapelon F, Fagherazzi G. Associations entre les mesures anthropométriques et le risque de dépression chez la femme post-ménopausée. Eur Psychiatry 2013. [DOI: 10.1016/j.eurpsy.2013.09.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
IntroductionLes études précédentes ont suggéré une association positive entre la dépression et le surpoids et/ou l’obésité notamment au sein de populations nord-américaines [2]. Notre objectif était d’identifier les associations transversales entre la dépression primo-incidente ou récurrente et différentes mesures anthropométriques au sein d’une population de femmes françaises post-ménopausées.
MethodsChez 38 974 femmes de la cohorte E3N en 2005, la dépression a été définie selon l’échelle CES-D (CESD ≥ 23) puis classée en dépression récurrente ou primo-incidente, selon l’existence ou non d’un antécédent autodéclaré de traitement pour trouble psychologique. Les associations entre les mesures anthropométriques, découpées en quartiles, et le risque de dépression ont ensuite été estimés grâce à des modèles logistiques multinomiaux.
RésultatsUn faible poids (< 55 kg) et un faible indice de masse corporel (IMC < 20 kg/m2) étaient associés au risque de dépression primo-incidente (respectivement OR = 1,14 ; 95 % IC 1,01–1,29 et OR = 1,20 ; 95 % IC 1,05–1,36) et récurrente (OR = 1,26, 95 % IC 1,12–1,40 et OR = 1,33, 95 % IC 1,18–1,50). L’augmentation de risque associé à un faible tour de hanche (TH < 93 cm) disparaissait après ajustement sur l’IMC. Les catégories les plus élevées de poids, d’IMC ou de TH étaient associées à un risque plus élevé de dépression récurrente. Une augmentation du tour de taille (TT) ou du ratio taille/hanche était significativement associée à une augmentation du risque des deux types de dépression (p-trend < 0,001), indépendamment de l’IMC.
ConclusionLes femmes les plus minces [1] ainsi que chez celles ayant un TT ou un ratio taille/hanche élevé [3] pourraient avoir un risque plus élevé de dépression, et notamment de dépression primo-incidente. De nouvelles études longitudinales sont cependant nécessaires afin de préciser la temporalité des associations entre ces mesures anthropométriques et la dépression et appuyer ces hypothèses.
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Penninx BWJH, Milaneschi Y, Lamers F, Vogelzangs N. Understanding the somatic consequences of depression: biological mechanisms and the role of depression symptom profile. BMC Med 2013; 11:129. [PMID: 23672628 PMCID: PMC3661358 DOI: 10.1186/1741-7015-11-129] [Citation(s) in RCA: 487] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 04/17/2013] [Indexed: 12/17/2022] Open
Abstract
Depression is the most common psychiatric disorder worldwide. The burden of disease for depression goes beyond functioning and quality of life and extends to somatic health. Depression has been shown to subsequently increase the risk of, for example, cardiovascular, stroke, diabetes and obesity morbidity. These somatic consequences could partly be due to metabolic, immuno-inflammatory, autonomic and hypothalamic-pituitary-adrenal (HPA)-axis dysregulations which have been suggested to be more often present among depressed patients. Evidence linking depression to metabolic syndrome abnormalities indicates that depression is especially associated with its obesity-related components (for example, abdominal obesity and dyslipidemia). In addition, systemic inflammation and hyperactivity of the HPA-axis have been consistently observed among depressed patients. Slightly less consistent observations are for autonomic dysregulation among depressed patients. The heterogeneity of the depression concept seems to play a differentiating role: metabolic syndrome and inflammation up-regulations appear more specific to the atypical depression subtype, whereas hypercortisolemia appears more specific for melancholic depression. This review finishes with potential treatment implications for the downward spiral in which different depressive symptom profiles and biological dysregulations may impact on each other and interact with somatic health decline.
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Affiliation(s)
- Brenda W J H Penninx
- Department of Psychiatry, EMGO+ Institute and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
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Pan A, Keum N, Okereke OI, Sun Q, Kivimaki M, Rubin RR, Hu FB. Bidirectional association between depression and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies. Diabetes Care 2012; 35:1171-80. [PMID: 22517938 PMCID: PMC3329841 DOI: 10.2337/dc11-2055] [Citation(s) in RCA: 514] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Epidemiological studies have repeatedly investigated the association between depression and metabolic syndrome (MetS). However, the results have been inconsistent. This meta-analysis aimed to summarize the current evidence from cross-sectional and prospective cohort studies that evaluated this association. RESEARCH DESIGN AND METHODS MEDLINE, EMBASE, and PsycINFO databases were searched for articles published up to January 2012. Cross-sectional and cohort studies that reported an association between the two conditions in adults were included. Data on prevalence, incidence, unadjusted or adjusted odds ratio (OR), and 95% CI were extracted or provided by the authors. The pooled OR was calculated separately for cross-sectional and cohort studies using random-effects models. The I(2) statistic was used to assess heterogeneity. RESULTS The search yielded 29 cross-sectional studies (n = 155,333): 27 studies reported unadjusted OR with a pooled estimate of 1.42 (95% CI 1.28-1.57; I(2) = 55.1%); 11 studies reported adjusted OR with depression as the outcome (1.27 [1.07-1.57]; I(2) = 60.9%), and 12 studies reported adjusted OR with MetS as the outcome (1.34 [1.18-1.51]; I(2) = 0%). Eleven cohort studies were found (2 studies reported both directions): 9 studies (n = 26,936 with 2,316 new-onset depression case subjects) reported adjusted OR with depression as the outcome (1.49 [1.19-1.87]; I(2) = 56.8%), 4 studies (n = 3,834 with 350 MetS case subjects) reported adjusted OR with MetS as the outcome (1.52 [1.20-1.91]; I(2) = 0%). CONCLUSIONS Our results indicate a bidirectional association between depression and MetS. These results support early detection and management of depression among patients with MetS and vice versa.
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Affiliation(s)
- An Pan
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.
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González-Castejón M, Rodriguez-Casado A. Dietary phytochemicals and their potential effects on obesity: A review. Pharmacol Res 2011; 64:438-55. [DOI: 10.1016/j.phrs.2011.07.004] [Citation(s) in RCA: 207] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 07/11/2011] [Indexed: 12/20/2022]
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