Depression trajectories and the association with metabolic adversities among the middle-aged adults

Depressive symptoms' trajectories since adolescence and sleep quality in early adulthood: results from the EPITeen cohort

OBJECTIVES

We aimed to estimate the association between depressive symptoms' trajectories during adolescence and young adulthood and sleep quality in early adulthood.

METHODS

Data from 802 participants of the EPITeen study, evaluated at 13, 17 and 21 years of age, were analysed. Depressive symptoms were assessed using the Beck Depression Inventory-II and three trajectory classes from adolescence to adulthood were previously identified (High, Moderate, Low). The prevalences of poor sleep quality, overall (score>5) and in its specific dimensions: subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleep drugs and daytime dysfunction (score≥2), at 21 years of age were evaluated using the Pittsburgh Sleep Quality Index. Associations were estimated using adjusted odds ratio (OR) and the respective 95 % confidence intervals (CI).

RESULTS

At 21 years of age, 29.8 % young adults presented poor sleep quality, which was significantly different between those in the Low and High depressive trajectories (14.3 and 53.1 %, respectively, p<0.001). Compared with participants in the Low trajectory, those in the High trajectory were more likely to present poorer sleep quality at 21 years of age (OR=6.34 95 % CI: 3.94-10.21), particularly worse levels of sleep disturbance (OR=5.89 95 % CI: 2.84-12.21), daytime dysfunction (OR=7.63 95 % CI: 3.63-16.06) and subjective sleep quality (OR=6.61 95 % CI: 3.69-11.85).

CONCLUSIONS

Poor sleep quality in early adulthood was more frequent among individuals who had high levels of depressive symptoms since adolescence. Monitoring depression until adulthood may help to identify those at higher risk of sleep problems which, in turn, can lead to worse health outcomes over time.

Association of serum oleic acid level with depression in American adults: a cross-sectional study

BACKGROUND

As the most abundant fatty acid in plasma, oleic acid has been found to be associated with multiple neurological diseases; however, results from studies of the relationship between oleic acid and depression are inconsistent.

METHODS

This cross-sectional study analyzed 4,459 adults from the National Health and Nutrition Examination Survey 2011-2014. The following covariates were adjusted in multivariable logistic regression models: age, sex, race/ethnicity, education level, marital status, body mass index, physical activity, smoking status, alcohol status, metabolic syndrome, omega-3 polyunsaturated fatty acids, and total cholesterol.

RESULTS

Serum oleic acid levels were positively associated with depression. After adjusting for all covariates, for every 1 mmol/L increase in oleic acid levels, the prevalence of depression increased by 40% (unadjusted OR: 1.35, 95%CI: 1.16-1.57; adjusted OR: 1.40, 95% CI: 1.03-1.90).

CONCLUSIONS

Our study suggests that oleic acid may play a role in depression. Further research is needed to investigate the potential benefits of changing oleic acid levels for the treatment and prevention of depression.

Mental health is related to metabolic syndrome: The Hispanic community health study/ study of Latinos

OBJECTIVE

Metabolic syndrome (MetS) is associated with common mental health conditions. Using cross-sectional data from the observational Hispanic Community Health Study / Study of Latinos (HCHS/SOL), this study examined the relationship between MetS and depression and anxiety in addition to testing moderating effects of gender and Hispanic heritage subgroups.

METHODS

Participants included 13,496 Hispanic Americans aged 18-74 (59% women, mean age 46.59 ± 13.65) from seven heritage subgroups. Depression was measured using the Center for Epidemiologic Studies Depression 10-item scale, and anxiety was assessed using the State-Trait Anxiety Inventory 10-item scale. A 3-level categorical variable was developed to assess the combined influence of depression and anxiety. The dependent variable is dichotomous, delineating the presence or absence of MetS as defined by the National Cholesterol Education Program Third Adult Treatment Panel. Logistic regression and Hayes' PROCESS macro assessed these relationships and the moderating effects of gender-heritage subgroups.

RESULTS

Results suggest depression (p < .001) and anxiety (p < .001) were associated with an increased likelihood of MetS. Puerto Ricans had the highest, and South Americans had the lowest, levels of depression and anxiety. Gender moderated the relationship between mental health and MetS, with women having a significant increase in the probability of MetS with depression (p < .001), anxiety (p < .001), or both (p < .001).

CONCLUSION

Elevated symptoms of depression and anxiety are associated with the presence of MetS in US Hispanic subgroups. Gender-heritage differences are present among the study variables. Strategies to manage psychological well-being must be employed to optimize cardiometabolic health in US Hispanics.

Mental health and quality of life in different obesity phenotypes: a systematic review

Objectives

It has been suggested that obesity phenotypes are related to mental health problems and health-related quality of life (HRQoL). However, there is no certain consensus. This systematic review aimed to evaluate the association between different obesity phenotypes with common psychiatric symptoms and HRQoL.

Methods

Electronic databases i.e. PubMed, Scopus, EMBASE, and google scholar were searched until September 2021, to identify studies that investigated associations between the obesity phenotypes with psychiatric symptoms and/or mental and physical HRQoL. Two researchers independently checked titles and abstracts, evaluated full-text studies, extracted data, and appraised their quality using the Newcastle–Ottawa Scale.

Results

Eighteen studies, with a total of 3,929,203 participants, were included. Of the studies included in this systematic review, 10 articles evaluated the association between obesity phenotypes and psychiatric symptoms, while six papers investigated the association between HRQoL and obesity phenotypes, and two studies assessed both. As a whole, the findings of these studies suggest that obese individuals with a favorable metabolic profile have a slightly higher risk of mental health problems and poor quality of life, however, the risk becomes larger when obesity is combined with an adverse metabolic profile. So, metabolically healthy obesity may not be a completely benign condition in relation to mental disorders and poor quality of life.

Conclusion

According to published research, obesity is likely to increase the risk of mental health problems and poor quality of life when metabolic disturbances are present.

The Association of Metabolic Dysfunction and Mood Across Lifespan Interacts With the Default Mode Network Functional Connectivity

Background: Numerous studies suggest a relationship between depression and metabolic syndrome, which is likely influenced by age. Interestingly, functional imaging analysis has shown an association between functional connectivity in the default mode network (DMN-FC) and components of metabolic syndrome, which is explored in this study.

Methods: From a larger longitudinal cohort study on healthy aging, 943 individuals were extensively characterized for mood and cognition. Among these, 120 individuals who were selected for displaying extreme cognitive performance within the normal range (good and poor performers) were further studied. Here, in a cross-sectional design, using confirmatory factor analysis (CFA), the association between metabolic dysfunction and depressive mood as a function of age and its relationship with DMN-FC was studied.

Results: Metabolic dysfunction was modeled as a second-order latent variable using CFA. First-order latent variables were obesity, glucose dysmetabolism, lipids imbalance, and blood pressure. Using multiple linear regression models, this study observed that metabolic dysfunction, glucose dysmetabolism, and lipids imbalance were linearly associated with depressive mood, and the association with obesity was U-shaped. The association of metabolic dysfunction, obesity, and glucose dysmetabolism with depressive mood is positive for the younger individuals in our sample and vanishes with aging. The FC of the right superior temporal gyrus with the DMN correlated with both obesity and depressive mood. In participants with higher obesity scores, FC increased with higher GDS scores, while in those with lower GDS scores, FC decreased. Age and blood pressure were associated with a more complex pattern of association between FC of the right supramarginal gyrus and GDS score.

Conclusion: The association of metabolic dysfunction with depressive mood is influenced by age and relates with differential patterns of DMN-FC. The combination of the effects of age, mood, and metabolic dysfunction is likely to explain the heterogeneity of DMN-FC, which deserves further investigation with larger and longitudinal studies.

Depressive symptoms and 5-year incident metabolic syndrome among older adults

Little is known regarding the association between depressive symptoms and metabolic syndrome (MetS) among older Chinese adults. This study aimed to examine the association of depressive symptoms with MetS and its components among Chinese elderly. Based on whether they showed depressive symptoms at baseline, 262 age-gender-matched participants from a community-based cohort study were included. The presence of depressive symptoms was measured using the nine-item Patient Health Questionnaire (PHQ-9). MetS was defined according to the Adult Treatment Panel III of the National Cholesterol Education Program. Linear regression and logistic regression analyses were performed to assess associations of depressive symptoms with MetS and its components. The incidence of MetS among the participants with depressive symptoms at baseline was 15.27% (20/131). The association of the presence of depressive symptoms with MetS was significant (odds ratio [OR] = 2.53, 95% confidence intervals [CI] = 1.07, 5.95). There was a negative association between depressive symptoms and hypertension (OR = 0.04, 95% CI = 0.002, 0.98). The change in mean arterial pressure varies approximately 1.03 mmHg with a 1-point change in PHQ-9 score. In this study, baseline depressive symptoms were associated with subsequent MetS. The presence of depressive symptoms was negatively associated with elevated mean arterial pressure.

Depression and metabolic syndrome in participants of the "Seguimiento Universidad de Navarra" (SUN) cohort study

BACKGROUND

Depression is a major public health concern worldwide and its association with metabolic syndrome (MetS) remains unclear. Thus, we prospectively examined the association between depression and the risk of MetS, according to different diagnosis criteria.

METHODS

This study included 9,237 participants of a Spanish dynamic prospective cohort of adult university graduates [mean (SD) age: 36.7 year (10.7)], initially free of any specific criterion of MetS, who were followed-up for a median of 8.3 years. The exposure variables were medical diagnosis of depression at baseline or in the first 2-year follow-up questionnaire. The outcome variable was the incidence of MetS, assessed according to each of three different criteria proposed by: International Diabetes Federation (IDF); National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III); IDF/NCEP-ATP III (updated harmonizing definition). Multivariable-adjusted Relative Risks (RR) of new-onset MetS and their 95% Confidence Intervals (95% CI) were estimated, using Poisson regression models.

RESULTS

The cumulative incidences of MetS were 475 cases (IDF definition), 288 cases (NCEP-ATP III definition) and 492 cases (update harmonized definition). No association was observed between baseline depression and incidence of MetS, but the presence of depression after 2-years of follow-up was significantly associated with a higher risk of new-onset MetS, according to NCEP-ATP III definition (multivariable-adjusted RR, 2.46; 95% CI, 1.06-5.67).

LIMITATIONS

Diagnosis of depression and MetS were self-reported.

CONCLUSIONS

In this large prospective cohort of Spanish middle-aged adult university graduates, a direct association between depression and the risk of MetS according to NCEP-ATP III definition was found.

Trajectories of Depression between 30s and 50s: Latent Growth Modeling

Objectives: Previous studies have primarily focused on depression among older adults. Given that middle age links young adulthood to older adulthood and encompasses a variety of changes in roles and status, which influence depression, it is important to understand the changes of depression during this period. Methods: This study used data from the National Longitudinal Survey of Youth 1979. The final sample consisted of 834 individuals, and four points in time were used: 34, 36, 40, and 50 years of age. The Latent Growth Model (LGM) was used to estimate the trajectories of depression. Results: The trajectories of depression present a non-linear change, referring to V-shaped curve. The conditional model shows that there are significant individual differences on initial status. Males were negatively associated with the latent initial level of depression. Individuals who showed higher self-esteem and cognitive ability were negatively associated with the latent initial level of depression. In addition, health insurance was negatively associated with the latent initial levels of depression. Both employment and net worth predicted lower intercepts of depression. Discussion: As the 40s is a bridge between the lowest levels of depression and a gradual increase of depression, service providers should be aware of changes of depression among middle-aged adults and spend more time and resources to encourage those individuals to prepare for changes in depression. Prevention programs for depression and providing more opportunities for employment and education to save money should be more focused on young adults.

Associations between depressive symptoms, cigarette smoking, and cardiovascular health: Longitudinal results from CARDIA

INTRODUCTION

Depression is associated with increased risk of incident and recurrent cardiovascular disease, while the association between depression and cardiovascular health (CVH) remains unknown. Because the natural course of depression varies widely, different patterns of depression, as well as co-occurring factors such as cigarette smoking, may influence this relationship. We examined potential interactions between longitudinal patterns of depression and smoking with CVH.

METHODS

Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, we modeled trajectories of depression (Center for Epidemiologic Studies Depression scale scores; Years 5, 10, 15, 20) and smoking (cigarettes/day; Years 0, 2, 5, 7, 10, 15, 20). We calculated a modified American Heart Association (AHA) CVH Score (weight, blood glucose, cholesterol, blood pressure, physical activity, and diet; Year 20); higher scores indicate better CVH. Generalized linear models evaluated associations between depression trajectories, smoking trajectories, and their interaction with CVH Score.

RESULTS

The depression trajectory x smoking trajectory interaction was not associated with CVH Score, but main effects of depression trajectory (p < .001) and smoking trajectory (p < .001) were observed. Participants with patterns of subthreshold depression (β = -0.26, SE=0.08), increasing depression (β = -0.51 SE = 0.14), and high depression (β = -0.65, SE = 0.32) had lower CVH Scores than those without depression. Compared to never smokers, participants who quit smoking had higher CVH Scores (β = 0.38, SE = 0.11), while participants with the greatest smoking exposure had lower CVH Scores (β = -0.49, SE = 0.22).

LIMITATIONS

CVH Scores were adapted from the AHA guidelines based on the available CARDIA data.

CONCLUSIONS

Deleterious depression and smoking trajectories are independently but not synergistically associated with worse CVH.

Inflammatory and metabolic disturbances are associated with more severe trajectories of late-life depression

Late-life depression is a highly prevalent mental health condition with devastating consequences even from its earliest stages. Alterations in physiological functions, such as inflammatory and metabolic, have been described in patients with depression. However, little is known on the association between depression symptom course and metabolic and inflammation dysregulation. This study aimed to depict the course of depression symptoms while ageing, taking into consideration inter-individual heterogeneity. Moreover, it intended to study the associations between inflammatory and metabolic risk profiles and symptom trajectories. To do so, data from 13,203 adults aged 50-90 years (52.75% women; mean age at baseline = 65.07, SD = 10.00) were used. Blood sample and blood pressure measures were taken from 1536 participants (56.58% women; mean age at baseline = 61.73 years, sd = 7.64). Depression symptoms were assessed every two years across a 10-year follow-up. Trajectories were identified by means of latent class mixed modelling. Inflammation and metabolic risk profile scores were obtained from plasma and diagnostic-based indicators in the follow-up, using a robust latent-factor approach. Multigroup modelling was used to study the associations between the profiles and symptom trajectories. As a result, three heterogeneous trajectories of symptoms were identified (low-symptom, moderate-symptom and high-symptom trajectory). Participants depicting a high-symptom trajectory showed the greatest inflammation profile score and high metabolic risk. Moderate-symptom trajectory was also related to high inflammation and metabolic risk. To sum up, at-risk trajectories of symptoms were associated with high inflammation and risk of metabolic diseases. This study provides valuable evidence to advance personalised medicine and mental health precision, considering person-specific profiles and physiological concomitants.

The relationship between visceral adiposity and depressive symptoms in the general Korean population

BACKGROUND

In Korea, depressive symptoms or depression are prevalent. Metabolic syndrome is the representative medical condition associated with depression. This study examined the association between clinically significant depressive symptoms and intra-abdominal fat, measured using abdominal computed tomography, in a large sample of the Korean population who underwent routine health examination.

METHODS

People who underwent routine health examinations at the Seoul National University Hospital Healthcare System, Gangnam Center, from October 2004 to July 2012 were included in the study. There were 11,434 cases of individuals with CT scan data and entries in the Beck Depression Inventory (BDI). Of these, 1156 men and women underwent CT scans more than once. In these cases, we analyzed the first scan.

RESULTS

We analyzed 4945 male and 2293 female participants; 333 participants (171 male, 162 female) were in the clinically depressed group. After controlling for confounding factors, we found that clinically depressive symptoms were associated with visceral adiposity in women. Per 1 cm² of visceral adipose tissue area, the risk of being clinically depressed increased 1.006-fold. Similarly, per 1% increase in the ratio of visceral and total adipose tissue area in women, the risk increased 1.028-fold.

CONCLUSIONS

Our large-sample study showed depressive symptoms are associated with intra-abdominal fat and the ratio of visceral and total adipose area in women, after controlling for confounding factors including BMI, hypertension, and diabetes.

Association Between Depression and Metabolic Syndrome in Korean Adults: Data From the 2014 and 2016 Korea National Health and Nutrition Examination Survey

This study aimed to examine the association of depression with metabolic syndrome and to investigate levels of awareness and treatment of depression in Korean adults. We analyzed data extracted from the Korea National Health and Nutrition Examination Survey (2014 and 2016) using the Patient Health Questionnaire-9 depression screening instrument. Among the survey participants, 10 459 were selected for data analysis. Of them, 7.2% had depression, 24.4% had metabolic syndrome, and 10.0% had both depression and metabolic syndrome. Among those with depression, 33.1% were aware of their condition and 25.7% received treatment, with significant differences found between those with and without metabolic syndrome. The mean Patient Health Questionnaire-9 scores significantly increased with the number of metabolic syndrome components ( F = 6.06, P = <.001). In logistic regression analysis, the odds ratio (OR) for depression with metabolic syndrome was 1.41 (95% confidence interval [CI] = 1.12-1.76). For the number of metabolic syndrome components, having 2 (OR = 1.37, 95% CI = 1.01-1.86), 3 (OR = 1.57, 95% CI = 1.12-2.21), 4 (OR = 1.95, 95% CI = 1.32-2.87), and 5 (OR = 2.18, 95% CI = 1.38-3.46) conditions significantly increased the OR for depression. Including depression in the management of metabolic syndrome could help make people with depression more aware of their condition.

Association of depression with body mass index classification, metabolic disease, and lifestyle: A web-based survey involving 11,876 Japanese people

Body mass index (BMI) and lifestyle-related physical illnesses have been implicated in the pathology of depression. We aimed to investigate the association of depression wih BMI classification (i.e., underweight, normal, overweight, and obese), metabolic disease, and lifestyle using a web-based survey in a large cohort. Participants were 1000 individuals who have had depression (mean age: 41.4 ± 12.3 years, 501 men) and 10,876 population-based controls (45.1 ± 13.6 years, 5691 men). The six-item Kessler scale (K6) test was used as a psychological distress scale. Compared to in the controls, obesity and hyperlipidemia were more common and frequency of a snack or night meal consumption was higher, whereas frequencies of breakfast consumption and vigorous and moderate physical activities were lower in the patients. K6 test scores were higher for underweight or obese people compared to normal or overweight people. A logistic regression analysis showed that the K6 test cut-off score was positively associated with being underweight, hyperlipidemia, and the frequency of a snack or night meal consumption, whereas it was negatively associated with the frequency of breakfast consumption in the patients. Logistic regression analyses showed that self-reported depression was positively associated with metabolic diseases and the frequency of a snack or night meal consumption, whereas it was negatively associated with the frequency of breakfast consumption. The observed associations of depression with BMI classification, metabolic disease, and lifestyle suggest that lifestyle and related physical conditions are involved in at least a portion of depressive disorders.

Associations between degree and sub-dimensions of depression and metabolic syndrome (MetS) in the community: results from the Gutenberg Health Study (GHS)

BACKGROUND

A growing number of studies have associated metabolic syndrome (MetS) and depression, both retrospectively and prospectively. However, it has remained unclear, which degrees, or sub-dimensions of depression are related to MetS and if comorbid depression affects health care utilization. The purpose of the study was to determine the associations of a) somatic and cognitive-affective symptoms to MetS and b) depression and MetS to health care utilization.

METHODS

In a population-based, representative survey of 14.499 participants we studied the associations of the two dimensions of depression with MetS and health care utilization. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9).

RESULTS

MetS and its components were associated with the degree of depression, particularly with moderately severe/ severe depressive symptoms (PHQ-9 > = 15). There were clear positive associations of somatic-affective depressive symptoms with the presence of MetS and its components. Cognitive-affective symptoms were negatively associated with MetS. At the single item level, disorders of sleep and appetite as well as exhaustion were positively, while trouble concentrating was negatively associated with MetS. Symptoms of depression were related to higher consultations of somatic and mental health care, while the presence of MetS was related to somatic health care utilization. There was an additional interaction of depressive symptoms and MetS with mental health care.

CONCLUSIONS

Somatic affective symptoms of depression are positively associated, while cognitive-affective symptoms are negatively associated with MetS.

A Review on the General Stability of Mood Disorder Diagnoses Along the Lifetime

PURPOSE OF REVIEW

The purpose of this review is to review the most recent literature regarding diagnostic stability of mood disorders, focusing on epidemiological, clinical-psychopathological, and neurobiological data for unipolar and bipolar affective disorders.

RECENT FINDINGS

Unipolar depression follows a chronic course in at least half of all cases and presents a considerable diagnostic stability across all age ranges. Studies using latent class analysis are allowing improved profiling of depressive subtypes and assessment of their prevalence. Advances have been made in our understanding of the neurobiological underpinnings of depression, with data highlighting the roles of amyloid deposits, the ApoE4 allele, and atrophy of the anterior hippocampus or frontal cortex. The diagnostic instability of bipolar disorder is manifest in the early years, seen in both the extent of diagnostic delay and the high rate of diagnostic conversion from unipolar depression. Regarding disruptive mood dysregulation disorder, we have little data to date, but those which exist indicate a high rate of comorbidity and minimal diagnostic stability for this disorder. Diagnostic stability varies substantially among mood disorders, which would be related to the validity of current diagnostic categories and our diagnostic accuracy.

Intergenerational relationships and the trajectory of depressive symptoms among older Chinese adults in rural migrant families

OBJECTIVES

This study examined the trajectory patterns of depressive symptoms of older rural Chinese adults in migrant families and the role of intergenerational relationships in predicting trajectory class memberships.

METHOD

Data were derived from the 2001, 2003, 2006, and 2009 waves of a longitudinal survey titled The Well-being of Older People in Anhui Province. The sample featured 486 respondents who had at least one migrant adult children at all four waves. Growth mixture modeling was used to investigate the trajectory classifications of depressive symptoms from 2001 to 2009 and antecedents in differentiating among class memberships.

RESULTS

The findings suggested a two-class model to interpret depressive symptom trajectory patterns: persistently high symptoms and low but increasing symptoms. Older adults who had better intergenerational relationships at baseline were more likely to have low but increasing depressive symptoms after controlling for other covariates.

DISCUSSION

The findings suggest that intergenerational relationships have long-term impacts on depressive symptom trajectory classes. Policy and intervention implications are discussed.

Sex-based Association between Depression and Metabolic Syndrome in Korean Middle-aged and Older Adults

OBJECTIVES

This study aimed to identify the sex-based association between depression and the development of metabolic syndrome (Mets) among middle-aged and older Korean adults.

METHODS

A cross-sectional design was used for the secondary analysis of the 2010-2014 Korean National Health and Nutrition Examination Survey. Data from 1,938 men and 2,404 women were analyzed. Mets was defined in accordance with the criteria used for clinical diagnosis. Depression was assessed with a question about having clinical depression. The association between depression and the development of Mets with or without adjustment for covariates was identified by conducting logistic regression analysis on weighted data using a complex sample procedure.

RESULTS

More women than men had depression. Before covariate adjustment, depression was significantly associated with the development of Mets among women (odds ratio [OR], 1.586; 95% confidence interval [CI], 1.152-2.183) and with a higher triglyceride level among men (OR, 1.679; 95% CI, 1.001-2.818). After covariate adjustment; depression was significantly associated with higher waist circumference among women (adjusted OR [AOR], 1.532; 95% CI, 1.046-2.245) and higher triglyceride level (AOR, 1.511; 95% CI, 1.029-2.219) than was Mets. Conversely, depression did not have significant effects on the development of Mets among men.

CONCLUSION

Depression was associated with the development of Mets among middle-aged and older Korean women. Healthcare providers in communities should assess women with depression for the presence of Mets components. Interventions for relieving depressive symptoms should also be provided to women at risk for Mets.

Demographics and Health Profiles of Depressive Symptoms in Korean Older Adults

This study examined the demographics and health characteristics of depressive symptoms of Korean older adults. Data were from the 2014 survey of the Korean Longitudinal Study of Aging (KLoSA). Hierarchical logistic regression was conducted to identify risk factors of depressive symptoms. Model 2 including socio-demographics and health characteristics explained 19.2% of depressive symptoms. Significant risk factors of depressive symptoms were men, age of 53-60 years, mid-sized city and rural area residents, less than high-school education, adults without spouse, 1st (lowest) quintile of annual household income, body shape as underweight, ex-smokers, non-drinkers, no regular exercise, perceived health status as poor, limited activities of daily living, and the number of comorbidities. Interventions to reduce depressive symptoms in these populations should include strategies to change some of these modifiable risk factors.

Association between depression and metabolic syndrome in korean women: Results from the korean national health and nutrition examination survey (2007-2013)

BACKGROUND

A considerable amount of research suggests that depression may be associated with cardiovascular disease (CVD) and the risk factors for the development of CVD such as metabolic syndrome (MetS). This study aimed to investigate the associations between depression, MetS, and combinations of the individual MetS components in Korean women.

METHODS

Cross-sectional data for 23,385 women who aged 19 years and older were obtained from the nationally representative Korean National Health and Nutrition Examination Survey (2007-2013). Associations between prior diagnosis of depression and MetS were estimated after adjusting for related factors using multivariable logistic regression analysis.

RESULTS

MetS was more prevalent in women with a prior diagnosis of depression than those without diagnosed depression (26.20% vs. 19.07%, p<.001). Depression was significantly associated with MetS (odds ratio, 1.20; 95% confidence interval, 1.01-1.43) after adjusting for age, education, monthly household income, smoking status, alcohol use, physical activity, and postmenopausal status. There was a higher prevalence of most MetS combinations among women with depression than women without depression. Specifically, significant differences between the two groups were found for MetS combinations including high triglycerides.

LIMITATIONS

A cross-sectional study design and lack of a standardized objective measure for depression.

CONCLUSIONS

Diagnosed depression is associated with MetS in Korean women. Specifically, women with diagnosed depression have significantly elevated levels of several combinations of MetS components including high triglycerides. Addressing these MetS combinations could help reduce CVD events and mortality among women with depression.