Depressive symptoms and metabolic syndrome in preventive healthcare: the Cooper Center longitudinal study

Does Better Diet Quality Offset the Association between Depression and Metabolic Syndrome?

Several studies have shown that depression increases the risk of metabolic syndrome (MetS), which is often exacerbated by the fact that both exist concurrently. People with depression are more likely to have unhealthy eating habits, which can eventually trigger the development of MetS. This study was to investigate whether diet quality modifies the association between depression and MetS in a total of 13,539 Korean adults aged 19 to 80 from 2014, 2016 and 2018 Korean National Health and Nutrition Examination Surveys. Depression was assessed by the Patient Health Questionnaire-9 (PHQ-9) and subjects were divided into subgroups according to the PHQ-9 scores: normal (<5), mild (5-9), and moderate-to-severe (≥10) groups. Diet quality was measured by the Korean Healthy Eating Index (KHEI). A complex sample multiple logistic regression stratified by tertiles of KHEI scores was used to explore whether diet quality modifies an association between depression severity and metabolic syndrome. Depression severity was positively associated with the risk of MetS (p trend = 0.006) after adjustment for potential confounders. Only the lowest diet quality, moderately-to-severely depressed group, showed a higher risk of MetS (OR: 1.72, 95% CI: 1.24-2.40) compared to the normal group. Our results suggest that healthy diet quality could offset the positive relationship between depression and MetS in the general Korean adult population. Encouraging a healthy diet regime can improve not only physical health but also the mental state of the general public.

Correlation of Orexin-A and brain-derived neurotrophic factor levels in metabolic syndrome and cognitive impairment in schizophrenia treated with clozapine

Orexin-A and brain-derived neurotrophic factor (BDNF) are implicated in regulating metabolic syndrome (MetS) and cognitive impairment of schizophrenia. However, the associations among them remains unclear. Here, we aimed to investigate the relationship between Orexin-A levels, BDNF, MetS, clinical symptom profile, and cognitive function in schizophrenia patients following long-term clozapine treatment. We measured Orexin-A and BDNF levels in 140 schizophrenia patients with and without MetS. We assessed clinical symptoms on the Positive and Negative Syndrome Scale and cognitive function by the assessment of Neuropsychological Status (RBANS), and examined their associations with Orexin-A. Patients with MetS had significantly lower Orexin-A levels and higher coding test, attention span and delayed retention in RBANS (P < 0.05). Correlation analysis showed that Orexin-A was associated with BDNF, TG, HDLC, PANSS active social avoidance and emotional withdrawal significantly. Besides, Orexin-A significantly interacted with BDNF for metabolic and cognitive profiles including waist circumference, delayed retention and list recognition. Logistic regression analysis showed that Orexin-A level (odds ratio [OR]= 0.380, 95% confidence interval [CI]: 0.151-0.952, P = 0.039) and total illness duration (OR = 0.932, 95% CI: 0.875-0.991, P = 0.025) were predictive variables of MetS. However, there was no significant relationship between Orexin-A and cognitive function after adjustment for age, sex and educational levels. Totally, a lower plasma Orexin-A level seems to be related to metabolic parameters more than cognitive profiles. The interaction of Orexin-A with BDNF may be partly responsible for worse MetS and better cognition of elderly schizophrenia, but the causal relationship needs further clarification.

The association between depression and metabolic syndrome and its components: a bidirectional two-sample Mendelian randomization study

Observational studies suggested a bidirectional correlation between depression and metabolic syndrome (MetS) and its components. However, the causal associations between them remained unclear. We aimed to investigate whether genetically predicted depression is related to the risk of MetS and its components, and vice versa. We performed a bidirectional two-sample Mendelian randomization (MR) study using summary-level data from the most comprehensive genome-wide association studies (GWAS) of depression (n = 2,113,907), MetS (n = 291,107), waist circumference (n = 462,166), hypertension (n = 463,010) fasting blood glucose (FBG, n = 281,416), triglycerides (n = 441,016), high-density lipoprotein cholesterol (HDL-C, n = 403,943). The random-effects inverse-variance weighted (IVW) method was applied as the primary method. The results identified that genetically predicted depression was significantly positive associated with risk of MetS (OR: 1.224, 95% CI: 1.091-1.374, p = 5.58 × 10^-4), waist circumference (OR: 1.083, 95% CI: 1.027-1.143, p = 0.003), hypertension (OR: 1.028, 95% CI: 1.016-1.039, p = 1.34 × 10^-6) and triglycerides (OR: 1.111, 95% CI: 1.060-1.163, p = 9.35 × 10^-6) while negative associated with HDL-C (OR: 0.932, 95% CI: 0.885-0.981, p = 0.007) but not FBG (OR: 1.010, 95% CI: 0.986-1.034, p = 1.34). No causal relationships were identified for MetS and its components on depression risk. The present MR analysis strength the evidence that depression is a risk factor for MetS and its components (waist circumference, hypertension, FBG, triglycerides, and HDL-C). Early diagnosis and prevention of depression are crucial in the management of MetS and its components.

Low-Intensity Exercise as a Modifier of Depressive Symptoms and Self-Perceived Stress Level in Women with Metabolic Syndrome

The study aims to determine the impact of low-intensity exercise and psychoeducation on depressive symptoms and self-perceived stress in women with metabolic syndrome (MetS). Seventy-four women (mean age 69.35 ± 7.20) were included in the study. Participants were divided into two groups: those with MetS (n = 33) and those without MetS (n = 41). Subjects participated in low-intensity general-fitness exercise sessions combined with psychoeducation distributed regularly over a 12-week period. Participants completed the Geriatric Depression Scale-15 (GDS) and the Stress Level Questionnaire (SLQ) before and after the intervention. All investigated parameters significantly decreased for the participants with metabolic syndrome after the intervention. The level of GDS in this group decreased by approximately 37% (p < 0.01), and SLQ by around 23% (p < 0.01). Our results suggest, that low-intensity exercise combined with psychoeducation could lower depressive symptoms and stress level in women with MetS. However, the intervention does not lower anthropometric parameter scores.

The relationship between depression and risk of metabolic syndrome: a meta-analysis of observational studies

INTRODUCTION

The link between metabolic syndrome and depression has always been controversial. Different studies that have examined the relationship between metabolic syndrome and depression have reported different results. Therefore, the goal of the present study was to examine the association between depression and MetS by meta-analysis.

METHODS

Embase, Scopus, PubMed, and ISI were searched for publications in English from January 1990 to February 2020. Search included cohort and cross-sectional studies aimed at examining the association between depression and MetS. The risk of bias was assessed by Newcastle-Ottawa Scale. Heterogeneity and publication bias were tested, subgroup analysis and meta-regression were conducted.

RESULTS

49 studies with total sample size 399,494 were analyzed. Results indicated the odds of MetS was higher in depressed compared to non-depressed individuals [OR: 1.48; 95 %CI: 1.33-1.64) vs. (OR: 1.38; 95 %CI: 1.17-1.64)]. For cross-sectional studies, depressed patients in Europe (OR = 1.35; 95 %CI: 1.47-1.99) were at higher odds of MetS compared to those in America and Asia. For cohort studies, depressed patients in America (OR = 1.46; 95 %CI: 1.16-1.84) were at higher odds of MetS than those in Europe. Cross-sectional studies indicated women with depression were at higher odds of MetS (OR = 1.95; 95 %CI: 1.38-2.74) compared to men. In both types of studies, the odds of MetS decreased with age.

CONCLUSIONS

Metabolic syndrome is more common in depressed compared to non-depressed individuals.

Early weight gain predicts later metabolic syndrome in depressed patients treated with antidepressants: Findings from the METADAP cohort

BACKGROUND

Metabolic syndrome (MetS) is a major public health issue. We assessed whether early weight gain predicts later MetS in depressed patients treated with antidepressants.

METHODS

In the 6-month prospective METADAP cohort, 260 non-overweight patients with a Major Depressive Disorder (MDD) and a current Major Depressive Episode (MDE) were assessed for early weight gain (>5%) after one month of treatment, and for the later incidence of MetS after three and six months of treatment. Outcome variables were MetS, the number of MetS criteria, and each MetS criterion (high Waist Circumference (WC), high Blood Pressure (BP), high triglyceridemia (TG), low HDL-Cholesterolemia, and high Fasting Plasma Glucose (FPG). Multivariate models were adjusted for age, sex, previous MDD duration, severity of current MDE, and antidepressants.

RESULTS

24.6% of patients had early weight gain. Compared to those without weight gain, patients with early weight gain had higher MetS incidence: 16.7% vs. 6.9% after 3 months (p = 0.07), and 23.8% vs. 7.1% after 6 months (p = 0.02). Among completers (n = 120), early weight gain was significantly associated with later MetS incidence (OR: 5.5) and a higher number of MetS criteria (IRR: 1.7). This effect was driven by the WC, TG, and HDL-C criteria.

CONCLUSION

Compared to Non-early weight gainers, patients with early weight gain in the first month of antidepressant treatment have a significant higher risk of developing MetS during the 6 months of treatment. Early weight monitoring is recommended in order to set preventive measures to avoid new metabolic syndromes in depressed patients treated with antidepressants.

Prevalence of metabolic syndrome among patients with depressive disorder admitted to a psychiatric inpatient unit: A comparison with healthy controls

OBJECTIVE

This study aimed to compare the prevalence of metabolic syndrome (MS) among inpatients with depressive disorders and matched healthy controls.

METHOD

One hundred fifty eight patients with depressive disorders and 52 age and gender matched healthy controls were assessed for the prevalence of MS using Common Criteria for MS.

RESULTS

Prevalence of Metabolic syndrome among inpatients with depressive disorders was 44.3%, which was significantly higher than the healthy control group (17.3%). Increased waist circumference was the most common abnormality in both the groups. Prevalence of MS among patients with recurrent depression disorder (60.3%) was almost double that seen among those with first episode depression (32.6%). Compared to healthy controls, significantly greater proportion of patients with depressive disorders had increased blood pressure, abnormal fasting blood sugar, and HDL levels. Besides the prevalence of MS in 44.3% of patients with depressive disorders, another 46% of patients fulfilled one or two criteria of MS. Significant predictors of MS were being married, obese, greater age, higher weight, higher body mass index, and multiple episodes of depression.

CONCLUSIONS

Nearly two-fifth of depressed patients have MS and another two-fifth of patients had one or two abnormalities in the MS criteria. The prevalence of MS among patients with depressive disorders is significantly higher than the healthy controls. Hence, patients with depressive disorders should be regularly evaluated for the presence of MS and other cardiovascular risk factors and appropriate management strategies must be instituted at the earliest.

Health-related quality of life in two randomized controlled trials of phentermine/topiramate for obesity: What mediates improvement?

PURPOSE

Phentermine/topiramate combination therapy resulted in significant weight loss and improvements in cardiometabolic risk factors in patients with obesity/overweight in two published 56-week randomized, placebo-controlled trials (EQUIP and CONQUER). The purpose of the current study was to examine whether phentermine/topiramate is also associated with greater improvements in health-related quality of life (HRQOL) and whether HRQOL improvements are solely attributable to weight reduction.

METHODS

Patients in EQUIP (n = 751) had a body mass index (BMI) ≥ 35 with no obesity-related comorbidity. Patients in CONQUER (n = 1623) had a BMI ≥ 27 and ≤ 45 and at least two obesity-related comorbid conditions. HRQOL was assessed with Impact of Weight on Quality of Life-Lite (IWQOL-Lite) and Medical Outcomes Study Short Form (SF-36) (CONQUER only).

RESULTS

Significant improvements in both obesity-specific and physical HRQOL were observed at 56 weeks in both trials (p < .0001). In EQUIP, BMI reduction fully mediated improvements in IWQOL-Lite total score (p < .0001). In CONQUER, both BMI reduction (all p values < .0001) and change in depressive symptoms (all p values < .025) were significant mediators of improved IWQOL-Lite total score and SF-36 Physical Component Summary score. Gender, psychiatric history, and baseline triglycerides moderated these relationships.

CONCLUSIONS

Both trials demonstrated that treatment with phentermine/topiramate improved HRQOL compared with placebo. Although reduction in BMI accounted for the majority of improvements in obesity-specific and physical HRQOL, decrease in depressive symptoms was also a significant mediator. Results highlight the predominance of weight reduction as a key factor in improving HRQOL in obesity.

Prevalence of Metabolic Syndrome among nursing personnel and its association with occupational stress, anxiety and depression

OBJECTIVE:

to identify the prevalence of Metabolic Syndrome among nursing personnel, and its association with occupational stress, anxiety and depression.

METHOD:

a descriptive correlational study undertaken with 226 nursing personnel from a teaching hospital. Data collection was undertaken through application of the Job Stress Scale, the Hospital Anxiety and Depression Scale and a sociodemographic questionnaire, with variables of Metabolic Syndrome. Univariate analyses and Chi-squared and Pearson tests were used for correlation between the variables, with a level of significance of 5%.

RESULTS:

86 (38.1%) workers presented Metabolic Syndrome, of whom 183 (81.1%) were female, and 43 (19.9%) male, aged between 23 and 66 years old. In relation to anxiety and depression, 154 (68.1%) presented anxiety, with 48 (31.2%) also presenting Metabolic Syndrome; 185 (81.8%) presented depression, of whom 62 (33.5%) also had Metabolic Syndrome. It was ascertained that 61 (27.0%) workers presented stress and that of these, 14 (22.9%) presented Metabolic Syndrome.

CONCLUSION:

a correlation was observed between the variables of anxiety and Metabolic Syndrome and stress and Metabolic Syndrome, there being no correlation between the variables of depression and Metabolic Syndrome.

Elevated depressive symptoms in metabolic syndrome in a general population of Japanese men: a cross-sectional study

BACKGROUND

Uncertainty still surrounds the association between metabolic syndrome (MetS) and depression. We aimed to evaluate the association between MetS and elevated depressive symptoms in a general Japanese population.

METHODS

This is a cross-sectional survey of 3,113 community-dwelling individuals aged 40 years or over. MetS was defined according to the joint interim statement. MetS was diagnosed when a subject had three or more of the following components: 1) central obesity (waist circumference ≥ 90 cm for men, ≥ 80 cm in for women); 2) elevated blood pressure (≥ 130/85 mmHg or current use of antihypertensive medication); 3) hypertriglyceridemia (≥ 1.7 mmol/L); 4) low HDL cholesterol (< 1.0 mmol/L for men, < 1.3 mmol/L for women); and 5) elevated fasting plasma glucose (≥ 5.55 mmol/L or current use of antidiabetic medication). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). The age- and multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI) were estimated using a logistic regression model.

RESULTS

Elevated depressive symptoms were observed in 4.3% of male and 6.3% of female participants. In men, the age-adjusted prevalence of elevated depressive symptoms was significantly higher in subjects with MetS than in those without (7.1% versus 3.6%, p = 0.04). The prevalence of elevated depressive symptoms rose progressively as the number of MetS components increased (3.5%, 3.6%, 5.8%, and 9.2% in male subjects with 0-1, 2, 3, and ≥ 4 components, respectively; p = 0.02 for trend). This association remained significant even after adjustment for age, marital status, history of cardiovascular disease, smoking habit, alcohol intake, and regular exercise. In women, on the other hand, there was no clear association between MetS and depressive symptoms.

CONCLUSIONS

MetS was associated with elevated depressive symptoms in a general population of Japanese men.

Sex Differences in Associations of Depressive Symptoms with Cardiovascular Risk Factors and Metabolic Syndrome among African Americans

Young to middle-aged women usually have notably lower rates of cardiovascular disease (CVD) than their male counterparts, but African American women lack this advantage. Their elevated CVD may be influenced by sex differences in associations between depressed mood and CVD risk factors. This cross-sectional study examined whether relations between scores on the Center for Epidemiologic Studies-Depression (CES-D) scale and a spectrum of CVD risk factors varied by sex among African Americans (n = 1076; ages 30-64) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Sex-stratified multiple regressions and logistic regressions were conducted. Among women, CES-D scores correlated positively with systolic blood pressure and waist-to-hip ratio (P's < .05), but inversely with high-density lipoprotein cholesterol (HDL-C) (P < .01). Women had twice the odds for metabolic syndrome if CES-D scores ≥16 and had a ≥14% increase in odds of hypertension, abdominal obesity, and low HDL-C with each 5-unit increase in CES-D scores. Among men, CES-D scores correlated positively with high-sensitivity C-reactive protein (P < .05), and odds of hypertension increased by 21% with each 5-unit increase in CES-D scores. Depressive symptoms may promote premature CVD risk in African Americans, at least in part, via CVD risk factors and prevalent metabolic syndrome, particularly in African American women.

Metabolic Syndrome in Drug-naïve Patients with Depressive Disorders

BACKGROUND

The prevalence of metabolic syndrome (MS) is found to be higher in patients with depression than in the general population. As there is lack of data from India, this study aimed to assess the prevalence of MS in patients with depression who had never been treated with antidepressants for their depressive disorder and compare the same with a matched group of healthy controls.

MATERIALS AND METHODS

Forty-three drug-naïve patients with depressive disorders and 43 age- and gender-matched healthy controls were assessed for the prevalence of MS as per the consensus definition.

RESULTS

The prevalence of MS in patients with depression was 37.2% and was significantly higher than that seen in the healthy controls (16.3%). Increased waist circumference was the most common abnormality in both the study groups. Compared to healthy controls, a significantly higher proportion of patients with depression had abnormal waist circumference, systolic blood pressure, or high blood pressure. Besides 16 patients with depressive disorders having MS, another 53.5% of patients fulfilled one or two criteria of MS. None of the sociodemographic variables was associated with development of MS in patients with depression.

CONCLUSIONS

Slightly more than one-third of depressed patients who are drug-naïve have MS and this prevalence rate is significantly higher than in healthy controls.

Prevalence of metabolic syndrome and its association with depression in patients with schizophrenia

PURPOSE

To identify the point prevalence of metabolic syndrome in patients with schizophrenia and to evaluate the association between depressive symptoms and metabolic syndrome in patients with schizophrenia.

PATIENTS AND METHODS

Metabolic syndrome was assessed based on an updated definition derived from the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and the International Diabetes Federation criteria. The 17-item Hamilton Depression Rating Scale (HDRS-17) was used to measure depressive symptoms in 80 patients with schizophrenia. Odds ratios and 95% confidence intervals were calculated using logistic regression for the association between each depressive symptom and metabolic syndrome.

RESULTS

The point prevalence rates of metabolic syndrome according to the modified NCEP-ATP III and International Diabetes Federation criteria were 37% and 35%, respectively. The risk of having metabolic syndrome significantly increased in those who were widowed or separated, or had longer duration of illness. Central obesity was the metabolic feature with the highest odds ratios for metabolic syndrome at 19.3. Three out of 17 items of HDRS subscales were found to be significantly associated with metabolic syndrome, including depressed mood, middle insomnia, and retardation with the odds ratios of 3.0, 3.4, and 3.6, respectively.

CONCLUSION

This study showed that the prevalence of metabolic syndrome in patients with schizophrenia was higher than the overall rate but was slightly lower than in the general population in the USA. Central obesity, measured by waist circumference, was found to be highly correlated with metabolic syndrome. Depressed mood, middle insomnia, and retardation were significantly associated with metabolic syndrome in patients with schizophrenia. Waist circumference and screening for depression should be done at the clinics during patient follow-up.

Metabolic syndrome and migraine

Migraine and metabolic syndrome are highly prevalent and costly conditions. The two conditions coexist, but it is unclear what relationship may exist between the two processes. Metabolic syndrome involves a number of findings, including insulin resistance, systemic hypertension, obesity, a proinflammatory state, and a prothrombotic state. Only one study addresses migraine in metabolic syndrome, finding significant differences in the presentation of metabolic syndrome in migraineurs. However, controversy exists regarding the contribution of each individual risk factor to migraine pathogenesis and prevalence. It is unclear what treatment implications, if any, exist as a result of the concomitant diagnosis of migraine and metabolic syndrome. The cornerstone of migraine and metabolic syndrome treatments is prevention, relying heavily on diet modification, sleep hygiene, medication use, and exercise.

Gender difference in association between low back pain and metabolic syndrome: locomotive syndrome and health outcome in Aizu cohort study (LOHAS)

STUDY DESIGN

Cross-sectional survey. OBJECTIVE.: To investigate the relationship between low back pain (LBP) and metabolic syndrome (Mets) in community-based Japanese subjects. SUMMARY OF BACKGROUND DATA.: Relatively few reports have demonstrated a relationship between general pain and Mets, and none have addressed the relationship between LBP and Mets.

METHODS

This study enrolled 2650 people from among residents aged 40 to 74 years in Tadami and Minamiaizu, Fukushima, Japan, who participated in health checkups conducted in 2008. LBP was defined as lower back pain continuing for more than 24 hours and severe enough to merit treatment, or it was based on clinical prediction rules from the clinical diagnosis support tool to identify patients with lumbar spinal stenosis. Mets was defined according to the Japanese criteria recommended by the Japanese Society of Internal Medicine. Prevalence of Mets was recorded for subjects with and without LBP. The relationship between LBP and Mets was investigated, using a generalized linear model. With LBP as the main explanatory variable and Mets as the outcome variable, risk ratios of Mets were calculated for men and women.

RESULTS

In this study, we analyzed a total of 1395 subjects. In men, the prevalence of Mets was 21.2% in those without LBP and 24.7% in those with LBP. In women, the prevalence of Mets was 12.4% in those without LBP and 23.7% in those with LBP. After adjusting for factors such as age, body mass index, occupational status, SF-36 mental health, and physical activity level, no relationship was noted between LBP and Mets in men. However, in women, the risk ratio for Mets in subjects with LBP compared with those without LBP was 1.5 (95% confidence interval, 1.0-2.1).

CONCLUSION

We observed a tendency toward higher prevalence of Mets among those with LBP than among those without it in women, but not in men.

Bidirectional association between depression and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies

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.

Prevalence of metabolic syndrome in subjects with melancholic and non-melancholic depressive symptoms. A Finnish population-based study

BACKGROUND

We aimed to evaluate the prevalence of the metabolic syndrome (MetS) and its components in subjects with predominantly melancholic or non-melancholic depressive symptoms (DS) in a population-based study evaluating the efficacy of the Finnish diabetes prevention program (FIN-D2D).

METHODS

Altogether, 4500 randomly-selected Finnish men and women aged 45-74 years were initially enrolled from the National Population Register: 2820 (63%) attended a health examination. Diagnosis of MetS was based on the criteria of the National Cholesterol Education Program (NCEP-ATPIII), and DS on the 21-item Beck Depression Inventory (BDI-21, ≥10 points). A summary score of the melancholic items in the BDI was used to divide the subjects with DS (N=432) into melancholic and a non-melancholic sub-groups.

RESULTS

The prevalence of MetS was higher among subjects with non-melancholic DS compared to those with melancholic DS (69 % versus 55%, p 0.004). The prevalence of MetS among subjects without DS was 51%. The sex- and age-adjusted odd ratio (OR) for MetS was 2.10 (95%CI 1.62 to 2.73, p<0.001) when comparing the non-melancholic and non-depressed groups, 1.15 (95%CI 0.81 to 1.61, p=0.44) for the melancholic and non-depressed groups, and 1.84 (95%CI 1.20 to 2.80, p=0.005) for the non-melancholic and melancholic groups.

LIMITATIONS

DS were based on a self-rating scale, and due to the cross-sectional design of our study, we cannot make inferences of causality.

CONCLUSIONS

Compared to subjects without DS and those with melancholic DS, persons with non-melancholic DS may more frequently suffer from MetS.

Association between depressive symptoms and metabolic syndrome in police officers: results from two cross-sectional studies

Policing is one of the most dangerous and stressful occupations and such stress can have deleterious effects on health. The purpose of this study was to examine the association between depressive symptoms and metabolic syndrome (MetSyn) in male and female police officers from two study populations, Buffalo, NY and Spokane, WA. Depressive symptoms were measured using the Center for Epidemiologic Studies-Depression (CES-D) scale. MetSyn was defined using the 2005 AHA/NHBLI guidelines. Analysis of covariance was used to describe differences in number of MetSyn components across depressive symptom categories. The number of MetSyn components increased significantly across categories of CES-D for Spokane men only (p-trend = 0.003). For each 5-unit increase in CES-D score, odds increased by 47.6% for having hypertriglyceridemia, by 51.8% for having hypertension, and by 56.7% for having glucose intolerance. Exploring this association is important since both are predictors of future chronic health problems and the results could be helpful in developing future gender-specific prevention and intervention efforts among police officers.