TY - JOUR
T1 - Hypercortisolemic depression is associated with the metabolic syndrome in late-life
AU - Vogelzangs, Nicole
AU - Suthers, Kristen
AU - Ferrucci, Luigi
AU - Simonsick, Eleanor M.
AU - Ble, Alessandro
AU - Schrager, Matthew
AU - Bandinelli, Stefania
AU - Lauretani, Fulvio
AU - Giannelli, Sandra V.
AU - Penninx, Brenda W.
N1 - Funding Information:
This study was supported in part by Grants R01 HL72972-01 (Dr. Penninx) and IRTA 2300 320 7 from the National Institutes of Health, Bethesda, MD (Drs. Suthers, Ble, & Schrager). The Extramural Branch of the NIH responsible for funding of the InChianti study did not have any role in the design and conduct of the study, the collection, management, analysis and interpretation of the data nor the preparation, review or approval of the manuscript. Cortisol assays were supported by a professional services contract from the Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging.
PY - 2007/2
Y1 - 2007/2
N2 - Introduction: Depression has been hypothesized to be associated with metabolic abnormalities which increase the risk of cardiovascular disease (CVD) and diabetes. Such a link could be due to increased HPA-axis activity. This study investigates the cross-sectional relationship between depression, urinary cortisol and metabolic syndrome in an older population. Methods: Data are from 867 participants of the InChianti Study, aged ≥65 years. Depressive symptoms were assessed using the CES-D scale; cortisol levels were determined in 24-h urine samples. Metabolic syndrome was defined as three or more of the following: abdominal obesity, high triglycerides, low HDL cholesterol, high blood pressure, and high fasting glucose. Results: Clinically relevant depressed mood (CES-D≥20) was present in 20.6% of the sample, and 24.5% had the metabolic syndrome. After adjustment for sociodemographics and health indicators, depression score (per SD increase: OR=1.20, 95% CI=1.02-1.41) and urinary cortisol level (per SD increase: OR=1.23, 95% CI=1.01-1.51) were significantly associated with presence of metabolic syndrome. There was, however, a significant interaction (p = 0.003) between depressed mood and urinary cortisol in the probability of having metabolic syndrome. The odds of metabolic syndrome in persons with both depressed mood and urinary cortisol excretion in the highest tertile was 1.84 (95% CI=1.02-3.34) compared to persons with neither condition. Discussion: This study suggests a synergistic relationship between depression, cortisol and metabolic syndrome. Hypercortisolemic depression may constitute a specific risk group for the metabolic syndrome.
AB - Introduction: Depression has been hypothesized to be associated with metabolic abnormalities which increase the risk of cardiovascular disease (CVD) and diabetes. Such a link could be due to increased HPA-axis activity. This study investigates the cross-sectional relationship between depression, urinary cortisol and metabolic syndrome in an older population. Methods: Data are from 867 participants of the InChianti Study, aged ≥65 years. Depressive symptoms were assessed using the CES-D scale; cortisol levels were determined in 24-h urine samples. Metabolic syndrome was defined as three or more of the following: abdominal obesity, high triglycerides, low HDL cholesterol, high blood pressure, and high fasting glucose. Results: Clinically relevant depressed mood (CES-D≥20) was present in 20.6% of the sample, and 24.5% had the metabolic syndrome. After adjustment for sociodemographics and health indicators, depression score (per SD increase: OR=1.20, 95% CI=1.02-1.41) and urinary cortisol level (per SD increase: OR=1.23, 95% CI=1.01-1.51) were significantly associated with presence of metabolic syndrome. There was, however, a significant interaction (p = 0.003) between depressed mood and urinary cortisol in the probability of having metabolic syndrome. The odds of metabolic syndrome in persons with both depressed mood and urinary cortisol excretion in the highest tertile was 1.84 (95% CI=1.02-3.34) compared to persons with neither condition. Discussion: This study suggests a synergistic relationship between depression, cortisol and metabolic syndrome. Hypercortisolemic depression may constitute a specific risk group for the metabolic syndrome.
KW - Cortisol
KW - Depression
KW - HPA-axis
KW - Metabolic syndrome
KW - Older persons
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U2 - 10.1016/j.psyneuen.2006.11.009
DO - 10.1016/j.psyneuen.2006.11.009
M3 - Article
C2 - 17224244
AN - SCOPUS:33847043489
SN - 0306-4530
VL - 32
SP - 151
EP - 159
JO - Psychoneuroendocrinology
JF - Psychoneuroendocrinology
IS - 2
ER -