A Longitudinal Relationship Between Depressive Symptoms and Development of Metabolic Syndrome: The Coronary Artery Risk Development in Young Adults Study

Abstract

Objective Despite variability in the burden of elevated depressive symptoms by sex and race and differences in the incidence of metabolic syndrome, few prior studies describe the longitudinal association of depressive symptoms with metabolic syndrome in a diverse cohort. We tested whether baseline and time-varying depressive symptoms were associated with metabolic syndrome incidence in black and white men and women from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Methods Participants reported depressive symptoms using the Center for Epidemiologic Studies Depression (CES-D) Scale at 4 examinations between 1995 and 2010. At those same examinations, metabolic syndrome was determined. Cox proportional hazards models were used to examine associations of depressive symptoms on development of metabolic syndrome in 3,208 participants without metabolic syndrome at baseline. Results Over 15 years, the incidence rate of metabolic syndrome (per 10,000 person-years) varied by race and sex with the highest rate in black women (279.2), followed by white men (241.9), black men (204.4) and white women (125.3). Depressive symptoms (per SD higher) were associated with incident metabolic syndrome in white men (hazard ratio [HR]=1.25, 95% confidence interval [CI]: 1.08, 1.45) and white women (HR=1.17, 95% CI: 1.00, 1.37) following adjustment for demographic characteristics and health behaviors. There was no significant association between depression and metabolic syndrome among black men or black women. Conclusion Higher depressive symptoms contribute modestly to the onset of metabolic syndrome among white adults.

Leisure-Time Physical Activity, Sedentary Behaviour and Diet Quality are Associated with Metabolic Syndrome Severity: The PREDIMED-Plus Study

“…Our analysis on depressive symptoms showed that risks of depression increased with increasing MetS severity, which is in accordance with previous results that show a bidirectional association between depression and MetS [8]. Other authors suggested that psychological characteristics, especially depression, may increase risks of MetS [36]. Comparing our results with previous findings [37], our participants showed a higher risk of depression, especially among MetSSS participants of highest severity.…”

“…Strong evidence has shown that high amounts of sedentary behaviour are associated with increased risks of several chronic conditions and mortality [5,6,38]. Prolonged TV viewing time is associated with an increased risk of type 2 diabetes mellitus (T2DM), CVD, and all-cause mortality [36]. Other authors showed that prolonged sedentary time is independently associated with deleterious health outcomes, regardless of PA [6].…”

Incidence of Metabolic Syndrome in Young Japanese Adults in a 6-Year Cohort Study: The Uguisudani Preventive Health Large-Scale Cohort Study (UPHLS)

“…[1][2][3] Many prior studies reported different incidences in MS from 3.1 to 22.9 per 1,000 person-years using different definition criteria for adults aged 40 years or older. [4][5][6][7] Regarding the incidence of MS per 1,000 person-years in young adults aged younger than 40, values of 11.7 for men and women aged 18-30 years 8 ; 13.3 for men and women aged 20-32 years 9 ; 12.0 for women aged 18-30 years 10 ; and 20.4 for black men and 24.9 for white men, and 27.9 for black women and 12.5 for white women aged 18-30 years 11 were reported in the United States using NCEP-ATP III criteria. In addition, Dreyfus et al reported a cumulative incidence of 24.8% in 2,534 African-American and white women aged 18-30 years during a 25-year follow-up.…”

Depressive symptom profiles, cardio-metabolic risk and inflammation: Results from the MIDUS study

“…In a recent meta-analysis, there was a stronger association between metabolic syndrome and depression when measured by self-reported scales rather than a structured clinical interview or clinical diagnosis (Pan et al, 2012). In another recent study, depressive symptoms (per standard deviation higher) were associated with 1.17–1.25 increased odds of metabolic syndrome incidence after 15 years, suggesting they may predict the development of cardio-metabolic conditions, even at subclinical levels (Womack et al, 2016). Most importantly, depression scales allow researchers to examine not only the presentation but also the severity of symptoms, whereas categorical dichotomization may lump together different symptoms clusters and severities into a single diagnosis.…”