Metabolic syndrome associated with the onset of depressive symptoms among women but not men in rural Northeast China

Abstract

Background: The present study aimed to assess the cumulative incidence of major depressive disorder (MDD) among rural Chinese residents. Furthermore, we intended to estimate whether metabolic syndrome (MetS) was associated with MDD by both cross-sectional and prospective analysis. Method: Data of 11,675 residents (46.3% men) was used for cross-sectional analysis. The residents were followed up with median 4.66 years. MDD was diagnosed using the Patient Health Questionnaire-9 (PHQ-9). The data of 2796 individuals without any depressive symptoms was used for prospective analysis. Result: With median of 4.66 years follow-up, the cumulative incidence of MDD among rural residents was 3.9%. Women had significantly higher cumulative incidence of MDD than men (5.3% for women and 2.9% for men, P < 0.01). The incidence of MDD was significantly higher among women with MetS (7.3% vs. 3.8%, P < 0.001), hypertriglyceridemia (7.0% vs. 4.5%, P < 0.001) or elevated blood pressure (6.4% vs. 3.4%, P < 0.001) at baseline compared with those without them. There was no incidence difference of MDD among men with or without baseline metabolic disorders. In prospective study, after adjusting possible confounders, baseline MetS was associated with higher incidence of MDD (OR: 1.82, 95%CI: 1.01, 3.27, P = 0.045) in women but not men (OR: 1.84, 95%CI: 0.88, 3.83, P = 0.104). Conclusion: Cumulative incidence of MDD in rural China was higher among women than among men. Baseline MetS was associated with higher cumulative incidence of MDD in women but not men. More concern should be put on women with MetS in case of onset depressive symptom in future.

Prospective Bidirectional Relations Between Depression and Metabolic Health: 30 Year Follow-up from the NHLBI CARDIA Study

“…Furthermore, the relations between depression with MetS were significant for White females, females, and White individuals, but not for other race/sex subgroups. Other studies also support the present results (Beydoun et al, 2020; Cooper et al, 2013; Womack et al, 2016; Yu et al, 2020). Further, the present findings replicate the prior 15-year findings (Womack et al, 2016) from CARDIA over a 30-year period later in the lifespan.…”

“…Also consistent with the present study are prior findings that systemic inflammation might be more pronounced among the subgroup of White-identified individuals (Beydoun et al, 2020). Another study indicates a sex difference in that major depressive disorder is associated with MetS among women but not among men (Yu et al, 2020). This may be due to differences that may exist in the metabolic processes between men and women.…”

The Relationship Between Metabolic Syndrome and Depression: A Literature Review

“…7 MetS increases individual risk factors of both cardiovascular disease and type 2 diabetes, especially in old age. 5,8,9 Based on International Diabetes Federation (IDF), approximately 20-25% adult population in the world have MetS. 7 MetS, including related metabolic biomarkers, is thought to be related to depression.…”

“…4 Individuals with one or more metabolic disorder show a higher risk of depression development. 9 MetS is considered to have association with early and late depression with 1%-5% prevalence in older. 8 MetS is suggested significantly associated with depression at age 60 years or more.…”

“…5 These differences are caused by 294 heterogeneity and complexity of both MetS and depression as multifactorial diseases, for examples, lifestyle factors related metabolic disorders (e.g., chronic alcohol consumption and smoking habits, and also reduced physical activity) show a higher risk of depression incidence. 5,9 MetS and depression's cooccurrence is suggested to have overlapping pathophysiological between these conditions. 4 Therefore, a comprehensive study is necessary to evaluate depression risk among metabolic syndrome patients and its possible correlation.…”