Pericardial adipose tissue and the metabolic syndrome is increased in patients with chronic major depressive disorder compared to acute depression and controls

Kahl, K.G.; Herrmann, Julian B.; Stubbs, Brendon; Krüger, Tillmann H.C.; Cordes, Joachim; Deuschle, Michael; Schweiger, Ulrich; Hüper, Katja; Helm, Saskia; Birkenstock, Anna; Hartung, Dagmar

doi:10.1016/j.pnpbp.2016.08.005

Cited by 22 publications

(29 citation statements)

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“…An altered fat distribution could be a possible link between depression and these effects. One of the studies included in our meta‐analysis reported additional fat compartment measurements, i.e., paracardial, pericardial and epicardial adipose tissue in depressed patients and controls (Kahl et al, 2014, 2017). Pericardial adipose tissue was increased in patients with chronic major depressive disorder compared to controls.…”

Section: Discussionmentioning

confidence: 99%

Fat compartments in patients with depression: A meta‐analysis

Cosan

Schweiger²,

Kahl

et al. 2020

Brain and Behavior

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Introduction Depressive disorders are a common illness worldwide. Major depression is known as a significant predictor of the metabolic syndrome. However, the effects of depression on adipose tissue compartments are controversial. This meta‐analysis aimed to evaluate the state of research on the relationship between patients with depression and adipose tissue compartments as compared to nondepressed individuals. Methods The PubMed database was searched for human studies that measured adipose tissue compartments such as visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and/or organ‐specific adipose tissue measurements using dual‐energy X‐ray absorptiometry, magnetic resonance imaging or computed tomography scan and reported the means and a measure of variance separately for depressed individuals and healthy controls. Twelve articles were identified, including a total of 1,141 depressed and 2,545 nondepressed individuals. Results Major depressive disorder and self‐reported depressive symptoms were associated with elevated visceral adipose tissue and elevated subcutaneous adipose tissue. Subanalyses for gender, age, method of adipose tissue measurement, and method of depression assessment showed elevated visceral adipose in depressed individuals. The results could be replicated when focussing on studies controlling for body mass index (BMI). Regarding other adipose tissue compartments, meta‐analysis could not be carried out due to lack of studies. Conclusions Depression is associated with enlarged visceral and subcutaneous adipose tissue. Further, especially longitudinal, research is needed to identify the mechanism through which depressive disorders contribute to visceral adiposity.

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Section: Discussionmentioning

confidence: 99%

Fat compartments in patients with depression: A meta‐analysis

Cosan

Schweiger²,

Kahl

et al. 2020

Brain and Behavior

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“…Seven studies reported C-reactive protein (CRP) levels (20, 37, 44, 45, 47, 49, 50), one study reported eosinophil cationic protein (ECP) levels (27), one study reported eosinophil chemotactic protein-2 (EOTAXIN-2) levels (27), five studies reported interferon-γ (IFN-γ) levels (22, 27, 36, 39, 43), six studies reported IL-1β levels (23, 31, 38, 40, 43, 46), two studies reported IL-1 receptor antagonist (IL-1RA) levels (31, 47), five studies reported IL-2 levels (23, 24, 26, 30, 39), two studies reported IL-4 levels (25, 39), 23 studies reported IL-6 levels (13, 21, 22, 25, 28, 29, 32–34, 35, 37, 38, 41–49–50), one study reported IL-8 levels (22), three studies reported IL-10 levels (22, 25, 39), one study reported monocyte chemoattractant protein-1 (MCP-1) levels (25), one study reported regulated on activation, normal T cell expressed and secreted (RANTES) levels (27), one study reported soluble IL-2 Receptor (sIL-2R) levels (41), 15 studies reported TNF-α levels (24, 25, 27, 28, 32–36, 37, 39, 44, 46, 48, 50), and one study reported vascular endothelial growth factor (VEGF) levels (25).…”

Section: Resultsmentioning

confidence: 99%

Glucocorticoid Resistance: Is It a Requisite for Increased Cytokine Production in Depression? A Systematic Review and Meta-Analysis

et al. 2019

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Background: Glucocorticoid resistance—reduced function of the glucocorticoid receptor (GR)—is seen in many depressed patients. It is argued that this resistance to glucocorticoids leads to failure of normal feedback regulation on the immune system. High levels of pro-inflammatory cytokines result. Purpose: We sought to identify evidence supporting or refuting a link between glucocorticoid resistance and immune dysregulation in depression and to summarize retrieved evidence in aggregate form. Methods: We systematically reviewed and meta-analyzed studies that examined cytokine levels in depressed patients compared with controls and that also reported a measure of glucocorticoid resistance. These measures included plasma cortisol, the dexamethasone suppression test (DST), GR expression levels, and the results of in vitro assays of GR function. We conducted four separate meta-analyses to test for moderating effects of glucocorticoid resistance on cytokine production in depression. Results: After sub-grouping 32 studies by the ratio of cortisol levels in patients compared with controls, we observed a trend for increasing glucocorticoid resistance (i.e., the most hypercortisolemic patients) to be associated with increased production of interleukin (IL)-6 [ d = 0.94; 95% CI (0.29, 1.59)] and tumour necrosis factor (TNF)-α [ d = 0.46; 95% CI (0.12, 0.79)]. We stratified nine studies that reported DST results by relative glucocorticoid resistance between patients and controls, identifying a trend for higher glucocorticoid resistance in patients, compared with controls, to be associated with higher cytokine production in patients (170 patients and 187 controls). This was particularly evident when studies were sub-grouped by source of cytokine—plasma ( d = 1.04; 95% CI, 0.57–1.50) versus in vitro ( d = 0.24; 95% CI, −0.20 to 0.67). Stratifying the four studies (147 patients and 118 controls) that used in vitro assays of GR function or GR expression to quantify glucocorticoid resistance revealed variable contributions to cytokine production in patients compared with controls (overall effect size: d = 1.35; 95% CI 0.53–2.18). Combining our analyses of studies that reported DST results with those that used in vitro assays of GR function or GR expression to quantify glucocorticoid resistance (302 patients and 277 controls), we noted that although depressed patients produced more cytokines than controls ( d = 1.02; 95% CI, 0.55–1.49), there was no evident positive correlation between glucocorticoid resistance and inflammation. Conclusions: Our work provides some support for a model conceptualizing glucocorticoid resistance...

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“…After adjustment for age, height, weight, and physical activity, increased values for PAT and PET were found in depressed men and women, whereas contrarily, no significant effect of depression was observed with regard to EAT, VAT, or SAT ( 91 ). In a further study, Kahl and colleagues assessed PAT volume in a cross-sectional study that included 16 patients with chronic and 34 patients with acute depression compared with 25 healthy controls ( 92 ). Male and female patients were included in the study, and PAT volume was assessed by MRI.…”

Section: Intrathoracic Cardiac Adipose Tissue and Depressionmentioning

confidence: 99%

“…Additionally, PAT volumes were significantly increased in patients with acute MDD compared with the control group, and similar results regarding PAT content were obtained when results were stratified according to sex. Furthermore, a positive association of PAT with self-reported and clinician-rated depressive scores was observed after adjustment for confounders ( 92 ). In a recent study, Richter et al compared EAT volumes measured by MRI in younger (mean age < 35 years) female patients with MDD and with MDD comorbid with BPD to a healthy control collective of comparable age ( 93 ).…”

Section: Intrathoracic Cardiac Adipose Tissue and Depressionmentioning

confidence: 99%

Adipose Tissue Compartments, Inflammation, and Cardiovascular Risk in the Context of Depression

et al. 2022

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The neurobiological and behavioral underpinnings linking mental disorders, in particular, major depressive disorder (MDD), with cardiovascular disorders are a matter of debate. Recent research focuses on visceral (intra-abdominal and epicardial) adipose tissue and inflammation and their impact on the development of cardiometabolic disorders. Intra-abdominal adipose tissue is defined as an endocrine active fat compartment surrounding inner organs and is associated with type 2 diabetes mellitus, a risk factor for the later development of cardiovascular disorders. Epicardial (pericardial) adipose tissue is a fat compartment surrounding the heart with close proximity to the arteries supporting the heart. Visceral adipose tissue (VAT) is an important source of inflammatory mediators that, in concert with other risk factors, plays a leading role in cardiovascular diseases. In conjunction with the behavioral (physical inactivity, sedentary lifestyle), psychological (adherence problems), and hormonal (dysfunction of the hypothalamus–pituitary–adrenal axis with subsequent hypercortisolism) alterations frequently accompanying MDD, an enhanced risk for cardiovascular disorders results.

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Pericardial adipose tissue and the metabolic syndrome is increased in patients with chronic major depressive disorder compared to acute depression and controls

Cited by 22 publications

References 80 publications

Fat compartments in patients with depression: A meta‐analysis

Fat compartments in patients with depression: A meta‐analysis

Glucocorticoid Resistance: Is It a Requisite for Increased Cytokine Production in Depression? A Systematic Review and Meta-Analysis

Adipose Tissue Compartments, Inflammation, and Cardiovascular Risk in the Context of Depression

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