Abstract
The metabolic syndrome and its components are associated with depressive symptomatology. This article discusses the rate of co-occurrence and the points of pathophysiologic commonality between the metabolic syndrome and major depressive disorder.
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References and Recommended Reading
Gans RO: The metabolic syndrome, depression, and cardiovascular disease: interrelated conditions that share pathophysiologic mechanisms. Med Clin North Am 2006, 90:573–591.
Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002, 287:356–359.
Hu G, Qiao Q, Tuomilehto J, et al.: Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med 2004, 164:1066–1076.
Laaksonen DE, Lakka HM, Niskanen LK, et al.: Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol 2002, 156:1070–1077.
Grundy SM, Cleeman JI, Daniels SR, et al.: Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005, 112:2735–2752.
Rasgon NL, Altshuler LL, Fairbanks L, et al.: Reproductive function and risk for PCOS in women treated for bipolar disorder. Bipolar Disord 2005, 7:246–259.
Lindley SE, Schroder CM, O’Hara R, Fazio S: Insulin resistance in schizophrenia, major depression, and bipolar disorder. In Insulin Resistance Syndrome and Neuropsychiatric Disease. Edited by Rasgon NL. New York: Informa Healthcare; 2008:49–86.
Taylor V, Macqueen G: Associations between bipolar disorder and metabolic syndrome: a review. J Clin Psychiatry 2006, 67:1034–1041.
McEvoy JP, Meyer JM, Goff DC, et al.: Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res 2005, 80:19–32.
Fagiolini A, Frank E, Scott JA, et al.: Metabolic syndrome in bipolar disorder: findings from the Bipolar Disorder Center for Pennsylvanians. Bipolar Disord 2005, 7:424–430.
Fagiolini A, Frank E, Turkin S, et al.: Metabolic syndrome in patients with bipolar disorder. J Clin Psychiatry 2008, 69:678–679.
Van WR, De HM, Van ED, et al.: Prevalence of diabetes and the metabolic syndrome in a sample of patients with bipolar disorder. Bipolar Disord 2008, 10:342–348.
Gavard JA, Lustman PJ, Clouse RE: Prevalence of depression in adults with diabetes. An epidemiological evaluation. Diabetes Care 1993, 16:1167–1178.
Teixeira PJ, Rocha FL: The prevalence of metabolic syndrome among psychiatric inpatients in Brazil. Rev Bras Psiquiatr 2007, 29:330–336.
Koponen H, Jokelainen J, Keinanen-Kiukaanniemi S, et al.: Metabolic syndrome predisposes to depressive symptoms: a population-based 7-year follow-up study. J Clin Psychiatry 2008, 23:e1–e5.
McIntyre RS, Soczynska JK, Konarski JZ, et al.: Should depressive syndromes be reclassified as “metabolic syndrome type II”? Ann Clin Psychiatry 2007, 19:257–264.
McIntyre RS, Soczynska JK, Konarski JZ, et al.: The effect of antidepressants on glucose homeostasis and insulin sensitivity: synthesis and mechanisms. Expert Opin Drug Saf 2006, 5:157–168.
McIntyre RS, Soczynska JK, Konarski JZ, et al.: The effect of antidepressants on lipid homeostasis: a cardiac safety concern? Expert Opin Drug Saf 2006, 5:523–537.
Kinder LS, Carnethon MR, Palaniappan LP, et al.: Depression and the metabolic syndrome in young adults: findings from the Third National Health and Nutrition Examination Survey. Psychosom Med 2004, 66:316–322.
Gil K, Radzillowicz P, Zdrojewski T, et al.: Relationship between the prevalence of depressive symptoms and metabolic syndrome. Results of the SOPKARD Project. Kardiol Pol 2006, 64:464–469.
Raikkonen K, Matthews KA, Kuller LH: Depressive symptoms and stressful life events predict metabolic syndrome among middle-aged women: a comparison of World Health Organization, Adult Treatment Panel III, and International Diabetes Foundation definitions. Diabetes Care 2007, 30:872–877.
Roos C, Lidfeldt J, Agardh CD, et al.: Insulin resistance and self-rated symptoms of depression in Swedish women with risk factors for diabetes: the Women’s Health in the Lund Area study. Metabolism 2007, 56:825–829.
Raikkonen K, Matthews KA, Kuller LH: The relationship between psychological risk attributes and the metabolic syndrome in healthy women: antecedent or consequence? Metabolism 2002, 51:1573–1577.
McCaffery JM, Niaura R, Todaro JF, et al.: Depressive symptoms and metabolic risk in adult male twins enrolled in the National Heart, Lung, and Blood Institute twin study. Psychosom Med 2003, 65:490–497.
Heiskanen TH, Niskanen LK, Hintikka JJ, et al.: Metabolic syndrome and depression: a cross-sectional analysis. J Clin Psychiatry 2006, 67:1422–1427.
Skilton MR, Moulin P, Terra JL, et al.: Associations between anxiety, depression, and the metabolic syndrome. Biol Psychiatry 2007, 62:1251–1257.
Vaccarino V, McClure C, Johnson BD, et al.: Depression, the metabolic syndrome and cardiovascular risk. Psychosom Med 2008, 70:40–48.
Frasure-Smith N, Lesperance F, Talajic M: Depression following myocardial infarction. Impact on 6-month survival. JAMA 1993, 270:1819–1825.
Osby U, Brandt L, Correia N, et al.: Excess mortality in bipolar and unipolar disorder in Sweden. Arch Gen Psychiatry 2001, 58:844–850.
Kashyap S, Belfort R, Gastaldelli A, et al.: A sustained increase in plasma free fatty acids impairs insulin secretion in nondiabetic subjects genetically predisposed to develop type 2 diabetes. Diabetes 2003, 52:2461–2474.
Reaven GM: Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988, 37:1595–1607.
Sarafidis PA, Bakris GL: Non-esterified fatty acids and blood pressure elevation: a mechanism for hypertension in subjects with obesity/insulin resistance? J Hum Hypertens 2007, 21:12–19.
McIntyre RS, Konarski JZ, Wilkins K, et al.: Obesity in bipolar disorder and major depressive disorder: results from a national community health survey on mental health and well-being. Can J Psychiatry 2006, 51:274–280.
Lapidus L, Bengtsson C, Larsson B, et al.: Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden. Br Med J (Clin Res Ed) 1984, 289:1257–1261.
Kalkhoff RK, Hartz AH, Rupley D, et al.: Relationship of body fat distribution to blood pressure, carbohydrate tolerance, and plasma lipids in healthy obese women. J Lab Clin Med 1983, 102:621–627.
Peiris AN, Sothmann MS, Hennes MI, et al.: Relative contribution of obesity and body fat distribution to alterations in glucose insulin homeostasis: predictive values of selected indices in premenopausal women. Am J Clin Nutr 1989, 49:758–764.
Lee ES, Kim YH, Beck SH, et al.: Depressive mood and abdominal fat distribution in overweight premenopausal women. Obes Res 2005, 13:320–325.
Moreira RO, Marca KF, Appolinario JC, et al.: Increased waist circumference is associated with an increased prevalence of mood disorders and depressive symptoms in obese women. Eat Weight Disord 2007, 12:35–40.
Southwick SM, Vythilingam M, Charney DS: The psychobiology of depression and resilience to stress: implications for prevention and treatment. Annu Rev Clin Psychol 2005, 1:255–291.
Banki CM, Karmacsi L, Bissette G, et al.: CSF corticotropin-releasing hormone and somatostatin in major depression: response to antidepressant treatment and relapse. Eur Neuropsychopharmacol 1992, 2:107–113.
Kapczinski F, Vieta E, Andreazza AC, et al.: Allostatic load in bipolar disorder: Implications for pathophysiology and treatment. Neurosci Biobehav Rev 2008, 32:675–692.
Craft S, Watson GS: Insulin and neurodegenerative disease: shared and specific mechanisms. Lancet Neurol 2004, 3:169–178.
Girgis RR, Javitch JA, Lieberman JA:Antipsychotic drug mechanisms: links between therapeutic effects, metabolic side effects and the insulin signaling pathway. Mol Psychiatry 2008, 13:918–929.
Gould TD, Manji HK: Glycogen synthase kinase-3: a putative molecular target for lithium mimetic drugs. Neuropsychopharmacology 2005, 30:1223–1237.
Raison CL, Capuron L, Miller AH: Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends Immunol 2006, 27:24–31.
Kiecolt-Glaser JK, Glaser R: Depression and immune function: central pathways to morbidity and mortality. J Psychosom Res 2002, 53:873–876.
Selley ML: Increased (E)-4-hydroxy-2-nonenal and asymmetric dimethylarginine concentrations and decreased nitric oxide concentrations in the plasma of patients with major depression. J Affect Disord 2004, 80:249–256.
Sarandol A, Sarandol E, Eker SS, et al.: Major depressive disorder is accompanied with oxidative stress: short-term antidepressant treatment does not alter oxidative-antioxidative systems. Hum Psychopharmacol 2007, 22:67–73.
Sarandol A, Sarandol E, Eker SS, et al.: Oxidation of apolipoprotein B-containing lipoproteins and serum paraoxonase/arylesterase activities in major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2006, 30:1103–1108.
Maiese K, Morhan SD, Chong ZZ: Oxidative stress biology and cell injury during type 1 and type 2 diabetes mellitus. Curr Neurovasc Res 2007, 4:63–71.
Forlenza MJ, Miller GE: Increased serum levels of 8-hydroxy-2′-deoxyguanosine in clinical depression. Psychosom Med 2006, 68:1–7.
Carney RM, Freedland KE, Veith RC: Depression, the autonomic nervous system, and coronary heart disease. Psychosom Med 2005, 67(Suppl 1):S29–S33.
Carnethon MR, Golden SH, Folsom AR, et al.: Prospective investigation of autonomic nervous system function and the development of type 2 diabetes: the Atherosclerosis Risk In Communities study, 1987–1998. Circulation 2003, 107:2190–2195.
Golden RN, Markey SP, Risby ED, et al.: Antidepressants reduce whole-body norepinephrine turnover while enhancing 6-hydroxymelatonin output. Arch Gen Psychiatry 1988, 45:150–154.
Benthem L, Keizer K, Wiegman CH et al.: Excess portal venous long-chain fatty acids induce syndrome X via HPA axis and sympathetic activation. Am J Physiol Endocrinol Metab 2000, 279:E1286–E1293.
McIntyre RS, McElroy SL, Konarski JZ, et al.: Substance use disorders and overweight/obesity in bipolar I disorder: preliminary evidence for competing addictions. J Clin Psychiatry 2007, 68:1352–1357.
Rasgon NL, Kenna HA: Insulin resistance in depressive disorders and Alzheimer’s disease: revisiting the missing link hypothesis. Neurobiol Aging 2005, 26(Suppl 1):103–107.
Dunn AL, Trivedi MH, Kampert JB, et al.: Exercise treatment for depression: efficacy and dose response. Am J Prev Med 2005, 28:1–8.
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McIntyre, R.S., Rasgon, N.L., Kemp, D.E. et al. Metabolic syndrome and major depressive disorder: Co-occurrence and pathophysiologic overlap. Curr Diab Rep 9, 51–59 (2009). https://doi.org/10.1007/s11892-009-0010-0
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DOI: https://doi.org/10.1007/s11892-009-0010-0