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Prospective associations of depression subtypes with cardio-metabolic risk factors in the general population

Molecular Psychiatry volume 22, pages 1026–1034 (2017)Cite this article

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Abstract

The mechanisms and temporal sequence underlying the association between major depressive disorder (MDD) and cardio-metabolic diseases are still poorly understood. Recent research suggests subtyping depression to study the mechanisms underlying its association with biological correlates. Accordingly, our aims were to (1) assess the prospective associations of the atypical, melancholic and unspecified subtypes of MDD with changes of fasting glucose, high-density lipoprotein-cholesterol, triglycerides, systolic blood pressure and the incidence of the metabolic syndrome, (2) determine the potential mediating role of inflammatory marker or adipokine concentrations, eating behaviors and changes in waist circumference during follow-up. Data stemmed from CoLaus|PsyCoLaus, a prospective cohort study including 35–66-year-old randomly selected residents of an urban area. Among the Caucasian participants who underwent the physical and psychiatric baseline evaluations, 2813 (87% participation rate) also accepted the physical follow-up exam (mean follow-up duration=5.5 years). Symptoms of mental disorders were elicited using a semi-structured interview. The atypical MDD subtype, and only this subtype, was prospectively associated with a higher incidence of the metabolic syndrome (OR=2.49; 95% CI 1.30–4.77), a steeper increase of waist circumference (β=2.41; 95% CI 1.19–3.63) and independently of this, with a steeper increase of the fasting glucose level (β=131; 95% CI 38–225) during follow-up. These associations were not attributable to or mediated by inflammatory marker or adipokine concentrations, eating behaviors, comorbid psychiatric disorders or lifestyle factors. Accordingly, our results further support the subtyping of MDD and highlight the particular need for prevention and treatment of metabolic consequences in patients with atypical MDD.

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Acknowledgements

We express our gratitude to the Lausanne inhabitants who volunteered to participate in the CoLaus|PsyCoLaus study. We thank all the investigators of the study. The CoLaus|PsyCoLaus study was and is supported by research grants from GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, and the Swiss National Science Foundation (grants 3200B0–105993, 3200B0-118308, 33CSCO-122661, 33CS30-139468 and 33CS30-148401). Aurélie Lasserre is supported by a grant from the Swiss National Science Foundation (grant 323530_151479).

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Authors and Affiliations

  1. Department of Psychiatry, Center for Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Prilly, Switzerland

    A M Lasserre, M-P F Strippoli, J Glaus, M Gholam-Rezaee, C L Vandeleur, E Castelao & M Preisig

  2. Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA

    J Glaus

  3. Department of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland

    P Marques-Vidal, G Waeber & P Vollenweider

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  1. A M Lasserre
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Lasserre, A., Strippoli, MP., Glaus, J. et al. Prospective associations of depression subtypes with cardio-metabolic risk factors in the general population. Mol Psychiatry 22, 1026–1034 (2017). https://doi.org/10.1038/mp.2016.178

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