Academic journal article Indian Journal of Psychiatry

Metabolic Syndrome and Central Obesity in Depression: A Cross-Sectional Study

Academic journal article Indian Journal of Psychiatry

Metabolic Syndrome and Central Obesity in Depression: A Cross-Sectional Study

Article excerpt

Byline: Anju. Agarwal, Manu. Agarwal, Kabir. Garg, Pronob. Dalal, Jitendra. Trivedi, J. Srivastava

Introduction: The current epidemiological data and meta-analyses indicate a bidirectional association between depression and metabolic syndrome (MetS). Aims: To assess the prevalence of metabolic syndrome and obesity in drug naive patients (in current episode) having Recurrent Major Depressive Disorder and Bipolar Depression. Method: This was a single point cross sectional observational study that involved administration of diagnostic and assessment tools and blood investigations. Recruitment for the study was done from a period of September 2008 to august 2009. Results: The prevalence of MetS was significantly more in the depression group when compared to healthy controls. The Bipolar depression group had 24% prevalence and recurrent depression group had 26% prevalence as opposed to none in the control group. The prevalence of MetS did not differ significantly amongst the both depression groups. Presence of central obesity was significantly more in the recurrent depression (30%) and Bipolar depression (24%) as compared to controls (8%). There was no statistically significant difference between the two depression subgroups. Discussion: Our study adds to the mounting evidence that links the presence of depression and metabolic syndrome. As we had ensured a drug free period of at least 3 months, the findings in our study indicate that the metabolic syndrome observed in our study is independent of drug exposure. Conclusions: This study demonstrated significantly more incidence of metabolic syndrome and central obesity in patients of depression than age and sex matched controls.

Introduction

Metabolic syndrome (MetS) is a set of metabolic, anthropometric, and hemodynamic abnormalities including abdominal obesity, impaired lipid profile (lowered high density lipoprotein [HDL] and elevated triglycerides), hypertension, and impaired fasting glucose or insulin resistance.[sup][1] Studies done on Western populations have pegged the prevalence at approximately one-third of the general population.[sup][2],[3] Similar studies in Indian populations have found comparable prevalence, ranging from 31 to 41% of studied adults, with greater prevalence in women.[sup][4],[5] Needless to say, the risk factors considered under MetS can cause significant physical impairments and adverse health outcomes, Type 2 diabetes and cardiovascular morbidity being the best established ones.[sup][6] It has also been associated with increasing the risk of mortality due to cardiovascular events and also an overall, all-cause increase in mortality in the general population.[sup][5],[7]

MetS has also been associated robustly with a number of psychiatric illnesses, including and in no ways limited to bipolar disorder, depression, and schizophrenia across multiple studies all around the globe.[sup][8],[9],[10],[11],[12],[13],[14],[15]

The current epidemiological data and meta-analyses indicate a bidirectional association between depression and MetS.[sup][16] It should also be noticed that a majority of the studies in this area focus on MetS as a whole, using a dichotomous outcome variable,[sup][17] which strongly varies among different treatment centers and settings. In a British study, it was demonstrated that MetS, and more importantly, its obesity and hyperlipidemia components predicted the development of depressive symptoms over a follow-up period of 6 years.[sup][18] Another meta-analysis involving 5000 depressed subjects calculated the estimated mean prevalence of MetS to be up to 30.5%.[sup][19] In another population-based study, women with MetS in their childhood were found to have increased levels of depressive symptoms in adulthood, and the severity of these symptoms increased in proportion to the duration of exposure to MetS over lifetime.[sup][20] Consequently, studies have found MetS to be a possible predisposing factor for the development of depression, and subsequently, have raised questions whether investigating individual components besides MetS per se would be useful. …

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