Depression: An Important Comorbidity With Metabolic Syndrome in a General Population

  1. James A. Dunbar, MD1,
  2. Prasuna Reddy, PHD1,
  3. Nathalie Davis-Lameloise, PHD1,
  4. Benjamin Philpot, BSC1,
  5. Tiina Laatikainen, MD, PHD12,
  6. Annamari Kilkkinen, PHD12,
  7. Stephen J. Bunker, PHD1,
  8. James D. Best, MD4,
  9. Erkki Vartiainen, MD, PHD2,
  10. Sing Kai Lo, PHD5 and
  11. Edward D. Janus, MD, PHD13
  1. 1Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, Victoria, Australia
  2. 2National Public Health Institute, Helsinki, Finland
  3. 3The University of Melbourne, Department of Medicine, Western Health, Melbourne, Victoria, Australia
  4. 4The University of Melbourne, Department of Medicine, St. Vincent's Hospital, Melbourne, Victoria, Australia
  5. 5Faculty of Health Medicine Nursing and Behavioural Sciences, Deakin University, Melbourne, Victoria, Australia
  1. Corresponding author: James Dunbar, director{at}greaterhealth.org

Abstract

OBJECTIVE—There is a recognized association among depression, diabetes, and cardiovascular disease. The aim of this study was to examine in a sample representative of the general population whether depression, anxiety, and psychological distress are associated with metabolic syndrome and its components.

RESEARCH DESIGN AND METHODS—Three cross-sectional surveys including clinical health measures were completed in rural regions of Australia during 2004–2006. A stratified random sample (n = 1,690, response rate 48%) of men and women aged 25–84 years was selected from the electoral roll. Metabolic syndrome was defined by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, Adult Treatment Panel III (NCEP ATP III), and International Diabetes Federation (IDF) criteria. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale and psychological distress by the Kessler 10 measure.

RESULTS—Metabolic syndrome was associated with depression but not psychological distress or anxiety. Participants with the metabolic syndrome had higher scores for depression (n = 409, mean score 3.41, 95% CI 3.12–3.70) than individuals without the metabolic syndrome (n = 936, mean 2.95, 95% CI 2.76–3.13). This association was also present in 338 participants with the metabolic syndrome and without diabetes (mean score 3.37, 95% CI 3.06–3.68). Large waist circumference and low HDL cholesterol showed significant and independent associations with depression.

CONCLUSIONS—Our results show an association between metabolic syndrome and depression in a heterogeneous sample. The presence of depression in individuals with the metabolic syndrome has implications for clinical management.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 3 October 2008.

    Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted August 27, 2008.
    • Received February 5, 2008.
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  1. Published online before print October 3, 2008, doi: 10.2337/dc08-0175 Diabetes Care December 2008 vol. 31 no. 12 2368-2373
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