Endocrine Abstracts

Background: Metabolic syndrome (MetSy) comprises a cluster of risk factors (central obesity, high blood pressure, low high density lipoprotein [HDL]-cholesterol, elevated triglycerides and hyperglycaemia) associated to the risk of cardiovascular diseases development. Depression has also been reported to be associated with an increased risk for diabetes and cardiovascular diseases, the underlying mechanisms being still poorly described. MetSy may mediate this association, but only limited data have been reported to support whether MetSy and depression are connected, and, moreover, whether this connection is gender-specific.

Objectives: The study aimed to evaluate the gender differences in patients with MetSy and depression.

Methods: Seventy patients with major depressive disorder (MDD) and MetSy were studied. The MDD was diagnosed according to DSM-IV-TR. MetSy was screened for considering the International Diabetes Federation consensus worldwide de-finition of the Metabolic Syndrome.

Results: The study group comprised 45 women and 25 men hospitalized for MDD (gender ratio F:M=1.8), with an average age of 45.34±5.43 years. The mean age of onset of the MDD was 41.12 years. The group of patients associating MDD and MetSy consisted of 15 women and 11 men (gender ratio 1.36, with no significant statistical difference). The female subjects associating MetSy met 4 or even 5 diagnosis criteria, compared to the male subjects, who generally met only 3 diagnosis criteria. The most frequent MetSy diagnosis criteria were high blood pressure, increased levels of triglycerides and increased levels of glucose, with no statistical significant differences between the male and the female groups. The maximum range of systolic blood pressure was higher in the female group compared to the male group (195 mmHg vs. 165 mmHg, P=0.03). There was a significant difference in the mean triglyceride level: the female group had higher values compared to the male group (mean value 229.7 mg/dL vs. 212.31 mg/dL, P<0.05). The female group had also higher HDL-cholesterol levels (mean value 44 mg/dL vs. 35 mmol/L, P=0.04).

Conclusions: The metabolic syndrome is associated with depression irrespective of gender. Patients with depression may be prone to metabolic syndrome both because of poor health-related behaviours and lifestyle, and antidepressant medication, causing prolongation of the depression episodes, increasing the percentage of relapses, and lowering the adherence to treatment. These findings highlight the importance of screening for depression in patients with metabolic syndrome, as lifestyle changes could reduce the visceral adiposity and inflammation that might ameliorate depression.