Younger, premenopausal women with major depressive disorder have more abdominal fat and increased serum levels of prothrombotic factors: implications for greater cardiovascular risk.
Major depressive disorder (MDD) is one of the most common psychiatric illnesses in the adult population. It is often associated with an increased risk of cardiovascular disease. We measured body fat distribution as well as plasminogen activator inhibitor-1 (PAI-1) concentration and factor VIII (fVIII) activity at 8:00 am and 8:00 pm in 45 premenopausal women with MDD vs 28 healthy controls (age, 37 +/- 6.8 vs 35 +/- 6.5; weight [kg], 75.3 +/- 17.2 vs 67.9 +/- 10.2; mean +/- SD] participating in a prospective study of bone turnover, the POWER Study. At the time of evaluation, women with MDD were mildly depressed and mostly in clinical remission on antidepressants. After adjusting for body weight, women with MDD had greater waist circumference and abdominal fat as well as significantly higher evening (8:00 pm) PAI-1 and fVIII levels than controls. Even when age-, race-, and body mass index-matched subsets were compared, the MDD group continued to exhibit statistically higher PAI-1 and fVIII levels. The observed alterations in body fat distribution (increased abdominal fat) and prothrombotic factors (increased PAI-1 and fVIII) may be in part responsible for the increased risk of cardiovascular disease reported in association with major depression.
Department of Medicine, Division of Clinical and Molecular Endocrinology, Case Western Reserve University, Cleveland, OH 44106, USA.
Farideh
F
Eskandari
Sejal
S
Mistry
Pedro E
PE
Martinez
Sara
S
Torvik
Christine
C
Kotila
Nancy
N
Sebring
Bart E
BE
Drinkard
Catherine
C
Levy
James C
JC
Reynolds
Gyorgy
G
Csako
Philip W
PW
Gold
McDonald
M
Horne
Giovanni
G
Cizza
D000005:Abdomen; D000273:Adipose Tissue; D000328:Adult; D001823:Body Composition; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000097:blood* / Q000150:complications / Q000473:pathology*; D005169:Factor VIII / Q000378:metabolism*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D017697:Premenopause; D011446:Prospective Studies
D017395:Plasminogen Activator Inhibitor 1; D005169:Factor VIII; D006854:Hydrocortisone