title: Depressive symptoms and serum lipid fractions in middle-aged men: physiologic and health behavior links.
abstract: OBJECTIVE
  To investigate alternative hypothetical models that could clarify the relationship between depressive symptoms and serum cholesterol fractions, i.e., high-density lipoprotein (HDL) and low-density lipoprotein (LDL). It was hypothesized that the impact of the depressive symptoms on cholesterol fractions is mediated through health behavior and body mass index, and at the same time there would be a direct link from depression to cholesterol.
  
  
  METHODS
  The study sample consisted of 893 middle-age men who participated in a trial aimed at preventing the metabolic syndrome, Type 2 diabetes and cardiovascular diseases. Serum cholesterol was measured by the enzymatic method. Participants completed self-report questionnaires assessing health behavior and depressive symptoms.
  
  
  RESULTS
  Depressive symptoms consistently correlated statistically significantly with adverse lifestyle factors and, as hypothesized, positively with HDL. Path analyses supported the parallel existence of two main pathways: from depression through adverse health behavior to unfavorable cholesterol fraction balance, and a direct physiological link indicative of beneficial effect of depression on cholesterol levels.
  
  
  CONCLUSIONS
  It is concluded that, among a sample of men, depressive symptoms are linked to cholesterol fractions through two different pathways. An adverse relationship of depression with serum lipids HDL-LDL balance is partly mediated through harmful health behaviors. At the same time, the results indicate a direct, physiological link between depressive symptoms and cholesterol that has a beneficial influence on the HDL-LDL balance.
authors.affiliation: Department of Psychology, University of Helsinki, Helsinki, Finland.
authors.forename: Cornel Victor
authors.initials: CV
authors.lastname: Igna
authors.forename: Juhani
authors.initials: J
authors.lastname: Julkunen
authors.forename: Hannu
authors.initials: H
authors.lastname: Vanhanen
authors.forename: Pertti
authors.initials: P
authors.lastname: Keskivaara
authors.forename: Markku
authors.initials: M
authors.lastname: Verkasalo
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D015984:Causality; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D015897:Comorbidity; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology / Q000523:psychology; D003863:Depression / Q000097:blood / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology; D004032:Diet; D004522:Educational Status; D005387:Finland / Q000453:epidemiology; D015438:Health Behavior; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000523:psychology; D008019:Life Style; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D008875:Middle Aged; D008954:Models, Biological; D008960:Models, Psychological; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL