title: Depressive symptoms and metabolic risk: effects of cortisol and gender.
abstract: We examined gender effects and the role of cortisol in the association between depressive symptoms and metabolic risk in the Stress, Atherosclerosis, and ECG Study (STRATEGY). In 215 healthy adults from the general population (n=107 men, n=108 women, distributed equally across four age groups, 30-70 years), we assessed depressive symptoms by the Patient Health Questionnaire (PHQ score >10) and measured variables of the metabolic syndrome: high-density lipoprotein (HDL), triglycerides, systolic and diastolic blood pressure, fasting blood glucose and waist circumference. Salivary cortisol was assessed at 08:00, 12:00, 16:00 and 22:00 h. Depressive symptoms were not associated with the metabolic syndrome as entity in the total sample or in men and women separately. However, women with depressive symptoms had larger waist circumferences, higher fasting blood glucose, lower HDL-cholesterol, higher diastolic blood pressure, and higher 16:00 and 22:00 h salivary cortisol compared to women without depressive symptoms. These results persisted after adjusting for age, education, smoking, and physical activity. In adjusted regression analyses, inclusion of cortisol attenuated the association between depressive symptoms and waist, fasting glucose, HDL and diastolic blood pressure in women. In men, we did not find an association between depressive symptoms and variables of the metabolic syndrome. In women, depressive symptoms are associated with several variables of the metabolic syndrome. Elevated afternoon and evening cortisol appear to partially mediate this association.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. cmuhtz@uke.uni-hamburg.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Muhtz
authors.forename: Birgit-Christiane
authors.initials: BC
authors.lastname: Zyriax
authors.forename: Tilman
authors.initials: T
authors.lastname: Klähn
authors.forename: Eberhard
authors.initials: E
authors.lastname: Windler
authors.forename: Christian
authors.initials: C
authors.lastname: Otte
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose; D001794:Blood Pressure; D008076:Cholesterol, HDL / Q000097:blood; D002940:Circadian Rhythm; D003863:Depression / Q000150:complications* / Q000378:metabolism; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000378:metabolism*; D008875:Middle Aged; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry; D012727:Sex Characteristics; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides; D006854:Hydrocortisone