title: Major depressive disorder is associated with cardiovascular risk factors and low Omega-3 Index.
abstract: OBJECTIVE
  Cardiovascular disease (CVD) and major depressive disorder (MDD) are frequent worldwide and have a high comorbidity rate. Omega-3 fatty acids have been suggested as disease modulators for both CVD and MDD. Therefore, we studied whether polyunsaturated fatty acids and the Omega-3 Index may represent markers for assessment of the cardiovascular risk in somatically healthy patients suffering from MDD.
  
  
  METHODS
  We conducted a case-control study from July 2004 to December 2007 in 166 adults (86 inpatients with MDD but without CVD from the Department of Psychiatry and Psychotherapy and 80 age- and sex-matched healthy controls from an outpatient clinic of the Division of Preventive Cardiology, Ludwig Maximilian University of Munich, Germany). Information gathered at baseline included MDD diagnosis according to DSM-IV criteria, depression ratings, conventional cardiovascular risk factors, and fatty acid and interleukin-6 determinations. Fatty acid composition was analyzed according to the HS-Omega-3 Index methodology. During the study, patients received no supplementation with omega-3 fatty acids. The main inclusion criteria were the diagnosis of MDD according to DSM-IV and a 17-item Hamilton Depression Rating Scale (HDRS-17) score of at least 17. Treatment response and remission were defined using the HDRS-17.
  
  
  RESULTS
  Several conventional risk factors such as high triglyceride (mean, 152 mg/dL vs 100 mg/dL; P < .001) and fasting glucose (mean, 96 mg/dL vs 87 mg/dL; P = .005) values as well as greater waist circumference (mean, 97 cm vs 87 cm; P = .019) and higher body mass index (calculated as kg/m(2); mean, 26 vs 24; P = .011) were more prevalent in MDD patients in comparison with controls. The Omega-3 Index (mean, 3.9% vs 5.1%; P < .001) and individual omega-3 fatty acids were significantly lower in MDD patients. An Omega-3 Index < 4% was associated with high concentrations of the proinflammatory cytokine interleukin-6 (χ(2) = 7.8, P = .02).
  
  
  CONCLUSIONS
  Conventional cardiovascular risk factors, the Omega-3 Index, and interleukin-6 levels indicated an elevated cardiovascular risk profile in MDD patients currently free of CVD. Our results support the employment of strategies to reduce the cardiovascular risk in still cardiovascularly healthy MDD patients by targeting conventional risk factors and the Omega-3 Index.
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Nussbaumstrasse 7, D-80336 Munich, Germany. Baghai@med.uni-muenchen.de
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Baghai
authors.forename: Gabriella
authors.initials: G
authors.lastname: Varallo-Bedarida
authors.forename: Christoph
authors.initials: C
authors.lastname: Born
authors.forename: Sibylle
authors.initials: S
authors.lastname: Häfner
authors.forename: Cornelius
authors.initials: C
authors.lastname: Schüle
authors.forename: Daniela
authors.initials: D
authors.lastname: Eser
authors.forename: Rainer
authors.initials: R
authors.lastname: Rupprecht
authors.forename: Brigitta
authors.initials: B
authors.lastname: Bondy
authors.forename: Clemens
authors.initials: C
authors.lastname: von Schacky
mesh_terms: D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000097:blood / Q000523:psychology*; D003865:Major Depressive Disorder / Q000097:blood* / Q000209:etiology; D015525:Fatty Acids, Omega-3 / Q000097:blood*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D018709:Statistics, Nonparametric; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D015525:Fatty Acids, Omega-3; D015850:Interleukin-6; D014280:Triglycerides