title: Clinical subtypes of depression are associated with specific metabolic parameters and circadian endocrine profiles in women: the power study.
abstract: BACKGROUND
  Major depressive disorder (MDD) has been associated with adverse medical consequences, including cardiovascular disease and osteoporosis. Patients with MDD may be classified as having melancholic, atypical, or undifferentiated features. The goal of the present study was to assess whether these clinical subtypes of depression have different endocrine and metabolic features and consequently, varying medical outcomes.
  
  
  METHODS
  Premenopausal women, ages 21 to 45 years, with MDD (N = 89) and healthy controls (N = 44) were recruited for a prospective study of bone turnover. Women with MDD were classified as having melancholic (N = 51), atypical (N = 16), or undifferentiated (N = 22) features. Outcome measures included: metabolic parameters, body composition, bone mineral density (BMD), and 24 hourly sampling of plasma adrenocorticotropin (ACTH), cortisol, and leptin.
  
  
  RESULTS
  Compared with control subjects, women with undifferentiated and atypical features of MDD exhibited greater BMI, waist/hip ratio, and whole body and abdominal fat mass. Women with undifferentiated MDD characteristics also had higher lipid and fasting glucose levels in addition to a greater prevalence of low BMD at the femoral neck compared to controls. Elevated ACTH levels were demonstrated in women with atypical features of depression, whereas higher mean 24-hour leptin levels were observed in the melancholic subgroup.
  
  
  CONCLUSIONS
  Pre-menopausal women with various features of MDD exhibit metabolic, endocrine, and BMD features that may be associated with different health consequences.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00006180.
authors.affiliation: Section on Neuroendocrinology of Obesity, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America. cizzag@intra.niddk.nih.gov
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cizza
authors.forename: Donna S
authors.initials: DS
authors.lastname: Ronsaville
authors.forename: Hayley
authors.initials: H
authors.lastname: Kleitz
authors.forename: Farideh
authors.initials: F
authors.lastname: Eskandari
authors.forename: Sejal
authors.initials: S
authors.lastname: Mistry
authors.forename: Sara
authors.initials: S
authors.lastname: Torvik
authors.forename: Nina
authors.initials: N
authors.lastname: Sonbolian
authors.forename: James C
authors.initials: JC
authors.lastname: Reynolds
authors.forename: Marc R
authors.initials: MR
authors.lastname: Blackman
authors.forename: Philip W
authors.initials: PW
authors.lastname: Gold
authors.forename: Pedro E
authors.initials: PE
authors.lastname: Martinez
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D019386:Alendronate / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D015519:Bone Density; D002940:Circadian Rhythm; D003865:Major Depressive Disorder / Q000097:blood / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology*; D004703:Endocrine System / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007753:Laboratories; D020738:Leptin / Q000097:blood; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000188:drug therapy; D017697:Premenopause; D015203:Reproducibility of Results; D055815:Young Adult
chemical_list: D015415:Biomarkers; D020738:Leptin; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone; D019386:Alendronate