title: Do depressed patients without activation of the hypothalamus-pituitary-adrenal (HPA) system have metabolic disturbances?
abstract: This study compared features of the metabolic syndrome between healthy controls and depressed patients without activation of the hypothalamus-pituitary-adrenal (HPA) system. After exclusion of non-suppressors to 1mg dexamethasone, we included 20 depressed inpatients and 34 healthy controls in the analyses. We assessed HPA system activity (diurnal saliva cortisol profile, cortisol excretion), normetanephrine excretion as well as fasting glucose, lipid profile and blood pressure. With regard to body composition, we measured waist circumference as well as visceral fat and adrenal volume by magnetic resonance (MR) imaging. Five depressed patients (25%) and five healthy controls (15%) fulfilled the criteria of the metabolic syndrome according NCEP-ATP-III. Depression was significantly related with fasting glucose and negatively associated with mean blood pressure (BP) and, by trend, with low HDL-cholesterol. We conclude that depressed patients may have modest metabolic disturbances even in the complete absence of activation of stress-responsive systems. Hence some metabolic disturbances in depressed patients may not be explicable by HPA activation. Additional factors are required to mediate the link between affective and metabolic disorders.
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany. Electronic address: barbara.scharnholz@zi-mannheim.de.
authors.forename: Barbara
authors.initials: B
authors.lastname: Scharnholz
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Gilles
authors.affiliation: Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, 68167 Mannheim, Germany.
authors.forename: Annika
authors.initials: A
authors.lastname: Marzina
authors.affiliation: Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, 68167 Mannheim, Germany.
authors.forename: Marcel
authors.initials: M
authors.lastname: Kommer
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Lederbogen
authors.affiliation: Steroid Research and Mass Spectrometry Unit, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, 35390 Gießen, Germany.
authors.forename: Stefan A
authors.initials: SA
authors.lastname: Wudy
authors.affiliation: Steroid Research and Mass Spectrometry Unit, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, 35390 Gießen, Germany.
authors.forename: Michaela F
authors.initials: MF
authors.lastname: Hartmann
authors.affiliation: Institute of Clinical Chemistry, Magdeburg University Hospital, 39120 Magdeburg, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Westphal
authors.affiliation: Laboratory Limbach, 69126 Heidelberg, Germany.
authors.forename: Heinz Jürgen
authors.initials: HJ
authors.lastname: Roth
authors.affiliation: Department of Psychiatry, Social Psychiatry and Psychotherapy, University of Hannover, 30625 Hannover, Germany.
authors.forename: Kai G
authors.initials: KG
authors.lastname: Kahl
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Meyer-Lindenberg
authors.affiliation: Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, 68167 Mannheim, Germany.
authors.forename: Henrik J
authors.initials: HJ
authors.lastname: Michaely
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Deuschle
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism / Q000503:physiopathology*; D007031:Hypothalamus / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000378:metabolism / Q000503:physiopathology*
keywords: Autonomic nervous system; Blood pressure; Body composition; Depression; Fasting glucose; HPA system; Metabolic syndrome; Visceral fat