title: Depression, obesity, and metabolic syndrome: prevalence and risks of comorbidity in a population-based representative sample of Mexican Americans.
abstract: BACKGROUND
  We examined the prevalence of depression, obesity, and metabolic syndrome and associations between them in a population-based representative cohort of Mexican Americans living on the United States-Mexico border.
  
  
  METHODS
  The sample in this cross-sectional analysis consisted of 1,768 Mexican American adults (≥ 18 years of age) assessed between the years 2004 and 2010, with whom we tested our central hypothesis of a significant relationship between obesity and depression. Depression was measured using the Center for Epidemiologic Studies-Depression scale (CES-D) with a cutoff score of ≥ 16 for depression and a cutoff score of ≥ 27 for severe depression. We categorized body mass index (BMI) values as obese (≥ 30kg/m(2)) and later subdivided the obese subjects into obese (30-39 kg/m(2)[inclusive]) and morbidly obese (≥ 40 kg/m(2)). Metabolic syndrome was defined using the American Heart Association definition requiring at least 3 of the following: increased waist circumference, elevated triglycerides, reduced high-density lipoprotein (HDL) cholesterol, elevated blood pressure, and elevated fasting glucose. Weighted data were analyzed to establish prevalence of depression, obesity, and metabolic syndrome. Univariate and multivariable weighted regression models were used to test potential associations between these disorders.
  
  
  RESULTS
  Using weighted prevalence, we observed high rates of depression (30%), obesity (52%), and metabolic syndrome (45%). Univariate models revealed female gender (P = .0004), low education (P = .003), low HDL level (P = .009), and increased waist circumference (P = .03) were associated with depression. Female gender (P = .01), low education (P = .003), and morbid obesity (P = .002) were risk factors for severe depression and remained significant in multivariable models.
  
  
  CONCLUSIONS
  In this large cohort of Mexican Americans, obesity, female gender, and low education were identified risk factors for depression. These indicators may serve as targets for early detection, prevention, and intervention in this population.
authors.affiliation: Department of Psychiatry, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229 olverar@UTHSCSA.edu.
authors.forename: Rene L
authors.initials: RL
authors.lastname: Olvera
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Williamson
authors.forename: Susan P
authors.initials: SP
authors.lastname: Fisher-Hoch
authors.forename: Kristina P
authors.initials: KP
authors.lastname: Vatcheva
authors.forename: Joseph B
authors.initials: JB
authors.lastname: McCormick
mesh_terms: D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D017058:Mexican Americans / Q000523:psychology / Q000706:statistics & numerical data*; D009765:Obesity / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors; D013781:Texas / Q000453:epidemiology