title: Metabolic dysregulation and late-life depression: a prospective study.
abstract: BACKGROUND
  Depression is associated with the metabolic syndrome (MS). We examined whether metabolic dysregulation predicted the 2-year course of clinical depression.
  
  
  METHODS
  A total of 285 older persons (⩾60 years) suffering from depressive disorder according to DSM-IV-TR criteria was followed up for 2 years. Severity of depression was assessed with the Inventory of Depressive Symptomatology (IDS) at 6-month intervals. Metabolic syndrome was defined according the National Cholesterol Education Programme (NCEP-ATP III). We applied logistic regression and linear mixed models adjusted for age, sex, years of education, smoking, alcohol use, physical activity, somatic co-morbidity, cognitive functioning and drug use (antidepressants, anti-inflammatory drugs) and severity of depression at baseline.
  
  
  RESULTS
  MS predicted non-remission at 2 years (odds ratioper component = 1.26, 95% confidence interval 1.00-1.58), p = 0.047), which was driven by the waist circumference and HDL cholesterol. MS was not associated with IDS sum score. Subsequent analyses on its subscales, however, identified an association with the somatic symptom subscale score over time (interaction time × somatic subscale, p = 0.005), driven by higher waist circumference and elevated fasting glucose level.
  
  
  CONCLUSIONS
  Metabolic dysregulation predicts a poor course of late-life depression. This finding supports the concept of 'metabolic depression', recently proposed on population-based findings of a protracted course of depressive symptoms in the presence of metabolic dysregulation. Our findings seem to be driven by abdominal obesity (as indicated by the waist circumference) and HDL cholesterol dysregulation.
authors.affiliation: Department of Old Age Psychiatry,ProPersona,Arnhem/Wolfheze,The Netherlands.
authors.forename: R M
authors.initials: RM
authors.lastname: Marijnissen
authors.affiliation: Department of Epidemiology,Cardiovascular Research Institute Maastricht (CARIM) & Maastricht Centre for Systems Biology (MaCSBio),Maastricht University,Maastricht,The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Vogelzangs
authors.affiliation: Department of Old Age Psychiatry,ProPersona,Arnhem/Wolfheze,The Netherlands.
authors.forename: M E
authors.initials: ME
authors.lastname: Mulder
authors.affiliation: University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion Regulation,University Medical Center Groningen,University of Groningen,Groningen,The Netherlands.
authors.forename: R H S
authors.initials: RH
authors.lastname: van den Brink
authors.affiliation: Department Psychiatry,EMGO Institute for Health and Care Research VU University Medical Center/GGZinGeest,Amsterdam,The Netherlands.
authors.forename: H C
authors.initials: HC
authors.lastname: Comijs
authors.affiliation: University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion Regulation,University Medical Center Groningen,University of Groningen,Groningen,The Netherlands.
authors.forename: R C
authors.initials: RC
authors.lastname: Oude Voshaar
mesh_terms: D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D008076:Cholesterol, HDL / Q000097:blood; D003866:Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000378:metabolism*; D008875:Middle Aged; D011379:Prognosis; D055105:Waist Circumference / Q000502:physiology
chemical_list: D008076:Cholesterol, HDL
keywords: Abdominal obesity; depression; elderly; metabolic syndrome; waist circumference