title: Metabolic Syndrome and Symptom Resolution in Depression: A 5-Year Follow-Up of Older Adults.
abstract: Although metabolic syndrome is associated with the incidence of depression, little is known about its contribution to the course of depression. We examined whether metabolic syndrome and its components are associated with long-term symptom resolution in older adults with depressive symptoms.
  
  
  
  Data from 965 participants in the Whitehall II cohort study (mean age = 62 years at baseline) were used to generate 1,172 person-observations of metabolic syndrome and its components (abdominal obesity, low level of high-density lipoprotein [HDL] cholesterol, high level of triglycerides, hypertension, and elevated fasting glucose or diabetes). All participants were depression cases at the beginning of 2 consecutive follow-up cycles: from 2002-2004 to 2007-2009 and from 2007-2009 to 2012-2013 (mean follow-up = 4.6 years). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale caseness at the beginning and the end of the 2 cycles.
  
  
  
  In multivariable adjusted analyses, metabolic syndrome per se was not associated with symptom resolution. Of its components, low HDL cholesterol (risk ratio [RR] = 0.82; 95% CI, 0.68-1.00; P = .045) and high triglyceride levels (RR = 0.81; 95% CI, 0.70-0.95; P = .007) were associated with a lower likelihood of symptom resolution. These findings were replicated in a subpopulation without coronary heart disease and stroke (RR = 0.77 [95% CI, 0.63-0.95; P = .015] for low HDL cholesterol; RR = 0.79 [95% CI, 0.67-0.94; P = .006] for high triglycerides).
  
  
  
  Low HDL cholesterol and high triglyceride levels are associated with lower likelihood of long-term symptom resolution in depression. These data suggest that an adverse lipid profile, but not other components of metabolic syndrome, may delay recovery from depression.
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland. marianna.virtanen@ttl.fi.|Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
authors.affiliation: Department of Epidemiology and Public Health, University College London, United Kingdom.|School of Social and Community Medicine, University of Bristol, United Kingdom.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Ferrie
authors.affiliation: Department of Epidemiology and Public Health, University College London, United Kingdom.|Inserm, U1198, Montpellier, France.|École Pratique des Hautes Études, Paris, France.|Department of Molecular Mechanisms of Neurodegenerative Diseases, University Montpellier, Montpellier, France.
authors.forename: Tasnime
authors.initials: T
authors.lastname: Akbaraly
authors.affiliation: Department of Epidemiology and Public Health, University College London, United Kingdom.|First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary.
authors.forename: Adam
authors.initials: A
authors.lastname: Tabak
authors.affiliation: Institute of Behavioral Sciences, University of Helsinki, Finland.
authors.forename: Markus
authors.initials: M
authors.lastname: Jokela
authors.affiliation: Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom.
authors.forename: Klaus P
authors.initials: KP
authors.lastname: Ebmeier
authors.affiliation: Department of Epidemiology and Public Health, University College London, United Kingdom.|Inserm, U1018, AP-HP, Villejuif, France.
authors.forename: Archana
authors.initials: A
authors.lastname: Singh-Manoux
authors.affiliation: Department of Epidemiology and Public Health, University College London, United Kingdom.|Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008131:London; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D012075:Remission, Spontaneous