Sang Won Jeon1, Se-Won Lim2, Dong-Won Shin3, Seungho Ryu4, Yoosoo Chang4, Sun-Young Kim1, Kang-Seob Oh1, Young-Chul Shin5, Young Hwan Kim6. 1. Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 2. Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Republic of Korea. Electronic address: healthysewon@daum.net. 3. Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: ntour@unitel.co.kr. 4. Center for Cohort Study, Total Healthcare Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 5. Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Republic of Korea. 6. Department of Nuclear Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND: Recent studies on the prospective association between metabolic syndrome (MetS) and depression have reported conflicting findings. METHODS: A cohort study was performed with 115,223 middle-aged adults, free of depression at baseline, who underwent at least 2 comprehensive exams between 2012 and 2015. MetS was assessed according to the National Cholesterol Education Program Adult Treatment Panel III. The study endpoint was new onset of depression, defined as a Center for Epidemiologic Studies-Depression Scale score ≥ 16. RESULTS: Over 253,451.6 person-years, 6,833 participants developed depression. When the participants with 0 MetS components were set as a reference, the multivariable-adjusted hazard ratio (HR, 95% confidence interval [CI]) for incident depression formed a U-shaped curve with the number of MetS components (p for trend = 0.229): 1 (1.07 [1.02-1.15]); 2 (0.92 [0.82-1.06]); 3 (0.85 [0.78-1.07]); 4 (1.16 [1.06-1.32]); and 5 MetS components (1.25 [1.10-1.54]). The presence or absence of MetS was not significant in new-onset depression. In examining potential clustering and synergistic effects of the constituent parts, waist circumference was the major driving factor of incident depression, and its relative excess risk due to interaction increased with the number of combinations. LIMITATIONS: We used a self-reported depression scale, and the follow-up period was relatively short. CONCLUSIONS: Future studies investigating the risk for incident depression should place more focus on the number of MetS abnormalities and specific MetS factors, such as waist circumference, than the presence or absence of MetS.
BACKGROUND: Recent studies on the prospective association between metabolic syndrome (MetS) and depression have reported conflicting findings. METHODS: A cohort study was performed with 115,223 middle-aged adults, free of depression at baseline, who underwent at least 2 comprehensive exams between 2012 and 2015. MetS was assessed according to the National Cholesterol Education Program Adult Treatment Panel III. The study endpoint was new onset of depression, defined as a Center for Epidemiologic Studies-Depression Scale score ≥ 16. RESULTS: Over 253,451.6 person-years, 6,833 participants developed depression. When the participants with 0 MetS components were set as a reference, the multivariable-adjusted hazard ratio (HR, 95% confidence interval [CI]) for incident depression formed a U-shaped curve with the number of MetS components (p for trend = 0.229): 1 (1.07 [1.02-1.15]); 2 (0.92 [0.82-1.06]); 3 (0.85 [0.78-1.07]); 4 (1.16 [1.06-1.32]); and 5 MetS components (1.25 [1.10-1.54]). The presence or absence of MetS was not significant in new-onset depression. In examining potential clustering and synergistic effects of the constituent parts, waist circumference was the major driving factor of incident depression, and its relative excess risk due to interaction increased with the number of combinations. LIMITATIONS: We used a self-reported depression scale, and the follow-up period was relatively short. CONCLUSIONS: Future studies investigating the risk for incident depression should place more focus on the number of MetS abnormalities and specific MetS factors, such as waist circumference, than the presence or absence of MetS.
Authors: Frank C T van der Heide; Indra L M Steens; Anouk F J Geraets; Yuri D Foreman; Ronald M A Henry; Abraham A Kroon; Carla J H van der Kallen; Thomas T van Sloten; Pieter C Dagnelie; Martien C J M van Dongen; Simone J P M Eussen; Tos T J M Berendschot; Jan S A G Schouten; Carroll A B Webers; Marleen M J van Greevenbroek; Anke Wesselius; Annemarie Koster; Nicolaas C Schaper; Miranda T Schram; Seb Köhler; Coen D A Stehouwer Journal: JAMA Netw Open Date: 2021-11-01