A new study using Bayesian network analysis from the NESDA cohort suggests that depressive symptoms, especially those related to low energy, hypersomnia, and appetite or weight changes, are closely connected to diabetes, dyslipidemia, and systemic inflammation. These findings indicate a bidirectional relationship between depression and cardiometabolic disorders. Energy-related depressive symptoms were found to be particularly associated with waist circumference and diabetes, emphasizing the role of abdominal adiposity in linking mood disturbances to metabolic health. The study was published in the journal of Brain, Behavior, and Immunity by Arja O. and colleagues.
These data were from 1,059 participants with a lifetime diagnosis of depression, where 68% of the participants were female, with an average age of 42.4 years ± 12.5 years. Data were collected at baseline and at 2-, 6-, and 9-year follow-ups to compile this longitudinal dataset.
The researchers conducted a Bayesian network analysis coupled with quantitative centrality measures to identify directional relationships between the depressive symptoms, inflammatory markers, and cardiometabolic parameters. Study variables that were included are depressive symptom profiles, metabolic syndrome components, inflammation, diabetes, and atherosclerotic disease. Changes for individuals over time were modeled first in generalized mixed models and then integrated into a DAG in order to assess the directional flow between symptoms and biological markers.
Key Findings
The DAG showed that the first symptom of low energy was part of the depressive symptom, followed by appetite or weight change and then hypersomnia.
These energy-related symptoms eventually linked to biological nodes representing diabetes, as well as markers of dyslipidemia and inflammation.
The waist circumference turned out to be the node with the highest centrality, therefore highlighting its critical position linking depressive symptoms to metabolic dysregulation.
The results for these associations were also robust in several sensitivity analyses, underlining the reliability of the findings.
This pathway links psychological features directly to metabolic and inflammatory processes, suggesting a biological mechanism underlying the bi-directional relationship between depression and cardiometabolic disease.
Energy-related depressive symptoms formed a predictive pathway to inflammation, dyslipidemia, and diabetes, with waist circumference as a central mediator. The identification of such links has presented new targets for clinical intervention in terms of reducing the cardiometabolic burden in depressed individuals. Addressing these intersecting biological and psychological factors may help lower the total morbidity associated with both depression and metabolic disease.
Reference:
Rydin, A. O., Milaneschi, Y., Lamers, F., Quax, R., van de Bunt, N., Koloi, A., Doornbos, B., & Penninx, B. W. J. H. (2025). Trajectories of depressive symptoms, metabolic syndrome, inflammation, and cardiometabolic diseases: A longitudinal Bayesian network approach. Brain, Behavior, and Immunity, 130(106120), 106120. https://doi.org/10.1016/j.bbi.2025.106120
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