UK: Increased arterial stiffness (AS) increases the risk of depression in patients with metabolic syndrome (MetS), a recent study in the journal JAMA Psychiatry has suggested.
The findings suggest that combined data on metabolic syndrome and inflammation among depression patients may improve the early identification of future cardiovascular risk.
Metabolic syndrome is a cluster of health condition that occur together increasing the risk of type 2 diabetes (T2D) and cardiovascular disease. A patient is considered to have metabolic syndrome if he or she has at least three of the following conditions: abdominal obesity, high blood pressure, high blood sugar, low levels of "good" cholesterol, and high levels of triglycerides.
Arterial stiffness is the hardening of the artery wall due to ageing and diverse pathologic states and can be a mediator of a major cardiovascular event.
Previous research has linked a history of depression with arterial stiffness (AS) during midlife. Depression patients generally at an increased risk of major cardiovascular events, including coronary heart disease and stroke. Alex Dregan, King's College London, London, United Kingdom, and colleagues assess the association of depression with elevated midlife AS and to investigate the extent to which this association is mediated via metabolic syndrome.
The population-based cohort study included 124,445 patients between 40-69 years old who participated in the UK Biobank. Patients without data on arterial stiffness at baseline or who reported a previous diagnosis of cardiovascular disease were not eligible.
The team assessed a lifetime history of depression through a verbal interview and linked hospital-based clinical depression diagnosis. They defined metabolic syndrome as the presence of 3 or more of hypertension, dyslipidemia, hyperglycemia, hypertriglyceridemia, and unhealthy waist circumference.
Key findings of the study include:
- A total of 10 304 participants (8.3%) reported a history of depression.
- Study findings indicated a significant direct association between depression and ASI levels (β = 0.25).
- A significant indirect association was also observed between depression and ASI levels (β = 0.10), indicating that 29% of the association of depression with ASI was mediated by MetS.
- The proportion of mediation increased to 37% when C-reactive protein was added to the MetS criteria (direct association: β = 0.21; indirect association: β = 0.13).
- Concerning components of MetS, the strongest indirect association was for waist circumference, accounting for 25% of the association between depression and ASI levels (direct association: β = 0.26; indirect association: β = 0.09).
- Among men, hypertriglyceridemia accounted for 19% of the association between depression and ASI (direct association: β = 0.22; indirect association: β = 0.05).
"One-third of the association of depression with elevated ASI levels during midlife may be accounted for by combined MetS and inflammatory processes," wrote the authors. "Unhealthy waist circumference and hypertriglyceridemia emerged as the most important potential targets for preventive interventions within women and men, respectively."
The study, "Associations Between Depression, Arterial Stiffness, and Metabolic Syndrome Among Adults in the UK Biobank Population Study," was published online JAMA Psychiatry.
DOI: 10.1001/jamapsychiatry.2019.4712
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