Journal
PSYCHOSOMATIC MEDICINE
Volume 71, Issue 4, Pages 410-416Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PSY.0b013e3181a20c9c
Keywords
abdominal obesity; depressive symptoms; African-American; women's health; cardiovascular disease
Categories
Funding
- NHLBI NIH HHS [R01 HL067128-02, R01 HL067128-05, R01 HL067128-04, R01 HL067128-01A1, R01 HL067128-03, HL067128, R01 HL067128, R01 HL067128-02S1] Funding Source: Medline
- NIA NIH HHS [U01 AG012495-12, AG012539, U01 AG012539-07, AG012531, U01 AG012495, U01 AG012531-07, U01 AG012554, U01 AG012535, U01 AG012505-08, U01 AG012553, U01 AG012539, AG012495, U01 AG012546, U01 AG012505, AG012554, U01 AG012535-07, AG012553, U01 AG012546-08, AG012546, U01 AG012554-08, AG012535, AG012505, U01 AG012531, U01 AG012553-11] Funding Source: Medline
- NIMH NIH HHS [MH075625, R13 MH075625, R13 MH075625-02] Funding Source: Medline
- NINR NIH HHS [U01 NR004061, NR004061, U01 NR004061-06] Funding Source: Medline
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Objective: To examine whether depressive symptoms are differentially associated with visceral adipose tissue (VAT), which is more metabolically active and confers greater cardiovascular risk than subcutaneous fat (SAT). Prior research has shown an association between depression and central adiposity. Mechanisms underlying the association between depression and increased cardiovascular risk remain poorly understood. Central adiposity is one potential pathway. Methods: We investigated the cross-sectional association between depressive symptoms, assessed by the Center for Epidemiological Studies Depression Scale (CES-D), and VAT and SAT, assessed by computed tomography, in a sample of 409 middle-aged women (44.7% African-Americans, 55.3% Whites; mean age = 50.4 years) participating in the Chicago site of the Study of Women's Health Across the Nation (SWAN). Results: With adjustments forage, race, total percent fat, and sex hormone binding globulin (SHBG), each 1-point higher score on the CES-D was associated with 1.03-cm(2) greater VAT (p < .001). Women with a CES-D score of >= 16, indicative of clinically relevant depressive symptomatology, had 24.5% more VAT than women with lower CES-D scores (p < .001). Further adjustment for Framingham Risk Score and physical activity did not alter the findings, and associations did not vary by race. Associations were strongest in obese and overweight women. Depressive symptoms were unrelated to SAT. Conclusions: Increased visceral fat may be one pathway by which depression contributes to excess risk for cardiovascular disease and diabetes. Further research is needed to examine whether depressive symptoms influence accumulation of VAT over time.
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