Depression is a risk factor for metabolic syndrome: Results from the ELSA-Brasil cohort study

Introduction: Metabolic Syndrome (MetS) and depression comorbidity has been recognized, but its directionality is still uncertain. The aims of this study was to assess the association between depression (diagnosis and severity) and MetS (components, diagnosis and trajectory) in the baseline and over a 4-year follow-up period. Material and methods: Baseline and follow-up data from 13,883 participants of the Brazilian Longitudinal Study of Adult Health were analyzed. The Clinical Interview Schedule Revised assessed depressive episode and its severity. MetS components and diagnosis were assessed according to the National Cholesterol Education Program Adult Treatment Panel III. Participants were grouped according to MetS trajectory as recovered, incident and persistent MetS. Logistic regression analysis was conducted estimating odds ratios (OR) and 95% confidence intervals (95% CI). Results: Baseline depression was positively associated with recovered (OR = 1.59, 95%CI 1.18-2.14), inci-dent (OR = 1.45, 95%CI 1.09-1.91) and persistent (OR = 1.70, 95%CI 1.39-2.07) MetS. Baseline depression was also associated with large waist circumference (OR = 1.47, 95%CI 1.23-1.75), high triglycerides (OR = 1.23, 95%CI 1.02-1.49), low high-density lipoprotein cholesterol (OR = 1.30, 95%CI 1.08-1.56), and hyperglycemia (OR = 1.38, 95%CI 1.15-1.66) at follow-up. Having three or more MetS components at follow-up was associated with baseline depression, with a positive dose-response effect (OR = 1.77, 95%CI 1.29-2.43; OR = 1.79, 95%CI 1.26-2.54; OR = 2.27, 95%CI 1.50-3.46, respectively). The magnitude of associations was greater in severe depression, when compared to moderate and mild. Discussion: These results support that depression is a risk factor for the development of MetS and highlights the need to follow metabolic and cardiovascular alterations in the presence of depression.

Automated summary

This study aimed to assess the association between depression and Metabolic Syndrome (MetS). The results showed that baseline depression was positively associated with recovered, incident, and persistent MetS. Baseline depression was also associated with specific components of MetS at follow-up, such as large waist circumference, high triglycerides, low high-density lipoprotein cholesterol, and hyperglycemia. The presence of three or more MetS components at follow-up was strongly associated with baseline depression. These findings suggest that depression is a risk factor for the development of MetS and emphasize the importance of monitoring metabolic and cardiovascular alterations in individuals with depression.