Late-life depression, cortisol, and the metabolic syndrome

Am J Geriatr Psychiatry. 2009 Aug;17(8):716-21. doi: 10.1097/JGP.0b013e3181aad5d7.

Abstract

Objectives: High-cortisol levels in depressed persons could possibly give rise to the metabolic syndrome. This study investigated cross-sectionally whether depression and high-cortisol levels increased the odds of metabolic syndrome in an older community-based sample.

Methods: In 1,212 participants, aged > or =65 years, enrolled in the Longitudinal Aging Study Amsterdam, depression (major [1-month diagnosis] or subthreshold [no 1-month diagnosis, but symptoms]), metabolic syndrome (modified Adult Treatment Panel III criteria), and free cortisol index (total serum cortisol/cortisol binding globulin) were assessed.

Results: Major depression was not associated with the metabolic syndrome (odds ratio [OR] = 1.16, 95% confidence interval [CI] = 0.54-2.49), but subthreshold depression was associated with a decreased odds (OR = 0.55, 95% CI = 0.37-0.82). Persons with higher levels of free cortisol index showed a higher odds of metabolic syndrome (OR per standard deviation increase = 1.21, 95% CI = 1.06-1.39).

Conclusions: As persons with high-cortisol levels more often had metabolic syndrome, hypercortisolemia within depressed persons may increase the risk of metabolic syndrome.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / psychology*
  • Body Composition
  • Confidence Intervals
  • Cross-Sectional Studies
  • Depression / blood*
  • Depression / epidemiology
  • Depression / psychology
  • Female
  • Geriatric Assessment
  • Humans
  • Hydrocortisone / blood*
  • Logistic Models
  • Male
  • Metabolic Syndrome / blood*
  • Metabolic Syndrome / epidemiology
  • Odds Ratio
  • Psychiatric Status Rating Scales
  • Risk Factors

Substances

  • Hydrocortisone