Metabolic syndrome in patients suffering from major depression

The accumulation of visceral fat is promoted by a specific endocrine syndrome, the metabolic syndrome, which is similar to endocrine changes found in major depression. The aim of this study was to investigate whether visceral fat depots increase in depressed patients during a follow-up period of about one year since we demonstrated previously larger abdominal fat masses in hypercortisolemic patients.

Intraabdominal fat was measured in 27 depressed patients and 26 age-matched healthy volunteers by CT at the level of lumbar vertebra 4. In patients fat measurements were done first during a major depressive episode and second after a follow-up period of 14 months; in controls the mean time interval between the two CT-measures was 29 months. Saliva was taken in patients and controls at 0800 hrs over a period of 7 days prior to each CT for the estimation of free cortisol. In patients only, an OGTT was carried out.

The major finding of the present study is a larger accumulation of visceral fat mass over time in depressed patients (index vs. follow-up; 120.5±50.7 vs. 136.8±48.5 cm², p<0.001) compared to controls (134.5±74 vs. 132.8±71 cm², p=0.8). Glucose concentrations during the OGTT were significantly higher in hypercortisolemic compared to normocortisolemic patients at follow-up.

The larger proportion of visceral fat accumulation in patients may constitute a link for explaining the increased cardiovascular mortality in patients suffering from major depression.