An interesting finding appears in the new issue of Archives of General Psychiatry (Volume 65 Number 12). Lead author Nicole Vogelzangs, MSc and colleagues report that there may be specific pathophysiological mechanisms that link depression with visceral fat accumulation...
The full article, "Depressive Symptoms and Change in Abdominal Obesity in Older Persons" discusses the hypothesis that Context Depression results in abdominal obesity through the accumulation of visceral fat. Yet no large study has tested this hypothesis longitudinally.
Thus, the objective of the study by Vogelzangs, et al., was to examine whether depressive symptoms predict an increase in abdominal obesity in a large population-based sample of well-functioning
older persons.
Here are some of the details:
- Design: The Health, Aging, and Body Composition Study, an ongoing prospective cohort study with 5 years of follow-up.
- Setting: Community-dwelling older persons residing in the areas surrounding Pittsburgh, Pennsylvania, and Memphis, Tennessee.
- Participants A total of 2088 well-functioning white and black persons aged 70 to 79 years.
- Main Outcome Measures: Baseline depression was defined as a Center for Epidemiological Studies Depression score of 16 or higher. At baseline and after 5 years, overall obesity measures included body mass index (calculated as weight in kilograms divided by height in meters squared) and percentage of body fat (measured by dual-energy x-ray absorptiometry). Abdominal obesity measures included waist circumference, sagittal diameter, and visceral fat (measured by computed tomography).
- Results: After adjustment for socio-demographics, lifestyle, diseases, and overall obesity, baseline depression was associated with a 5-year increase in sagittal diameter (beta = .054; P = .01) and visceral fat (beta = .080; P = .001).
Through their research, the authors were able to draw the following conclusions...depressive symptoms result in an increase in abdominal obesity independent of overall obesity, suggesting
that there may be specific pathophysiological mechanisms that link depression with visceral fat accumulation.
These results might also help explain why depression increases the risk of diabetes and cardiovascular
disease.
Which leads me to another important recent study which shows that depression prevents glucose control in Type 2 Diabetes patients.
"Diabetes in Control" is a free newsletter that provides information about the condition to medical pprofessionals. Issue #444 includes an article that reports about new research which suggests that 30%of patients with Type 2 diabetes have depression and that their depressive symptoms are aassociated with higher blood glucose levels over time.
Here is an excerpt: "Our study shows depression is a major and important co-morbidity in people with type 2 diabetes. The fact that the difference persisted over time and that the depressed group had higher mean HbA1c at all 36 time points was surprising," study coauthor Leonard Egede, MD, MS, from
the Medical University of South Carolina in Charleston, said in a statement.
Dr. Egede added that this difference is "quite significant" and is enough to push individuals with diabetes over the optimal threshold for glucose control and increase their risk for poor outcomes."
Co-morbid depression occurs in approximately 30% of adults with diabetes and is associated with poor metabolic control, higher complication rates, increased healthcare use and costs, poorer quality of life, and increased disability and mortality rates.
The study authors point out that although there is a great deal of literature reporting the association between depression and diabetes outcomes, to date, none of the research has examined the effects of
depression on glycemic control in adults with type 2 diabetes with time.
The article continues..."It is noteworthy that this study found a significant association
between depression and glycemic control over time even in a sample with relatively well-controlled diabetes. This suggests that in populations with higher baseline HbA1c, the magnitude of association may be much higher," the study authors write. Among depressed participants, the change in HbA1c levels did not differ according to race or age."
Another article in the same issue reports a related effect of Type 2 Diabetes in that it appears to also slow mental processing speed, something we frequently observe in depressed individuals.
Important considerations, given the high rates of depression and diabetes among our eating disorders patients...
Comments