Relations of Depression to Metabolic Risk Profile and Hormones in non-Clinical Samples
Date Issued
2007
Date
2007
Author(s)
Kuo, Shu-Yu
DOI
en-US
Abstract
Depression and obesity are both increasingly prevalent in different developmental stages. The nature of the relationships between depression and obesity, and other metabolic variables, however, remains inconclusive. The etiology underlying the depression-obesity link is also largely not clear. In this dissertation, three studies were carried out in order to investigate the nature of the association between depression and metabolic function in adolescents, and older adults, respectively; and to examine the underlying determinants of the association. A special focus will be made on the hormonal factors, such as cortisol and leptin, to examine their role in the association. Such a combination of detailed psychological assessments and physiological measurement is expected to help shed light on the interrelation of psychological well-being and metabolic function.
Study 1: Genetic Correlation between Anxious/Depression and Metabolic Risk Factors in Adolescents: A Multivariate Twin/Sibling Analysis
Background: To examine whether anxious/depression was associated with metabolic risk factors in non-referred adolescents and determine the relative influence of genetic and environmental factors underlying the association. The role of cortisol on the association was also investigated. Method: In a sample of same-sex twins (n = 183 pairs) and sib-pairs (n = 30 pairs) aged 12-18 recruited from middle schools in Taipei, anxious/depression was assessed using the Child Behavior Checklist. Metabolic phenotypes including body mass index (BMI), levels of glucose, insulin, high-density lipoprotein cholesterol (HDL-C), and blood pressure as well as cortisol levels were measured. Desired BMI was also examined. Multivariate genetic analyses were conducted using structural equation modeling. Results: The majority of participants fell within the category of normal weight (55%) or underweight (38%), of which 84% and 37%, respectively, wished to lose weight as revealed by the disparity between actual and desired weight. Higher scores in anxious/depression were associated with lower levels in BMI, desired BMI, and systolic blood pressure as well as with higher levels in HDL-C and, with a borderline significance level, mid-morning cortisol. There were genetic correlations between anxious/depression and BMI (rG = -0.14), desired BMI (rG = -0.18), systolic blood pressure (rG = -0.15), and the metabolic factor (rG = -0.19) derived from factor analysis. Conclusions: There was a small but significant genetic association between anxious/depression and certain metabolic risk factors, which was unlikely explained by cortisol levels, in adolescents mainly of normal- or under-weight. These provide new insights regarding the etiology of both anxious/depression and metabolic profiles.
Study 2: Genetic Correlations Between Leptin and Insulin Resistance Independent of Body Mass Index in Adolescents: A Multivariate Twin/Sibling Analysis
Background: Leptin levels are frequently correlated with insulin levels, blood pressure, even after adjustment for body mass index (BMI). Nonetheless, the extent to which genes or environmental factors contribute to the covariation among these traits has not been fully understood. We aimed to determine the relative influence of genetic and environmental factors underlying the associations between leptin and metabolic traits. Methods: A cross-sectional twin study was performed in 2002. Participants were recruited from middle schools in Taipei. A sample of monozygotic twins (n = 130 pairs), dizygotic twins (n= 68 pairs), and sib-pairs (n = 30 pairs) aged 12-18 was studied. Serum leptin levels and metabolic phenotypes including BMI, levels of fasting insulin, fasting glucose, and blood pressure were measured. Insulin resistance was determined by homeostasis model assessment (HOMA-IR). Multivariate genetic analyses were conducted using structural equation modeling. Results: Leptin, BMI, insulin, HOMA-IR, and systolic blood pressure tended to be genetically correlated with each other, with genetic correlation ranging from 0.25 to 0.66. After adjusting for BMI, the positive genetic correlations of leptin with insulin levels and HOMA-IR were attenuated but remained significant, while those of leptin, insulin, and HOMA-IR with systolic blood pressure disappeared. Multivariate modeling identified a common genetic factor influenced leptin, insulin, and HOMA-IR. Conclusions: Substantial genetic correlations between leptin and insulin as well as between leptin and insulin resistance were found. These results provide empirical evidence to include both leptin and insulin for future multivariate genetic analyses of metabolic function.
Study 3: Depression trajectories and obesity in a longitudinal study of elderly in Taiwan
Background: Depression and obesity are common in older adults. However, the course of depression changes over time and their relationship with obesity are not clear. We aimed to 1) characterize trajectories of depressive symptoms and identify predictors of trajectory classes; 2).determine the association between these trajectories and obesity as well as subsequent metabolic function and cortisol levels. Method: A prospective cohort study of older Taiwanese adults (n = 3922) was carried out between 1989 and 1999. Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Metabolic variables including body mass index (BMI), lipid profile, levels of glucose, and blood pressure as well as cortisol levels were measured. Trajectory analyses were conducted using semi-parametric group-based modeling. The associations between depression trajectories and baseline characteristics, and BMI categories were examined using multinomial logistic regression. Results: Four distinctive trajectories of depressive symptom were identified: class 1 (“persistent low”; 41.8 %), class 2 (“persistent mild”; 46.8 %), class 3 (“late peak”; 4.2 %), and class 4 (“high-chronic”; 7.2 %). Gender, educational level, regular exercise, chronic disease, and self-assessed health predicted development of trajectory pattern. The pattern of depression trajectory was inversely associated with BMI. Women with BMI≧25.0 were less likely to be in class 2, 3, and 4 (OR = 0.61, 0.48, 0.19 respectively). The odds for men with BMI <18.5 to develop class 3 and 4 were 3.24, and 4.14, respectively. High depressive symptoms were positively linked to subsequent high blood pressure and high levels of cortisol. Conclusions: There existed distinct classes of depressive symptoms changes over time. An inverse association for depression and BMI, while a positive association for depression and high blood pressure was found. These findings may be of interest to health professionals who wish to target depression and obesity to promote the well-being in late life.
Subjects
遺傳度
青少年
老年人
憂鬱
肥胖
新陳代謝指標
賀爾蒙
Heritability
adolescents
older adults
depression
obesity
metabolic profile
hormones
SDGs
Type
thesis
File(s)![Thumbnail Image]()
Loading...
Name
ntu-96-D91842002-1.pdf
Size
23.31 KB
Format
Adobe PDF
Checksum
(MD5):35e2c9d230dd80fa72bbaf16b5c8ce08