Abstract P082: Lower Adiponectin Levels May Underlie Association Between Depressive Symptoms And Markers of Cardiometabolic Health
Introduction: Depressive symptoms have been linked to CVD risk factors, including metabolic dysregulation. One pathway by which depression may influence CVD risk is via alterations in adiponectin, an abundant adipocytokine with anti-inflammatory effects. This mechanism has not been studied in population-based samples.
Hypothesis: The relationship of depressive symptoms with metabolic syndrome (MetSyn) and Framingham Risk Score (FRS) will be partly mediated by adiponectin.
Methods: Participants were 581 women (61.3% white; 38.7% black) from the Chicago and Pittsburgh sites of the Study of Women’s Health Across the Nation. Adiponectin was measured from stored serum specimens and assayed in duplicate using a commercially available enzyme linked immunosorbent assay and log transformed for analysis. Depressive symptoms were measured with the 20-item Center for Epidemiological Studies Depression Scale (CES-D); a standard cutoff (>16) was used to determine clinically significant symptoms. MetSyn was defined by ATP-III criteria and considered present if the participant had at least 3 of the following: waist circumference >88cm; triglycerides >150 mg/dl; HDL cholesterol < 50 mg/dl; blood pressure > 130 mmHg systolic and / or 85 mmHg diastolic; impaired fasting glucose (>110 mg/dl) or diabetes. The FRS was defined by the participant’s age, smoking status, blood pressure, cholesterol, and use of anti-hypertensives. Logistic regression models were constructed to examine the cross-sectional relationship between depressive symptoms and MetSyn controlling for age, race and study site. A subsequent model included adiponectin to evaluate whether it attenuated the observed association. Linear regression models were used to conduct the same analysis with FRS as the outcome. Due to missing values, analytic sample sizes were 558 for MetSyn and 568 for FRS.
Results: 147 women (25.3%) had elevated CES-D scores and 113 (20.7%) met criteria for MetSyn. Average FRS was 8.7 (sd=4.6) and the mean, untransformed adiponectin value was 9.9 (sd=4.9) μ g/mL. In models adjusted for age, race, and study site, women with high CES-D scores had increased odds of MetSyn (OR=1.64; 95% CI=1.03, 2.60) and a higher FRS (estimate=0.98; se=0.41, p<.02). Separate bivariate analyses showed that adiponectin was inversely related to CES-D scores (p=.03), MetSyn (p<.001) and FRS (p<.001). Subsequently including adiponectin in the regression models attenuated the associations between CES-D and MetSyn (OR=1.45; 95% CI=0.89, 2.36) and FRS (estimate=0.76; se=0.41; p=.06).
Conclusions: Adiponectin may partially explain the relation between depressive symptoms and measures of cardiometabolic health. Longitudinal studies are needed to more fully understand the temporality of these associations. Supported by NIH/DHHS grants HL091290, AG012505, AG012546, MH59770, AG17719.
- © 2012 by American Heart Association, Inc.