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Prospective Associations Between Depressive Symptoms and the Metabolic Syndrome: the Spirited Life Study of Methodist Pastors in North Carolina

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Metabolic syndrome (Met-S) has a robust concurrent association with depression. A small, methodologically limited literature suggests that Met-S and depression are reciprocally related over time, an association that could contribute to their overlapping influences on morbidity and mortality in cardiovascular disease, diabetes, and cancer.

Purpose

Using a refined approach to the measurement of Met-S as a continuous latent variable comprising continuous components, this study tested the prospective associations between Met-S and depression.

Methods

This study of 1114 clergy included four annual assessments of depressive symptoms and Met-S components. Standard methods were used to measure Met-S risk factors, and the Patient Health Questionnaire-8 was used to assess depressive symptoms. We used confirmatory factor analysis to verify the structure of Met-S and depression and structural equation modeling to quantify the prospective relationships.

Results

The statistical models confirmed the validity of quantifying Met-S as a continuous latent variable, replicated previous evidence of a concurrent association, and indicated a significant prospective association of initial depressive symptoms with subsequent Met-S. Initial Met-S was at most only weakly associated with subsequent depressive symptoms, and the former prospective effect was significantly larger. Associations of depressive symptoms and Met-S were significant for both men and women, but somewhat stronger among men.

Conclusions

Results support representation of Met-S as a continuous latent variable. The association of initial depressive symptoms with later Met-S suggests that interventions addressing these correlated risk factors may prove useful in preventive efforts.

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Abbreviations

Met-S:

Metabolic syndrome

UMC:

United Methodist Church

PHQ-8:

Patient Health Questionnaire (8)

SEM:

Structural equation modeling

CFA:

Confirmatory factor analysis

CFI:

Comparative fit index

RMSEA:

Root mean square error approximation

FIML:

Full information maximum likelihood

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Acknowledgments

We wish to thank the Duke Clergy Health Initiative and its Principal Investigator, David Toole. Westat, Inc., was contracted for the collection of the survey data; health screenings were conducted by in-house project staff. This study was approved by the Arts and Sciences Institutional Review Board at Duke University. A previous version of this manuscript was presented at the annual meetings of the American Psychosomatic Association held in Charleston, SC, March 18–21, 2015.

Author Contributions

Dr. Proeschold-Bell and Dr. Eagle had full access to all the data in the study and take full responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Smith, Proeschold-Bell, Eagle. Acquisition, analysis and interpretation of data: Proeschold-Bell and Eagle. Drafting of manuscript: Smith, Eagle, Proeschold-Bell. Critical revision of the manuscript for important intellectual content: Smith. Statistical Analysis: Eagle. Obtained Funding: Proeschold-Bell. Study supervision: Proeschold-Bell

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Authors and Affiliations

  1. Department of Psychology, University of Utah, Salt Lake City, UT, USA

    Timothy W. Smith PhD

  2. Center for Health Policy and Inequalities Research, Duke University, PO Box 90392, Durham, NC, 27710, USA

    David E. Eagle PhD

  3. Duke Global Health Institute and Duke Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA

    Rae Jean Proeschold-Bell PhD

Authors
  1. Timothy W. Smith PhD
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  2. David E. Eagle PhD
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  3. Rae Jean Proeschold-Bell PhD
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Corresponding author

Correspondence to David E. Eagle PhD.

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Funding/Support

This study was funded by a grant from the Rural Church Area of The Duke Endowment. The Duke Endowment had no control over the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards Authors Smith, Eagle, and Proeschold-Bell declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

Additional information

All authors of this study contributed equally.

This study was approved by the Arts and Science Institutional Review Board at Duke University, Durham, NC, under protocol 2288.

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Smith, T.W., Eagle, D.E. & Proeschold-Bell, R.J. Prospective Associations Between Depressive Symptoms and the Metabolic Syndrome: the Spirited Life Study of Methodist Pastors in North Carolina. ann. behav. med. 51, 610–619 (2017). https://doi.org/10.1007/s12160-017-9883-3

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  • DOI: https://doi.org/10.1007/s12160-017-9883-3

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