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Depressive symptoms and serum lipid levels in young adult women

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Abstract

Accumulating data suggest that depression is associated with risk factors for cardiovascular disease, but few studies have investigated potential behavioral mediators of such associations, particularly among women. In this study of healthy young adult women (n = 225), we examined associations among depressive symptoms, health behaviors, and serum lipid levels. Depressive symptoms were assessed with the 20-item Center for Epidemiologic Studies-Depression scale, and a fasting blood sample was obtained for serum lipid levels, including total cholesterol, high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C). Diet was measured using 24-h recalls, and other health behaviors (physical activity, smoking) were assessed via self-report questionnaire. Results indicated a modest negative association between depressive symptoms and LDL-C levels. Higher levels of depressive symptoms were also associated with lower total and insoluble dietary fiber intake, both of which were associated with HDL-C and LDL-C. Mediational analyses indicated a significant indirect effect of depressive symptoms on LDL-C via total and insoluble dietary fiber in unadjusted analyses, but not in adjusted analyses. The present findings suggest that depressive symptoms are inversely associated with serum LDL-C levels in young adult women, but that these associations are not likely mediated by adverse lifestyle behaviors.

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Notes

  1. The six DISC clinical centers were located at Childrens’ Hospital, New Orleans, LA; Johns Hopkins Hospital, Baltimore, MD; Kaiser Permanente Center for Health Research, Portland, OR; New Jersey Medical School, Newark, NJ; Northwestern University Feinberg School of Medicine, Chicago, IL; and University of Iowa, Iowa City, IA; and the DISC coordinating center was located at Maryland Medical Research Institute, Baltimore, MD.

References

  • Ainsworth, B. E., Haskell, W. L., Whitt, M. C., Irwin, M. L., Swartz, A. M., Strath, S. J., et al. (2000). Compendium of physical activities: an update of activity codes and MET intensities. Medicine and Science in Sports and Exercise, 32, S498–S504.

    Article  PubMed  CAS  Google Scholar 

  • Brien, S. E., Ronksley, P. E., Turner, B. J., Mukamal, K. J., & Ghali, W. A. (2011). Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. British Medical Journal, 342. doi:10.1136/bmj.d636

  • Broms, U., Silventoinen, K., Lahelma, E., Koskenvuo, M., & Kaprio, J. (2004). Smoking cessation by socioeconomic status and marital status: The contribution of smoking behavior and family background. Nicotine & Tobacco Research, 6, 447–455. doi:10.1080/14622200410001696637

    Google Scholar 

  • Carnethon, M. R., Loria, C. M., Hill, J. O., Sidney, S., Savage, P. J., & Liu, K. (2004). Risk factors for the metabolic syndrome: The Coronary Artery Risk Development in Young Adults (CARDIA) study, 1985–2001. Diabetes Care, 27, 2707–2715. doi:10.2337/diacare.27.11.2707

  • Clevidence, B. A., Reichman, M. E., Judd, J. T., Muesing, R. A., Schatzkin, A., Schaefer, E. J., et al. (1995). Effects of alcohol consumption on lipoproteins of premenopausal women: A controlled diet study. Arteriosclerosis, Thrombosis, and Vascular Biology, 15, 179–184.

    Article  PubMed  CAS  Google Scholar 

  • Denke, M. A., Sempos, C. T., & Grundy, S. M. (1994). Excess body weight. An under-recognized contributor to dyslipidemia in white American women. Archives of Internal Medicine, 154, 401–410.

    Article  PubMed  CAS  Google Scholar 

  • DISC Collaborative Research Group. (1993). Dietary intervention study in children (DISC) with elevated low-density-lipoprotein cholesterol. Design and baseline characteristics. DISC Collaborative Research Group. Annals of Epidemiology, 3, 393–402.

    Article  Google Scholar 

  • Dorgan, J. F., Liu, L., Klifa, C., Hylton, N., Shepherd, J. A., Stanczyk, F. Z., et al. (2010). Adolescent diet and subsequent serum hormones, breast density, and bone mineral density in young women: Results of the Dietary Intervention Study in Children follow-up study. Cancer Epidemiology, Biomarkers and Prevention, 19, 1545–1556. doi:10.1158/1055-9965.EPI-09-1259

  • Engelberg, H. (1992). Low serum cholesterol and suicide. Lancet, 339, 727–729. doi:10.1016/0140-6736(92)90609-7

  • Fischer, P., Gruenblatt, E., Pietschmann, P., & Tragl, K. H. (2006). Serotonin transporter polymorphism and LDL-cholesterol. Molecular Psychiatry, 11, 707–709.

    Article  PubMed  CAS  Google Scholar 

  • Friedewald, W. T., Levy, R. I., & Fredrickson, D. S. (1972). Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clinical Chemistry, 18, 499–502.

    PubMed  CAS  Google Scholar 

  • Galobardes, B., Morabia, A., & Bernstein, M. S. (2001). Diet and socioeconomic position: Does the use of different indicators matter? International Journal of Epidemiology, 30, 334–340.

    Article  PubMed  CAS  Google Scholar 

  • Gary, T. L., Crum, R. M., Cooper-Patrick, L., Ford, D., & Brancati, F. L. (2000). Depressive symptoms and metabolic control in African-Americans with type 2 diabetes. Diabetes Care, 23, 23–29.

    Article  PubMed  CAS  Google Scholar 

  • Georgiou, C. C., Betts, N. M., Hoerr, S. L., Keim, K., Peters, P. K., Stewart, B., & Voichick, J. (1997). Among young adults, college students and graduates practiced more healthful habits and made more healthful food choices than did nonstudents. Journal of the American Dietetic Association, 97, 754–759. doi: 10.1016/S0002-8223(97)00187-9

    Google Scholar 

  • Golomb, B. A., Criqui, M. H., White, H. L., & Dimsdale, J. E. (2004). The UCSD Statin Study: A randomized controlled trial assessing the impact of statins on selected noncardiac outcomes. Controlled Clinical Trials, 25, 178–202.

    Article  PubMed  CAS  Google Scholar 

  • Gravely-Witte, S., Stewart, D. E., Suskin, N., & Grace, S. L. (2009). The association among depressive symptoms, smoking status and antidepressant use in cardiac outpatients. Journal of Behavioral Medicine, 32, 478–490. doi:10.1007/s10865-009-9218-3

    Google Scholar 

  • Gupta, R., Rastogi, P., Sarna, M., Gupta, V. P., Sharma, S. K., & Kothari, K. (2007). Body-mass index, waist-size, waist-hip ratio and cardiovascular risk factors in urban subjects. Journal of the Association of Physicians of India, 55, 621–627.

    PubMed  CAS  Google Scholar 

  • Harrell, F. E., Jr. (2001). Regression modeling strategies. New York: Springer.

    Book  Google Scholar 

  • Horsten, M., Wamala, S. P., Vingerhoets, A., & Orth-Gomer, K. (1997). Depressive symptoms, social support, and lipid profile in healthy middle-aged women. Psychosomatic Medicine, 59, 521–528.

    PubMed  CAS  Google Scholar 

  • Houston, M. C., Fazio, S., Chilton, F. H., Wise, D. E., Jones, K. B., Barringer, T. A., & Bramlet, D. A. (2009). Nonpharmacologic treatment of dyslipidemia. Progress in Cardiovascular Diseases, 52, 61–94. doi:10.1016/j.pcad.2009.02.002

  • Igna, C. V., Julkunen, J., Vanhanen, H., Keskivaara, P., & Verkasalo, M. (2008). Depressive symptoms and serum lipid fractions in middle-aged men: Physiologic and health behavior links. Psychosomatic Medicine, 70, 960–966. doi:10.1097/PSY.0b013e318189a942

    Google Scholar 

  • Imai, K., Keele, L., & Tingley, D. (2010). A general approach to causal mediation analysis. Psychological Methods, 15, 309–334. doi:10.1037/a0020761

    Google Scholar 

  • Kaplan, J. R., Shively, C. A., Fontenot, M. B., Morgan, T. M., Howell, S. M., Manuck, S. B., et al. (1994). Demonstration of an association among dietary cholesterol, central serotonergic activity, and social behavior in monkeys. Psychosomatic Medicine, 56, 479–484.

    PubMed  CAS  Google Scholar 

  • Katcher, H. I., Hill, A. M., Lanford, J. L. G., Yoo, J. S., & Kris-Etherton, P. M. (2009). Lifestyle approaches and dietary strategies to lower LDL-cholesterol and triglycerides and raise HDL-cholesterol. Endocrinology and Metabolism Clinics of North America, 38, 45–78. doi:10.1016/j.ecl.2008.11.010

    Google Scholar 

  • Kinder, L. S., Carnethon, M. R., Palaniappan, L. P., King, A. C., & Fortmann, S. P. (2004). Depression and the metabolic syndrome in young adults: Findings from the Third National Health and Nutrition Examination Survey. Psychosomatic Medicine, 66, 316–322.

    Article  PubMed  Google Scholar 

  • Kohlmeier, M. (1986). Direct enzymatic measurement of glycerides in serum and in lipoprotein fractions. Clinical Chemistry, 32, 63–66.

    PubMed  CAS  Google Scholar 

  • Kriska, A. M. (1997). Historical Leisure Activity Questionnaire. Medicine and Science in Sports and Exercise, 29, S43–S45.

    Google Scholar 

  • Kriska, A. M., Knowler, W. C., LaPorte, R. E., Drash, A. L., Wing, R. R., Blair, S. N., et al. (1990). Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians. Diabetes Care, 13, 401–411.

    Article  PubMed  CAS  Google Scholar 

  • Lamb, K. A., Lee, G. R., & DeMaris, A. (2003). Union formation and depression: Selection and relationship effects. Journal of Marriage and Family, 65, 953–962. doi:10.1111/j.1741-3737.2003.00953.x

    Google Scholar 

  • Leach, L., Christensen, H., Mackinnon, A., Windsor, T., & Butterworth, P. (2008). Gender differences in depression and anxiety across the adult lifespan: The role of psychosocial mediators. Social Psychiatry and Psychiatric Epidemiology, 43, 983–998. doi:10.1007/s00127-008-0388-z

    Google Scholar 

  • Lee, S., Cho, E., Grodstein, F., Kawachi, I., Hu, F. B., & Colditz, G. A. (2005). Effects of marital transitions on changes in dietary and other health behaviours in US women. International Journal of Epidemiology, 34, 69–78. doi:10.1093/ije/dyh258

    Google Scholar 

  • Lett, H. S., Blumenthal, J. A., Babyak, M. A., Sherwood, A., Strauman, T., Robins, C., et al. (2004). Depression as a risk factor for coronary artery disease: Evidence, mechanisms, and treatment. Psychosomatic Medicine, 66, 305–315.

    Article  PubMed  Google Scholar 

  • Lopez-Leon, S., Aulchenko, Y. S., Tiemeier, H., Oostra, B. A., van Duijn, C. M., & Janssens, A. C. J. W. (2010). Shared genetic factors in the co-occurrence of symptoms of depression and cardiovascular risk factors. Journal of Affective Disorders, 122, 247–252.

    Article  PubMed  Google Scholar 

  • Lopez-Leon, S., Janssens, A. C. J. W., Gonzalez-Zuloeta Ladd, A. M., Del-Favero, J., Claes, S. J., Oostra, B. A., et al. (2008). Meta-analyses of genetic studies on major depressive disorder. Molecular Psychiatry, 13, 772–785.

    Article  PubMed  CAS  Google Scholar 

  • Markovitz, J. H., Smith, D., Raczynski, J. M., Oberman, A., Williams, O. D., Knox, S., et al. (1997). Lack of relations of hostility, negative affect, and high-risk behavior with low plasma lipid levels in the Coronary Artery Risk Development in Young Adults Study. Archives of Internal Medicine, 157, 1953–1959.

    Article  PubMed  CAS  Google Scholar 

  • Martinez-Gonzalez, M. A., Fernandez-Garcia, J., Sanchez-Izquierdo, F., Lardelli-Claret, P., Jimenez Moleon, J., & Galvez-Vargas, R. (1998). Life-style factors associated with changes in serum lipids in a follow-up study of cardiovascular risk factors. European Journal of Epidemiology, 14, 525–533.

    Article  PubMed  CAS  Google Scholar 

  • Matsuzaki, Y., Kawaguchi, E., Morita, Y., et al. (1996). Evaluation of two kinds of reagents for direct determination of HDL-cholesterol. Journal of Analytical Bio-Science, 19, 419–427.

    Google Scholar 

  • McCaffery, J. M., Niaura, R., Todaro, J. F., Swan, G. E., & Carmelli, D. (2003). Depressive symptoms and metabolic risk in adult male twins enrolled in the National Heart, Lung, and Blood Institute twin study. Psychosomatic Medicine, 65, 490–497.

    Article  PubMed  Google Scholar 

  • Obarzanek, E., Hunsberger, S. A., Van Horn, L., Hartmuller, V. V., Barton, B. A., Stevens, V. J., et al. (1997). Safety of a fat-reduced diet: The Dietary Intervention Study in Children (DISC). Pediatrics, 100, 51–59.

    Article  PubMed  CAS  Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.

    Article  Google Scholar 

  • Schakel, S. F. (1997). Procedures for estimating nutrient values for food composition databases. Journal of Food Composition and Analysis, 10, 102–114.

    Article  CAS  Google Scholar 

  • Schoenborn, C. A. (2004). Marital status and health: United States, 1999–2002. Hyattsville, MD: National Center for Health Statistics.

    Google Scholar 

  • Schubert, C. M., Rogers, N. L., Remsberg, K. E., Sun, S. S., Chumlea, W. C., Demerath, E. W., et al. (2006). Lipids, lipoproteins, lifestyle, adiposity and fat-free mass during middle age: The Fels Longitudinal Study. International Journal of Obesity (London), 30, 251–260. doi:10.1038/sj.ijo.0803129

    Google Scholar 

  • Schulz, L. O., Harper, I. T., Smith, C. J., Kriska, A. M., & Ravussin, E. (1994). Energy intake and physical activity in Pima Indians: Comparison with energy expenditure measured by doubly-labeled water. Obesity Research, 2, 541–548.

    Article  PubMed  CAS  Google Scholar 

  • Shin, J. Y., Suls, J., & Martin, R. (2008). Are cholesterol and depression inversely related? A meta-analysis of the association between two cardiac risk factors. Annals of Behavioral Medicine, 36, 33–43. doi:10.1007/s12160-008-9045-8

    Google Scholar 

  • Shrivastava, S., Pucadyil, T. J., Paila, Y. D., Ganguly, S., & Chattopadhyay, A. (2010). Chronic cholesterol depletion using statin impairs the function and dynamics of human serotonin(1A) receptors. Biochemistry, 49, 5426–5435.

    Article  PubMed  CAS  Google Scholar 

  • Shrout, P. E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7, 422–445.

    Article  PubMed  Google Scholar 

  • Siedel, J., Hagele, E. O., Ziegenhorn, J., & Wahlefeld, A. W. (1983). Reagent for the enzymatic determination of serum total cholesterol with improved lipolytic efficiency. Clinical Chemistry, 29, 1075–1080.

    PubMed  CAS  Google Scholar 

  • Steegmans, P. H., Fekkes, D., Hoes, A. W., Bak, A. A., van der Does, E., & Grobbee, D. E. (1996). Low serum cholesterol concentration and serotonin metabolism in men. British Medical Journal (Clinical Research Edition), 312, 221.

    Article  CAS  Google Scholar 

  • Suarez, E. C. (1999). Relations of trait depression and anxiety to low lipid and lipoprotein concentrations in healthy young adult women. Psychosomatic Medicine, 61, 273–279.

    PubMed  CAS  Google Scholar 

  • Sugiuchi, H., Uji, Y., Okabe, H., Irie, T., Uekama, K., Kayahara, N., et al. (1995). Direct measurement of high-density lipoprotein cholesterol in serum with polyethylene glycol-modified enzymes and sulfated alpha-cyclodextrin. Clinical Chemistry, 41, 717–723.

    PubMed  CAS  Google Scholar 

  • Tomson, K., Merenäkk, L., Loit, H.-M., Mäestu, J., & Harro, J. (2011). The relationship between serotonin transporter gene promoter polymorphism and serum lipid levels at young age in a longitudinal population-representative study. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 35, 1857–1862. doi:10.1016/j.pnpbp.2011.08.004

  • Trost, S. G., Owen, N., Bauman, A. E., Sallis, J. F., & Brown, W. (2002). Correlates of adults’ participation in physical activity: Review and update. Medicine and Science in Sports and Exercise, 34, 1996–2001.

    Article  PubMed  Google Scholar 

  • Tsuboi, H., Tatsumi, A., Yamamoto, K., Kobayashi, F., Shimoi, K., & Kinae, N. (2006). Possible connections among job stress, depressive symptoms, lipid modulation and antioxidants. Journal of Affective Disorders, 91, 63–70.

    Article  PubMed  CAS  Google Scholar 

  • Vogelzangs, N., Suthers, K., Ferrucci, L., Simonsick, E. M., Ble, A., Schrager, M., et al. (2007). Hypercortisolemic depression is associated with the metabolic syndrome in late-life. Psychoneuroendocrinology, 32, 151–159.

    Article  PubMed  CAS  Google Scholar 

  • Whooley, M. A., de Jonge, P., Vittinghoff, E., Otte, C., Moos, R., Carney, R. M., et al. (2008). Depressive symptoms, health behaviors, and risk of cardiovascular events in patients with coronary heart disease. JAMA: The Journal of the American Medical Association, 300, 2379–2388. doi:10.1001/jama.2008.711

    Google Scholar 

  • Williams, R. L. (2000). A note on robust variance estimation for cluster-correlated data. Biometrics, 56, 645–646.

    Article  PubMed  CAS  Google Scholar 

  • Wood, R. G., Goesling, B., & Avellar, S. (2007). The effects of marriage on health: Synthesis of current research evidence. In U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Planning and Evaluation (ASPE) & Office of Human Services Policy (HSP) (Eds.). Washington, D.C.

  • Wulsin, L. R., & Singal, B. M. (2003). Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosomatic Medicine, 65, 201–210.

    Article  PubMed  Google Scholar 

  • Yamamoto, A., Temba, H., Horibe, H., Mabuchi, H., Saito, Y., Matsuzawa, Y., et al. (2003). Life style and cardiovascular risk factors in the Japanese population—From an epidemiological survey on serum lipid levels in Japan 1990 part 2: Association of lipid parameters with hypertension. Journal of Atherosclerosis and Thrombosis, 10, 176–185.

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was supported by grants P30CA006927 and R01CA104670 from the National Institutes of Health. We thank Dr. Bruce Barton and the Maryland Medical Research Institute for overseeing data management for this study and Dr. John Himes for his assistance with the dietary data variables. We would also like to thank the DISC06 participants for their continuing participation.

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Authors and Affiliations

  1. Cancer Prevention and Control Program, Fox Chase Cancer Center, Robert C. Young Pavilion, 4th Floor, 333 Cottman Avenue, Philadelphia, PA, 19111, USA

    Carolyn Y. Fang & Margaret L. Longacre

  2. Department of Biostatistics and Bioinformatics, Fox Chase Cancer Center, Reimann Building, 333 Cottman Avenue, Philadelphia, PA, 19111, USA

    Brian L. Egleston

  3. Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health Austin Regional Campus, University of Texas Administration Building (UTA), The University of Texas Health Science Center at Houston, 1616 Guadalupe Street, Suite 6.300, Austin, TX, 78701, USA

    Kelley Pettee Gabriel

  4. Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA

    Victor J. Stevens

  5. Lipid Research/Atherosclerosis Unit, Departments of Pediatrics and Medicine, Johns Hopkins University School of Medicine, David M. Rubenstein Child Health Building, 200 North Wolfe St., Room 3093, Baltimore, MD, 21287, USA

    Peter O. Kwiterovich Jr.

  6. Department of Epidemiology, College of Public Health, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    Linda G. Snetselaar

  7. Women’s Cancer Program, Fox Chase Cancer Center, Robert C. Young Pavilion, 4th Floor, 333 Cottman Avenue, Philadelphia, PA, 19111, USA

    Joanne F. Dorgan

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  1. Carolyn Y. Fang
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Fang, C.Y., Egleston, B.L., Gabriel, K.P. et al. Depressive symptoms and serum lipid levels in young adult women. J Behav Med 36, 143–152 (2013). https://doi.org/10.1007/s10865-012-9409-1

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