Skip to main content
SpringerLink
Log in

Leptin and its Association with Somatic Depressive Symptoms in Patients with the Metabolic Syndrome

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

This study aimed to determine the association between circulating leptin levels and total depressive symptoms as well as depressive symptom dimensions (cognitive and somatic) after controlling for important confounding factors.

Methods

The study sample was comprised of 135 participants with the metabolic syndrome. Depressive symptoms were measured using the Beck Depression Inventory—II. Leptin was measured using a leptin-specific enzyme immunoassay. Inflammation was assessed using C-reactive protein and interleukin-6 levels.

Results

Leptin was significantly associated with somatic depressive symptoms (β = 0.33, P = 0.018), but not total depressive symptoms (β = 0.27, P = 0.067) or cognitive depressive symptoms (β = 0.21, P = 0.182), after controlling for age, gender, body mass index, and insulin resistance. Further adjustment for C-reactive protein and interleukin-6 levels did not alter the relationship (β = 0.32, P = 0.023) between circulating leptin levels and somatic depressive symptoms.

Conclusions

Leptin is independently associated with somatic depressive symptoms in patients with the metabolic syndrome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome—A new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med. 2006;23:469-480.

    Article  PubMed  CAS  Google Scholar 

  2. Isomaa B, Almgren P, Tuomi T, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001;24:683-689.

    Article  PubMed  CAS  Google Scholar 

  3. Lorenzo C, Okoloise M, Williams K, Stern MP, Haffner SM. The metabolic syndrome as predictor of type 2 diabetes: The San Antonio heart study. Diabetes Care. 2003;26:3153-3159.

    Article  PubMed  Google Scholar 

  4. Skilton MR, Moulin P, Terra JL, Bonnet F. Associations between anxiety, depression, and the metabolic syndrome. Biol Psychiatry. 2007;62:1251-1257.

    Article  PubMed  CAS  Google Scholar 

  5. Raikkonen K, Matthews KA, Kuller LH. Depressive symptoms and stressful life events predict metabolic syndrome among middle-aged women: A comparison of World Health Organization, Adult Treatment Panel III, and International Diabetes Foundation definitions. Diabetes Care. 2007;30:872-877.

    Article  PubMed  Google Scholar 

  6. Jonas BS, Franks P, Ingram DD. Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Arch Fam Med. 1997;6:43-49.

    Article  PubMed  CAS  Google Scholar 

  7. Nouwen A, Nefs G, Caramlau I, et al. Prevalence of depression in individuals with impaired glucose metabolism or undiagnosed diabetes: A systematic review and meta-analysis of the European Depression in Diabetes (EDID) Research Consortium. Diabetes Care. 2011;34:752-762.

    Article  PubMed  Google Scholar 

  8. Faith MS, Butryn M, Wadden TA, et al. Evidence for prospective associations among depression and obesity in population-based studies. Obes Rev. 2011;12:e438-e453.

    Article  PubMed  CAS  Google Scholar 

  9. Wellen KE, Hotamisligil GS. Inflammation, stress, and diabetes. J Clin Invest. 2005;115:1111-1119.

    PubMed  CAS  Google Scholar 

  10. Suarez EC. C-reactive protein is associated with psychological risk factors of cardiovascular disease in apparently healthy adults. Psychosom Med. 2004;66:684-691.

    Article  PubMed  CAS  Google Scholar 

  11. Shelton RC, Miller AH. Eating ourselves to death (and despair): The contribution of adiposity and inflammation to depression. Prog Neurobiol. 2010;91:275-299.

    Article  PubMed  CAS  Google Scholar 

  12. Capuron L, Su S, Miller AH, et al. Depressive symptoms and metabolic syndrome: Is inflammation the underlying link? Biol Psychiatry. 2008;64:896-900.

    Article  PubMed  CAS  Google Scholar 

  13. Miller GE, Freedland KE, Carney RM, Stetler CA, Banks WA. Pathways linking depression, adiposity, and inflammatory markers in healthy young adults. Brain Behav Immun. 2003;17:276-285.

    Article  PubMed  CAS  Google Scholar 

  14. Wozniak SE, Gee LL, Wachtel MS, Frezza EE. Adipose tissue: The new endocrine organ? A review article. Dig Dis Sci. 2009;54:1847-1856.

    Article  PubMed  Google Scholar 

  15. Lu XY. The leptin hypothesis of depression: A potential link between mood disorders and obesity? Curr Opin Pharmacol. 2007;7:648-652.

    Article  PubMed  CAS  Google Scholar 

  16. Duman RS, Monteggia LM. A neurotrophic model for stress-related mood disorders. Biol Psychiatry. 2006;59:1116-1127.

    Article  PubMed  CAS  Google Scholar 

  17. Gutt M, Davis CL, Spitzer SB, et al. Validation of the insulin sensitivity index (ISI(0,120)): Comparison with other measures. Diabetes Res Clin Pract. 2000;47:177-184.

    Article  PubMed  CAS  Google Scholar 

  18. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412-419.

    Article  PubMed  CAS  Google Scholar 

  19. Collins LM, Schafer JL, Kam CM. A comparison of inclusive and restrictive strategies in modern missing data procedures. Psychol Methods. 2001;6:330-351.

    Article  PubMed  CAS  Google Scholar 

  20. Antonijevic IA, Murck H, Frieboes RM, et al. Elevated nocturnal profiles of serum leptin in patients with depression. J Psychiatr Res. 1998;32:403-410.

    Article  PubMed  CAS  Google Scholar 

  21. Pasco JA, Jacka FN, Williams LJ, et al. Leptin in depressed women: Cross-sectional and longitudinal data from an epidemiologic study. J Affect Disord. 2008;107:221-225.

    Article  PubMed  CAS  Google Scholar 

  22. Labad J, Price JF, Strachan MW, et al. Leptin levels and depressive symptoms in people with type 2 diabetes: The Edinburgh type 2 diabetes study. Psychosom Med. 2012;74:39-45.

    Article  PubMed  CAS  Google Scholar 

  23. Dozois DJ, Dobson KS, Ahnberg JL. A psychometric evaluation of the Beck Depression Inventory—II. Psychol Assess. 1998;10:83-89.

    Article  Google Scholar 

  24. Lorton D, Lubahn CL, Estus C, et al. Bidirectional communication between the brain and the immune system: Implications for physiological sleep and disorders with disrupted sleep. Neuroimmunomodulation. 2006;13:357-374.

    Article  PubMed  CAS  Google Scholar 

  25. Kupper N, Widdershoven JW, Pedersen SS. Cognitive/affective and somatic/affective symptom dimensions of depression are associated with current and future inflammation in heart failure patients. J Affect Disord. 2012;136:567-576.

    Article  PubMed  Google Scholar 

  26. de Jonge P, Ormel J, van den Brink RH, et al. Symptom dimensions of depression following myocardial infarction and their relationship with somatic health status and cardiovascular prognosis. Am J Psychiatry. 2006;163:138-144.

    Article  PubMed  Google Scholar 

  27. Doyle F, Conroy R, McGee H, Delaney M. Depressive symptoms in persons with acute coronary syndrome: Specific symptom scales and prognosis. J Psychosom Res. 2010;68:121-130.

    Article  PubMed  Google Scholar 

  28. Hoen PW, Whooley MA, Martens EJ, et al. Differential associations between specific depressive symptoms and cardiovascular prognosis in patients with stable coronary heart disease. J Am Coll Cardiol. 2010;56:838-844.

    Article  PubMed  Google Scholar 

  29. Linke SE, Rutledge T, Johnson BD, et al. Depressive symptom dimensions and cardiovascular prognosis among women with suspected myocardial ischemia: A report from the National Heart, Lung, and Blood Institute-sponsored Women’s Ischemia Syndrome Evaluation. Arch Gen Psychiatry. 2009;66:499-507.

    Article  PubMed  Google Scholar 

  30. Martens EJ, Hoen PW, Mittelhaeuser M, de Jonge P, Denollet J. Symptom dimensions of post-myocardial infarction depression, disease severity and cardiac prognosis. Psychol Med. 2010;40:807-814.

    Article  PubMed  CAS  Google Scholar 

  31. Roest AM, Thombs BD, Grace SL, et al. Somatic/affective symptoms, but not cognitive/affective symptoms, of depression after acute coronary syndrome are associated with 12-month all-cause mortality. J Affect Disord. 2011;131:158-163.

    Article  PubMed  Google Scholar 

  32. Schiffer AA, Pelle AJ, Smith OR, et al. Somatic versus cognitive symptoms of depression as predictors of all-cause mortality and health status in chronic heart failure. J Clin Psychiatry. 2009;70:1667-1673.

    Article  PubMed  Google Scholar 

  33. Smolderen KG, Spertus JA, Reid KJ, et al. The association of cognitive and somatic depressive symptoms with depression recognition and outcomes after myocardial infarction. Circ Cardiovasc Qual Outcomes. 2009;2:328-337.

    Article  PubMed  Google Scholar 

  34. Stewart JC, Janicki DL, Muldoon MF, Sutton-Tyrrell K, Kamarck TW. Negative emotions and 3-year progression of subclinical atherosclerosis. Arch Gen Psychiatry. 2007;64:225-233.

    Article  PubMed  Google Scholar 

  35. Munzberg H, Bjornholm M, Bates SH, Myers MG Jr. Leptin receptor action and mechanisms of leptin resistance. Cell Mol Life Sci. 2005;62:642-652.

    Article  PubMed  CAS  Google Scholar 

  36. Hafner S, Baumert J, Emeny RT, et al. Sleep disturbances and depressed mood: A harmful combination associated with increased leptin levels in women with normal weight. Biol Psychol. 2012;89:163-169.

    Article  PubMed  CAS  Google Scholar 

  37. Vgontzas AN, Bixler EO, Chrousos GP. Sleep apnea is a manifestation of the metabolic syndrome. Sleep Med Rev. 2005;9:211-224.

    Article  PubMed  Google Scholar 

  38. Hayano J, Carney RM, Watanabe E, et al. Interactive associations of depression and sleep apnea with adverse clinical outcomes after acute myocardial infarction. Psychosom Med. 2012;74:832-839.

    Article  PubMed  Google Scholar 

  39. Morris AA, Ahmed Y, Stoyanova N, et al. The association between depression and leptin is mediated by adiposity. Psychosom Med. 2012;74:483-488.

    Article  PubMed  CAS  Google Scholar 

  40. Cizza G, Ronsaville DS, Kleitz H, et al. Clinical subtypes of depression are associated with specific metabolic parameters and circadian endocrine profiles in women: The power study. PLoS One. 2012;7:e28912.

    Article  PubMed  CAS  Google Scholar 

  41. Herva A, Laitinen J, Miettunen J, et al. Obesity and depression: Results from the longitudinal Northern Finland 1966 Birth Cohort Study. Int J Obes (Lond). 2006;30:520-527.

    Article  CAS  Google Scholar 

  42. Herva A, Rasanen P, Miettunen J, et al. Co-occurrence of metabolic syndrome with depression and anxiety in young adults: The Northern Finland 1966 Birth Cohort Study. Psychosom Med. 2006;68:213-216.

    Article  PubMed  Google Scholar 

  43. Fulton S, Pissios P, Manchon RP, et al. Leptin regulation of the mesoaccumbens dopamine pathway. Neuron. 2006;51:811-822.

    Article  PubMed  CAS  Google Scholar 

  44. Ahima RS, Bjorbaek C, Osei S, Flier JS. Regulation of neuronal and glial proteins by leptin: Implications for brain development. Endocrinology. 1999;140:2755-2762.

    Article  PubMed  CAS  Google Scholar 

  45. Plotsky PM, Owens MJ, Nemeroff CB. Psychoneuroendocrinology of depression. Hypothalamic–pituitary–adrenal axis. Psychiatr Clin North Am. 1998;21:293-307.

    Article  PubMed  CAS  Google Scholar 

  46. Sandoval DA, Davis SN. Leptin: Metabolic control and regulation. J Diabetes Complications. 2003;17:108-113.

    Article  PubMed  Google Scholar 

  47. Guo M, Huang TY, Garza JC, Chua SC, Lu XY. Selective deletion of leptin receptors in adult hippocampus induces depression-related behaviours. Int J Neuropsychopharmacol. In press. doi:10.1017/S1461145712000703.

  48. Guo M, Lu Y, Garza JC, et al. Forebrain glutamatergic neurons mediate leptin action on depression-like behaviors and synaptic depression. Transl Psychiatry. 2012;2:e83.

    Article  PubMed  Google Scholar 

  49. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: Findings from the third National Health and Nutrition Examination Survey. JAMA. 2002;287:356-359.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by National Institutes of Health grant P01 HL365888.

Conflict of Interest

The authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Miami, P.O. Box 248185, Coral Gables, FL, 33124-0751, USA

    Diana A. Chirinos M.S., Marc Gellman Ph.D., Judith R. McCalla Ph.D., Maria M. Llabre Ph.D. & Neil Schneiderman Ph.D.

  2. Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA

    Ronald Goldberg M.D., Armando J. Mendez Ph.D. & Miriam Gutt Ph.D.

Authors
  1. Diana A. Chirinos M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ronald Goldberg M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marc Gellman Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Armando J. Mendez Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Miriam Gutt Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Judith R. McCalla Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Maria M. Llabre Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Neil Schneiderman Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Diana A. Chirinos M.S..

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

ESM 1

(DOC 47 kb)

About this article

Cite this article

Chirinos, D.A., Goldberg, R., Gellman, M. et al. Leptin and its Association with Somatic Depressive Symptoms in Patients with the Metabolic Syndrome. ann. behav. med. 46, 31–39 (2013). https://doi.org/10.1007/s12160-013-9479-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12160-013-9479-5

Keywords

Search

Navigation