Components of the metabolic syndrome and depressive symptoms in community-dwelling older people: the Bambuí Cohort Aging Study

Ruas, Luiz Gustavo; Diniz, Breno S.; Firmo, Josélia O.; Peixoto, Sérgio V.; Mambrini, Juliana V.; Loyola-Filho, Antônio Ignácio de; Lima-Costa, Maria Fernanda; Castro-Costa, Érico

doi:10.1590/1516-4446-2015-1856

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Brazilian Journal of Psychiatry

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Original Articles • Rev. Bras. Psiquiatr. 38 (3) • Jul-Sep 2016 • https://doi.org/10.1590/1516-4446-2015-1856 copy

Components of the metabolic syndrome and depressive symptoms in community-dwelling older people: the Bambuí Cohort Aging Study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

To investigate the moderating effect of an increasing number of clustered metabolic syndrome (MetS) components on the association between MetS and depressive symptoms in a population-based cohort of older adults in Brazil.

Methods:

This analysis used data from the Bambuí Cohort Aging Study. Participants in this cross-sectional study comprised 1,469 community-dwelling older people aged ≥ 60 years. Analyses were performed to assess both the association between depressive symptoms and each individual MetS component and the association between depressive symptoms and clustering of an increasing number of MetS components.

Results:

High triglyceride level was the individual component that showed the strongest association with depressive symptoms (odds ratio [OR]: 1.47; 95% confidence intervals [95%CI] 1.19-1.81; p < 0.0001). Only the presence of three MetS components was associated with depressive symptoms (OR = 1.53; 95%CI 1.05-2.23; p = 0.025). No graded association was detected between increasing number of clustered MetS components and depressive symptoms.

Conclusions:

Increasing the number of MetS components did not impact the association with depressive symptoms. The association between high triglyceride level and depressive symptoms highlights the relevance of lipid metabolism abnormalities for the emergence of depressive symptoms in older adults.

Metabolic syndrome; depressive symptoms; elderly; population-based

	Depressive symptoms
	Total(n=1,469)	1st tertile(n=507)	2nd tertile(n=512)	3rd tertile(n=450)	p-value^* * p-value = ANOVA, test for trend, and Kruskal-Wallis test for differences between means, frequencies, and medians respectively.
MetS component
High fasting plasma glucose	49.1	48.9	51.3	46.8	0.387
High blood pressure	38.5	39.9	37.7	37.8	0.719
Low HDL	45.1	41.0	44.4	50.5	0.015
High triglycerides	39.2	34.1	37.3	47.0	< 0.0001
High waist circumference	48.8	40.4	52.6	53.7	< 0.0001
Sociodemographic
Female	61.1	47.9	66.3	69.5	< 0.0001
Age in years, mean (SD)	69.3 (7.4)	68.3 (6.7)	69.1 (7.2)	69.6 (7.5)	< 0.018
Schooling 0-3 years	64.1	56.5	65.7	70.5	< 0.0001
Monthly family income, minimum wages
< 2.00	29.3	21.3	30.9	36.4
2.00-3.99	37.9	35.2	39.2	39.4
4.00-9.99	24.5	32.2	22.4	18.4
> 9.99	8.3	11.3	7.5	5.8	< 0.0001
Lifestyle
Current smoking	18.3	20.0	16.9	17.9	0.424
Alcohol consumption^† † At least one glass/week in the previous 12 months.	18.4	25.8	15.8	13.0	< 0.0001
No exercise	86.8	83.3	86.6	90.8	0.002
Cognitive functioning^‡ ‡ Mini-Mental State Examination score < 22.	19.6	13.8	17.7	28.1	< 0.0001
Biological variables
Trypanosoma cruzi infection	37.5	29.9	37.7	46.2	< 0.0001
Stroke	3.4	1.0	3.4	6.2	< 0.0001
CRP, median (IQR)	3.2 (1.4-6.7)	2.9 (1.3-5.9)	3.4 (1.6-7.0)	3.5 (1.5-6.8)	0.030
BNP, median (IQR)	81.0 (43.0-149.0)	73.0 (39.0-144.0)	74.5 (42.0-132.0)	93.0 (50.0-180.0)	0.0005
Urea, median (IQR)	35.4 (29.3-42.7)	35.9 (29.3-42.9)	35.0 (29.3-42.6)	35.6 (29.6-42.0)	0.623
Creatinine, median (IQR)	0.85 (0.75-0.99)	0.87 (0.76-1.0)	0.84 (0.75-0.97)	0.84 (0.74-0.96)	0.043
Current psychoactive drug use	21.7	12.6	22.3	31.0	< 0.0001

	n	1st tertile	2nd tertile	3rd tertile	p-value^* * Test for trend for differences between frequencies was calculated using the Cuzick method. (trend)
Component
High fast plasma glucose	721	34.4	36.2	29.4	0.534
High blood pressure	565	35.9	33.9	30.2	0.490
Low HDL	662	31.3	34.2	34.5	0.004
High triglycerides	576	30.0	33.0	37.0	< 0.001
High waist circumference	717	28.2	37.8	34.0	< 0.001
Clustered components
0	192	41.2	30.2	28.6
1	339	37.6	38.6	23.8
2	354	35.6	32.9	31.5
3	299	30.4	31.8	37.8
4	202	28.7	42.6	28.7
5	83	31.2	30.0	38.8	0.001

	Unadjusted	Adjusted bysociodemographic status^* * Gender, age, schooling, and monthly family income.	Adjusted by sociodemographicstatus and lifestyle^† † Current smoking, alcohol consumption, and no exercise.	Fully adjusted model^‡ ‡ Adjusted by sociodemographic status, lifestyle, cognitive functioning (Mini-Mental State Examination score), biological variables (Trypanosoma cruzi infection, creatinine, urea, brain natriuretic peptide, C-reactive protein, and stroke), and current use of psychoactive drugs.
Individual components
High fasting plasma glucose	0.94 (0.77-1.14)	0.93 (0.76-1.12)	0.95 (0.78-1.15)	0.94 (0.77-1.16)
High blood pressure	0.93 (0.76-1.13)	0.94 (0.77-1.15)	0.96 ( 0.79-1.18)	0.94 (0.76-1.16)
Low HDL	1.32 (1.09-1.60) ^§ § p < 0.05.	1.25 (1.02-1.52) ^§ § p < 0.05.	1.22 (1.00-1.49) ^§ § p < 0.05.	1.17 (0.95-1.45)
High triglycerides	1.49 (1.22-1.81) ^∥ ∥ p < 0.0001.	1.47 (1.20-1.80) ^∥ ∥ p < 0.0001.	1.48 (1.21-1.82) ^∥ ∥ p < 0.0001.	1.47 (1.19-1.81) ^∥ ∥ p < 0.0001.
High waist circumference	1.49 (1.23-1.80) ^∥ ∥ p < 0.0001.	1.18 (0.95-1.46)	1.19 (0.95-1.47)	1.19 (0.94-1.51)
Clustered components
Continuous	1.12 (1.04-1.20) ^§ § p < 0.05.	1.07 (1.00-1.18) ^§ § p < 0.05.	1.08 (1.01-1.16) ^§ § p < 0.05.	1.08 (0.99-1.16)
Ordered
0	1.00	1.00	1.00	1.00
1	0.99 (0.70-1.39)	0.93 (0.66-1.32)	0.93 (0.66-1.32)	0.96 (0.67-1.38)
2	1.22 (0.87-1.71)	1.10 (0.78-1.56)	1.13 (0.80-1.60)	1.10 (0.77-1.59)
3	1.60 (1.13-2.26) ^§ § p < 0.05.	1.48 (1.03-2.13) ^§ § p < 0.05.	1.52 (1.05-2.18) ^§ § p < 0.05.	1.53 (1.05-2.23) ^§ § p < 0.05.
4	1.34 (0.93-1.95)	1.11 (0.75-1.64)	1.14 (0.77-1.69)	1.16 (0.77-1.75)
5	1.61 (0.98-2.63)	1.29 (0.77-2.16)	1.32 (0.79-2.20)	1.25 (0.74-2.13)

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[1] Correspondence: Érico Castro-Costa, Laboratório de Epidemiologia e Antropologia Médica, Centro de Pesquisas René Rachou/Fiocruz, Av, Augusto de Lima, 1715/6° andar, CEP 30190-002, Belo Horizonte, MG, Brazil. E-mail: ericocastrocosta@gmail.com