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Metabolic and inflammatory markers: associations with individual depressive symptoms

Published online by Cambridge University Press:  11 September 2017

F. Lamers*
Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience research institute, VU University Medical Center/GGZ inGeest, Amsterdam, the Netherlands
Y. Milaneschi
Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience research institute, VU University Medical Center/GGZ inGeest, Amsterdam, the Netherlands
P. de Jonge
Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center, Groningen, the Netherlands
E. J. Giltay
Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
B. W. J. H. Penninx
Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience research institute, VU University Medical Center/GGZ inGeest, Amsterdam, the Netherlands
Author for correspondence: F. Lamers, Ph.D., E-mail:



Literature has shown that obesity, metabolic syndrome and inflammation are associated with depression, however, evidence suggests that these associations are specific to atypical depression. Which of the atypical symptoms are driving associations with obesity-related outcomes and inflammation is unknown. We evaluated associations between individual symptoms of depression (both atypical and non-atypical) and body mass index (BMI), metabolic syndrome components and inflammatory markers.


We included 808 persons with a current diagnosis of depression participating in the Netherlands Study of Depression and Anxiety (67% female, mean age 41.6 years). Depressive symptoms were derived from the Composite International Diagnostic Interview and the Inventory of Depressive Symptomatology. Univariable and multivariable regression analyses adjusting for sex, age, educational level, depression severity, current smoking, physical activity, anti-inflammatory medication use, and statin use were performed.


Increased appetite was positively associated with BMI, number of metabolic syndrome components, waist circumference, C-reactive protein and tumor necrosis factor-α. Decreased appetite was negatively associated with BMI and waist circumference. Psychomotor retardation was positively associated with BMI, high-density lipoprotein cholesterol and triglycerides, and insomnia with number of metabolic syndrome components.


Increased appetite – in the context of a depressive episode – was the only symptom that was associated with both metabolic as well as inflammatory markers, and could be a key feature of an immuno-metabolic form of depression. This immuno-metabolic depression should be considered in clinical trials evaluating effectiveness of compounds targeting metabolic and inflammatory pathways or lifestyle interventions.

Original Articles
Copyright © Cambridge University Press 2017 

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