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Depressive Symptoms and Metabolic Risk in Adult Male Twins Enrolled in the National Heart, Lung, and Blood Institute Twin Study

From the Centers for Behavioral and Preventive Medicine (J.M.M., R.N., J.F.T.), Brown Medical School and The Miriam Hospital, Providence, Rhode Island; and SRI International (G.E.S., D.C.), Menlo Park, California.

Address reprint requests to: Jeanne McCaffery, PhD, Centers for Preventive and Behavioral Medicine, Coro Building, Suite 5000, One Hoppin Street, Providence, RI 02903. Email: Jeanne_McCaffery{at}brown.edu

OBJECTIVE: To determine the extent to which depressive symptoms are associated with metabolic risk factors and whether genetic or environmental factors account for this association.

METHOD: Twin structural equation modeling was employed to estimate genetic and environmental contributions to the covariation of depressive symptoms, as indexed by the Centers for Epidemiological Studies–Depression Scale, and common variance among blood pressure, body mass index, waist-to-hip ratio, and serum triglycerides and glucose among 87 monozygotic and 86 dizygotic male twin pairs who participated in the NHLBI twin study.

RESULTS: Depressive symptoms were associated with individual components of the metabolic syndrome and common variance among the risk factors. Twin structural equation modeling indicated that the associations were attributable to environmental (nongenetic) factors.

CONCLUSIONS: These results support the hypothesis that depressive symptoms may increase risk for a pattern of physiological risk consistent with the metabolic syndrome.

Key Words: depression, • metabolic syndrome, • twins, • cardiovascular disease, • diabetes, • cholesterol.

Abbreviations: a² = additive genetic variance;; BMI = body mass index;; c² = shared environmental variance;; CES-D = Centers for Epidemiological Studies–Depression Scale;; d² = dominant genetic variance;; DBP = diastolic blood pressure;; DZ = dizygotic;; e² = nonshared environmental variance;; GLUC = glucose;; HDL = high-density lipoprotein cholesterol;; MZ = monozygotic;; NHLBI = National Heart, Lung, and Blood Institute;; SBP = systolic blood pressure;; MAP = mean arterial pressure;; TRIG = triglycerides;; WHR = waist-to-hip ratio.

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