Original scientific paper

ACTIVITY OF THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS AND INFLAMMATORY MEDIATORS IN MAJOR DEPRESSIVE DISORDER WITH OR WITHOUT METABOLIC SYNDROME

Marko Martinac ; Mostar Center for Mental Health, Mostar Health Center, Mostar, Bosnia and Herzegovina; University of Mostar, School of Medicine, Mostar, Bosnia and Herzegovina
Dragan Babić ; Clinical Department of Psychiatry, Mostar University Hospital, Mostar, Bosnia and Herzegovina; University of Mostar, School of Medicine, Mostar, Bosnia and Herzegovina
Milenko Bevanda ; Clinical Department of Internal Medicine, Mostar University Hospital, Mostar, Bosnia and Herzegovina; University of Mostar, School of Medicine, Mostar, Bosnia and Herzegovina
Ivan Vasilj ; University of Mostar, School of Medicine, Mostar, Bosnia and Herzegovina
Danijela Bevanda Glibo ; Clinical Department of Internal Medicine, Mostar University Hospital, Mostar, Bosnia and Herzegovina
Dalibor Karlović ; Clinical Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
Miro Jakovljević ; Clinical Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia

Abstract

Background: The aim of the present study was to explore the differences in serum CRP, IL-6, TNF-α, ACTH and cortisol among
patients with major depressive disorder with or without metabolic syndrome (MS) compared to a healthy control group.
Subjects and methods: The MDD study group consisted of 80 patients (mean age of 50.03±9.55 years). The control group was
recruited from the hospital personnel and it consisted of 40 examinees (mean age of 47.20±7.99 years). All patients who participated
in the study were diagnosed with depressive disorder using MINI questionnaire, and Hamilton rating scale for depression. Diagnosis
of the metabolic syndrome was set by NCEP ATP III criteria.
Results: Examinees with depression but without MS had significantly more cortisol concentration when compared to the control
group. CRP was significantly higher in the MDD group when compared to the control group and in MDD+MS group when
compared to the control group. IL6 serum levels were significantly higher in the MDD group when compared to the healthy control
group, and in MDD+MS group when compared to the healthy control group. ACTH had significant independent predictive values
for abdominal obesity. Levels of TNF-α were statistically significant independent predictors for hyperglycaemia. Statistically
significant predictive values for MDD were found for cortisol, and IL-6.
Conclusion: Results shown here emphasise the importance of neuroendocrine and inflammatory factors in pathogenesis of
depressive disorder and MS. Further prospective research is necessary to clarify possible causal relationship between depression
and MS. It is necessary to investigate the possibility of a joint biological mechanism in pathogenesis of these two disorders with the
special attention given to the disturbances in the immune system.

Keywords

depressive disorder; metabolic syndrome; inflammatory mediators; HPA axis; cortisol

Hrčak ID:

178602

URI

https://hrcak.srce.hr/178602

Publication date:

20.3.2017.

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