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Hypercortisolemia Cited in Link Between Depression and Cardiovascular Disorders

Depressed patients who are also hypercortisolemic appear to have resistance to insulin and increased visceral fat, possibly accounting for a link between major depression and cardiovascular disorders.

In a study of 22 postmenopausal depressed women with 23 healthy controls comparing levels of free cortisol and visceral fat, the depressed patients who were also hypercortisolemic had higher levels of fat accumulation than controls. Also, the depressed patients with hypercortisolemia also had greater fat deposits than depressed patients whose cortisol levels were normal.

No difference in fat was found when comparing all patients with the healthy women, suggesting that it is hypercortisolemia in depression that accounts for the greater fat accumulation.

Researchers at the Central Institute of Mental Health , Mannheim, and the Department of Psychiatry, Free University of Berlin, Germany measured intra-abdominal fat by computer tomography at the level of lumbar vertebrae 1 (L1) and 4 (L4). Over a seven-day drug free period, saliva was taken at 8 a.m. from both patient and control groups to measure free cortisol.

Oral glucose tolerance tests were also perfumed in the patient group only. While glucose concentrations were found to be higher in the hypercortisolemic patients than in the normocortisolemic patients, only a tendency towards an increase was seen in their insulin levels, the researchers report.

"The fact that hypercortisolemia reverses depression-related fat loss, particularly in the visceral area, might partially explain why major depression can be considered a risk factor for cardiovascular disorders," they say.
Psychosomatic Medicine 64:274-277 (2002). "Hypercortisolemic Depression Is Associated With Increased Intra-Abdominal Fat"

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