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Clinical Research

Sex-specific roles of cellular inflammation and cardiometabolism in obesity-associated depressive symptomatology

International Journal of Obesity volume 43, pages 2045–2056 (2019)Cite this article

Subjects

Abstract

Background

Obesity and depression are complex conditions with stronger comorbid relationships among women than men. Inflammation and cardiometabolic dysfunction are likely mechanistic candidates for increased depression risk, and their prevalence differs by sex. Whether these relationships extend to depressive symptoms is poorly understood. Therefore, we analyzed sex in associations between inflammation and metabolic syndrome (MetS) criteria on depressive symptomatology. Specifically, we examined whether sex positively moderates the relationship between depressive symptoms and inflammation among women, and whether MetS has parallel effects among men.

Methods

Depressive symptoms, MetS, and inflammation were assessed in 129 otherwise healthy adults. Depressive symptoms were assessed using Beck Depression Inventory (BDI-Ia). Monocyte inflammation regulation (BARIC) was quantified using flow cytometry measurement of TNF-α suppression by β-agonist. Moderation effects of sex on associations between BARIC, MetS criteria, and BDI were estimated using two-way ANOVA and linear regression, adjusting for BMI, and by sex subgroup analyses.

Results

Obese individuals reported more depressive symptoms. Sex did not formally moderate this relationship, though BDI scores tended to differ by BMI among women, but not men, in subgroup analysis. Poorer inflammation control and higher MetS criteria were correlated with somatic depressive symptoms. Sex moderated associations between MetS criteria and somatic symptoms; among men, MetS criteria predicted somatic symptoms, not among women. Subgroup analysis further indicated that poorer inflammation control tended to be associated with higher somatic symptoms in women.

Conclusions

These results indicate that obesity-related inflammation and MetS factors have sex-specific effects on depressive symptoms in a non-clinical population. Although pathophysiological mechanisms underlying sex differences remain to be elucidated, our findings suggest that distinct vulnerabilities to depressive symptoms exist between women and men, and highlight the need to consider sex as a key biological variable in obesity-depression relationships. Future clinical studies on comorbid obesity and depression should account for sex, which may optimize therapeutic strategies.

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Acknowledgements

This work was partially supported by the research grants R01HL090975 (SH) and HL090975S1 (American Recovery and Reinvestment Act grant; SH), UL1RR031980 for the UCSD Clinical and Translational Science Awards, and TL1TR001443 (JNK) from the National Institutes of Health.

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Authors and Affiliations

  1. Department of Psychiatry, University of California San Diego, La Jolla, 92093, California, United States

    Jordan N. Kohn, Nicholas Guay-Ross, Farah D. Shaikh & Suzi Hong

  2. Neuroscience Interdepartmental PhD Program, University of California, Los Angeles, CA, 90095, USA

    Yesenia Cabrera

  3. Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, 72076, Tübingen, Germany

    Stoyan Dimitrov

  4. Department of Family Medicine and Public Health, University of California San Diego, La Jolla, 92093, CA, USA

    Christopher Pruitt & Suzi Hong

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Correspondence to Suzi Hong.

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Kohn, J.N., Cabrera, Y., Dimitrov, S. et al. Sex-specific roles of cellular inflammation and cardiometabolism in obesity-associated depressive symptomatology. Int J Obes 43, 2045–2056 (2019). https://doi.org/10.1038/s41366-019-0375-3

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