Depressive symptom profiles, cardio-metabolic risk and inflammation: Results from the MIDUS study

This study aimed to (1) provide a comprehensive characterization of depressive symptoms profiles, and (2) examine the cross-sectional association between depressive symptom profiles and cardio-metabolic outcomes, including metabolic syndrome and obesity, while controlling for sociodemographic variables, health behaviors and inflammation.

Our sample was comprised of 1085 participants (55.80% female) enrolled in the MIDUS-II biomarker study. Latent profile analysis (LPA) was used to derive depressive symptom profiles using subscales of the Mood and Anxiety Symptom Questionnaire (MASQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) subscales as well as Pittsburgh Sleep Quality Index (PSQI) global score. Metabolic syndrome was defined according to the Interim Joint Statement definition. CRP was used as a marker of inflammation.

Four depressive symptom profiles were identified. The "No Symptoms" subgroup (60.65% of the sample) had the lowest overall scores across subscales. The "Mild Symptoms" subgroup (26.73%) was characterized by lower scores across indicators, with subscales measuring somatic symptoms being the highest within group. The "Moderate Symptoms" subgroup (10.32%) had higher scores across subscales (1 SD above the mean), with subscales measuring negative affect/loss of interest being the highest within group. Finally, the "Acute symptoms" subgroup (2.30%) was characterized by the highest overall scores (1.5-3 SD above the mean) on all indicators. After controlling for sociodemographic characteristics and health behaviors, the "Moderate Symptoms" subgroup was significantly associated with metabolic syndrome (OR=1.595, p=0.035) and obesity (OR=1.555, p=0.046). Further, there was a trend between the "Mild Symptoms" subgroup and the presence of obesity (OR=1.345, p=0.050). Inflammation attenuated these associations.

Four depressive symptom profiles were identified among healthy mid-life individuals in the US. These profiles are differentially associated with cardio-metabolic outcomes. Future work should examine whether distinct symptom profiles may reflect differential pathways to increased risk, and whether tailored management of symptoms is needed.