Non-overweight depressed patients who respond to antidepressant treatment have a higher risk of later metabolic syndrome: findings from the METADAP cohort

K. El Asmar (1) , N. Annan , R. Khoury (2) , R. Colle (3) , S. Martin (4) , T. Ghoul , S. Trabado (5, 6) , P. Chanson (7, 6) , B. Feve (3, 8, 9) , C. Verstuyft (1, 7) , L. Becquemont , E. Corruble (10)

1 CESP - Centre de recherche en épidémiologie et santé des populations
2 LPICM - Laboratoire de physique des interfaces et des couches minces [Palaiseau]
3 CRSA - Centre de Recherche Saint-Antoine
4 CHU Angers - Centre Hospitalier Universitaire d'Angers
5 Service de génétique moléculaire, pharmacogénétique et hormonologie
6 PHYSENDO - Physiologie et physiopathologie endocriniennes
7 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
8 CHU Saint-Antoine [AP-HP]
9 IHU ICAN - Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière]
10 SMSP - U1178 - Santé mentale et santé publique

Abstract Background Major depressive disorder (MDD) is a complex disorder with a significant public health burden. Depression remission is often associated with weight gain, a major risk factor for metabolic syndrome (MetS). The primary objective of our study was to assess prospectively the impact of response to antidepressant treatment on developing MetS in a sample of MDD patients with a current major depressive episode (MDE) and who are newly initiating their treatment. Methods In the 6-month prospective METADAP cohort, non-overweight patients, body mass index <25 kg/m 2 , with MDD and a current MDE were assessed for treatment response after 3 months of treatment, and incidence of MetS after 3 and 6 months of treatment. Outcome variables were MetS, number of MetS criteria, and each MetS criterion (high waist circumference, high blood pressure, high triglyceridemia, low high-density lipoprotein-cholesterolemia, and high fasting plasma glucose). Results In total, 98/169 patients (58%) responded to treatment after 3 months. A total of 2.7% (1/38) developed MetS out of which 12.7% (10/79) ( p value < 0.001) had responded to treatment after 3 months. The fixed-effect regression models showed that those who responded to treatment after 3 months of follow-up had an 8.6 times higher odds of developing MetS (odds ratio = 8.58, 95% confidence interval 3.89–18.93, p value < 0.001). Conclusion Compared to non-responders, non-overweight patients who responded to treatment after 3 months of antidepressant treatment had a significantly higher risk of developing MetS during the 6 months of treatment. Psychiatrists and nurses should closely monitor the metabolic profile of their patients, especially those who respond to treatment.

Domaines: Endocrinologie et métabolisme

K. El Asmar, N. Annan, R. Khoury, R. Colle, S. Martin, et al.. Non-overweight depressed patients who respond to antidepressant treatment have a higher risk of later metabolic syndrome: findings from the METADAP cohort. Psychological Medicine, 2023, 53 (14), pp.6560-6569. ⟨10.1017/S0033291722003919⟩. ⟨hal-04337649⟩