Metabolic syndrome and metabolic abnormalities in patients with major depressive disorder: a meta-analysis of prevalences and moderating variables

Background. Individuals with depression have an elevated risk of cardiovascular disease (CVD) and metabolic syndrome (MetS) is an important risk factor for CVD. We aimed to clarify the prevalence and correlates of MetS in persons with robustly defined major depressive disorder (MDD). Method. We searched Medline, PsycINFO, EMBASE and CINAHL up until June 2013 for studies reporting MetS prevalences in individuals with MDD. Medical subject headings \u27metabolic\u27 OR \u27diabetes\u27 or \u27cardiovascular\u27 or \u27blood pressure\u27 or \u27glucose\u27 or \u27lipid\u27 AND \u27depression\u27 OR \u27depressive\u27 were used in the title, abstract or index term fields. Manual searches were conducted using reference lists from identified articles. Results. The initial electronic database search resulted in 91 valid hits. From candidate publications following exclusions, our search generated 18 studies with interview-defined depression (n= 5531, 38.9% male, mean age= 45.5 years). The overall proportion with MetS was 30.5% [95% confidence interval (CI) 26.3-35.1] using any standardized MetS criteria. Compared with age-and gender-matched control groups, individuals with MDD had a higher MetS prevalence [odds ratio (OR) 1.54, 95% CI 1.21-1.97, p= 0.001]. They also had a higher risk for hyperglycemia (OR 1.33, 95% CI 1.03-1.73, p= 0.03) and hypertriglyceridemia (OR 1.17, 95% CI 1.04-1.30, p= 0.008). Antipsychotic use (