Association between visceral adipose tissue and major depressive disorder across the lifespan: A scoping review

Abstract

Objectives Increasing evidence supports a bidirectional relationship between major depressive disorder (MDD) and obesity, but the role of visceral adipose tissue (VAT) as a measure of obesity in relation to MDD is not well understood. Here we review literature investigating the link between MDD and VAT in terms of biomarkers, sex differences, and aging. Methods PubMed, EMBASE, PsycINFO, and CINAHL searches were conducted on December 11, 2020. No date or language limits were imposed. Major concepts searched were Depressive Disorder linked with Adipose Tissue, White, Hypothalmo–Hypophyseal System, and Pituitary–Adrenal System in addition to keywords. A final set of 32 items meeting criteria for inclusion. Results Converging biological evidence suggests a significant bidirectional relationship between VAT and MDD across the lifespan. In adulthood, greater VAT was associated with increased risk for depression, especially in vulnerable groups such as individuals who are overweight/obese, postmenopausal women, and individuals with comorbid medical or psychiatric illness. In older adults, sarcopenia had an impact on the relationship between abnormal VAT and risk of depression. Additionally, sex differences emerged as a potential factor affecting the strength of the association between VAT and depression. Conclusions Elucidating the pathophysiological mechanisms associated with increased rates of depression in obese individuals will be crucial for developing specific treatment strategies that seek to improve outcomes in individuals with comorbid depression and obesity. Moreover, identifying age‐ and sex‐specific risk factors may contribute to a more personalized medicine approach, thereby improving the quality of clinical care.

Association between depressive symptoms and pericardial fat in healthy older men and women

“…As expected, we found a sex-specific relationship between depressive symptoms and pericardial fat at baseline. This finding is in line with many studies showing sex differences in the association between depression and visceral adipose tissue 41 – 43 . For example, a cross-sectional study of 1581 women and 1718 men from the Framingham Heart Study found that depressive symptoms were positively associated with visceral adipose tissue after adjustment for overall obesity and other confounders in women, but not men 43 .…”

Association between Sarcopenia and Depressive Symptoms in Community-Dwelling People Aged 40 Years and Older

“…In the present study, sarcopenic individuals had a higher BMI compared to non-sarcopenic individuals (Table 1). The association between sarcopenic obesity and depression has been previously reported (Hamer et al 2015;Lee et al 2021), and visceral adipose tissue was suggested to play a role through obesity-related endocrine hormones (Lee et al 2021). Thus, sarcopenia might be associated with an adverse, obesity-related trait, which might also explain the robust association between sarcopenia and depressive symptoms.…”

Adipose Tissue Compartments, Inflammation, and Cardiovascular Risk in the Context of Depression

“…Overall, two recent meta-analyses concluded that MDD as well as self-reported depressive symptoms were associated with enlarged VAT compartments. This association appears independent of sex, age, and method of VAT content assessment (i.e., MRI or CT) as well as method of depression assessment ( 97 , 98 ). Additionally, the association of VAT with depression remained significant when only studies controlling for BMI were taken into account ( 98 ).…”