Exp Clin Endocrinol Diabetes 2000; Vol. 108(3): 187-190
DOI: 10.1055/s-2000-7742
Articles

© Johann Ambrosius Barth

Major depression and impaired glucose tolerance

B. Weber, U. Schweiger, M. Deuschle, I. Heuser
  • Max-Planck-Institute of Psychiatry, Clinical Institute, Munich, Germany
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Summary:

Hypercortisolism is a frequent endocrine sign in major depression and cortisol is a well-known anti-insulinergic hormone. Impaired oral glucose tolerance has already been described in major depression. However, thus far no information is available on spontaneous, circadian insulin secretion in patients.

We studied 26 depressed inpatients along with 33 age- and sex-matched controls. Blood samples were collected at 30-minute intervals over a period of 26 hours (h) for estimation of cortisol, insulin and glucose. No differences in 24 h mean-insulin and glucose concentrations were detectable despite significantly reduced caloric consumption in patients. At the second morning a strictly standardized test meal of 2125 kjoule was given. Insulin and glucose responses to the test meal were significantly increased in hypercortisolemic patients compared to controls.

Hence, patients with major depression have an impaired insulin sensitivity.

References

  • 1 American Psychiatric Association .Diagnostic Criteria from DSM-IV Washington DC. American Psychiatric Association 1994
  • 2 Björntorp P. Visceral obesity: a “civilization syndrome”.  Obes Res. 1 206-222 1993; 
  • 3 Goodnick P, Henry J, Buki V. Treatment of depression in patients with diabetes mellitus.  J Clin Psychiatry. 56 128-136 1995; 
  • 4 Glassmann A, Shapiro P. Depression and the course of coronary artery disease.  Am J Psychiatry. 155 1, 4-11 1998; 
  • 5 Haffner S. Epidemiology of insulin resistance and its relation to coronary artery disease.  Am J Cardiol 84 (SI) 11J-14J 1999; 
  • 6 Hamilton M. A rating scale for depression.  J Neurol Neurosurg Psychiatry. 23 56-62 1960; 
  • 7 Heuser I. The hypothalamic-pituitary-adrenal system in depression.  Pharmacopsychiatry. 31 10-13 1998; 
  • 8 Lustman P, Griffith S, Clouse R, Freeland K, Eisen S, Rubin E, Carney R, McGill J. Effects of nortriptyline on depression and glycemic control in diabetes: results of a double-blind, placebo-controlled trial.  Psychosom Med. 59 241-250 1997; 
  • 9 Mueller P S, Heninger G R, McDonald R K. Intravenous glucose tolerance test in depression.  Arch Gen Psychiatry. 21 470-477 1989; 
  • 10 Plat L, Leproult R, L'Hermite-Baleriaux F, Mockel J, Polonsky K, Van Cauter E. Metabolic effects of short-term elevations of plasma cortisol are more pronounced in the evening than in the morning.  J Clin Endocrinol Metab. 84 3082-3092 1999; 
  • 11 Reaven P, Napoli C, Merat S, Witztum J. Lipoprotein modification and atherosclerosis in aging.  Exp Gerontol. 34 527-537 1999; 
  • 12 Saad M A, Folli F, Kahn C R. Insulin and dexamethasone regulate insulin receptors, insulin receptor substrate 1, and phosphatidylinositol 3 kinase in fao hepatoma cells.  Endocrinology. 136 1579-1588 1995; 
  • 13 Shepherd P, Kahn B. Glucose transporters and insulin action. Implication for insulin resistance and diabetes mellitus.  N Engl J Med. 341 248-257 1999; 
  • 14 Winokur A, Maislin G, Phillips J L, Amsterdam J D. Insulin resistance after oral glucose tolerance testing in patients with major depression.  Am J Psychiatry. 145 325-330 1988; 

Dr. Bettina Weber

Central Institute of Mental Health

P.O. Box 122120

D-68072 Mannheim

Phone: +49-6 21-1 70 36 01

Fax: +49-6 21-1 70 38 91

Email: weber@as200.zi-mannheim.de

    >