VOL. 4, No. 2, July 2008

K. Nabe, et al. [2008] Med. Hypotheses Res. 1: 79‒83.

Depression is a Component of the Metabolic Syndrome

Koichiro Nabe*, Kazuhiro Nomura, Hiroki Ikeda, Sachiko Honjo,
Yoshiharu Wada, Tetsuya Kimura, Tomohisa Aoyama, Yoshiyuki
Hamamoto and Hiroyuki Koshiyama

Center for Diabetes and Endocrinology, The Tazuke Kofukai Foundation Medical Research
Institute Kitano Hospital, Osaka Japan (K.N., K.N., H.I., S.H., Y.W., T.K., T.A., Y.H., H.
K.), and Department of Diabetes and Clinical Nutrition, Graduate School of Medicine,
Kyoto University, Kyoto, Japan (Y.H., H.K.)

Abstract. Type 2 diabetes is known to be frequently associated with depression. It is
reasonable to assume that diabetes may increase the risk for depression, and that depression
may aggravate glycemic control. However, it is also possible that there may exist some
common pathogenetic mechanisms of the two disorders, ie type 2 diabetes and depression.
Several possible candidates for ‘common soil’ can be listed. First, hyperactivity of the
hypothalamo-pituitary-adrenal axis may underlie type 2 diabetes and depression, as typically
found in Cushing syndrome, which presents with both diabetes mellitus and depression.
Second, there have been some preliminary evidences that decreased central serotonergic
activity, which is considered to be responsible for depression, may result in insulin resistance.
Third, some hypothalamic abnormality may underlie at least some portion of type 2 diabetes
and metabolic syndrome. Based on those backgrounds, here we present a hypothesis that
depression is one component of metabolic syndrome, and that antidepressant may improve
glycemic control in type 2 diabetes. This hypothetical viewpoint may lead to the development
of new drug for the prevention of metabolic syndrome.

Correspondence: Dr. Koichiro Nabe, Center for Diabetes and Endocrinology, the
Tazuke Kofukai Foundation Medical Research Institute Kitano Hospital, Osaka, 530-8480,
Japan. Tel: 81-6-6312-1221. Fax: 81-6-6361-0588.

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