Testosterone imbalance may link depression and increased body weight in premenopausal women

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Abstract

Accumulating evidence supports a link between depression and being overweight in women. Given previously reported sex differences in fat accumulation and depression prevalence, as well as the likely role of sex hormones in both overweight and mood disorders, we hypothesised that the depression-overweight association may be mediated by sex hormones. To this end, we investigated the association of being overweight with depression, and then considered the role of sex hormones in relation to being overweight and depression in a large population-based cohort. We included a total of 3124 women, 970 premenopausal and 2154 postmenopausal from the LIFE-Adult cohort study in our analyses. We evaluated associations between being overweight (BMI >25 kg/m ²), sex hormone levels, and depressive symptomatology according to Centre for Epidemiologic Studies Depression (CES-D) scores, and explored mediation of depression in a mediation model. Being overweight was significantly associated with depressive symptoms in premenopausal but not postmenopausal women. Both premenopausal and postmenopausal overweight women had higher free testosterone levels compared with normal weight women. Premenopausal women with depressive symptomatology had higher free testosterone levels compared to women without. We found a significant mediation effect of depressive symptomatology in overweight premenopausal women through free testosterone level. These findings highlight the association between being overweight and depressed, and suggest that high free testosterone levels may play a significant role in depression of overweight premenopausal women. Based on this, pharmacological approaches targeting androgen levels in overweight depressed females, in particular when standard anti-depressive treatments fail, could be of specific clinical relevance.

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Compelling evidence exists for pervasive sex differences in pathological conditions, including anxiety and depressive disorders, with females more than twice as likely to be afflicted. Gonadal hormones may be a major factor in this disparity, given that women are more likely to experience mood disturbances during times of hormonal flux, and testosterone may have protective benefits against anxiety and depression. In this review we focus on the effects of testosterone in males and females, revealed in both human and animal studies. We also present possible neurobiological mechanisms underlying testosterone's mostly protective benefits, including the brain regions, neural circuits, and cellular and molecular pathways involved. While the precise underlying mechanisms remain unclear, both activational and organizational effects of testosterone appear to contribute to these effects. Future clinical studies are necessary in order to better understand when and how testosterone therapy may be effective in both sexes.

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Author and article information

Contributors

Daniela Stanikova: +421-903 290 753 , daniela.stanikova@savba.sk

Journal

Journal ID (nlm-ta): Transl Psychiatry

Journal ID (iso-abbrev): Transl Psychiatry

Title: Translational Psychiatry

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2158-3188

Publication date (Electronic): 7 June 2019

Publication date PMC-release: 7 June 2019

Publication date Collection: 2019

Volume: 9

Electronic Location Identifier: 160

Affiliations

[1 ]ISNI 0000 0001 2230 9752, GRID grid.9647.c, Institute of Social Medicine, Occupational Health and Public Health, , University of Leipzig, ; Leipzig, Germany

[2 ]ISNI 0000 0001 2180 9405, GRID grid.419303.c, DIABGENE Laboratory, Institute of Experimental Endocrinology, Biomedical Research Center, , Slovak Academy of Sciences, ; Bratislava, Slovakia

[3 ]ISNI 0000000109409708, GRID grid.7634.6, Department of Pediatrics, , Medical Faculty at the Comenius University, ; Bratislava, Slovakia

[4 ]ISNI 0000 0001 0041 5028, GRID grid.419524.f, Department of Neurology, , Max Planck Institute for Human Cognitive and Brain Sciences, ; Leipzig, Germany

[5 ]ISNI 0000 0001 0041 5028, GRID grid.419524.f, Emotion & NeuroimaGinG (EGG) Lab, , Max Planck Institute for Human Cognitive and Brain Sciences, ; Leipzig, Germany

[6 ]Department of Economic and Social Sciences & Institute of Social Medicine, Rehabilitation Sciences and Healthcare Research (ISRV), University of Applied Sciences Nordhausen, Nordhausen, Germany

[7 ]ISNI 0000 0001 2230 9752, GRID grid.9647.c, LIFE-Leipzig Research Center for Civilization Diseases, , University of Leipzig, ; Leipzig, Germany

[8 ]ISNI 0000 0001 2230 9752, GRID grid.9647.c, Institute for Medical Informatics, Statistics and Epidemiology, , University of Leipzig, ; Leipzig, Germany

[9 ]ISNI 0000 0001 2230 9752, GRID grid.9647.c, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, , University of Leipzig, ; Leipzig, Germany

[10 ]ISNI 0000 0001 2230 9752, GRID grid.9647.c, Center for Pediatric Research Leipzig, University Hospital for Children & Adolescents, , University of Leipzig, ; Leipzig, Germany

[11 ]ISNI 0000 0001 2230 9752, GRID grid.9647.c, Clinic of Cognitive Neurology, , University of Leipzig, ; Leipzig, Germany

Author information

Yoon Ju Bae http://orcid.org/0000-0003-3438-173X

Article

Publisher ID: 487

DOI: 10.1038/s41398-019-0487-5

PMC ID: 6555814

PubMed ID: 31175272

SO-VID: 55d5ba44-4fd3-44b9-9e6c-4bfd83b42ec1

License:

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