Table 2

Overview of meta-analyses examining the cross-sectional association between biological dysregulations and depression status
Reference Nr studies included Nr subjects included Pooled effect size (95% CI)
Metabolic dysregulation
Metabolic syndrome Pan et al. 20121[22] 29 155,333 OR = 1.42 (1.28 to 1.57)
Abdominal obesity Xu et al. 20111[57] 15 34,832 OR = 1.38 (1.22 to 1.57)
Immuno-inflammatory dysregulation
C-Reactive Protein Howren et al. 20091[58] 49 51,234 d = 0.15 (0.10 to 0.21)
Interleukin-6 61 24,837 d = 0.25 (0.18 to 0.31)
Interleukin-1β 14 756 d = 0.35 (0.03 to 0.67)
Interleukin-1RA 9 1,214 d = 0.25 (0.04 to 0.46)
Interleukin-6 Dowlati et al. 20102[59] 16 892 MD = 1.8 pg/mL (1.2 to 2.3)
TNF-α 13 788 MD = 4.0 pg/mL (2.2 to 5.7)
Interleukin-1β 9 533 MD = -1.6 pg/mL (-3.6 to 0.4)
Soluble Interleukin-2R Liu et al. 20122[60] 8 596 MD = 0.56 pg/mL (0.28 to 0.84)
Interleukin-6 18 923 MD = 0.68 pg/mL (0.44 to 0.92)
TNF-α 15 995 MD = 0.55 pg/mL (0.13 to 0.99)
Interleukin-1β 10 580 MD = -0.53 pg/mL (-1.36 to 0.31)
Autonomic dysregulation
Heart rate variability Rottenberg, 20072[61] 13 686 d = 0.33 (0.18 to 0.49)
Heart rate variability Kemp et al. 20102[62] 14 726 Hedges’ g = -0.21 (-0.40 to -0.02)4
HPA-axis dysregulation
Higher cortisol 3 Stetler and Miller 20111[63] 354 18,374 d = 0.60 (0.54 to 0.66)
Higher ACTH 96 3,812 d = 0.28 (0.16 to 0.41)
Higher CRH 16 888 d = -0.53 (-1.71 to 0.65)
Saliva morning cortisol Knorr et al. 20101[64] 20 2,318 MD = 2.6 nmol/l (1.0 to 4.2)
Saliva evening cortisol 10 1,617 MD = 0.3 nmol/l (0.03 to 0.5)

ACTH, Adrenocorticotropin hormone; CI, Confidence interval; CRH, Corticotropin-releasing hormone; d, Cohen’s d; HPA, hypothalamic-pituitary-adrenal; MD, Mean difference between depressed and non-depressed; OR, Odds ratio; TNF, Tumor necrosis factor.

1 Included depressed cases based on self-report checklists or psychiatric diagnostic criteria.

2 Only included depressed cases conform to psychiatric diagnostic criteria.

3 Cumulative assessment of cortisol across body fluids and across various time points.

4 Did not include data from one study including 1,018 depression patients and 515 controls that found a much smaller effect size (d = 0.12).

Penninx et al.

Penninx et al. BMC Medicine 2013 11:129   doi:10.1186/1741-7015-11-129

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