Psychoneuroendocrinology (2015) 58, 1—8 Available online at www.sciencedirect.com ScienceDirect j ourna l h om epa ge : www.elsevier.com/locate/psyneuen Adrenal gland volume, intra-abdominal and pericardial adipose tissue in major depressive disorder Kai G. Kahl a,* , Ulrich Schweiger d , Kaweh Pars a , Alicja Kunikowska a , Michael Deuschle e , Marcel Gutberlet b , Ralf Lichtinghagen c , Stefan Bleich a , Katja Hüper b , Dagmar Hartung b a Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany b Institute for Diagnostic and Interventional Radiology, MHH, Hannover, Germany c Institute of Clinical Chemistry, MHH, Hannover, Germany d Department of Psychiatry and Psychotherapy, University of Lubeck, Lubeck, Germany e Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany Received 5 March 2015; received in revised form 7 April 2015; accepted 8 April 2015 KEYWORDS Major depressive disorder; Adrenal gland volume; Ectopic fat Summary Major depressive disorder (MDD) is associated with an increased risk for the devel- opment of cardio-metabolic diseases. Increased intra-abdominal (IAT) and pericardial adipose tissue (PAT) have been found in depression, and are discussed as potential mediating factors. IAT and PAT are thought to be the result of a dysregulation of the hypothalamus—pituitary—adrenal axis (HPAA) with subsequent hypercortisolism. Therefore we examined adrenal gland volume as proxy marker for HPAA activation, and IAT and PAT in depressed patients. Twenty-seven depressed patients and 19 comparison subjects were included in this case-control study. Adrenal gland volume, pericardial, intraabdominal and subcutaneous adipose tissue were measured by magnetic resonance imaging. Further parameters included factors of the metabolic syndrome, fasting cortisol, fasting insulin, and proinflammatory cytokines. Adrenal gland and pericardial adipose tissue volumes, serum concentrations of cortisol and insulin, and serum concentra- tions tumor—necrosis factor- were increased in depressed patients. Adrenal gland volume was positively correlated with intra-abdominal and pericardial adipose tissue, but not with subcuta- neous adipose tissue. Our findings point to the role of HPAA dysregulation and hypercortisolism ∗ Corresponding author. Tel.: +49 511 5322495; fax: +49 511 5328573. E-mail address: kahl.kai@mh-hannover.de (K.G. Kahl). http://dx.doi.org/10.1016/j.psyneuen.2015.04.008 0306-4530/© 2015 Elsevier Ltd. All rights reserved.