In the report, researchers from the University of Chicago challenge the conventional wisdom that simply having high levels of good cholesterol (HDL) and low levels of bad cholesterol (LDL) is necessary for good heath. Instead, they show that the good cholesterol has varying degrees of quality and that poor quality HDL is actually bad for you.

"For many years, HDL has been viewed as good cholesterol and has generated a false perception that the more HDL in the blood, the better," said Angelo Scanu, M.D., a pioneer in blood lipid chemistry from University of Chicago and first author of the study. "It is now apparent that subjects with high HDL are not necessarily protected from heart problems and should ask their doctor to find out whether their HDL is good or bad."

The researchers came to this conclusion after reviewing published research on this subject. In their review, they found that the HDL from people with chronic diseases such as rheumatoid arthritis, kidney disease, and diabetes is different from the HDL in healthy individuals, even when blood levels of HDL are comparable. They observed that normal, "good," HDL reduces inflammation, while the dysfunctional, "bad," HDL does not.

"This is yet one more line of research that explains why some people can have perfect cholesterol levels, but still develop cardiovascular disease," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "Just as the discovery of good and bad cholesterol rewrote the book on cholesterol management, the realization that some of the 'good cholesterol' is actually bad will do the same."

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There are several mechanisms by which depression might increase abdominal fat, they note. Chronic stress and depression may activate certain brain areas and lead to increased levels of the hormone cortisol, which promotes the accumulation of visceral fat. Individuals with depression may have unhealthier lifestyles, including a poor diet, that could interact with other physiological factors to produce an increase in abdominal obesity.

"Our longitudinal results suggest that clinically relevant depressive symptoms give rise to an increase in abdominal obesity, in particular visceral fat, which seems to be stronger than and independent of overall obesity," the authors conclude. "This could also help explain why depression is often followed by diabetes or cardiovascular disease. Future research should further disentangle these mechanisms because this will yield important information for prevention or treatment of depression-related health consequences."

(Arch Gen Psychiatry. 2008;65[12]:1386-1393.

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