CRP and obesity due to melanocortin 4 receptor deficiency: MDD has been associated with numerous alterations of the immune system,29,30 and obesity is consistently associated with subclinical inflammation and increased cardiovascular disease risk.28 In our sample, 73% of participants (117 of 160) had hypertension, 35% of participants (55 of 160) met modified criteria of metabolic syndrome, and 65% (102 of 160) had CRP levels greater than 3 mg/L, an established cutoff for increased cardiovascular risk.31 However, despite these metabolic and immune alterations, we failed to demonstrate an antidepressive effect of simvastatin.