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Jia QF, Yang HX, Zhuang NN, Yin XY, Zhu ZH, Yuan Y, Yin XL, Wang Y, Cheung EFC, Chan RCK, Hui L. The role of lipoprotein profile in depression and cognitive performance: a network analysis. Sci Rep 2020; 10:20704. [PMID: 33244178 PMCID: PMC7693273 DOI: 10.1038/s41598-020-77782-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 11/17/2020] [Indexed: 12/18/2022] Open
Abstract
Lipid profile (total cholesterol and lipoprotein fractions) has been found to correlate with depression and cognitive impairment across the lifespan. However, the role of lipid levels in self-rated depressive state and cognitive impairment remains unclear. In this study, we examined the relationship between lipid profile (total cholesterol, triglycerides, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol) and cognition in adults with and without self-rated depression. Four hundred and thirty-eight healthy participants completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Self-Rating Depression Scale (SDS), and a serum lipoprotein test. Using multivariate ANOVA, partial correlation and network analysis, a network linking lipoprotein profile, depressive state and cognition was constructed. A significant difference in serum lipid profile between the high and low depressive groups was detected. Depressive state had a strong negative correlation with cognitive performance. Of the lipid profile, only high-density lipoprotein was positively correlated with depressive symptom severity, whereas the other three indices showed negative correlation with both depressive state and cognitive performance. Our results suggest that serum lipid profile may be directly linked to self-rated depression and cognitive performance. Further studies recruiting larger clinical samples are needed to elucidate the specific effect of lipoprotein on cognitive impairment in mood disorder.
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Affiliation(s)
- Qiu-Fang Jia
- The Affiliated Guangji Hospital of Soochow University, Medical College of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Han-Xue Yang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health Institute of Psychology, Beijing, People's Republic of China
| | - Nan-Nan Zhuang
- The Affiliated Guangji Hospital of Soochow University, Medical College of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Xu-Yuan Yin
- The Affiliated Guangji Hospital of Soochow University, Medical College of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Zhen-Hua Zhu
- The Affiliated Guangji Hospital of Soochow University, Medical College of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Ying Yuan
- The Affiliated Guangji Hospital of Soochow University, Medical College of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Xiao-Li Yin
- Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health Institute of Psychology, Beijing, People's Republic of China
| | | | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health Institute of Psychology, Beijing, People's Republic of China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, People's Republic of China.
| | - Li Hui
- The Affiliated Guangji Hospital of Soochow University, Medical College of Soochow University, Suzhou, Jiangsu, People's Republic of China.
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Fan H, Ma X, Lin P, Kang Q, Zhao Z, Wang L, Sun D, Cheng J, Li Y. Scutellarin Prevents Nonalcoholic Fatty Liver Disease (NAFLD) and Hyperlipidemia via PI3K/AKT-Dependent Activation of Nuclear Factor (Erythroid-Derived 2)-Like 2 (Nrf2) in Rats. Med Sci Monit 2017; 23:5599-5612. [PMID: 29172017 PMCID: PMC5712520 DOI: 10.12659/msm.907530] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Nonalcoholic fatty liver disease (NAFLD) is a condition characterized by excessive fat accumulation in the form of triglycerides. The incidence of NAFLD and hyperlipidemia, with their associated risks of end-stage liver and cardiovascular diseases, is increasing rapidly. This study aimed to investigate the effects of scutellarin on the experimental NAFLD in high-fat diet fed and chronic stress rats, and its possible mechanism. Material/Methods Sprague-Dawley rats were fed with high-fat diet and subjected to chronic stress for 12 weeks, and administered orally with scutellarin for 4 weeks (n=8), and then blood and livers were harvested for analyzing. Enzyme activity assay, immunofluorescence, Western blot, and quantitative RT-PCR were performed to analyze the factors of the oxidant/antioxidant system and pathway. Results After the high-fat diet and chronic stress administration for 12 weeks, serum and liver lipid metabolism of treatment groups with the different doses of SCU effectively improved and the degree of oxidative damage reduced. Using Western blot assay and immunofluorescence (IF) staining assay, Nrf2, HO-1, and PI3K, and AKT proteins significantly increased after SCU treatment for 4 weeks (P<0.01). The hepatic mRNA expression of HO-1, NQO1, and Nrf2 in SCU treatment groups was upregulated significantly through quantitative RT-PCR assay (P<0.05). However, compared to the positive control group, no difference was detected in the SCU (100 or 300 mg/kg) groups (P>0.05). These results indicate that SCU protects against NAFLD in rats via attenuation of oxidative stress. Conclusions The antioxidant effects of SCU on NAFLD are possibly dependent on PI3K/AKT activation with subsequent Nrf2 nuclear translocation, which increases expression of HO-1 and NQO1. We therefore suggest that breviscapine may be a potentially useful therapeutic strategy for NAFLD and hyperlipidemia.
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Affiliation(s)
- Hua Fan
- Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China (mainland)
| | - Xiande Ma
- Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China (mainland)
| | - Peng Lin
- Liaoning Institute for Drug Control, Shenyang, Liaoning, China (mainland)
| | - Qiang Kang
- Liaoning Institute for Drug Control, Shenyang, Liaoning, China (mainland)
| | - Zhilong Zhao
- Liaoning Institute for Drug Control, Shenyang, Liaoning, China (mainland)
| | - Lina Wang
- Liaoning Institute for Drug Control, Shenyang, Liaoning, China (mainland)
| | - Dan Sun
- Liaoning Institute for Drug Control, Shenyang, Liaoning, China (mainland)
| | - Jiayi Cheng
- Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China (mainland)
| | - Yajun Li
- Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China (mainland)
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Persons JE, Robinson JG, Payne ME, Fiedorowicz JG. Serum lipid changes following the onset of depressive symptoms in postmenopausal women. Psychiatry Res 2017; 247:282-287. [PMID: 27940323 PMCID: PMC6004601 DOI: 10.1016/j.psychres.2016.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 12/01/2016] [Indexed: 01/23/2023]
Abstract
A cross-sectional association between depression and serum low-density lipoprotein cholesterol (LDL-c) has been noted in psychiatric literature, raising the question of temporality: does low LDL-c predict depression, does depression lead to changes in LDL-c levels, or is this relationship bidirectional? In a previous longitudinal analysis of postmenopausal women ages 50-79 who participated in the Women's Health Initiative (WHI), we detected an association between low LDL-c and the subsequent onset of depressive symptoms (HR=1.25, 95% CI 1.05-1.49, p=0.01). This current study uses the WHI cohort to explore the question of temporality in the opposite direction, examining the influence of depressive symptoms on subsequent changes in LDL-c levels. This study provides no evidence to suggest an association between depression and subsequent changes in LDL-c level (-2.78mg/dL, 95% CI=-7.49 to 1.92, p=0.25), nor was any association detected for total cholesterol, HDL, or triglyceride changes over time. Further, this study demonstrates that the relationship between depression and serum LDL changes is not mediated by changes in weight, exercise, or energy intake.
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Affiliation(s)
- Jane E. Persons
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Jennifer G. Robinson
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, USA,Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, IA, USA
| | - Martha E. Payne
- Office of Research Development, Duke University Medical Center, Durham, NC, USA
| | - Jess G. Fiedorowicz
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, USA,Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, IA, USA,Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, IA, USA,François M. Abboud Cardiovascular Research Center, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, IA, USA
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Persons JE, Fiedorowicz JG. Depression and serum low-density lipoprotein: A systematic review and meta-analysis. J Affect Disord 2016; 206:55-67. [PMID: 27466743 PMCID: PMC6201299 DOI: 10.1016/j.jad.2016.07.033] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/26/2016] [Accepted: 07/16/2016] [Indexed: 01/20/2023]
Abstract
BACKGROUND A cross-sectional association between depression and serum low-density lipoprotein (LDL) has been noted in the literature. This study aims to employ meta-analytic techniques to clarify the relationship between depression and serum LDL. METHODS Published articles through April 2015 were identified through systematic query of PubMed with follow-up manual searches. Data from 36 studies reporting mean difference and 7 studies reporting odds ratios were analyzed separately. RESULTS Meta-analysis of studies modeling serum LDL as a continuous measure demonstrates overall significantly lower serum LDL in depression (Mean difference=-4.29, 95% CI=-8.19, -0.40, p=0.03). Meta-analysis of studies modeling serum LDL as a categorical measure demonstrates a marginally significant lower odds of depression in the presence of low serum LDL relative to high serum LDL (OR=0.90, 95% CI=0.80, 1.01, p=0.08). LIMITATIONS High heterogeneity was noted across sampled studies, which may be a function of variations in study design, participants sampled, or other factors. The potential for publication bias was also assessed. CONCLUSIONS This meta-analysis demonstrates a cross-sectional link between depression and low serum LDL.
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Affiliation(s)
- Jane E. Persons
- Department of Epidemiology College of Public Health,Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA,Corresponding author (Jane E. Persons):
| | - Jess G. Fiedorowicz
- Department of Epidemiology College of Public Health,Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA,Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA,François M. Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, IA
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Lee MY, Kim EY, Kim SH, Cho KC, Ha K, Kim KP, Ahn YM. Discovery of serum protein biomarkers in drug-free patients with major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2016; 69:60-8. [PMID: 27105922 DOI: 10.1016/j.pnpbp.2016.04.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/12/2016] [Accepted: 04/18/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is a systemic and multifactorial disorder involving complex interactions between genetic predisposition and disturbances of various molecular pathways. Its underlying molecular pathophysiology remains unclear, and no valid and objective diagnostic tools for the condition are available. METHODS We performed large-scale proteomic profiling to identify novel peripheral biomarkers implicated in the pathophysiology of MDD in 25 drug-free female MDD patients and 25 healthy controls. First, quantitative serum proteome profiles were obtained and analyzed by liquid chromatography-tandem mass spectrometry using serum samples from 10 MDD patients and 10 healthy controls. Next, candidate biomarker sets, including differentially expressed proteins from the profiling experiment and those identified in the literature, were verified using multiple-reaction monitoring in 25 patients and 25 healthy controls. The final panel of potential biomarkers was selected using multiparametric statistical analysis. RESULTS We identified a serum biomarker panel consisting of six proteins: apolipoprotein D, apolipoprotein B, vitamin D-binding protein, ceruloplasmin, hornerin, and profilin 1, which could be used to distinguish MDD patients from controls with 68% diagnostic accuracy. Our results suggest that modulation of the immune and inflammatory systems and lipid metabolism are involved in the pathophysiology of MDD. CONCLUSIONS Our findings of functional proteomic changes in the peripheral blood of patients with MDD further clarify the molecular biological pathway underlying depression. Further studies using larger, independent cohorts are needed to verify the role of these candidate biomarkers for the diagnosis of MDD.
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Affiliation(s)
- Min Young Lee
- Institute for Systems Biology, Seattle, WA, United States; Department of Applied Chemistry, College of Applied Science, Kyung Hee University, Yongin, Republic of Korea
| | - Eun Young Kim
- Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Se Hyun Kim
- Department of Neuropsychiatry, Dongguk University Medical School, Dongguk University International Hospital, Goyang, Republic of Korea
| | - Kyung-Cho Cho
- Department of Applied Chemistry, College of Applied Science, Kyung Hee University, Yongin, Republic of Korea
| | - Kyooseob Ha
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea;; Seoul National Hospital, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kwang Pyo Kim
- Department of Applied Chemistry, College of Applied Science, Kyung Hee University, Yongin, Republic of Korea.
| | - Yong Min Ahn
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Somatic concerns, depressive traits, atherosclerosis and the incidence of cardiovascular disease in ageing Finnish men. J Psychosom Res 2015; 79:207-13. [PMID: 26013320 DOI: 10.1016/j.jpsychores.2015.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 05/06/2015] [Accepted: 05/11/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To examine the impact of somatic concerns and depressive traits on carotid artery intima-media thickness (IMT) and on the incidence of cardiovascular disease (CVD). METHODS In the cross-sectional study of 2682 Finnish men aged 42 to 61years, a subsample of 1333 men had their carotid artery IMT recorded. In the prospective part of the study participants (n=1453) were followed up for an average of 20years. Data on incident CVD (n=766) were obtained from the National Population Register. For both subsamples, the Minnesota Multiphasic Personality Inventory (MMPI) was used to measure depressive traits and somatic concerns. In addition, composite scales of general ill-being, sleep and pain problems, psychological well-being, energy level, and cheerfulness were formed. RESULTS In the final corrected models there were no significant associations between somatic concerns or depressive traits and IMT. Both somatic concerns and depressive traits predicted a higher CVD incidence after adjustments for age and risk factors. The association between depressive traits and CVD incidence was highest among the subgroup of men with the highest levels of hsCRP, but this result did not reach statistical significance. Of the composite scales, general ill-being predicted a higher CVD incidence in the fully adjusted model, even when all the composite scales were entered into the model simultaneously. CONCLUSION Somatic concerns and depressive traits predict a higher CVD incidence. In particular, general ill-being contributes to this association. The association between depressive traits and CVD may be moderated by low-grade inflammation.
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Beydoun MA, Beydoun HA, Dore GA, Fanelli-Kuczmarski MT, Evans MK, Zonderman AB. Total serum cholesterol, atherogenic indices and their longitudinal association with depressive symptoms among US adults. Transl Psychiatry 2015; 5:e518. [PMID: 25734511 PMCID: PMC4354360 DOI: 10.1038/tp.2015.4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 12/02/2014] [Indexed: 11/17/2022] Open
Abstract
Serum cholesterol, both total and lipoprotein fractions, has been associated with mid- and late-life depression. Using longitudinal data on a large and ethnically diverse sample of urban adults, the associations of serum lipid profile measured by high or low total cholesterol (TC; >200 mg dl(-1); <160 mg dl(-1)) and by atherogenic indices, namely high total cholesterol and low-density lipoprotein cholesterol relative to high-density lipoprotein cholesterol, with change in total and domain-specific depressive symptoms over time were examined. Findings were compared by sex. (Hypothesis 1) In addition, baseline depressive symptoms as predictors for longitudinal change in lipid profile trajectory were tested. (Hypothesis 2) Mixed-effects regression analyses stratified by sex was used. Sample sizes of participants (n) and repeated observations (n') were: Hypothesis 1 (Men: n=826 ; n'=1319; Women: n=1099 ; n'=1817); Hypothesis 2 (Men: n=738; n'=1230; Women: n=964; n'=1678). As hypothesized, a higher level of atherogenic indices was linked to faster increase in depressive symptom scores, particularly depressed affect and interpersonal problems, though this relationship was found only among women. Among men a U-shaped relationship between baseline TC and longitudinal increase in somatic complaints and a direct link between low TC and longitudinal putative improvement in positive affect was found. On excluding statin users among women, low TC was associated with slower increase in depressed affect over time, whereas high TC was associated with faster increase in interpersonal problems. In summary, atherogenic indices were directly linked to faster increase in depressive symptoms among women only. More studies are needed to explain these sex-specific associations.
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Affiliation(s)
- M A Beydoun
- NIH Biomedical Research Center, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA
| | - H A Beydoun
- Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA, USA
| | - G A Dore
- NIH Biomedical Research Center, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA
| | - M T Fanelli-Kuczmarski
- Department of Health, Nutrition and Exercise Sciences, University of Delaware, Newark, DE, USA
| | - M K Evans
- NIH Biomedical Research Center, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA
| | - A B Zonderman
- NIH Biomedical Research Center, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA
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Lehto SM, Tolmunen T, Ruusunen A, Voutilainen S, Tuomainen TP, Kauhanen J. Serum zinc and the risk of depression in men: observations from a 20-year follow-up study. Biol Psychiatry 2015; 77:e11-e12. [PMID: 25034952 DOI: 10.1016/j.biopsych.2014.05.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 05/16/2014] [Accepted: 05/17/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Soili M Lehto
- Department of Psychiatry, Institute of Clinical Medicine, University of Eastern Finland; Department of Psychiatry, Kuopio University Hospital.
| | - Tommi Tolmunen
- Department of Psychiatry, Institute of Clinical Medicine, University of Eastern Finland; Department of Psychiatry, Kuopio University Hospital
| | - Anu Ruusunen
- Department of Psychiatry, Kuopio University Hospital
| | - Sari Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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Ladwig KH, Lederbogen F, Albus C, Angermann C, Borggrefe M, Fischer D, Fritzsche K, Haass M, Jordan J, Jünger J, Kindermann I, Köllner V, Kuhn B, Scherer M, Seyfarth M, Völler H, Waller C, Herrmann-Lingen C. Position paper on the importance of psychosocial factors in cardiology: Update 2013. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2014; 12:Doc09. [PMID: 24808816 PMCID: PMC4012565 DOI: 10.3205/000194] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Indexed: 12/30/2022]
Abstract
Background: The rapid progress of psychosomatic research in cardiology and also the increasing impact of psychosocial issues in the clinical daily routine have prompted the Clinical Commission of the German Heart Society (DGK) to agree to an update of the first state of the art paper on this issue which was originally released in 2008. Methods: The circle of experts was increased, general aspects were implemented and the state of the art was updated. Particular emphasis was dedicated to coronary heart diseases (CHD), heart rhythm diseases and heart failure because to date the evidence-based clinical knowledge is most advanced in these particular areas. Differences between men and women and over the life span were considered in the recommendations as were influences of cognitive capability and the interactive and synergistic impact of classical somatic risk factors on the affective comorbidity in heart disease patients. Results: A IA recommendation (recommendation grade I and evidence grade A) was given for the need to consider psychosocial risk factors in the estimation of coronary risks as etiological and prognostic risk factors. Furthermore, for the recommendation to routinely integrate psychosocial patient management into the care of heart surgery patients because in these patients, comorbid affective disorders (e.g. depression, anxiety and post-traumatic stress disorder) are highly prevalent and often have a malignant prognosis. A IB recommendation was given for the treatment of psychosocial risk factors aiming to prevent the onset of CHD, particularly if the psychosocial risk factor is harmful in itself (e.g. depression) or constrains the treatment of the somatic risk factors. Patients with acute and chronic CHD should be offered anti-depressive medication if these patients suffer from medium to severe states of depression and in this case medication with selective reuptake inhibitors should be given. In the long-term course of treatment with implanted cardioverter defibrillators (ICDs) a subjective health technology assessment is warranted. In particular, the likelihood of affective comorbidities and the onset of psychological crises should be carefully considered. Conclusions: The present state of the art paper presents an update of current empirical evidence in psychocardiology. The paper provides evidence-based recommendations for the integration of psychosocial factors into cardiological practice and highlights areas of high priority. The evidence for estimating the efficiency for psychotherapeutic and psychopharmacological interventions has increased substantially since the first release of the policy document but is, however, still weak. There remains an urgent need to establish curricula for physician competence in psychodiagnosis, communication and referral to ensure that current psychocardiac knowledge is translated into the daily routine.
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Affiliation(s)
- Karl-Heinz Ladwig
- Deutsches Forschungszentrum für Gesundheit und Umwelt, Institut für Epidemiologie-2, Helmholtz-Zentrum München, Neuherberg, Germany ; Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Klinikum Rechts der Isar der TU München, Germany
| | - Florian Lederbogen
- Zentralinstitut für Seelische Gesundheit, Universität Heidelberg, Medizinische Fakultät Mannheim, Germany
| | - Christian Albus
- Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universitätsklinikum Köln, Germany
| | | | - Martin Borggrefe
- I. Medizinische Klinik für Kardiologie, Angiologie, Pneumologie, Internistische Intensivmedizin und Hämostaseologie, Universitätsmedizin Mannheim, Germany
| | - Denise Fischer
- Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Kurt Fritzsche
- Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Freiburg, Germany
| | - Markus Haass
- Innere Medizin II: Kardiologie, Angiologie und Internistische Intensivmedizin, Theresienkrankenhaus und St. Hedwig-Klinik, Mannheim, Germany
| | - Jochen Jordan
- Herz-, Thorax- und Rheumazentrum, Abteilung für Psychokardiologie, Kerckhoff Klinik, Bad Nauheim, Germany
| | - Jana Jünger
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Universität Heidelberg, Germany
| | - Ingrid Kindermann
- Innere Medizin III (Kardiologie/Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Volker Köllner
- Medizinische Fakultät, Universität des Saarlandes, Blieskastel, Germany
| | - Bernhard Kuhn
- Fachpraxis für Innere Medizin, Kardiologie, Angiologie und Notfallmedizin, Heidelberg, Germany
| | - Martin Scherer
- Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Melchior Seyfarth
- Medizinische Klinik 3 (Kardiologie), Helios-Klinikum Wuppertal-Herzzentrum, Universität Witten/Herdecke, Wuppertal, Germany
| | - Heinz Völler
- Fachklinik für Innere Medizin, Abteilung Kardiologie, Klinik am See, Rüdersdorf, Germany
| | - Christiane Waller
- Abteilung Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Germany
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Tolmunen T, Lehto SM, Julkunen J, Hintikka J, Kauhanen J. Trait anxiety and somatic concerns associate with increased mortality risk: a 23-year follow-up in aging men. Ann Epidemiol 2014; 24:463-8. [PMID: 24731699 DOI: 10.1016/j.annepidem.2014.03.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 03/11/2014] [Accepted: 03/11/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE We aimed to examine the impact of anxiety and somatic concerns on the mortality risk during a 23-year follow-up of a representative sample of men. METHODS Finnish men aged 42-61 years (n = 2388) were followed up for a median of 23.4 years. Anxiety was assessed using baseline scores for the Minnesota Multiphasic Personality Inventory Psychasthenia subscale and somatic concerns were measured with the Hypochondriasis subscale. Mortality data were obtained from the National Population Register. RESULTS All-cause, injury, disease, cardiovascular, and cancer mortalities were examined as endpoints. Adjustments were performed for age, smoking, alcohol consumption, physical activity, low- and high-density lipoprotein cholesterol, body mass index, systolic blood pressure, a history of cardiovascular disease, marital status, socioeconomic status, the Framingham Type A Behavior Pattern Scale, and life events during the 12 months before the baseline examination. Anxiety and somatic concerns predicted the all-cause mortality risk after full adjustments for sociodemographic background, lifestyle factors, and descriptors of somatic health. Regarding other forms of mortality, the risk ratios were significant after full adjustments in anxiety for injury and in somatic concerns for disease death. CONCLUSIONS This study supported previous findings of anxiety predicting the all-cause mortality risk in men. Somatic concerns are a novel factor that needs to be taken into account while examining associations between personality and the risk of increased mortality.
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Affiliation(s)
- Tommi Tolmunen
- Department of Psychiatry, Institute of Clinical Medicine, University of Eastern Finland, Finland; Department of Psychiatry, Kuopio University Hospital, Finland.
| | - Soili M Lehto
- Department of Psychiatry, Institute of Clinical Medicine, University of Eastern Finland, Finland; Department of Psychiatry, Kuopio University Hospital, Finland
| | - Juhani Julkunen
- Department of Psychiatry, Kuopio University Hospital, Finland; Department of Psychology, Institute of Behavioural Sciences, University of Helsinki, Finland
| | - Jukka Hintikka
- Department of Psychology, Institute of Behavioural Sciences, University of Helsinki, Finland; Department of Psychiatry, Päijät-Häme Central Hospital and University of Tampere, Lahti, Finland; Department of Psychiatry, University of Tampere, Lahti, Finland
| | - Jussi Kauhanen
- Department of Psychiatry, Päijät-Häme Central Hospital and University of Tampere, Lahti, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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Hocaoglu C, Kural B, Aliyazıcıoglu R, Deger O, Cengiz S. IL-1β, IL-6, IL-8, IL-10, IFN-γ, TNF-α and its relationship with lipid parameters in patients with major depression. Metab Brain Dis 2012; 27:425-30. [PMID: 22707092 DOI: 10.1007/s11011-012-9323-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 06/07/2012] [Indexed: 01/22/2023]
Abstract
There is some evidence that an immune response with an increased production of proinflammatory cytokines frequently accompanies major depression. The aim of this study was to determine the serum levels of interleukines (IL-1β, IL-6, IL-8, IL-10), tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ) and immonuglobulines (IgG, IgA and IgM) levels and to examine the relationships between all above parameters and lipid parameters. The study group included 30 patients and 30 healthy volunteers. Although total cholesterol, HDL-cholesterol, and IgM levels were increased significantly (p < 0.05) in patients and compared to those of the controls, no statistically significant differences (p > 0.05) were observed with other parameters. IFN-γ were positively correlated with total cholesterol (r = 0.425; P = 0.019) and LDL-cholesterol (r = 0.391; P = 0.032) levels in patients. Other cytokines and immunoglobulins did not show any correlation with lipid parameters. It was concluded that although no differences was observed in cytokines and immunoglobulin levels in the present study, the dysregulation of the lipids and immune system including the cytokine network is associated with the etiology and pathophysiology of major depressive disorders.
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Affiliation(s)
- Cicek Hocaoglu
- Department of Psychiatry, Faculty of Medicine, Rize University, 53100, Rize, Turkey.
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Woods AG, Sokolowska I, Taurines R, Gerlach M, Dudley E, Thome J, Darie CC. Potential biomarkers in psychiatry: focus on the cholesterol system. J Cell Mol Med 2012; 16:1184-95. [PMID: 22304330 PMCID: PMC3823072 DOI: 10.1111/j.1582-4934.2012.01543.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Measuring biomarkers to identify and assess illness is a strategy growing in popularity and relevance. Although already in clinical use for treating and predicting cancer, no biological measurement is used clinically for any psychiatric disorder. Biomarkers could predict the course of a medical problem, and aid in determining how and when to treat. Several studies have indicated that of candidate psychiatric biomarkers detected using proteomic techniques, cholesterol and associated proteins, specifically apolipoproteins (Apos), may be of interest. Cholesterol is necessary for brain development and its synthesis continues at a lower rate in the adult brain. Apos are the protein component of lipoproteins responsible for lipid transport. There is extensive evidence that the levels of cholesterol and Apos may be disturbed in psychiatric disorders, including autistic spectrum disorders (ASD). Here, we describe putative serum biomarkers for psychiatric disorders, and the role of cholesterol and Apos in central nervous system (CNS) disorders.
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Affiliation(s)
- Alisa G Woods
- Department of Chemistry & Biomolecular Science, Biochemistry & Proteomics Group, Clarkson University, Potsdam, NY 13699, USA.
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Comparative proteomic analysis of plasma from major depressive patients: identification of proteins associated with lipid metabolism and immunoregulation. Int J Neuropsychopharmacol 2012; 15:1413-25. [PMID: 22717272 DOI: 10.1017/s1461145712000302] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Major depressive disorder is a common neuropsychiatric disorder contributing to several socio-economic burdens including disability and suicide. As the underlying pathophysiology of major depressive disorder remains unclear, no objective test is yet available for aiding diagnosis or monitoring disease progression. To contribute to a better understanding of its pathogenesis, a comparative proteomic study was performed to identify proteins differentially expressed in plasma samples obtained from first-onset, treatment-naive depressed patients as compared to healthy controls. Samples from the two groups were immunodepleted of seven high-abundance proteins, labelled with isobaric tags for relative and absolute quantitation and then analysed by multi-dimensional liquid chromatography-tandem mass spectrometry. The proteomic results were further validated by immunoblotting or enzyme-linked immunoadsorbent assays and analysed with the MetaCore database. The results demonstrate that the functions of the altered proteins are primarily involved in lipid metabolism and immunoregulation. These findings suggest that early perturbation of lipid metabolism and immunoregulation may be involved in the pathophysiology of major depressive disorder.
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Jaddoe VWV, van Duijn CM, Franco OH, van der Heijden AJ, van Iizendoorn MH, de Jongste JC, van der Lugt A, Mackenbach JP, Moll HA, Raat H, Rivadeneira F, Steegers EAP, Tiemeier H, Uitterlinden AG, Verhulst FC, Hofman A. The Generation R Study: design and cohort update 2012. Eur J Epidemiol 2012. [PMID: 23086283 DOI: 10.1007/s10654‐012‐9735‐1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Generation R Study is a population-based prospective cohort study from fetal life until adulthood. The study is designed to identify early environmental and genetic causes and causal pathways leading to normal and abnormal growth, development and health during fetal life, childhood and adulthood. The study focuses on six areas of research: (1) maternal health; (2) growth and physical development; (3) behavioural and cognitive development; (4) respiratory health and allergies; (5) diseases in childhood; and (6) health and healthcare for children and their parents. Main exposures of interest include environmental, endocrine, genetic and epigenetic, lifestyle related, nutritional and socio-demographic determinants. In total, n = 9,778 mothers with a delivery date from April 2002 until January 2006 were enrolled in the study. Response at baseline was 61 %, and general follow-up rates until the age of 6 years exceed 80 %. Data collection in mothers, fathers and children include questionnaires, detailed physical and ultrasound examinations, behavioural observations, and biological samples. A genome and epigenome wide association screen is available in the participating children. From the age of 5 years, regular detailed hands-on assessments are performed in a dedicated research center including advanced imaging facilities such as Magnetic Resonance Imaging. Eventually, results forthcoming from the Generation R Study contribute to the development of strategies for optimizing health and healthcare for pregnant women and children.
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Affiliation(s)
- Vincent W V Jaddoe
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.
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Jaddoe VWV, van Duijn CM, Franco OH, van der Heijden AJ, van IIzendoorn MH, de Jongste JC, van der Lugt A, Mackenbach JP, Moll HA, Raat H, Rivadeneira F, Steegers EAP, Tiemeier H, Uitterlinden AG, Verhulst FC, Hofman A. The Generation R Study: design and cohort update 2012. Eur J Epidemiol 2012; 27:739-56. [DOI: 10.1007/s10654-012-9735-1] [Citation(s) in RCA: 423] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 09/20/2012] [Indexed: 12/11/2022]
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Tedders SH, Fokong KD, McKenzie LE, Wesley C, Yu L, Zhang J. Low cholesterol is associated with depression among US household population. J Affect Disord 2011; 135:115-21. [PMID: 21802743 DOI: 10.1016/j.jad.2011.06.045] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 06/28/2011] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Serum cholesterol was reported to be associated with depressed mood, but the studies conducted among household population are rare. METHODS We used the data of 4115 men and 4275 women aged 18 or older, who completed a depression screening interview and had blood collected as a part of the National Health and Nutrition Examination Survey, 2005-2008. The serum concentrations of total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were gender-specifically categorized into lower, intermediate, and upper quartiles. Depression was measured using the Patient Health Questionnaire, a 9-item screening instrument asking about the frequency of depression symptoms over the past 2 weeks. RESULTS After adjustment for socio-demographics and behavioral risks, a U-shaped association was detected between severe depression and LDL-C among men. The odds ratios (ORs) of severe depression were 5.13 (95% CI=1.74-15.09), 1 (reference) and 2.28 (1.07-4.86) respectively for the men with lower (<169 mg/dL), intermediate (169-221 mg/dL), and upper quartile (≥ 222 mg/dL) LDL-C. Among women, lower HDL-C was significantly associated with an elevated odds of severe depression [OR=2.96 (1.59-5.52)] compared with upper quartile of HDL-C, the association diminished after adjustment for covariates [OR=1.24 (0.66-2.32)]. No clear pattern of association between cholesterol and moderate depression was observed from either men or women. LIMITATION The inherent limitation of cross-sectional design prevented the authors from investigating causality. CONCLUSIONS A U-shaped association was identified between LDL-C and severe depression among men. Further studies are necessary to explore the biological mechanism and identify the clinical implication among populations vulnerable to psychiatric disorders.
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Affiliation(s)
- Stuart H Tedders
- Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA
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Ilomäki J, Bell JS, Kauhanen J, Enlund H. Heavy drinking and use of sedative or anxiolytic drugs among aging men: an 11-year follow-up of the FinDrink study. Ann Pharmacother 2011; 45:1240-7. [PMID: 21896919 DOI: 10.1345/aph.1q375] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Most studies on heavy drinking and sedative/anxiolytic drug use have been cross-sectional, and evidence for a possible temporal association is lacking. OBJECTIVE To prospectively investigate whether heavy drinking predicts initiation, continuation, or discontinuation of sedative/anxiolytic drugs at 4 and 11 years and, conversely, whether sedative/anxiolytic drug use predicts heavy drinking. METHOD This was a longitudinal population-based study conducted in Kuopio, Finland. An age-stratified random sample of 1516 men aged 42, 48, 54, and 60 years received a structured clinical examination at baseline (August 1986-December 1989). Follow-up clinical examinations were conducted at 4 (n = 1038) and 11 (n = 854) years. Multinomial logistic regression was used to compute odds ratios and 95% confidence intervals for the association between sedative/anxiolytic drug use and initiation, continuation, and discontinuation of heavy drinking (≥ 14 drinks/wk). The reverse association between heavy drinking and sedative/anxiolytic drug use was also investigated. Regression models were adjusted for age, working status, smoking, and depressive symptoms. RESULTS At baseline 12.9% (134/1038) of participants were heavy drinkers and 4.0% (41/1030) used sedative/anxiolytic drugs. In multivariate analyses, baseline heavy drinking predicted initiation of sedative/anxiolytic drug use at 4 years (OR 2.96; 95% CI 1.23 to 7.15). Conversely, baseline sedative/anxiolytic drug use predicted continuation of heavy drinking at 11 years in unadjusted analysis (OR 3.30; 95% CI 1.19 to 8.44). However, the association was not statistically significant in adjusted analyses (OR 2.69; 95% CI 0.86 to 8.44). CONCLUSIONS The main finding of this study was the association between heavy drinking and subsequent initiation of sedative/anxiolytic drugs that was not fully explained by baseline depressive symptoms. This may inform strategies to optimize the use of sedative/anxiolytic drugs, and assist in the early identification of patients at risk of heavy drinking. Clinicians should consider a patient's alcohol consumption prior to prescribing or dispensing sedative/anxiolytic drugs. Clinicians should also monitor patients prescribed sedative/anxiolytic drugs for subsequent heavy drinking.
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Affiliation(s)
- Jenni Ilomäki
- Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
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Hofman A, van Duijn CM, Franco OH, Ikram MA, Janssen HLA, Klaver CCW, Kuipers EJ, Nijsten TEC, Stricker BHC, Tiemeier H, Uitterlinden AG, Vernooij MW, Witteman JCM. The Rotterdam Study: 2012 objectives and design update. Eur J Epidemiol 2011; 26:657-86. [PMID: 21877163 PMCID: PMC3168750 DOI: 10.1007/s10654-011-9610-5] [Citation(s) in RCA: 263] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Accepted: 08/08/2011] [Indexed: 01/09/2023]
Abstract
The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, oncological, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in over a 1,000 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy ). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.
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Affiliation(s)
- Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
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