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Liu Z, Sun L, Sun F, Zhang Y, Wang J, Zhang Z, Sun G, Sun L, Yang R, Yao G, Liu Y. The abnormalities of lipid metabolism in children and adolescents with major depressive disorder and relationship with suicidal ideation and attempted suicide. Heliyon 2024; 10:e30344. [PMID: 38726112 PMCID: PMC11079100 DOI: 10.1016/j.heliyon.2024.e30344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 04/11/2024] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
Background Major depressive disorder (MDD) is a widespread health issue in many countries, which has an extremely negative impact on the health of children and adolescents in particular. In the context of depression and metabolic disorders, dyslipidemia and metabolism-related problems become more prominent comorbidities. However, they continue to be the main barrier to the successful recovery of the clinical progress. In this study we investigated the rate of dyslipidemia, additional risk factors among Chinese children and adolescents with MDD, and association of the suicidal behavior with lipid levels. Methods The study took 756 people from the Third People's Hospital of Fuyang between January 2020 and December 2021, aged between 8 and 18, with major depressive disorders diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). We determined the FBG (fasting blood glucose) and lipid parameters in all subjects and also investigated the history of suicidal ideation, the cases of attempted suicide, and the scores of depressive symptoms. Sociodemographic and clinical data were gathered and analyzed using the SPSS-23.0 version. Results The prevalence of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C were 5.42 % (41/756), 10.58 % (80/756), 3.84 % (29/756) and 5.42 % (41/756) respectively. For hypercholesterolemia and hypertriglyceridemia, they were positive associated with suicidal ideation and suicide attempts, and the positive correlation is shown between low HDL-C levels and suicide attempts. Nevertheless, non-ideation and inversely suicidal attempts were not discovered among high-LDL-C subjects. Logistic analysis showed that high levels of FBG (OR = 2.86, 95 % CI: 1.31-6.25, P = 0.008) and worse LDL-C (OR = 357.82, 95 % CI: 66.16-1935.10, P < 0.001) are the independent associated factors for hypercholesterolemia. More hospitalizations (OR = 1.89, 95 % CI: 1.07-3.35, P = 0.028), obesity (OR = 2.55, 95 % CI: 1.25-5.18, P = 0.010), high levels of TC (OR = 2.15, 95 % CI: 1.03-4.48, P = 0.042), and higher doses of antidepressants (OR = 1.02, 95 % CI: 1.00-1.04, P = 0.029) were independently associated factors for hypertriglyceridemia, while high levels of HDL-C (OR = 0.11, 95 % CI: 0.04-0.31, P < 0.001) were protective factors. In addition, high levels of TC (OR = 113.94, 95 % CI: 20.01-648.85) were statistically different (P < 0.001) and suggested that the factor was significantly related to high LDL-C. Meanwhile, older age (OR = 1.25, 95 % CI: 1.02-1.52, P = 0.030) and high levels of TG (OR = 3.00, 95 % CI: 1.98-4.55, P < 0.001) were independent factors contributing to low HDL-C. Conclusion The high prevalence of dyslipidemia in childhood and adolescence among children and adolescents with depressive disorder has become a public health issue. Hypercholesterolemia and hypertriglyceridemia showed a positive correlation with suicidal thoughts and suicidal attempts. Monitoring the incidence of suicidal thoughts and attempts among them would carry some predictor meaning in therapy and for jumping back to health.
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Affiliation(s)
- Zhiwei Liu
- Department of Psychiatry, The Third People's Hospital of Fuyang, Fuyang, 236015, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, 236015, China
| | - Liang Sun
- Department of Psychiatry, The Third People's Hospital of Fuyang, Fuyang, 236015, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, 236015, China
| | - Feng Sun
- Department of Psychiatry, The Third People's Hospital of Fuyang, Fuyang, 236015, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, 236015, China
| | - Yulong Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 238000, China
| | - Juan Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 610036, China
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, 610036, China
| | - Zhaokun Zhang
- Department of Psychiatry, The Third People's Hospital of Fuyang, Fuyang, 236015, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, 236015, China
| | - Guangying Sun
- Department of Psychiatry, The Third People's Hospital of Fuyang, Fuyang, 236015, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, 236015, China
| | - Longlong Sun
- Department of Psychiatry, The Third People's Hospital of Fuyang, Fuyang, 236015, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, 236015, China
| | - Rongchun Yang
- Department of Psychiatry, The Third People's Hospital of Fuyang, Fuyang, 236015, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, 236015, China
| | - Gaofeng Yao
- Department of Psychiatry, The Third People's Hospital of Fuyang, Fuyang, 236015, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, 236015, China
| | - Yun Liu
- Department of Psychiatry, The Third People's Hospital of Fuyang, Fuyang, 236015, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, 236015, China
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Qing G, Deng W, Zhou Y, Zheng L, Wang Y, Wei B. The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and suicidal ideation in adults: a population-based study in the United States. Lipids Health Dis 2024; 23:17. [PMID: 38218917 PMCID: PMC10788025 DOI: 10.1186/s12944-024-02012-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/09/2024] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND The ratio of non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) (NHHR) serves as a reliable lipid indicator associated with atherogenic characteristics. Studies have indicated a potential connection between suicidality and lipid metabolism. This research aims to investigate any possible association between the NHHR and the emergence of suicidal ideation within the confines of the study. METHODS This study examined the association between NHHR levels and suicidal ideation using data from the National Health and Nutrition Examination Survey (NHANES), conducted in the United States spanning 2005 and 2016. Calculation of the NHHR corresponds to the proportion of HDL-C to Non-HDL-C. The Patient Health Questionnaire-9's ninth question was implemented for assessing suicidal ideation. Using subgroup analysis, smooth curve fitting, and multivariate logistic regression analysis, the research was conducted. RESULTS Encompassing a cohort of 29,288 participants, the analysis identified that 3.82% of individuals reported suicidal ideation. After using multivariable logistic regression and thorough adjustments, elevated NHHR levels were significantly and positively associated with a heightened likelihood of suicidal ideation, according to the findings (odds ratio [OR] = 1.06; 95% confidence interval [CI]: 1.02-1.11; P = 0.0048). Despite extensive adjustment for various confounding factors, this relationship remained consistent. An inverted U-shaped curve was utilized to illustrate the link between NHHR and suicidal ideation among nonsmokers; the curve's inflection point was situated at 7.80. Subgroup analysis and interaction tests (all P for interaction > 0.05) demonstrated that there was no significant influence of the following variables on this positive relationship: age, sex, race, body mass index, education level, married status, hypertension, diabetes, and smoking status. CONCLUSION Significantly higher NHHR levels were associated with an elevated likelihood of suicidal ideation. Based on these results, it is probable that NHHR may serve as a predictive indicator of suicidal ideation, emphasizing its potential utility in risk assessment and preventive strategies.
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Affiliation(s)
- Guangwei Qing
- Department of Psychiatry, Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Nanchang, Jiangxi, 330029, China
- Third Clinical Medical College, Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Wenpeng Deng
- Department of Psychiatry, Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Nanchang, Jiangxi, 330029, China
- Third Clinical Medical College, Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Yuxin Zhou
- Department of Psychiatry, Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Nanchang, Jiangxi, 330029, China
| | - Liyun Zheng
- Department of Psychiatry, Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Nanchang, Jiangxi, 330029, China
| | - Yanlai Wang
- Department of Psychiatry, Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Nanchang, Jiangxi, 330029, China
| | - Bo Wei
- Department of Psychiatry, Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Nanchang, Jiangxi, 330029, China.
- Nanchang City Key Laboratory of Biological Psychiatry, Jiangxi Provincial Clinical Research Center on Mental Disorders, Jiangxi Mental Hospital, Nanchang, Jiangxi, 330029, China.
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Hiller JK, Jangmo A, Tesli MS, Jaholkowski PP, Hoseth EZ, Steen NE, Haram M. Lipid Biomarker Research in Bipolar Disorder: A Scoping Review of Trends, Challenges, and Future Directions. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:594-604. [PMID: 37881590 PMCID: PMC10593953 DOI: 10.1016/j.bpsgos.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 10/27/2023] Open
Abstract
Bipolar disorder (BD) is a disabling disorder with heterogeneous symptom profiles and trajectories. Like many other neuropsychiatric disorders, clinical decision making related to diagnoses and choice of treatment is based on clinical assessments alone, and risk prediction for treatment success or resistance at an individual level remains sparse. An enormous effort to add biological markers to this risk prediction is ongoing. The role of lipids in normal brain functioning is well established, and several hypotheses about the role of lipids in the pathogenesis of neuropsychiatric disorders, including BD, have been made. The frequent comorbidity between neuropsychiatric disorders and cardiovascular disease, the genetic overlap of risk genes for severe mental disorders and genes involved in lipid regulation, and the lipid-altering effects of antipsychotics and mood stabilizers indicate that lipids could hold promise as biomarkers for neuropsychiatric disorders, including BD. To date, reviews of lipid biomarkers in schizophrenia and major depression have noted caveats for future investigations, while reviews of lipid biomarker research in BD is missing. In the current scoping review, we present a comprehensive overview of trends in previous research on lipid biomarkers in BD. The current literature varies greatly in the phenotypes investigated and study designs, leading to divergent findings. Small sample size; potential confounders related to physical activity, nutritional status, and medication use; and cross-sectional designs were frequently reported limitations. Future research may benefit from pivoting toward utilization of newer laboratory techniques such as lipidomics, but consistent use of study methods across cohorts is also needed.
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Affiliation(s)
| | - Andreas Jangmo
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Martin Steen Tesli
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Centre for Research and Education in Forensic Psychiatry, Department of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Piotr Pawel Jaholkowski
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Eva Zsuzsanna Hoseth
- Clinic of Mental Health and Addiction, Møre and Romsdal Health Trust, Kristiansund, Norway
| | - Nils Eiel Steen
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marit Haram
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Liu Y, Zhang X, Wang P, Yang M, Li N. Comparison of Clinical Features, Serum Lipid, and Uric Acid Levels in Patients with Unipolar Depression and Bipolar Depression. PSYCHIAT CLIN PSYCH 2022; 32:313-319. [PMID: 38764881 PMCID: PMC11082628 DOI: 10.5152/pcp.2022.22473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 11/14/2022] [Indexed: 05/21/2024] Open
Abstract
Background The level of uric acid and serum lipids has been suggested as a possible biomarker of bipolar disorder. We aimed to investigate the differences in clinical features and serum levels of lipids and uric acid in patients with bipolar depression or unipolar depression in order to distinguish them. Methods The clinical data of 53 patients with unipolar depression (unipolar group) and 61 patients with bipolar depression (bipolar group), who all met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders-IV of the American Psychiatric Association, were compared with each other retrospectively. The serum levels of uric acid and lipids (including total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides) were measured after hospital admission. The Statistical Package for the Social Science version 22.0 software was used for statistical analysis, and logistic regression was employed to identify the susceptible factors of bipolar depression. Results Taking into account confounding factors, logistic regression analysis revealed that the high levels of uric acid (odds ratio = 1.016, P = .001) and low levels of triglycerides (odds ratio = 0.457, P = .025) were significantly correlated with bipolar depression. Conclusion It has been demonstrated from this study that individuals with bipolar depression have higher serum uric acid levels and lower triglyceride levels than unipolar depression ones. Therefore, serum levels of uric acid and triglycerides might have the potential to be the biomarkers for differential diagnosis between bipolar and unipolar depression.
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Affiliation(s)
- Yi Liu
- Department of Psychiatry, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Xiuyue Zhang
- Department of Psychiatry, Yuxi People’s Hospital, Yuxi, Yunnan, China
| | - Ping Wang
- Department of Psychiatry, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Mei Yang
- Department of Psychiatry, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Na Li
- Department of Psychiatry, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
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Which Clinical and Biochemical Parameters Are Associated with Lifetime Suicide Attempts in Bipolar Disorder? Diagnostics (Basel) 2022; 12:diagnostics12092215. [PMID: 36140615 PMCID: PMC9498201 DOI: 10.3390/diagnostics12092215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 08/26/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: Bipolar Disorder (BD) is a disabling condition with suicidal behavior as one of the most common adverse outcomes. The purpose of the present research is to investigate the relationship between lifetime suicide attempts and the clinical factors/biochemical parameters in a large sample of bipolar patients. Methods: A total of 561 patients, consecutively hospitalized for BD in Milan and Monza (Italy), were recruited. Data about the demographic and clinical variables, as well as the values of blood analyses, were collected. The groups identified according to the presence/absence of lifetime suicide attempts were compared using univariate analyses. Then, three preliminary binary logistic regressions and a final logistic regression model were performed to identify the clinical and biochemical parameters associated with lifetime suicide attempts in BD. Results: Lifetime suicide attempts in BD were predicted by a longer duration of untreated illness (DUI) (p = 0.005), absence of lifetime psychotic symptoms (p = 0.025), presence of poly-substance use disorders (p = 0.033), comorbidity with obesity (p = 0.022), a last mood episode of manic polarity (p = 0.044), and lower bilirubin serum levels (p = 0.002); higher total cholesterol serum levels showed a trend toward statistical significance (p = 0.058). Conclusions: BD patients with lifetime suicide attempts present unfavorable clinical features. Some specific biochemical characteristics of bipolar patients may represent potential markers of suicidal behavior and need to be better investigated to identify new targets of treatment in the framework of personalized medicine. These preliminary findings have to be confirmed by further studies in different clinical settings.
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Blood hormones and suicidal behaviour: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 139:104725. [PMID: 35690122 DOI: 10.1016/j.neubiorev.2022.104725] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 05/31/2022] [Accepted: 06/03/2022] [Indexed: 12/28/2022]
Abstract
This study was to evaluate the relationship between blood hormone levels and suicidal behaviour. We reviewed Web of Science, PubMed and Embase for literature published up to 10 April 2022. Studies were restricted to English-language articles. Studies measuring blood hormone levels in suicidal and non-suicidal subjects were eligible. Standardized mean differences (SMDs) were applied to evaluate group differences. Overall, 57 studies were eligible, of which 51 evaluated suicide attempts, and 9 assessed suicidal ideation. Random-effects meta-analysis indicated that levels of thyrotropin stimulating hormone (TSH) (SMD = 0.50; 95% CI, 0.27-0.72), leptin (SMD = -1.16; 95% CI, -1.94 to -0.38) and dehydroepiandrosterone sulfate (DHEAS) (SMD = -0.67; 95% CI, -1.13 to -0.21) were related to suicide attempts, whereas progesterone levels (SMD = 0.22; 95% CI, 0.03-0.41) were related to suicidal ideation. This analysis offers evidence linking abnormalities of blood hormones with suicidal behaviour, which may be essential for identifying individuals with suicide attempts and suicidal ideation. Large prospective studies are needed for further clarification of roles of hormones in suicidal behaviour.
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Zhang SF, Chen HM, Xiong JN, Liu J, Xiong J, Xie JZ, Wang XM, Tian Q, Xia B, Li Y, Qu N. Comparison of cognitive impairments with lipid profiles and inflammatory biomarkers in unipolar and bipolar depression. J Psychiatr Res 2022; 150:300-306. [PMID: 35429740 DOI: 10.1016/j.jpsychires.2022.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 03/25/2022] [Accepted: 04/04/2022] [Indexed: 02/07/2023]
Abstract
Cognitive impairments is one of important accompanied symptom in Unipolar depressive disorder (UD) and bipolar disorder (BD) that was hard to distinguish, as their diagnosis is based on behavioural observations and subjective symptoms. In this study, we could highlight the difference of cognitive ability in UD and BD by testing lipid profiles and inflammatory biomarkers in major depressive episodes (MDE). 207 subjects (96 unipolar and 111 bipolar depressed patients) were included in this study. We applied Montreal Cognitive Assessment (MoCA) to test cognitive ability. The 24-item Hamilton Depression Rating Scale was used for assessment at the beginning of treatment. A series of clinical variables and lipid profiles were collected from clinic record. We detected pro-inflammatory biomarkers Interleukin-1β (IL-1β), Interleukin-6 (IL-6), C-reaction protein (CRP) levels and brain-derived neurotrophic factor (BDNF) by enzyme linked immunosorbent assay. From the results, cognitive impairments were more popular in BD than UD, most obviously in severe cognitive impairments (MoCA score<23). And UD showed better cognitive ability than BD in MoCA, particularly in language domain. Compared lipid profiles like total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), Apolipoprotein B (ApoB) and lipoprotein α (Lpα), we found that ApoB was higher in BD than UD that maybe a risk factor in cognition. There was no obviously difference in TC, TG, HDL-C, LDL-C, ApoA1, or Lpα. Also, we found CRP level in BD was higher than UD, and showed no significant difference in IL-1β and IL-6 levels. Furthermore, BDNF level which was neurotrophic biomarker for cognition and mood was significantly declined in BD compared with UD. Correlation analysis showed that ApoB and CRP was negative closed associated with MoCA scores. And BDNF level was positive related with cognitive ability in MDE patients. From our results mentioned that quantitative lipid profiles and inflammatory biomarkers analysis might help to objectively identify between these disorders and up our understanding of their pathophysiology. And ApoB, CRP and BDNF could be as potential peripheral candidates in cognitive evaluation to distinguish UD and BD.
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Affiliation(s)
- Shu-Fang Zhang
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China; Department of Psychological Trauma, Wuhan Hospital for Psychotherapy, Wuhan, 430012, Hubei Province, China; Research Center for Mental Health and Neuroscience, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China; Affiliated Wuhan Mental Health Center, Jianghan University, Wuhan, 430012, Hubei Province, China; Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430012, Hubei Province, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, 430012, Hubei Province, China
| | - Hua-Min Chen
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China; Department of Psychological Trauma, Wuhan Hospital for Psychotherapy, Wuhan, 430012, Hubei Province, China; Research Center for Mental Health and Neuroscience, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China; Affiliated Wuhan Mental Health Center, Jianghan University, Wuhan, 430012, Hubei Province, China
| | - Jia-Ni Xiong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China; Department of Psychological Trauma, Wuhan Hospital for Psychotherapy, Wuhan, 430012, Hubei Province, China; Research Center for Mental Health and Neuroscience, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, 430012, Hubei Province, China
| | - Jun Liu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China; Department of Psychological Trauma, Wuhan Hospital for Psychotherapy, Wuhan, 430012, Hubei Province, China; Research Center for Mental Health and Neuroscience, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China
| | - Jie Xiong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China; Department of Psychological Trauma, Wuhan Hospital for Psychotherapy, Wuhan, 430012, Hubei Province, China; Research Center for Mental Health and Neuroscience, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China
| | - Jia-Zhao Xie
- Department of Pathology and Pathophysiology, Key Laboratory of Neurological Disease of National Education Ministry, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao-Ming Wang
- Department of Pathology and Pathophysiology, Key Laboratory of Neurological Disease of National Education Ministry, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qing Tian
- Department of Pathology and Pathophysiology, Key Laboratory of Neurological Disease of National Education Ministry, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Bin Xia
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China; Department of Psychological Trauma, Wuhan Hospital for Psychotherapy, Wuhan, 430012, Hubei Province, China; Research Center for Mental Health and Neuroscience, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China
| | - Yi Li
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China; Department of Psychological Trauma, Wuhan Hospital for Psychotherapy, Wuhan, 430012, Hubei Province, China; Research Center for Mental Health and Neuroscience, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China; Affiliated Wuhan Mental Health Center, Jianghan University, Wuhan, 430012, Hubei Province, China; Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430012, Hubei Province, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, 430012, Hubei Province, China.
| | - Na Qu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China; Department of Psychological Trauma, Wuhan Hospital for Psychotherapy, Wuhan, 430012, Hubei Province, China; Research Center for Mental Health and Neuroscience, Wuhan Mental Health Center, Wuhan, 430012, Hubei Province, China; Affiliated Wuhan Mental Health Center, Jianghan University, Wuhan, 430012, Hubei Province, China; Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430012, Hubei Province, China; Department of Pathology and Pathophysiology, Key Laboratory of Neurological Disease of National Education Ministry, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, 430012, Hubei Province, China.
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8
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Shapiro LR, Kennedy KG, Dimick MK, Goldstein BI. Elevated atherogenic lipid profile in youth with bipolar disorder during euthymia and hypomanic/mixed but not depressive states. J Psychosom Res 2022; 156:110763. [PMID: 35193092 DOI: 10.1016/j.jpsychores.2022.110763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Abnormal blood lipid levels are common in individuals with bipolar disorder (BD). Previous studies have revealed lipid-mood associations in adults with BD, but no data on this relationship is available in youth populations. This cross-sectional study examined the associations of lipid levels with mood states and symptoms in a cohort of youth with BD. METHODS Participants were youth with BD and healthy controls (HCs) between the ages of 13-20 years. We compared the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and TG/HDL-C ratio between 4 participant episode groups: BD-euthymic (n = 28), BD-depressed (n = 29) BD-hypomanic/mixed (n = 31), and HCs (n = 89). We also examined for dimensional associations of lipids with mania and depression scores in the overall BD group and within BD episode subgroups. RESULTS TG levels were significantly higher in the BD-euthymic group (p = 0.008, d = 0.59) and in the BD-mixed/hypomanic group (p = 0.03, d = 0.44) compared to the HC group. TG/HDL-C ratio was also higher in the BD-euthymic group compared to the HC group (p = 0.01, d = 0.51). No dimensional associations were found between lipids and mood symptom scores in the overall BD group. However, within the BD-mixed/hypomanic subgroup, higher mania scores were associated with higher TG (β = 0.42, p = 0.04), TG/HDL-C ratio (β = 0.59, p = 0.002), and lower HDL-C (β = 0.56 p = 0.002). CONCLUSIONS Youth with BD demonstrate atherogenic lipid profiles. Higher atherogenic lipids were associated with hypomanic but, contrasting adult BD studies, not depressive symptoms. Future prospective studies are warranted to evaluate the temporal association between lipids and mood among youth with BD.
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Affiliation(s)
- Lila R Shapiro
- Centre for Youth Bipolar Disorder, Centre for Addictions and Mental Health, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Kody G Kennedy
- Centre for Youth Bipolar Disorder, Centre for Addictions and Mental Health, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Mikaela K Dimick
- Centre for Youth Bipolar Disorder, Centre for Addictions and Mental Health, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Centre for Addictions and Mental Health, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada.
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Vasupanrajit A, Jirakran K, Tunvirachaisakul C, Solmi M, Maes M. Inflammation and nitro-oxidative stress in current suicidal attempts and current suicidal ideation: a systematic review and meta-analysis. Mol Psychiatry 2022; 27:1350-1361. [PMID: 34997194 DOI: 10.1038/s41380-021-01407-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/25/2021] [Indexed: 12/12/2022]
Abstract
A meta-analysis showed a significant association between activated immune-inflammatory and nitro-oxidative (IO&NS) pathways and suicide attempts (SA). There is no data on whether recent suicidal ideation (SI) is accompanied by activated IO&NS pathways and whether there are differences between recent SA and SI. The current study searched PubMed, Google Scholar, and Web of Science, for articles published from inception until May 10, 2021, and systematically reviewed and meta-analysed the association between recent SA/SI (<3 months) and IO&NS biomarkers. We included studies which compared psychiatric patients with and without SA and SI and controls (either healthy controls or patients without SA/SI) and used meta-analysis (random-effect model with restricted maximum-likelihood) to delineate effect sizes with 95% confidence intervals (CI). Our search included 59 studies comprising 4.034 SA/SI cases and 12.377 controls. Patients with SA/SI showed activated IO&NS pathways (SMD: 0.299; CI: 0.200; 0.397) when compared to controls. The immune profiles were more strongly associated with SA than with SI, particularly when compared to healthy controls, as evidenced by activated IO&NS (SMD: 0.796; CI: 0.503; 1.089), immune (SMD: 1.409; CI: 0.637; 1.462), inflammatory (SMD: 1.200; CI: 0.584; 1.816), and neurotoxic (SMD: 0.904; CI: 0.431; 1.378) pathways. The effects sizes of the IO&NS, immune and inflammatory profiles were significantly greater in SA than in SI. In conclusion: activated IO&NS pathways are associated with recent SA and SI, and inflammation, T helper-1 activation, nitro-oxidative stress, lowered neuroprotection, and increased neurotoxicity explain at least in part why psychiatric patients show increased suicidal behaviours, especially SA.
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Affiliation(s)
- Asara Vasupanrajit
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Ketsupar Jirakran
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Maximizing Thai Children's Developmental Potential Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chavit Tunvirachaisakul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Marco Solmi
- University of Ottawa, Psychiatry Department, Ottawa, ON, Canada.,The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,IMPACT Strategies Research Center, Deakin University, Geelong, VIC, Australia. .,Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria.
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10
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Association between abnormal glycolipid level and cognitive dysfunction in drug-naïve patients with bipolar disorder. J Affect Disord 2022; 297:477-485. [PMID: 34715186 DOI: 10.1016/j.jad.2021.10.100] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/13/2021] [Accepted: 10/23/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Cognitive impairment and abnormal glycolipid metabolism are common clinical features of bipolar disorder (BD). The purpose of this study was to investigate the relationship between conventional glycolipid metabolism indicators and cognitive impairment in patients with BD. METHODS A total of 132 drug-naïve patients with BD and 129 healthy controls (HC) were recruited in the study. Five serum glycolipid metabolism indicators were measured and cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Stroop Color-Word Test (Stroop test) for each participant. RESULTS The scores of immediate memory, attention, language and delayed memory in BD group were significantly lower than those in HC group (P < 0.05). The triglyceride (TG) level in BD group was higher than that in HC group (P = 0.011), and the total cholesterol and high-density lipoprotein cholesterol (HDL) levels were lower than those in HC group (P = 0.026; P = 0.001). Regression analysis showed that TG level was significantly correlated with RBANS total score (β = 0.245, P = 0.008), attention (β = 0.289, P = 0.03) and delayed memory (β = 0.221, P = 0.023). Fasting blood glucose (FBG) level was significantly correlated with language subscale score (β = -0.187, P = 0.046) in BD. LIMITATIONS Cross-sectional design and limited control variables. CONCLUSIONS Elevated FBG and TG levels may be associated with cognitive dysfunction in BD patients. Improving glycolipid metabolism in patients with BD may help to improve certain domain-specific cognitive functions.
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11
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Zhang Q, Zhao S, Liu Z, Luo B, Yang Y, Shi Y, Geng F, Xia L, Zhang K, Liu H. Association of thyroid-stimulating hormone and lipid levels with suicide attempts among adolescents with major depressive disorder in China. Front Psychiatry 2022; 13:1031945. [PMID: 36733417 PMCID: PMC9887045 DOI: 10.3389/fpsyt.2022.1031945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES Evidence suggested that thyroid-stimulating hormone (TSH) and lipid levels were associated with major depressive disorder (MDD). However, its role in suicide attempts in adolescents with MDD was unclear. This investigation was to probe into the relationship between TSH, lipid levels, and attempted suicide in adolescents with MDD. METHODS A total of 179 adolescents with MDD were included from January 2021 to January 2022. Socio-demographic data and clinical data were obtained through self-made questionnaires. TSH and lipid levels were analyzed by a recognized laboratory. The Epidemiological Studies Depression Scale (CES-D) was used to assess the severity of depression. Questions about whether there was a behavior of suicide attempts were completed through conversation interviews. RESULTS Results showed that the CES-D total score, TSH, and low-density lipoprotein cholesterol (LDL-C) of suicide attempters were significantly higher than those of non-suicide attempters. Ordinary family relationships were more likely to attempt suicide than good family relationships. The CES-D total score, ordinary family relationships, TSH and LDL-C were still significant in binary logistic regression, with an adjusted odds ratio (OR) of 1.04, 3.42, 5.14, and 1.76, respectively. The area under the receiver operating characteristic (ROC) curve showed that the area under the ROC curve (AUC) ranged from 0.60 to 0.74. CONCLUSION Suicide attempts are common among adolescents with MDD and were associated with CES-D total score, ordinary family relationships, TSH, and LDL-C. Given the association between suicide attempts and TSH and LDL-C, the dynamic changes in TSH and LDL-C levels should be detected regularly.
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Affiliation(s)
- Qing Zhang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Shuyi Zhao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Zhichun Liu
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Bei Luo
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yingying Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yudong Shi
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Feng Geng
- Department of Psychiatry, Hefei Fourth People's Hospital, Hefei, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Kai Zhang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
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12
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Morris G, Berk M, Walder K, O'Neil A, Maes M, Puri BK. The lipid paradox in neuroprogressive disorders: Causes and consequences. Neurosci Biobehav Rev 2021; 128:35-57. [PMID: 34118292 DOI: 10.1016/j.neubiorev.2021.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 04/27/2021] [Accepted: 06/06/2021] [Indexed: 02/07/2023]
Abstract
Chronic systemic inflammation is associated with an increased risk of cardiovascular disease in an environment of low low-density lipoprotein (LDL) and low total cholesterol and with the pathophysiology of neuroprogressive disorders. The causes and consequences of this lipid paradox are explored. Circulating activated neutrophils can release inflammatory molecules such as myeloperoxidase and the pro-inflammatory cytokines interleukin-1 beta, interleukin-6 and tumour necrosis factor-alpha. Since activated neutrophils are associated with atherosclerosis and cardiovascular disease and with major depressive disorder, bipolar disorder and schizophrenia, it seems reasonable to hypothesise that the inflammatory molecules released by them may act as mediators of the link between systemic inflammation and the development of atherosclerosis in neuroprogressive disorders. This hypothesis is tested by considering the association at a molecular level of systemic inflammation with increased LDL oxidation; increased small dense LDL levels; increased lipoprotein (a) concentration; secretory phospholipase A2 activation; cytosolic phospholipase A2 activation; increased platelet activation; decreased apolipoprotein A1 levels and function; decreased paroxonase-1 activity; hyperhomocysteinaemia; and metabolic endotoxaemia. These molecular mechanisms suggest potential therapeutic targets.
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Affiliation(s)
- Gerwyn Morris
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Deakin University, CMMR Strategic Research Centre, School of Medicine, Geelong, Victoria, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Ken Walder
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Adrienne O'Neil
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Michael Maes
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, King Chulalongkorn University Hospital, Bangkok, Thailand
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13
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Kułak-Bejda A, Bejda G, Lech M, Waszkiewicz N. Are Lipids Possible Markers of Suicide Behaviors? J Clin Med 2021; 10:jcm10020333. [PMID: 33477435 PMCID: PMC7830691 DOI: 10.3390/jcm10020333] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/10/2021] [Accepted: 01/13/2021] [Indexed: 01/26/2023] Open
Abstract
Suicides and suicidal behaviors are very important causes of mortality and morbidity and have become a serious global problem. More than 800,000 people die from suicide every year. Previous researches have established that lipids play an important role in the pathogenesis of suicide. Moreover, lipid levels might be a biological marker of suicide. A lot of researchers have tried to identify biological markers that might be related to depressive disorder, bipolar disorder or schizophrenia and suicidal behavior. It was also important to consider the usefulness of an additional tool for prevention actions. Metabolic deregulation, particularly low total cholesterol and low-density lipoproteins-cholesterol levels may cause higher suicide risk in patients with these psychiatric disorders.
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Affiliation(s)
- Agnieszka Kułak-Bejda
- Department of Psychiatry, Medical University of Bialystok, 16-070 Choroszcz, Poland; (M.L.); (N.W.)
- Correspondence:
| | - Grzegorz Bejda
- Faculty of General Medicine, School of Medical Science in Bialystok, 15-875 Bialystok, Poland;
| | - Magdalena Lech
- Department of Psychiatry, Medical University of Bialystok, 16-070 Choroszcz, Poland; (M.L.); (N.W.)
| | - Napoleon Waszkiewicz
- Department of Psychiatry, Medical University of Bialystok, 16-070 Choroszcz, Poland; (M.L.); (N.W.)
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14
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Association between serum lipid concentrations and attempted suicide in patients with major depressive disorder: A meta-analysis. PLoS One 2020; 15:e0243847. [PMID: 33301469 PMCID: PMC7728216 DOI: 10.1371/journal.pone.0243847] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 11/30/2020] [Indexed: 11/19/2022] Open
Abstract
Background There is growing evidence that serum lipid concentrations may be associated with attempted suicide in patients with major depressive disorder (MDD), but these findings remain controversial. Thus, we performed a comprehensive meta-analysis to quantitatively assess the associations between serum lipid concentrations and attempted suicide in MDD patients. Materials and methods Electronic databases (PubMed, Embase, the Cochrane Library and the China National Knowledge Library) were searched for relevant literature up to 10 February 2020. We used a random-effects model based on heterogeneity amongst studies and generated pooled standardised mean differences (SMDs). Results Thirty-two studies comprising 7,068 subjects met the inclusion criteria. A pooled analysis showed that compared with non-attempters, MDD patients who had attempted suicide had significantly lower serum concentrations of total cholesterol (TC) (SMD: -0.63, 95% CI: -0.83 to -0.44) and low-density lipoprotein cholesterol (LDL-C) (SMD: -0.69, 95% CI: -1.04 to -0.34), but the serum concentrations of high-density lipoprotein cholesterol (HDL-C) (SMD: -0.12, 95% CI: -0.33 to 0.10) and triglycerides (TGs) (SMD: 0.00, 95% CI: -0.20 to 0.20) were not significantly different between the two groups. Subgroup and meta-regression analysis indicated that heterogeneity with respect to TC concentrations may be due to different ages (p = 0.041) and sample sizes (p = 0.016) of studies, and that heterogeneity with respect to HDL-C concentrations may be partly due to different settings of studies (p = 0.017). Conclusions This meta-analysis demonstrated that lower concentrations of TC and LDL-C, but not of HDL-C and TGs, were associated with attempted suicide in MDD patients. This indicates that TC and LDL-C may be useful as biological markers for predicting whether MDD patients may attempt to commit suicide.
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15
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Morris G, Puri BK, Olive L, Carvalho A, Berk M, Walder K, Gustad LT, Maes M. Endothelial dysfunction in neuroprogressive disorders-causes and suggested treatments. BMC Med 2020; 18:305. [PMID: 33070778 PMCID: PMC7570030 DOI: 10.1186/s12916-020-01749-w] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/16/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Potential routes whereby systemic inflammation, oxidative stress and mitochondrial dysfunction may drive the development of endothelial dysfunction and atherosclerosis, even in an environment of low cholesterol, are examined. MAIN TEXT Key molecular players involved in the regulation of endothelial cell function are described, including PECAM-1, VE-cadherin, VEGFRs, SFK, Rho GEF TRIO, RAC-1, ITAM, SHP-2, MAPK/ERK, STAT-3, NF-κB, PI3K/AKT, eNOS, nitric oxide, miRNAs, KLF-4 and KLF-2. The key roles of platelet activation, xanthene oxidase and myeloperoxidase in the genesis of endothelial cell dysfunction and activation are detailed. The following roles of circulating reactive oxygen species (ROS), reactive nitrogen species and pro-inflammatory cytokines in the development of endothelial cell dysfunction are then described: paracrine signalling by circulating hydrogen peroxide, inhibition of eNOS and increased levels of mitochondrial ROS, including compromised mitochondrial dynamics, loss of calcium ion homeostasis and inactivation of SIRT-1-mediated signalling pathways. Next, loss of cellular redox homeostasis is considered, including further aspects of the roles of hydrogen peroxide signalling, the pathological consequences of elevated NF-κB, compromised S-nitrosylation and the development of hypernitrosylation and increased transcription of atherogenic miRNAs. These molecular aspects are then applied to neuroprogressive disorders by considering the following potential generators of endothelial dysfunction and activation in major depressive disorder, bipolar disorder and schizophrenia: NF-κB; platelet activation; atherogenic miRs; myeloperoxidase; xanthene oxidase and uric acid; and inflammation, oxidative stress, nitrosative stress and mitochondrial dysfunction. CONCLUSIONS Finally, on the basis of the above molecular mechanisms, details are given of potential treatment options for mitigating endothelial cell dysfunction and activation in neuroprogressive disorders.
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Affiliation(s)
- Gerwyn Morris
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | | | - Lisa Olive
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | - Andre Carvalho
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Michael Berk
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia.
- Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.
| | - Ken Walder
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Lise Tuset Gustad
- Department of Circulation and medical imaging, Norwegian University of Technology and Science (NTNU), Trondheim, Norway
- Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, Norway
| | - Michael Maes
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
- Department of Psychiatry, King Chulalongkorn University Hospital, Bangkok, Thailand
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
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16
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Akyol O, Chowdhury I, Akyol HR, Tessier K, Vural H, Akyol S. Why are cardiovascular diseases more common among patients with severe mental illness? The potential involvement of electronegative low-density lipoprotein (LDL) L5. Med Hypotheses 2020; 142:109821. [PMID: 32417641 DOI: 10.1016/j.mehy.2020.109821] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/22/2020] [Accepted: 05/05/2020] [Indexed: 02/07/2023]
Abstract
Despite tremendous efforts of experimental and clinical studies and knowledge, the pathophysiology of severe mental illness (SMI), including bipolar disorder (BD), unipolar depression (mood disorders, MD), and schizophrenia (SCZ), remains poorly understood. Besides their chronic course and high prevalence in society, mental and somatic comorbidities are really serious problems; patients with these disorders have increased risk of cardiovascular (CV) diseases (CVD) including coronary artery diseases (CAD, i.e. myocardial infarction and angina), stroke, sudden cardiac death, hypertension, cardiomyopathy, arrhythmia, and thromboembolic disease. Although it is determined that triglycerides, cholesterol, glucose, and low-density lipoprotein (LDL) levels are increased in MD and SCZ, the underlying reason remains unknown. Considering this, we propose that electronegative LDL (L5) is probably the main crucial element to understanding CVD induced by SMI and to discovering novel remedial approaches for these diseases. When it is hypothesized that L5 is greatly presupposed in CV system abnormalities, it follows that the anti-L5 therapies and even antioxidant treatment options may open new therapeutic opportunities to prevent CVD diseases secondary to SMI. In this review article, we tried to bring a very original subject to the attention of readers who are interested in lipoprotein metabolism in terms of experimental, clinical, and cell culture studies that corroborate the involvement of L5 in physiopathology of CVD secondary to SMI and also the new therapeutic approaches for these disorders.
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Affiliation(s)
- Omer Akyol
- Michigan Math & Science Academy, Department of Science, Warren, MI, USA.
| | - Imtihan Chowdhury
- Michigan Math & Science Academy, High School, 11th grade, Warren, MI, USA
| | - Hafsa Rana Akyol
- Illinois Institute of Technology, Biology, Sophomore, Chicago, IL, USA
| | - Kylie Tessier
- Michigan Math & Science Academy, High School, 11th grade, Warren, MI, USA
| | - Huseyin Vural
- Institute of Molecular Pathobiochemistry, Experimental Gene Therapy and Clinical Chemistry, RWTH University Hospital Aachen, Aachen, Germany
| | - Sumeyya Akyol
- Beaumont Health, Beaumont Research Institute, Royal Oak, MI, USA
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