A controlled study of serum lipid profiles in Indian patients with depressive episode

Increased atherogenicity in mood disorders: a systematic review, meta-analysis and meta-regression

BACKGROUND

Major depressive disorder (MDD) and bipolar disorder (BD) often coexist with metabolic syndrome. Both are linked to increased atherogenicity and a higher risk of cardiovascular diseases. Nevertheless, a comprehensive analysis of key atherogenic biomarkers in MDD/BD is still lacking.

OBJECTIVES

This meta-analysis evaluates the relationship between atherogenic indices and MDD/BD, while identifying the most effective atherogenic biomarker.

METHODS

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched electronic databases, including PubMed, Google Scholar, and Web of Science, for articles published up to August 1, 2024.

RESULTS

We included 85 eligible studies (14 on BD and 71 on MDD), covering 70,856 participants: 18,738 patients and 52,118 healthy controls. MDD/BD patients showed significant increases (p < 0.001) in the Castelli Risk Index 2 (CRI2), Atherogenic Index of Plasma (AIP), and (triglyceride or TG + low-density lipoprotein + very low-density lipoprotein)/(high-density lipoprotein cholesterol or HDL + Apolipoprotein A or ApoA) ratio, but not CRI1 and ApoB/ApoA ratio. Significant lower HDL and lecithin: cholesterol acyltransferase activity, and higher TG levels were observed in MDD/BD patients compared with controls. There were no significant differences between MDD and BD patients. Most included studies lacked the most essential information on the inclusion and exclusion of important confounders.

CONCLUSIONS

AIP is the most effective atherogenicity index for mood disorders. Regular lipid profiling and metabolic syndrome screening are crucial in MDD/BD. Early intervention with lipid-lowering therapies is recommended to prevent the worsening of atherogenicity and disease progression.

Lipid variability in drug-naïve individuals affected with Major Depressive Disorder: a systematic review and meta-analysis

BACKGROUND

This study aimed to provide a comprehensive synthesis of the evidence examining lipid profiles in drug-naïve MDD patients.

MATERIALS AND METHODS

We searched PubMed, Scopus, and ISI Web of Science up to August 2023 for total cholesterol, HDL-C, LDL-C, and triglyceride levels in drug-naïve MDD patients.

RESULTS

A total of 17 articles comprising 2174 individuals including drug-naïve MDD subjects and controls were included. Our results showed that concentrations of total cholesterol were lower in drug-naïve MDD patients compared with healthy controls (SMD -0.49, 95% CI -0.881 to -0.105; p = 0.015; I2 = 90.6%). However, comparison of other lipid levels between MDD patients and healthy controls demonstrated no significant difference. The results revealed that the association of total cholesterol levels with MDD is more prominent in male-dominant studies (SMD -1.20, 95% CI -2.23 to -0.18, I2 = 87.9%) than in female-dominant studies (SMD -0.25, 95% CI -0.63-0.13, I2 = 89.0%). In meta-regression, none of the factors including year of publication, Newcastle-Ottawa Scale score, sample size, BMI, and mean age of participants had a significant influence on the association between cholesterol levels and MDD.

CONCLUSIONS

Lower levels of total cholesterol, especially in males, are associated with MDD, so early lipid monitoring and targeted interventions are necessary.

A detection system for serum cholesterol based on the fluorescence color detection of beta-cyclodextrin-capped gold nanoclusters

Cholesterol is one of the major markers for cardiovascular diseases. Herein, a portable cholesterol measurement system based on fluorescence color detection was constructed by combining the high sensitivity of fluorescence analysis with the ease of color sensing to determine low levels of serum cholesterol. Cyclodextrin capping gold nanoclusters with blue-green emission were used as fluorescent probes because cholesterol exposure induced fluorescence enhancement of the probe due to the host-guest inclusion interaction between cholesterol and the cavity of cyclodextrin. The integrated sensing system consisted of modules including a microprocessor, a power supply, an LED light with a constant current source, an RGB color sensor, a display, and a darkroom. All the modules except the display screen were placed in a 3D printing darkroom to avoid interference from ambient light. An RGB color sensor TCS230 was applied to capture the RGB signals of the fluorescent color of the probe solution before and after cholesterol addition. Then the obtained RGB signals were converted into the signals in Hue, Saturation, and Value (HSV) color space with a central control chip STM32F407. The Hue value of the fluorescent color of the solution can discriminate the concentration change of cholesterol. Experimental results demonstrate that the system responds linearly to cholesterol in the concentration range of 20.00 ∼ 150.00 μmol·L-1 with a detection limit of 16.07 μmol·L-1 (3σ, n = 3). The detection of the system has good consistency and accuracy compared with the standard instrument, showing potential for the detection of low levels of serum cholesterol.

Gender-specific association of biochemical variables with depression: a population-based case-control study from North India

Background

Depression is a highly prevalent mental disorder with complex aetiology. An emerging body of evidence shows that depression tends to co-occur with abnormal blood glucose levels and dyslipidaemia. This study aimed to understand the overall and gender-specific associations of abnormal glucose levels and dyslipidaemia with depression in a single Mendelian population from rural Haryana, India. To achieve the aim, a population-based case-control study, which constituted of 251 depressed (cases) and 251 non-depressed (controls) individuals, was set up. The study was conducted among the Jat community of Palwal District, Haryana (North India). Data collection was done using a pre-tested interview schedule through the household survey method. Depression status was ascertained using Beck Depression Inventory-II. Fasting blood glucose analysis and lipid profiling were done using commercial kits (Randox, USA) through spectrophotometry. Statistical analysis was done using MS-Excel 2010 and SPSS version 16.0.

Results

In the present study, overall fasting blood sugar level was not found to be associated with depression. However, high blood sugar posed a 3.6-folds elevated risk for depression among females with borderline significance (p = 0.058). Further, higher levels of TC and LDL were found to be inversely associated with depression. In the sex-wise analysis inverse association of TC and LDL with depression remained significant among males but not among females. Instead, high TG and high VLDL showed an increased risk for depression in females.

Conclusions

This study suggests gender-specific associations of some of the studied biochemical variables with depression. Longitudinal studies are warranted to explicate cause-effect relationships between the studied biochemical variables and depression.

A systematic review and meta-analysis of lipid metabolomic signatures of Major Depressive Disorder

The aim of this meta-analysis was to provide a comprehensive synthesis of the evidence examining biomarker signatures in MDD patients including lipids, lipid regulatory proteins (LRP), and polyunsaturated fatty acid (PUFA) as compared to healthy individuals. We performed meta-analyses and meta-regression of the studies comparing lipid, LRP, and PUFA levels between MDD patients and healthy individuals by searching Embase, Ovid Medline, Scopus, PsycINFO, PubMed, and Cochrane databases. Search was performed in these databases up to September 2019 and 29 studies were included. Levels of lipid parameter triglyceride (TG) (SMD 0.55, 95% CI 0.30-0.80, p < 0.0001) were higher while total cholesterol (TC) (SMD = -0.46, 95%CI -0.93 to -0.001, p = 0.04) and very low-density lipoprotein (VLDL) (SMD = -0.46, 95%CI -0.71 to -0.20, p = 0.02) were lower in MDD patients than controls. Subgroup analysis for age showed that the levels of high-density lipoprotein (HDL) were lower in ≥40-year age group (SMD = -0.38, 95%CI -0.70 to -0.06, p = 0.01) and levels of TC was lower in MDD patients in studies from Asian countries (SMD = -0.74, 95%CI -1.37 to -0.10, p = 0.02). TG levels were found to be high all subgroups in MDD patients than controls. A negative association between TC levels and use of lipid lowering medications and a positive association between smoking and LDL levels was found using meta-regression analysis. This study will be useful for physicians when considering the assessment of lipidand LRP profiles in MDD patients to reduce the cardiovascular morbidity and mortality.

Statin use and safety concerns: an overview of the past, present, and the future

INTRODUCTION

Dyslipidemia is a significant risk factor for cardiovascular disorders and contributes to significant morbidity and mortality associated with CAD and stroke worldwide. Statins are the most commonly prescribed drugs for the prevention and management of dyslipidemia globally. Although they provide immense therapeutic benefit, they are associated with clinically significant adverse effects, predominantly muscle, nerve, liver, and cognition-related besides new-onset diabetes. This has sparked various controversies, bringing to the fore, ambiguities that continue to exist in the scientific evidence, in relation to statin-associated harms. Therefore, it becomes essential to have a better understanding of safety issues related to statin use in various populations.

AREAS COVERED

This review describes the most common adverse effects of statins, examines available evidence and highlights the role of ethnicity, lipophilicity and other biological factors that could mediate and/or influence the relationship. MEDLINE was searched via PubMed to obtain relevant articles on dyslipidemia and statin safety.

EXPERT OPINION

The effectiveness of statins is presently unmatched. Further research is warranted to gain insights into the diverse pharmacological effects of statins in various population subgroups. This would assist prescribers in making better informed decisions. Specific treatment strategies for vulnerable groups can significantly attenuate harms, improve risk-benefit ratios, and ultimately enhance patient experience.

The Importance of Cholesterol in Psychopathology: A Review of Recent Contributions

AIM

The aim of this study was to describe systematically recent studies that show the importance of cholesterol in psychopathology.

METHODS

This study was a review. The following databases were searched for relevant published articles on human studies: MEDLINE, Web of Science, EBSCOhost Academic Search Complete, and Psychology and Behavioral Sciences Collection (papers from January 2012 to March 2016).

RESULTS

Eighteen recent papers were selected, and thematic dimensions showing correlations between cholesterol and behavioral and psychopathological variables were depression, suicide, personality, and aggression.

CONCLUSION

This paper demonstrates that recent research corroborates the idea that cholesterol plays an important role in governing behavior and psychopathology in humans. Deepening the studies in this field could be a promising avenue for future research, with implications for treating people with behavior or mental health problems.

Serum lipid changes following the onset of depressive symptoms in postmenopausal women

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.

Depression and serum low-density lipoprotein: A systematic review and meta-analysis

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.

HBK-14 and HBK-15 Do Not Influence Blood Pressure, Lipid Profile, Glucose Level, or Liver Enzymes Activity after Chronic Treatment in Rats

Older and even new antidepressants cause adverse effects, such as orthostatic hypotension, hyper- or hypoglycemia, liver injury or lipid disorders. In our previous experiments we showed significant antidepressant- and anxiolytic-like activities of dual 5-HT_1A and 5-HT₇ antagonists with α₁-adrenolitic properties i.e. 1-[(2,6-dimethylphenoxy)ethoxyethyl]-4-(2-methoxyphenyl)piperazine hydrochloride (HBK-14) and 1-[(2-chloro-6-methylphenoxy)ethoxyethyl]-4-(2-methoxyphenyl)piperazine hydrochloride (HBK-15). Here, we evaluated the influence of chronic administration of HBK-14 and HBK-15 on blood pressure (non-invasive blood pressure measurement system for rodents), lipid profile (total cholesterol, low density lipoproteins—LDL, high density lipoproteins—HDL, triglycerides), glucose level, and liver enzymes activity (aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transferase). We determined potential antihistaminic (isolated guinea pig ileum) and antioxidant properties (ferric reducing ability of plasma–FRAP, non-protein thiols–NPSH, stable free radical diphenylpicrylhydrazyl—DPPH) cytotoxicity. Our experiments revealed that HBK-14 and HBK-15 did not influence blood pressure, lipid profile, glucose level or liver enzymes activity in rats after 2-week treatment. We also showed that none of the compounds possessed antioxidant or cytotoxic properties at antidepressant- and anxiolytic-like doses. HBK-14 and HBK-15 very weakly blocked H₁ receptors in guinea pig ileum. Positive results of our preliminary experiments on the safety of HBK-14 and HBK-15 encourage further studies concerning their effectiveness in the treatment of depression and/or anxiety disorders.

Study the effects of saffron on depression and lipid profiles: A double blind comparative study

Depression is a one of the most prevalent psychiatric disorder. Despite several pharmacological treatments, still treating depression is a challenge. Herbal medicine that is better culturally accepted may play an important role in treatment of depression. In this double blind placebo controlled clinical trial, 40 patients that were suffering from major depression according to DSM-IV criteria were randomly allocated to take either fluoxetine and saffron (20 patients) or fluoxetine and placebo (20 patients). The patients of the two groups were evaluated with Beck depression scale at the beginning of the study and after four weeks. Lipid profile (total Triglyceride (TG) level, total cholesterol level, low density lipoprotein (LDL) level and high density lipoprotein (HDL) level) of the patients also was measured at the beginning and end of the trial. 30 patients (19 in saffron group and 11 in placebo group) completed the study. The two groups improved significantly in depression severity at the end of the study without significant difference (P: 0.560). The lipid profile of the two groups did not change significantly. Our study did not demonstrate antidepressive effects for saffron. We did not observe any lipid lowering effect in saffron group too. Of note is that our study is preliminary and larger studies with more patients and longer duration are needed to prove our results.

CLINICAL TRIAL REGISTRATION NUMBER

IRCT 2013110915334.

The Prevalence and Predictors of Depression in Type 2 Diabetic Population of Punjab

The present cross sectional study was carried out on 787 type 2 diabetic subjects from tertiary health care hospitals to identify the prevalence and predictors of depression in diabetes. Depression was tested using Patient Health Questionnaire-9. Of the study participants, 199 (25.29%) met the criteria for mild to moderate depression, 252 (32.02%) were severely depressed and 336 (42.69%) were clinically non-depressed. The prevalence of depression was 65.02 % in women, which is 1.87 fold higher (p < 0.0001) than men (49.87%). Depression was observed to be strongly associated with advancing age >30 years (p < 0.05), low income (p = 0.0001), sedentary life style (p = 0.001), Plasma levels of low density lipoproteins (LDL) >100 mg/dl and triglycerides (TG) >150 mg/dl (p < 0.05), drinking alcohol (p < 0.001), statin use (p < 0.001), BMI >35-39.9 kg m(-2) (p = 0.018), WHR >0.9 cm (p < 0.0001), Glucose levels >125 mg/dl (p < 0.0001) and duration of diabetes 2-4 years (p = 0.003). In multivariate logistic regression model, risk factors such as, being a woman, duration of diabetes ≥10 years, BMI ≥30 kg m(-2), LDL >100 mg/dl, TG >150 mg/dl and sedentary life style emerged as independent predictors of depression in diabetes. In the present study, 86.4 % diabetic subjects were not diagnosed for depression prior participation. In conclusion, the present study revealed that higher prevalence of depression in diabetes was evident in population of Punjab, especially in women and majority of these patients remain undiagnosed for depression.

Clinical predictor and circulating microRNA profile expression in patients with early onset post-stroke depression

OBJECTIVE

We aim to explore the clinical factors and blood biomarker for predicting the early-onset post-stroke depression (PSD).

METHODS

251 acute ischemic stroke patients were divided into PSD group and non-PSD group by Hamilton depression scale in 2 weeks after stroke. The clinical data, the severity, etiology and location of stroke were recorded. The analysis of inflammatory mediator, glycose and lipid metabolism was performed on the day of admission. The association between clinical factors and early onset PSD was studied by logistic regression analysis. In addition, the differentially expressed miRNAs in plasma between the two groups were screened by gene chip and the bio-information was further investigated by GO and KEEG analysis.

RESULTS

Among 251 patients, 45 (17.93%) were diagnosed as early onset PSD. NIHSS score (>3) and carotid stenosis were independent relative factors with early-onset PSD (OR 3.479 and 2.617, p=0.000 and 0.009, respectively). Moreover, lower LDL trended toward association with early onset PSD in minor stroke subgroup (p=0.084). MiRNA profile demonstrated 25 differential expressed circulating miRNAs with FC≥2 and P≤0.05 between the two groups. The target genes of these miRNAs were enriched in pathways of cancer and MAPK signaling.

LIMITATIONS

The sample of the study was small. The results should be further confirmed in large cohort patients.

CONCLUSIONS

Early onset PSD was more likely in patients with severe neurological deficits and carotid artery stenosis, also note the possible association between lower LDL and depression in minor stroke. Blood miRNAs may be served as a potential biomarker for PSD diagnosis.

Association between total serum cholesterol and depression, aggression, and suicidal ideations in war veterans with posttraumatic stress disorder: a cross-sectional study

Aim

To investigate the relationship between total serum cholesterol and levels of depression, aggression, and suicidal ideations in war veterans with posttraumatic stress disorder (PTSD) without psychiatric comorbidity.

Methods

A total of 203 male PTSD outpatients were assessed for the presence of depression, aggression, and suicidality using the 17-item Hamilton Depression Rating Scale (HAM-D₁₇), Corrigan Agitated Behavior Scale (CABS), and Scale for Suicide Ideation (SSI), respectively, followed by plasma lipid parameters determination (total cholesterol, high density lipoprotein [HDL]-cholesterol, low density lipoprotein [LDL]-cholesterol, and triglycerides). PTSD severity was assessed using the Clinician-Administered PTSD Scale for DSM-IV, Current and Lifetime Diagnostic Version (CAPS-DX) and the Clinical Global Impressions of Severity Scale (CGI-S), before which Mini-International Neuropsychiatric Interview (MINI) was administered to exclude psychiatric comorbidity and premorbidity.

Results

After adjustments for PTSD severity, age, body mass index, marital status, educational level, employment status, use of particular antidepressants, and other lipid parameters (LDL- and HDL- cholesterol and triglycerides), higher total cholesterol was significantly associated with lower odds for having higher suicidal ideation (SSI≥20) (odds ratio [OR] 0.09; 95% confidence interval [CI] 0.03-0.23], clinically significant aggression (CABS≥22) (OR 0.28; 95% CI 0.14-0.59), and at least moderate depressive symptoms (HAM-D₁₇≥17) (OR 0.20; 95% CI 0.08-0.48). Association of total cholesterol and HAM-D₁₇ scores was significantly moderated by the severity of PTSD symptoms (P < 0.001).

Conclusion

Our results indicate that higher total serum cholesterol is associated with lower scores on HAM-D₁₇, CABS, and SSI in patients with chronic PTSD.

Suicidal behaviour and lipid levels in unipolar and bipolar depression

INTRODUCTION

Evidence for a possible association between a low level of cholesterol and increased suicidal behaviour has accumulated in the recent 3 decades. The present study investigates whether lipid levels can make state-dependent markers of suicidal behaviour in Polish patients with mood disorder recently admitted to a psychiatric hospital owing to an acute depressive episode.

MATERIALS AND METHODS

The study was conducted on 223 patients (73 male and 150 female) with unipolar (n=171) and bipolar (n=52) depression. They were interviewed to assess any occurrence of suicidal thoughts, suicidal tendencies and/or suicidal attempts during the 3 months before admission. Laboratory measurements [total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides and total lipids] were obtained within 24-72 h after hospital admission.

RESULTS

Suicidal thoughts, tendencies, and attempts were associated with low total cholesterol, LDL cholesterol, and total lipids in both male and female patients, in both diagnostic categories. Triglycerides were significantly lower in male and female patients with suicidal thoughts compared with their non-suicidal counterparts. No association with suicidality was found with HDL cholesterol.

CONCLUSIONS

The results of our study support a majority of research showing the association in depressed patients between suicidal behaviour and low levels of total and LDL cholesterol. In addition, the data suggest a similar association with low total lipids, and in some instances, with low triglycerides.