Factors influencing insulin resistance in relation to atherogenicity in mood disorders, the metabolic syndrome and tobacco use disorder

• Published in: Journal of affective disorders Vol. 179; pp. 148 - 155
• Main Authors: Bortolasci, Chiara Cristina, Vargas, Heber Odebrecht, Vargas Nunes, Sandra Odebrecht, de Melo, Luiz Gustavo Piccoli, de Castro, Márcia Regina Pizzo, Moreira, Estefania Gastaldello, Dodd, Seetal, Barbosa, Décio Sabbatini, Berk, Michael, Maes, Michael
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-07-2015
• Subjects: Adolescent; Adult; Aged; Atherogenic; Atherosclerosis - blood; Atherosclerosis - complications; Biomarkers - blood; Bipolar disorder; Bipolar Disorder - blood; Bipolar Disorder - complications; Blood Glucose; Body Mass Index; Cholesterol, HDL - blood; Depression; Depression - blood; Depression - complications; Female; Humans; Inflammation; Insulin - blood; Insulin Resistance; Male; Malondialdehyde; Metabolic syndrome; Metabolic Syndrome - blood; Metabolic Syndrome - complications; Middle Aged; Oxidative Stress; Psychiatry; Risk Factors; Tobacco Use Disorder - blood; Tobacco Use Disorder - complications; Triglycerides - blood; Uric Acid - blood; Young Adult; DSM-IV; tobacco use disorder; high-density lipoprotein; Bipolar disorder; HOMA2IR; MDA; homeostasis model assessment of β-cell function; MEIA; malondialdehyde; HDRS; BMI; microparticle enzyme immunoassay; cardiovascular disease; atherogenic index of plasma; Diagnostic and Statistical Manual of Mental Disorders; homeostasis model assessment of insulin resistance; TUD; OS; LDL-c; body mass index; HOMA2S; AIP; Depression; Inflammation; triglycerides; low-density lipoprotein; CVD; HDL-c; metabolic syndrome; HOMA2B; Hamilton Depression Rating Scale; MetS; TG; homeostasis model assessment of insulin sensitivity; enzyme-linked immunosorbent assay; Atherogenic; oxidative stress; ELISA; Oxidative stress; Metabolic syndrome
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2015.03.041

Abstract Objective This study examines the effects of malondialdehyde (MDA) and uric acid on insulin resistance and atherogenicity in subjects with and without mood disorders, the metabolic syndrome (MetS) and tobacco use disorder (TUD). Methods We included 314 subjects with depression and bipolar depression, with and without the MetS and TUD and computed insulin resistance using the updated homeostasis model assessment (HOMA2IR) and atherogenicity using the atherogenic index of plasma (AIP), that is log10 (triglycerides/high density lipoprotein (HDL) cholesterol. Results HOMA2IR is correlated with body mass index (BMI) and uric acid levels, but not with mood disorders and TUD, while the AIP is positively associated with BMI, mood disorders, TUD, uric acid, MDA and male sex. Uric acid is positively associated with insulin and triglycerides and negatively with HDL cholesterol. MDA is positively associated with triglyceride levels. Comorbid mood disorders and TUD further increase AIP but not insulin resistance. Glucose is positively associated with increasing age, male gender and BMI. Discussion The results show that mood disorders, TUD and BMI together with elevated levels of uric acid and MDA independently contribute to increased atherogenic potential, while BMI and uric acid are risk factors for insulin resistance. The findings show that mood disorders and TUD are closely related to an increased atherogenic potential but not to insulin resistance or the MetS. Increased uric acid is a highly significant risk factor for insulin resistance and increased atherogenic potential. MDA, a marker of lipid peroxidation, further contributes to different aspects of the atherogenic potential. Mood disorders and TUD increase triglyceride levels, lower HDL cholesterol and are strongly associated with the atherogenic, but not insulin resistance, component of the MetS.