Łucka Anna, Arabska Jaśmina, Fife Elizaveta, Kroc Łukasz, Sołtysik Bartłomiej Konrad, Kłoszewska Iwona, Sobów Tomasz, Kostka Tomasz, Wysokiński Adam
1 Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz , Lodz, Poland .
2 Department of Geriatrics, Medical University of Lodz , Lodz, Poland .
Metab Syndr Relat Disord. 2017 Aug;15(6):291-295. doi: 10.1089/met.2017.0008. Epub 2017 Apr 12.
Blood lipids are widely used in monitoring the risk of cardiovascular diseases; however, atherogenic indices are more precise markers. The aim of the study was to determine differences in atherogenic indices in elderly patients with unipolar depression (DEP) compared with nondepressed elderly patients (nonDEP) using case-control analysis.
Fasting serum lipid profiles were measured in 564 (depressed: n = 282, nondepressed: n = 282, 83.7% (n = 236) women in both groups) Caucasian inpatients aged ≥60, with mean age 76.9 years. Patients from both groups were matched for age and sex. Atherogenic index of plasma (AIP) was calculated as log(triglycerides/HDL cholesterol). Castelli atherogenic indices were calculated as follows: AI is the ratio of low-density lipoprotein (LDL) cholesterol to high-density lipoprotein (HDL) cholesterol and AI is the ratio of total cholesterol to HDL cholesterol.
HDL levels were significantly decreased in depressed patients (48.2 ± 14.4 mg/dL vs. 54.5 ± 17.7 mg/dL). No other differences in lipid profile were found. We found that all three analyzed atherogenic indices were increased in depressed patients (AIP: 0.41 ± 0.28 vs. 0.33 ± 0.27, AI: 2.90 ± 1.41 vs. 2.42 ± 1.07, AI: 4.51 ± 1.84 vs. 3.79 ± 1.21). We found associations between depression severity and reduced level of HDL (β = -0.02) or increased AIP (β = 1.66).
All three atherogenic indices were increased in elderly patients with depression. Since depression and age are associated with elevated risk of cardiovascular events, elderly patients with depression should be carefully monitored for abnormal lipid status to reduce their cardiovascular risk. The role of lipid abnormalities in the pathogenesis of depression requires further studies.
血脂广泛用于监测心血管疾病风险；然而，致动脉粥样硬化指数是更精确的标志物。本研究的目的是通过病例对照分析，确定老年单相抑郁症（DEP）患者与非抑郁老年患者（nonDEP）在致动脉粥样硬化指数上的差异。
对564名年龄≥60岁、平均年龄76.9岁的白种人住院患者（抑郁组：n = 282，非抑郁组：n = 282，两组女性均占83.7%（n = 236））测量空腹血脂谱。两组患者在年龄和性别上进行匹配。血浆致动脉粥样硬化指数（AIP）计算为log（甘油三酯/高密度脂蛋白胆固醇）。卡斯泰利致动脉粥样硬化指数计算如下：AI是低密度脂蛋白（LDL）胆固醇与高密度脂蛋白（HDL）胆固醇的比值，AI是总胆固醇与HDL胆固醇的比值。
抑郁患者的HDL水平显著降低（48.2±14.4mg/dL对54.5±17.7mg/dL）。未发现血脂谱的其他差异。我们发现，抑郁患者的所有三项分析致动脉粥样硬化指数均升高（AIP：0.41±0.28对0.33±0.27，AI：2.90±1.41对2.42±1.07，AI：4.51±1.84对3.79±1.21）。我们发现抑郁严重程度与HDL水平降低（β = -0.02）或AIP升高（β = 1.66）之间存在关联。
老年抑郁症患者的所有三项致动脉粥样硬化指数均升高。由于抑郁和年龄与心血管事件风险升高相关，应仔细监测老年抑郁症患者的血脂异常情况，以降低其心血管风险。血脂异常在抑郁症发病机制中的作用需要进一步研究。
