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Child Psychiatrist /Adult Psychiatrist

Elevated Triglycerides, Low HDLC Increases Risk for Psychiatric Disorders

Keypoint: Elevated levels of high-density lipoprotein may be protective against psychiatric disorder risk.

Psychiatric Disorders

Carbohydrate and lipid metabolism may play a role in the development of depression, anxiety, and stress-related disorders, according to study results published in JAMA Network Open.

Depression, anxiety, and stress-related disorders are highly prevalent mental health issues and have been commonly associated with cardiometabolic dysfunction. However, research on the relationship between glucose or lipid biomarkers and these disorders has yielded inconsistent results and the directionality of this association remains unclear. To this aim, investigators conducted a longitudinal population-based cohort study to assess how carbohydrate, lipid, and apolipoprotein metabolism may affect the risk of developing depression, anxiety, and stress-related disorders.

Investigators used data collected in Sweden between January 1, 1985, and December 31, 1996, from the Apolipoprotein-Related Mortality Risk (AMORIS) cohort. The investigators identified participants aged 16 years and older who underwent routine health screenings in an occupational setting, had no psychiatric disorders at baseline, and had at least 1 biomarker measured during the recruitment period. The primary outcomes of interest were incident cases of depression, anxiety, or stress disorders – confirmed via International Classification of Diseases codes – following enrollment in the AMORIS study.

The investigators assessed 211,200 participants and matched each case with up to 10 controls based on birth year, sex, and enrollment year. On average, participants were 42.1 (SD, 12.6) years of age at first biomarker measurement and 42% of individuals were women. Over a 21-year follow-up, 16,256 people were diagnosed with depression, anxiety, or stress-related disorders, for an incidence rate of 36.4 per 10,000 person-years.

The investigators found that psychiatric disorder risk was higher among those with elevated glucose (hazard ratio [HR], 1.30; 95% CI, 1.20-1.41) and triglyceride levels (HR, 1.15; 95% CI, 1.10-1.20). Conversely, elevated levels of high-density lipoprotein lowered psychiatric disorder risk (HR, 0.88; 95% CI, 0.80-0.97). These results did not differ significantly between men and women and remained robust in sensitivity analyses.

These findings indicate that individuals diagnosed with depression, anxiety, or stress-related disorders exhibited elevated levels of glucose, triglycerides, and total cholesterol up to 20 years before their diagnosis. “These results add further evidence of the association between cardiometabolic health and psychiatric disorders and potentially advocate for a closer follow-up of individuals with metabolic dysregulations for prevention and early diagnosis of psychiatric disorders,” the investigators concluded.

Study limitations include potential biases due to recruitment through employment-related health screenings, which may restrict the generalizability of findings beyond the study population.

Note: This article originally appeared on Psychiatry Advisor

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