Association between suicidal behaviour and impaired glucose metabolism in depressive disorders

Abstract

BackgroundDisturbances in lipid metabolism have been linked to suicidal behaviour, but little is known about the association between suicide risk and abnormal glucose metabolism in depression. Hyperglycaemia and hyperinsulinaemia may increase the risk of depression and also the risk for suicide, we therefore studied associations between suicidal behaviour and disturbances in glucose metabolism in depressive patients who had been referred to depression nurse case managers.MethodsPatients aged 35 years and older (N = 448, mean age 51 years) who were experiencing a new depressive episode, who were referred to depression nurse case managers in 2008–2009 and who scored ≥10 on the Beck Depression Inventory were enrolled in this study. The study was conducted in municipalities within the Central Finland Hospital District (catchment area of 274 000 inhabitants) as part of the Finnish Depression and Metabolic Syndrome in Adults study. The patients’ psychiatric diagnoses and suicidal behaviour were confirmed by the Mini-International Neuropsychiatric Interview. Blood samples, for glucose and lipid determinations, were drawn from participants after 12 h of fasting, which was followed by a 2-hour oral glucose tolerance test (OGTT) when blood was drawn at 0 and 2 h. Insulin resistance was measured by the Quantitative Insulin Sensitivity Check Index (QUICKI) method.ResultsSuicidal ideation (49 %) and previous suicide attempts (16 %) were common in patients with major depressive disorder or dysthymia. Patients with depression and suicidal behaviour had higher blood glucose concentrations at baseline and at 2 hours in the OGTT. Glucose levels associated positively with the prevalence of suicidal behaviour, and the linearity was significant at baseline (p for linearity: 0.012, adjusted for age and sex) and for 2-hour OGTT glucose (p for linearity: 0.004, adjusted for age and sex). QUICKI levels associated with suicidal behavior (p for linearity across tertiles of QUICKI: 0.026). Total and LDL cholesterol and triglyceride levels were also higher in those patients with suicidal behaviour. Multivariate analysis revealed that blood glucose levels, BDI scores and antidepressive medications associated with suicidal behaviour.ConclusionInsulin resistance and disturbances in glucose and lipid metabolism may be more common in middle-aged depressive patients with suicidal behaviour.

Leisure time physical activity and its relation to psychiatric comorbidities in depression. Findings from Finnish Depression and Metabolic Syndrome in Adults (FDMSA) study

“…The severity of depressive symptoms (DS) was captured using the 21-item Beck Depression Inventory (BDI-21) (Beck et al, 1961), which was completed by the participants. The cut-off point was set to ≥10 (Koponen et al, 2015). The psychiatric diagnosis and number of other psychiatric comorbidities were confirmed and obtained with a diagnostic Mini-International Neuropsychiatric Interview (M.I.N.I.)…”

Potential metabolic monitoring indicators of suicide attempts in first episode and drug naive young patients with major depressive disorder:a cross-sectional study

“…Koponen revealed in his research that higher level of blood glucose for the OGTT at baseline and 2 hours were found in depression patients with suicide attempt compared to those without suicide attempt [23]. Other studies also showed the relationship between high level of blood glucose and suicide [20,29].…”

“…For example, Ji Hyun Baek et al suggested that in MDD patients , the serum lipids levels are associated with suicide attempts [22]. Hannu Koponen et al indicated that glucose disturbances and lipid metabolism commonly exist in the groups of patients with depression aged 35 years and older [23],their results could be better if the subjects of depression are further subdivided according to the degrees. Since of all the age groups, the incidence of suicide in youth is higher.…”

Identification of gene ontology and pathways implicated in suicide behavior: Systematic review and enrichment analysis of GWAS studies

“…For example, Forsman et al () studied 17 SV and 27 nonsuicide controls and compared glucose lactate levels and HbA1c; they found that mean HbA1c was higher and mean estimated blood glucose was lower among SV. In addition, there is a hypothesis that hyperglycemia and hyperinsulinemia may increase the risk for depression and suicide; the group of Koponen, Kautiainen, Leppanen, Mantyselka, and Vanhala () studied the associations between SB and disturbances in glucose metabolism in depressive subjects. These researchers in sample of 448 depressive patients concluded that insulin resistance and disturbance in glucose and lipid metabolism are more common in depressive patients with SB.…”