Glucose metabolism in completed suicide: a forensic-pathological pilot study

Abstract

AimTo determine whether antemortem blood levels of glycated hemoglobin (HbA1c) and glucose predict completed suicide and, by extension, whether markers of glucose metabolism might be associated with a prosuicidal trait or state.MethodFrom consecutively performed autopsies, samples of blood and vitreous humor from 17 suicide victims and 27 non-suicide controls were compared with regard to levels of glucose, lactate, and HbA1c.ResultsMean HbA1c was higher and mean estimated blood glucose was lower among suicide victims, although tests revealed no significant differences (P = 0.171 and P = 0.395, respectively). HbA1c levels exceeding 48.0 mmol/mol, which were indicative of persistent hyperglycemia, were twice as common in suicide victims (59% vs 30%; P = 0.068).ConclusionThe finding of this pilot study suggest that deranged glucose metabolism may reflect biological events antecedent to, or concomitant with, completed suicide, with the following clinical implications: recurring hyperglycemia due to defective glucose transport, which may give rise to depression and suicidal ideation, and elevated HbA1c levels, which may represent an assayable correlate to neurobiological conditions predisposing to suicide.

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

“…Research also suggests that blood glucose levels are associated with suicide risk. A pilot study suggested that abnormal glucose metabolism may reflect biological changes prior to or concomitant with suicide [19]. Diabetes mellitus among patients with depression is also associated with a higher rate of suicide attempts [20].…”

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

“…To begin with the regulation of glucose import in response to insulin stimulus GO has not been per se linked with SB; nevertheless, it is not the case of the glucose metabolism and insulin related. 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.…”

Blood lactate as a biomarker of depression: a comparative study between runners and sedentary people

“…The total inventory score is obtained by summing the 21 items, yielding a total score ranging from 0 to 63. Thus, the score range indicates a: minimal depression (0-13), a mild depression (14)(15)(16)(17)(18)(19), a moderate depression (20)(21)(22)(23)(24)(25)(26)(27)(28), and a severe depression .…”

“…A current hypothesis suggests that physical exercise, like recreational running, stimulates blood lactate production, with this biomarker having antidepressant effects due to psychological processes regulation. This regulation mechanism results from increased intracellular glucose availability to the brain 20 . In this view, low lactate blood levels could be an interesting indicator of depressive symptom development 21,14 , leading to alternative pathways to treat depression, such as physical activity, associated with lactate stimulation.…”