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Association between suicidal behaviour and impaired glucose metabolism in depressive disorders.

Koponen H, Kautiainen H, Leppänen E, Mäntyselkä P, Vanhala M - BMC Psychiatry (2015)

Bottom Line: QUICKI levels associated with suicidal behavior (p for linearity across tertiles of QUICKI: 0.026).Multivariate analysis revealed that blood glucose levels, BDI scores and antidepressive medications associated with suicidal behaviour.Insulin resistance and disturbances in glucose and lipid metabolism may be more common in middle-aged depressive patients with suicidal behaviour.

View Article: PubMed Central - PubMed

Affiliation: Old Age Psychiatry, University of Helsinki, and Helsinki University Hospital, P.O. Box 22, FIN-00014, Helsinki, Finland. hannu.j.koponen@hus.fi.

ABSTRACT

Background: Disturbances 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.

Methods: Patients 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.

Results: Suicidal 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.

Conclusion: Insulin resistance and disturbances in glucose and lipid metabolism may be more common in middle-aged depressive patients with suicidal behaviour.

No MeSH data available.


Related in: MedlinePlus

Age and sex-adjusted association between QUICKI tertiles and suicidal behavior
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Fig2: Age and sex-adjusted association between QUICKI tertiles and suicidal behavior

Mentions: The blood glucose concentrations associated positively with the prevalence of suicidal behaviour (Fig. 1), and linearity was significant for baseline glucose concentrations (p for linearity: 0.012, adjusted for age and sex) and for 2-hour OGTT glucose concentrations (p for linearity: 0.004, adjusted for age and sex adjusted). The OR for suicidal behaviour for the highest vs. the lowest tertile of fasting glucose concentrations at baseline for the OGTT was 2.18 (95 % CI: 1.27–3.74) whereas the corresponding tertile values for 2-hour glucose, OR was 1.99 (95 % CI: 1.64–3.38). The baseline or 2-hour insulin levels were not significantly different from each other, but QUICKI levels showed a significant association with suicidal behaviour (p for linearity across tertiles of QUICKI: 0.026; Fig. 2). When the 72 patients who had a previous suicide attempt were scrutinized separately from the 218 patients who had suicidal ideation, no statistically significant linearity in the OGTT values was observed.Fig. 1


Association between suicidal behaviour and impaired glucose metabolism in depressive disorders.

Koponen H, Kautiainen H, Leppänen E, Mäntyselkä P, Vanhala M - BMC Psychiatry (2015)

Age and sex-adjusted association between QUICKI tertiles and suicidal behavior
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4509469&req=5

Fig2: Age and sex-adjusted association between QUICKI tertiles and suicidal behavior
Mentions: The blood glucose concentrations associated positively with the prevalence of suicidal behaviour (Fig. 1), and linearity was significant for baseline glucose concentrations (p for linearity: 0.012, adjusted for age and sex) and for 2-hour OGTT glucose concentrations (p for linearity: 0.004, adjusted for age and sex adjusted). The OR for suicidal behaviour for the highest vs. the lowest tertile of fasting glucose concentrations at baseline for the OGTT was 2.18 (95 % CI: 1.27–3.74) whereas the corresponding tertile values for 2-hour glucose, OR was 1.99 (95 % CI: 1.64–3.38). The baseline or 2-hour insulin levels were not significantly different from each other, but QUICKI levels showed a significant association with suicidal behaviour (p for linearity across tertiles of QUICKI: 0.026; Fig. 2). When the 72 patients who had a previous suicide attempt were scrutinized separately from the 218 patients who had suicidal ideation, no statistically significant linearity in the OGTT values was observed.Fig. 1

Bottom Line: QUICKI levels associated with suicidal behavior (p for linearity across tertiles of QUICKI: 0.026).Multivariate analysis revealed that blood glucose levels, BDI scores and antidepressive medications associated with suicidal behaviour.Insulin resistance and disturbances in glucose and lipid metabolism may be more common in middle-aged depressive patients with suicidal behaviour.

View Article: PubMed Central - PubMed

Affiliation: Old Age Psychiatry, University of Helsinki, and Helsinki University Hospital, P.O. Box 22, FIN-00014, Helsinki, Finland. hannu.j.koponen@hus.fi.

ABSTRACT

Background: Disturbances 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.

Methods: Patients 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.

Results: Suicidal 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.

Conclusion: Insulin resistance and disturbances in glucose and lipid metabolism may be more common in middle-aged depressive patients with suicidal behaviour.

No MeSH data available.


Related in: MedlinePlus