New research adds to the growing evidence that metabolic health affects the brain and can adversely affect mental health.
Among more than 200,000 adults, high glucose and triglycerides and low high-density lipoprotein (HDL) cholesterol were associated with a higher future risk for depression, anxiety, and stress-related disorders.
“These findings may support closer follow-up of individuals with metabolic dysregulations for the prevention and diagnosis of psychiatric disorders,” study investigators, led by Charilaos Chourpiliadis, MD, Karolinska Institutet, Stockholm, Sweden, wrote.
The findings also suggest additional studies explore whether intervening in cardiometabolic diseases could counteract these associations, they added.
The study was published online on April 2 in JAMA Network Open.
Higher Glucose, Triglycerides, Cholesterol
The findings stem from longitudinal data on 211,200 adults (58% men) enrolled in the Apolipoprotein-Related Mortality Risk cohort.
The researchers examined whether the blood biomarkers of carbohydrate, lipid, and apolipoprotein metabolism are associated with the risk for depression, anxiety, and stress-related disorders. Participants had a mean age of 42 years at the first biomarker blood draw.
During a mean follow-up of 21 years, 16,256 individuals were diagnosed with depression, anxiety, or stress-related disorders.
Compared with low or normal levels, high levels of glucose (hazard ratio [HR], 1.30) and triglycerides (HR, 1.15) were associated with a higher risk for depression, anxiety, or stress-related disorders, whereas high levels of HDL (HR, 0.88) were associated with reduced risk.
The results were consistent when examining depression, anxiety, and stress-related disorders separately and were comparable for men and women.
The researchers also performed nested case-control analyses within the cohort, including all incident cases of depression, anxiety, and stress-related disorders, and up to 10 matched controls per individual case.
Compared with controls, patients with depression, anxiety, or stress-related disorders had consistently higher levels of glucose, triglycerides, and total cholesterol during the two decades preceding diagnosis, as well as higher levels of apolipoprotein A-I and apolipoprotein B during the 10 years preceding diagnosis.
Important Confirmation
Commenting on the research for Medscape Medical News, Christopher M. Palmer, MD, founder and director of the Metabolic and Mental Health Program, McLean Hospital, Belmont, Massachusetts, and assistant professor of psychiatry, Harvard Medical School, Boston, noted that this is one of the largest longitudinal studies looking at metabolic biomarkers and the subsequent risk for depression, anxiety, or a stress-related disorder.
Palmer explained that a common question related to area of research is whether depression and anxiety cause people to eat more junk food or crave sweets or exercise less, which might affect blood glucose and lipids.
“These researchers tried to rule out this possibility by including only participants who were free of any psychiatric diagnoses at the beginning of the study and also excluding people who developed new mental health conditions within the first 5 years of follow-up, knowing that sometimes early signs of depression and anxiety can be missed,” Palmer noted.
“This research confirms that metabolic health and mental health are interconnected. We have numerous other studies looking at levels of glucose metabolism, oxidative stress, and neuroinflammation in the brain as also being associated with mental health conditions and metabolic health conditions, such as obesity and diabetes.”
“This study raises the important question of whether we might be able to prevent these common mental disorders by improving people’s metabolic health. More research will be needed to prove this, but in the meantime, eating a healthier diet, getting good sleep, and getting an appropriate amount of exercise might be what the doctor ordered, not just for your physical health but also for your mental health,” Palmer added.
This study was supported by EU Horizon 2020 Research and Innovation Action Grant. Chourpiliadis had no relevant disclosures. Palmer is the author of the book Brain Energy published by Penguin Random House.
Source: Medscape
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