Leo Sher, M.D.

A research report, “Metabolic profile and long-term risk of depression, anxiety, and stress-related disorders” was recently published in JAMA Network Open (1). The results of this study indicate that carbohydrate and lipid metabolism may be involved in the development of psychiatric disorders.

The study assessed individuals from the Apolipoprotein-Related Mortality Risk (AMORIS) cohort who underwent occupational health screening between January 1, 1985, and December 31, 1996, mainly in the Stockholm region in Sweden. The associations between biomarker levels and the risk of developing depression, anxiety, and stress-related disorders through the end of 2020 were examined using Cox proportional hazards regression models. In addition, nested case-control analyses were conducted within the cohort. The following biomarkers were tested: glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, the ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol, apolipoprotein A-I, apolipoprotein B, and the ratio of apolipoprotein B to apolipoprotein A-I. A total of 211,200 individuals (mean [SD] age at first biomarker measurement, 42.1 [12.6] years; 122,535 [58.0%] male; 188,895 [89.4%] born in Sweden) participated in the study.

During a mean (SD) follow-up of 21.0 (6.7) years, a total of 16,256 individuals were diagnosed with depression, anxiety, or stress-related disorders. High levels of glucose (hazard ratio [HR], 1.30; 95% CI, 1.20-1.41) and triglycerides (HR, 1.15; 95% CI, 1.10-1.20) were associated with an increased subsequent risk of all tested psychiatric disorders, whereas high levels of high-density lipoprotein (HR, 0.88; 95% CI, 0.80-0.97) were associated with a reduced risk. These results were similar for male and female participants as well as for all tested disorders. The nested case-control analyses demonstrated that patients with depression, anxiety, or stress-related disorders had higher levels of glucose, triglycerides, and total cholesterol during the 20 years preceding diagnosis, as well as higher levels of apolipoprotein A-I and apolipoprotein B during the 10 years preceding diagnosis, compared with control participants.

The authors suggest that the results of their study provide further longitudinal evidence that metabolic dysregulation or metabolic syndrome increases the risk of developing psychiatric disorders. The authors also suggest that the findings of their study may support closer follow-up of individuals with metabolic dysregulations for the prevention and diagnosis of psychiatric disorders.

Reference

1. Chourpiliadis C, Zeng Y, Lovik A, Wei D, Valdimarsdóttir U, Song H, Hammar N, Fang F. Metabolic profile and long-term risk of depression, anxiety, and stress-related disorders. JAMA Netw Open. 2024 Apr 1;7(4):e244525. doi: 10.1001/jamanetworkopen.2024.4525.