Skip to main content
SpringerLink
Log in

Association of Inflammatory and Liver Markers with Cardiometabolic Risk Factors in Patients with Depression

  • Original Research Article
  • Published:
Indian Journal of Clinical Biochemistry Aims and scope Submit manuscript

Abstract

Metabolic syndrome (MS) is found to be more prevalent in patients with psychiatric disorders including depression. This study aimed to assess the association of inflammatory and liver markers with cardiometabolic risk factors in patients with Depressive disorders. Prevalence of MS by using Modified NCEP ATP-III Criteria and liver enzymes and CRP were assessed in 382 patients with depressive disorders. MS prevalence was 27.7% and lower HDL level was the commonest metabolic abnormality. ALT, GGT, and CRP levels were positively correlated with weight and BMI. ALT, GGT, and CRP levels were significantly greater in patients with abnormal waist circumference, triglyceride levels and raised blood pressure, compared to patients with normal indices. Such association was not found with abnormal HDL cholesterol and hyperglycemia. Levels of GGT and CRP were significantly greater in patients with MS compared to patients without MS and CRP was significant predictor for MS. To conclude, one-fourth of depressed patients had MS. MS and metabolic abnormalities were associated with inflammatory marker and liver enzymes. Patients with depression should be regularly evaluated for cardiovascular risk factors, liver enzymes, and inflammatory markers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Murray CJ, Lopez AD. Measuring the global burden of disease. N Engl J Med. 2013;369:448–57.

    Article  CAS  PubMed  Google Scholar 

  2. Goldbacher EM, Bromberger J, Matthews KA. Lifetime history of major depression predicts the development of the metabolic syndrome in middle-aged women. Psychosom Med. 2009;71:266–72.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Vancampfort D, Stubbs B, Mitchell AJ, De Hert M, Wampers M, Ward PB, et al. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis. World Psychiatry. 2015;14:339–47.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Devers MC, Campbell S, Shaw J, Zimmet P, Simmons D. Should liver function tests be included in definitions of metabolic syndrome? Evidence from the association between liver function tests, components of metabolic syndrome and prevalent cardiovascular disease. Diabet Med. 2008;25:523–9.

    Article  CAS  PubMed  Google Scholar 

  5. Ahn HR, Shin MH, Nam HS, Park KS, Lee YH, Jeong SK. The association between liver enzymes and risk of type 2 diabetes: the Namwon study. Diabetol Metab Syndr. 2014;6:14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Nannipieri M, Gonzales C, Baldi S, Posadas R, Williams K, Haffner SM, et al. Liver enzymes, the metabolic syndrome, and incident diabetes. Diabetes Care. 2005;28:1757–62.

    Article  CAS  PubMed  Google Scholar 

  7. Zelber-Sagi S, Toker S, Armon G, Melamed S. Elevated alanine aminotransferase independently predicts new onset of depression in employees undergoing health screening examinations. Psychol Med. 2013;43:2603–13.

    Article  CAS  PubMed  Google Scholar 

  8. Schindhelm RK, Dekker JM, Nijpels G, Bouter LM, Stehouwer CD, Heine RJ, et al. Alanine aminotransferase predicts coronary heart disease events: a 10-year follow-up of the Hoorn Study. Atherosclerosis. 2007;191:391–6.

    Article  CAS  PubMed  Google Scholar 

  9. Topic R, Milicic D, Stimac Z, Loncar M, Velagic V, Marcinko D, et al. Somatic comorbidity, metabolic syndrome, cardiovascular risk, and CRP in patients with recurrent depressive disorders. Croat Med J. 2013;54:453–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. World Health Organization. The ICD-10 classification of mental and behavioural disorders—clinical descriptions and diagnostic guidelines. Geneva: WHO; 1992.

    Google Scholar 

  11. Lecrubier Y, Sheehan D, Weiller E, Amorim P, Bonora I, Sheehan KH, et al. The Mini International Neuropsychiatric Interview (M.I.N.I.) a short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry. 1997;12:224–31.

    Article  Google Scholar 

  12. Nebhinani N, Sharma P, Pareek V. Associations of metabolic syndrome with elevated liver enzymes and C-reactive protein in drug-naive patients with depressive disorders. J Ment Health Hum Behav. 2016;21:91–7.

    Article  Google Scholar 

  13. Hamilton M. Hamilton Psychiatric Rating Scale for primary depressive illness. Br J Soc Clin Psychol. 1967;6:278–96.

    Article  CAS  PubMed  Google Scholar 

  14. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of obesity. Circulation. 2009;120:1640–5.

    Article  CAS  PubMed  Google Scholar 

  15. Pan A, Keum N, Okereke OI, Sun Q, Kivimaki M, Rubin RR, et al. Bidirectional association between depression and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies. Diabetes Care. 2012;35:1171–80.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Mattoo SK, Singh SM. Prevalence of metabolic syndrome in psychiatric inpatients in a tertiary care centre in north India. Indian J Med Res. 2010;131:46–52.

    PubMed  Google Scholar 

  17. Aggarwal M, Grover S, Chakrabarti S, Dutt A, Avasthi A, Kulhara P. Prevalence of metabolic syndrome in depression. J Ment Health Hum Behav. 2012;17:15–24.

    Google Scholar 

  18. Grover S, Nebhinani N, Chakrabarti S, Avasthi A, Kulhara P. Metabolic syndrome in drug naïve patient’s with depression. Indian J Psychol Med. 2013;35:167–73.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Rathi A, Jhanjee A, Bhatia MS. A study of the prevalence, socio-demographic and clinical correlates of metabolic syndrome (MS) in drug-naive patients of anxiety and depressive disorders. Delhi Psychiatry J. 2013;16:7–14.

    Google Scholar 

  20. Agarwal A, Agarwal M, Garg K, Dalal PK, Trivedi JK, Srivastava JS. Metabolic syndrome and central obesity in depression: a cross-sectional study. Indian J Psychiatry. 2016;58:281–6.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Vancampfort D, Correll CU, Wampers M, Sienaert P, Mitchell AJ, De Herdt A, et al. Metabolic syndrome and metabolic abnormalities in patients with major depressive disorder: a meta-analysis of prevalences and moderating variables. Psychol Med. 2014;44:2017–28.

    Article  CAS  PubMed  Google Scholar 

  22. Music M, Dervisevic A, Pepic E, Lepara O, Fajkic A, Ascic-Buturovic B, Tuna E. Metabolic syndrome and serum liver enzymes level at patients with type 2 diabetes mellitus. Med Arch. 2015;69:251–5.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Zhang L, Ma X, Jiang Z, Zhang K, Zhang M, Li Y, et al. Liver enzymes and metabolic syndrome: a large-scale case-control study. Oncotarget. 2015;6:26782–8.

    PubMed  PubMed Central  Google Scholar 

  24. Zhang X, Mu Y, Yan W, Ba J, Li H. Alanine aminotransferase within reference range is associated with metabolic syndrome in middle-aged and elderly Chinese men and women. Int J Environ Res Public Health. 2014;11:12767–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Chen S, Guo X, Yu S, Zhou Y, Li Z, Sun Y. Metabolic syndrome and serum liver enzymes in the general chinese population. Int J Environ Res Public Health. 2016;13:223.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Kälsch J, Bechmann LP, Heider D, Best J, Manka P, Kälsch H. Normal liver enzymes are correlated with severity of metabolic syndrome in a large population based cohort. Sci Rep. 2015;5:13058.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Labayen I, Ruiz JR, Ortega FB, Davis CL, Rodríguez G, González-Gross M, et al. Liver enzymes and clustering cardiometabolic risk factors in European adolescents: the HELENA study. Pediatr Obes. 2015;10:361–70.

    Article  CAS  PubMed  Google Scholar 

  28. Clement K, Viguerie N, Poitou C, Carette C, Pelloux V, Curat CA, et al. Weight loss regulates inflammation-related genes in white adipose tissue of obese subjects. FASEB J. 2004;18:1657–69.

    Article  CAS  PubMed  Google Scholar 

  29. Rethorst CD, Bernstein I, Trivedi MH. Inflammation, obesity, and metabolic syndrome in depression: analysis of the 2009–2010 National Health and Nutrition Examination Survey (NHANES). J Clin Psychiatry. 2014;75:e1428–32.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This project has received intramural grant from All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan.

Author information

Authors and Affiliations

  1. Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan, 342005, India

    Naresh Nebhinani, Vrinda Pareek, Navratan Suthar, Shobhan Jakhotia & Mukesh Gehlot

  2. Department of Biochemistry, All India Institute of Medical Science, Jodhpur, Rajasthan, 342005, India

    Praveen Sharma & Purvi Purohit

Authors
  1. Naresh Nebhinani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Praveen Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vrinda Pareek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Navratan Suthar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shobhan Jakhotia
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mukesh Gehlot
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Purvi Purohit
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Naresh Nebhinani.

Ethics declarations

Conflict of interest

The authors report no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nebhinani, N., Sharma, P., Pareek, V. et al. Association of Inflammatory and Liver Markers with Cardiometabolic Risk Factors in Patients with Depression. Ind J Clin Biochem 34, 219–224 (2019). https://doi.org/10.1007/s12291-018-0738-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12291-018-0738-x

Keywords

Search

Navigation