Clinical correlates, lipid metabolic parameters and thyroid hormones are associated with abnormal glucose metabolism in first-episode and drug-naïve major depressive disorder patients with suicide attempts: A large cross-sectional study

Abstract

Background

The factors associated with glucose disturbances in major depressive disorder (MDD) patients with comorbid suicide attempts remains unclear. To the best of our knowledge, this is the first study with a large sample size to examine risk factors for glucose disturbances, including clinically relevant factors, lipid metabolic parameters, and thyroid hormone levels in first-episode drug-naïve (FEDN) MDD patients with comorbid suicide attempts.

Methods

A total of 1718 FEDN MDD patients were enrolled. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) were used to assess the clinical symptoms of the patients. Fasting blood samples were collected and biochemical parameters were measured, including fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), thyroid stimulating hormone (TSH), free thyroxine (FT4, FT3), anti-thyroid autoantibodies (TgAb), and thyroid peroxidase antibody (TPOAb). Statistical analyses were performed using multivariate logistic regression analyses and receptor operating characteristic curves.

Results

The prevalence of glucose disturbances was 24 % in MDD patients with comorbid suicide attempts, which was 1.88 times higher than that in MDD patients without suicide attempts (11 %). Among MDD patients with comorbid suicide attempters, compared with patients without glucose disturbances, patients with glucose disturbances had higher mean scores on the HAMA, HAMD and PANSS positive subscale scores, and higher mean levels of TC, TG, TSH, HDL-C, LDL-C, and TPOAb. The combination of HAMA score, HAMD score, PANSS positive subscale score and TSH distinguished between patients with and without glucose disturbances.

Conclusions

Our findings suggest a high prevalence of glucose disturbances in FEDN MDD patients with comorbid suicide attempts. Several clinical correlates, lipid metabolism parameters, and thyroid hormone function are associated with glucose disturbances in MDD patients with comorbid suicide attempts.