Evaluation of inflammatory and metabolic impairments regarding depression dimensions: a case control study

Abstract

Background: Patients with depression are at a higher risk of developing serious medical problems such as diabetes mellitus, hypertension, and cardiovascular diseases, increasing the burden of depression and worsening its outcome. Recent studies revealed the presence of low-grade systemic inflammation and metabolic impairments which are playing an important role in the development of these medical problems among patients with depression. It should be noted that not all patients with depressive disorder have these immune or metabolic impairments. The study aims to evaluate inflammatory and metabolic impairments among patients with depression through categorizing patients with depression into four dimensional profilers which are (1) atypical energy-related symptom dimension, (2) melancholic dimension, (3) childhood trauma dimension, and (4) anxious distress dimension. Also, the current study will evaluate inflammatory and metabolic impairments among patients with depression and a control group. Results: This study highlights that of the patients with metabolic impairments (including hypertension, impaired glycemic control, low/high-density lipoprotein, elevated triglycerides, and central obesity), all of them had reported significantly higher scores in the atypical, energy-related symptom dimension. Also, patients with impaired glycemic control had reported significantly (p < 0.001) high scores in the anxious distress symptom dimension. While patients with inflammatory impairment (serum CRP > 3 mg/L) had significantly (p = 0.009) reported higher scores in the childhood trauma symptom dimension. In addition, statistically significant metabolic and inflammatory impairments are detected among the depression cases group in comparison with the control group. Conclusions: This study found that patients with depression presented by atypical, energy-related symptoms were at a higher risk of metabolic impairments than other depression profilers. Also, patients of the Anxious distress symptom dimension reported significant impaired glycemic control. In addition, patients with depression of the childhood trauma dimension were associated with high levels of inflammatory marker (C-reactive protein). Potential implications: These results can be applied clinically to improve treatment and prognosis in patients with depression. For example, depressed patients with atypical, energy-related symptoms should increase their daily physical activities and exercise, and they should follow a special diet. Also, anti-inflammatory medications could be added to depressed patients of the childhood trauma dimension.