Association between serum lipid levels, osteoprotegerin and depressive symptomatology in psychotic disorders

Sherif M Gohar,Ragni H Mørch,Trude S Iversen,Ingrid Dieset,Nils Eiel Steen,Ole A Andreassen,Vidar M Steen,Ingrid Melle

doi:10.1007/s00406-018-0897-z

Abstract

Although the relationship between positive and negative symptoms of psychosis and dyslipidemia has been thoroughly investigated in recent studies, the potential link between depression and lipid status is still under-investigated. We here examined the association between lipid levels and depressive symptomatology in patients with psychotic disorders, in addition to their possible inflammatory associations. Participants (n = 652) with the following distribution: schizophrenia, schizophreniform and schizoaffective disorder (schizophrenia group, n = 344); bipolar I, II, NOS, and psychosis NOS (non-schizophrenia group, n = 308) were recruited consecutively from the Norwegian Thematically Organized Psychosis (TOP) Study. Clinical data were obtained by Positive and Negative Syndrome Scale (PANSS), and Calgary Depression Scale for Schizophrenia (CDSS). Blood samples were analyzed for total cholesterol (TC), low-density lipoprotein (LDL), triglyceride (TG), C-reactive protein (CRP), soluble tumor necrosis factor receptor 1(sTNF-R1), osteoprotegerin (OPG), and interleukin 1 receptor antagonist (IL-1Ra). After adjusting for age, gender, BMI, smoking, and dyslipidemia-inducing antipsychotics, TC and LDL scores showed significant associations with depression [β = 0.13, p = 0.007; β = 0.14, p = 0.007], and with two inflammatory markers: CRP [β = 0.14, p = 0.007; β = 0.16, p = 0.007] and OPG [β = 0.14, p = 0.007; β = 0.11, p = 0.007]. Total model variance was 17% for both analyses [F(12, 433) = 8.42, p < 0.001; F(12, 433) = 8.64, p < 0.001]. Current findings highlight a potential independent role of depression and inflammatory markers, CRP and OPG in specific, in the pathophysiology of dyslipidemia in psychotic disorders.

Highlights

Patients with schizophrenia and other psychotic disorders tend to have higher serum lipid levels than the general population [1]
The baseline dyslipidemia found in this study, in addition to the shared genetic overlap between schizophrenia and cardio-metabolic risk factors found in genome-wide association studies (GWASs), especially the loci related to triglyceride, low- and high-density lipoproteins cholesterol gives rise to the possibility of a diseasespecific lipid pathway underlying the pathophysiology of psychotic disorders [5]
The primary aim of the current study is to investigate the association between serum lipid levels and depressive symptoms in a large clinical sample of patients with psychotic disorders; to investigate if higher levels of serum lipids are associated with higher levels of depressive symptoms

Summary

Introduction

Patients with schizophrenia and other psychotic disorders tend to have higher serum lipid levels than the general population [1]. The findings of a recent 5-year follow-up study about the associations between higher lipids levels, severity of psychotic symptoms and level of functioning support the idea that raised lipid levels could be a disease trait in schizophrenia [6]. It is not clear if this association is specific to schizophrenia, and whether it is related to specific clusters of symptoms or symptom domain, i.e. only positive and negative symptoms or if it could be related to depressive symptoms

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Conclusion