Associations of serum cystatin C with depressive symptoms and suicidal ideation in major depressive disorder

Ting Sun,Qian Chen,Yan Li

doi:10.1186/s12888-021-03509-3

Ting Sun, Qian Chen + Show 1 more

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https://doi.org/10.1186/s12888-021-03509-3

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Abstract

BackgroundIndividuals with major depressive disorder (MDD) have high suicidal ideation. There is evidence that serum cystatin C (Cys C) may be involved in the pathophysiology of MDD. The present study aimed to investigate Cys C concentration in patients with MDD and clarify its possible association with depressive symptoms and suicidal ideation.MethodsAn online cross-sectional survey of 159 patients diagnosed with MDD was conducted. Serum Cys C levels were measured using ADVIA 2400 biochemical analyzer. The 24-item Hamilton Depression Scale (HAMD-24) was administered to evaluate the depressive symptoms. Generalized linear regression, logistic regression and restricted cubic spline models were used to examine the association of serum Cys C levels with depressive symptoms and suicidal ideation.ResultsSerum Cys C levels were higher in MDD patients than in controls (p = 0.001) and were positively associated with scores on HAMD-24 in unadjusted (gender distribution, age, smoking, alcohol consumption, family history of depression and traumatic life events; (p = 0.003) and fully adjusted linear regression model (p = 0.005). The fully adjusted regression coefficient with 95% confidence intervals for serum Cys C levels and HAMD-24 score was 30.339 (9.602 to 51.077). The level of Cys C in the suicidal ideation (SI) group was significantly higher than that in the non-suicide ideation (non-SI) group (p = 0.001). Serum Cys C levels were positively associated with suicidal ideation in each logistic regression model (all p < 0.05).ConclusionSerum Cys C levels were elevated in MDD patients and appeared to be positively correlated with depressive symptoms and suicidal ideation. These findings suggest that the dysfunction of Cys C may be involved in the severity of depression and in the pathophysiological process of MDD. Thus, regulation of serum Cys C could potentially be an effective predictor of the severity of depression and potentially, play a role in reducing the risk of suicide in MDD patients.

Highlights

Major depressive disorder (MDD), with profound impairment in cognitive and social functioning, is a common and complex psychiatric disorder characterized by high morbidity [1, 2], high disability rate [3], and high suicide rate [4, 5]
The analysis indicated that serum cystatin C (Cys C) levels were higher in major depressive disorder (MDD) patients than in healthy controls (p = 0.001) (Table 1)
Serum Cys C was divided into quartiles Crude no adjustment Model 1 adjusted for age, gender distribution, smoking, alcohol consumption, family history of depression and traumatic life events Model 2 adjusted for the same variables as Model 1 as well as Urea, Cr, uric acid (UA), estimate glomerular filtration rate (eGFR) and high-sensitivity C-reactive protein (hs-CRP) and environmental factors contributing to the overall risk [38,39,40]. The mechanisms of these risk factors are still unknown. In this retrospective study of MDD patients, we found a positive correlation between serum Cys C level and 24-item Hamilton Depression Scale (HAMD-24) score, which remained significant after controlling for potential confounding factors

Summary

Introduction

Major depressive disorder (MDD), with profound impairment in cognitive and social functioning, is a common and complex psychiatric disorder characterized by high morbidity [1, 2], high disability rate [3], and high suicide rate [4, 5]. The etiology and pathogenesis of depression have not been fully understood, consistent and robust empirical evidence suggests that neuronal injury [9] and immune inflammation [10,11,12,13,14] are important factors associated with depression. As a major cysteine protease inhibitor in the brain, Cys C is closely related to neuronal damage [15] and immune inflammation [16]. Individuals with major depressive disorder (MDD) have high suicidal ideation. There is evidence that serum cystatin C (Cys C) may be involved in the pathophysiology of MDD. The present study aimed to investigate Cys C concentration in patients with MDD and clarify its possible association with depressive symptoms and suicidal ideation

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Conclusion