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Research article
Eva O Melin
Lund University, Faculty of Medicine, Department of Clinical Sciences, Diabetes Research Laboratory, Lund, Sweden
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7835-2650
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Low levels of soluble TNF-like weak inducer of apoptosis (sTWEAK) have previously been linked to cardiovascular disease, which is also the case for depression. High levels of galectin-3 and HbA1c, and low levels of HDL-cholesterol, have previously been linked to depression in these patients. The aim was to explore whether low levels of sTWEAK were associated with depression in type 1 diabetes patients. We adjusted for age, sex, galectin-3, HbA1c, HDL-cholesterol, antidepressants, and cardiovascular complications.
Methods
Cross-sectional design. Type 1 diabetes patients (n=287, men 56%, age18-59 years) were consecutively recruited from one specialist diabetes out-patient clinic. Depression was defined as Hospital Anxiety and Depression Scale-Depression sub scale ≥8 points. Blood samples, anthropometrics and blood pressure were collected, supplemented with data from electronic medical records. ELISA was used to measure sTWEAK and galectin-3. Low sTWEAK was defined as <7.1 ng/ml (<70th percentile), high galectin-3 as ≥2.562 µg/l (≥85th percentile) and high HbA1c as >70 mmol/mol (>8.6%). Non-parametric tests were used. Multiple logistic regression analyses (Backward: Wald) were performed, and calibrated and validated for goodness of fit with the data variables.
Results
Median (q1, q3) (ng/ml) sTWEAK were for 30 depressed and 257 non-depressed patients 1.5 (1.2, 2.9) and 2.7 (1.3, 13.0) respectively (p =0.021); median (q1, q3) (µg/l) galectin-3 were 1.348 (0.827, 2.850) and 0.916 (0.533, 1.637) respectively (p = 0.005). Four-teen percent of patients with low sTWEAK were depressed, and 2% of patients with high sTWEAK were depressed (p = 0.003). Low sTWEAK (adjusted odds ratio (AOR) (CI)) 9.5 (2.0-46) ), high galectin-3 (AOR (CI) 6.5 (2.3-18.7)), use of antidepressants (AOR (CI) 10.3 (3.3-30.4)), HDL-cholesterol (per mmol/l) (inversely) (AOR (CI) 0.1 (0.03-0.5)), and age (per year) (AOR (CI) 1.05 (1.00-1.09)) were associated with depression.
Conclusions
The depressed patients with type 1 diabetes had lower levels of sTWEAK than the non-depressed, which might contribute to the increased risk for cardiovascular disease and mortality previously demonstrated in patients with depression. Low levels of sTWEAK and HDL-cholesterol and high levels of galectin-3 were independently associated with depression.
Keywords
Cardiovascular complications, Depression, Galectin-3, HbA1c, HDL-cholesterol, Inflammation, sTWEAK, Type 1 diabetes
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CURRENT STATUS: Published
View the published article at BMC Psychiatry.
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Submission checks complete
On 21 Nov, 2020
Editorial decision: Accept
On 17 Nov, 2020
Version 1
Posted 30 Dec, 2019
No comments provided
Review #2 received
Received 26 Sep, 2020
Reviewer #3 agreed
On 07 Sep, 2020
Reviewer #2 agreed
On 13 Feb, 2020
Review #1 received
Received 28 Jan, 2020
Reviewers invited
Invitations sent on 13 Jan, 2020
Reviewer #1 agreed
On 13 Jan, 2020
Editor invited
On 23 Dec, 2019
Editor assigned
On 18 Dec, 2019
First submitted
On 17 Dec, 2019
Submission checks complete
On 17 Dec, 2019
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Subject Areas
Psychiatry
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A new preprint design is coming!
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See the published version of this preprint at BMC Psychiatry.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Eva O Melin
Lund University, Faculty of Medicine, Department of Clinical Sciences, Diabetes Research Laboratory, Lund, Sweden
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7835-2650
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Psychiatry.
No community comments so far
Submission checks complete
On 21 Nov, 2020
Editorial decision: Accept
On 17 Nov, 2020
Version 1
Posted 30 Dec, 2019
No comments provided
Review #2 received
Received 26 Sep, 2020
Reviewer #3 agreed
On 07 Sep, 2020
Reviewer #2 agreed
On 13 Feb, 2020
Review #1 received
Received 28 Jan, 2020
Reviewers invited
Invitations sent on 13 Jan, 2020
Reviewer #1 agreed
On 13 Jan, 2020
Editor invited
On 23 Dec, 2019
Editor assigned
On 18 Dec, 2019
First submitted
On 17 Dec, 2019
Submission checks complete
On 17 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Psychiatry
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Psychiatry.
Background
Low levels of soluble TNF-like weak inducer of apoptosis (sTWEAK) have previously been linked to cardiovascular disease, which is also the case for depression. High levels of galectin-3 and HbA1c, and low levels of HDL-cholesterol, have previously been linked to depression in these patients. The aim was to explore whether low levels of sTWEAK were associated with depression in type 1 diabetes patients. We adjusted for age, sex, galectin-3, HbA1c, HDL-cholesterol, antidepressants, and cardiovascular complications.
Methods
Cross-sectional design. Type 1 diabetes patients (n=287, men 56%, age18-59 years) were consecutively recruited from one specialist diabetes out-patient clinic. Depression was defined as Hospital Anxiety and Depression Scale-Depression sub scale ≥8 points. Blood samples, anthropometrics and blood pressure were collected, supplemented with data from electronic medical records. ELISA was used to measure sTWEAK and galectin-3. Low sTWEAK was defined as <7.1 ng/ml (<70th percentile), high galectin-3 as ≥2.562 µg/l (≥85th percentile) and high HbA1c as >70 mmol/mol (>8.6%). Non-parametric tests were used. Multiple logistic regression analyses (Backward: Wald) were performed, and calibrated and validated for goodness of fit with the data variables.
Results
Median (q1, q3) (ng/ml) sTWEAK were for 30 depressed and 257 non-depressed patients 1.5 (1.2, 2.9) and 2.7 (1.3, 13.0) respectively (p =0.021); median (q1, q3) (µg/l) galectin-3 were 1.348 (0.827, 2.850) and 0.916 (0.533, 1.637) respectively (p = 0.005). Four-teen percent of patients with low sTWEAK were depressed, and 2% of patients with high sTWEAK were depressed (p = 0.003). Low sTWEAK (adjusted odds ratio (AOR) (CI)) 9.5 (2.0-46) ), high galectin-3 (AOR (CI) 6.5 (2.3-18.7)), use of antidepressants (AOR (CI) 10.3 (3.3-30.4)), HDL-cholesterol (per mmol/l) (inversely) (AOR (CI) 0.1 (0.03-0.5)), and age (per year) (AOR (CI) 1.05 (1.00-1.09)) were associated with depression.
Conclusions
The depressed patients with type 1 diabetes had lower levels of sTWEAK than the non-depressed, which might contribute to the increased risk for cardiovascular disease and mortality previously demonstrated in patients with depression. Low levels of sTWEAK and HDL-cholesterol and high levels of galectin-3 were independently associated with depression.
Figure 1
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