South Clin Ist Euras. 2023; 34(4): 335-341 | DOI: 10.14744/scie.2023.22599

Unipolar ve Bipolar Depresyonda Kardiyovasküler Risk Parametrelerinin Deðerlendirilmesi

Burcu Kök Kendirlioðlu¹, Ayse Ece Buyuksandalyaci Tunc¹, Hidayet Ece Arat Celik¹, Esma Corekli Kaymakcý¹, Elif Sude Erturan², Þevin Demir³, Suat Kucukgoncu^1
1Maltepe Üniversitesi Týp Fakültesi, Psikiyatri Anabilim Dalý, Ýstanbul, Türkiye
²Maltepe Üniversitesi Týp Fakültesi, Ýstanbul, Türkiye
³Maltepe Üniversitesi Týp Fakültesi, Aile Hekimliði Anabilim Dalý, Ýstanbul, Türkiye

GÝRÝÞ ve AMAÇ: Unipolar depresyon (UD) ve bipolar bozukluk - depresif dönem (BB-d) hastalarýnda erken kardiyovasküler hastalýk (KVH) oluþtuðuna dair güçlü kanýtlar vardýr. Bu çalýþmanýn amacý, UD ve BD-d’de plazma aterojenik indeks (AIP), aterojenik katsayý (AC), Castelli risk indeksi I-II (CRI-I ve II) ve yüksek yoðunluklu lipoprotein (HDL) ile iliþkili oranlarý deðerlendirmektir.
YÖNTEM ve GEREÇLER: Retrospektif ve gözlemsel olarak tasarlanan bu çalýþmaya 128 UD hastasý, 184 saðlýklý kontrol grubu ve 34 BB-d hastasý dahil edildi. AIP [log (TG/HDL)], AC [(TC-HDL)/HDL], CRI-I (TC/HDL) ve II (LDL/HDL), MHR (monosit/HDL), NHR (nötrofil/HDL), PHR (trombosit/HDL) ve LHR (lenfosit/HDL) deðerleri hesaplandý. Yaþ ve cinsiyete göre düzenlenmiþ ortalamalar için ANCOVA kullanýldý.
BULGULAR: Açlýk glukozu (FG) (p=0.016), LDL (p=0.004), HDL (p<0.001), TG (p<0.001), TC (p=0.01), AIP (p<0.001), CRI-I (p=0.038), AC (p=0.038), NHR (p<0.001), MHR (p=0.007), LHR (p<0.001), PHR (p<0.001) deðerleri arasýnda üç grup arasýnda anlamlý farklýlýk bulunmuþtur. Bonferroni düzeltmesinden sonra, CRI-I ve AC’deki farklýlýklar kaybolmuþtur. Tüm bu metabolik parametreler hastalýðýn süresi ile korele idi.
TARTIÞMA ve SONUÇ: Depresif epizodun tanýsý, takibi ve tedavisi sýrasýnda anormal metabolik parametrelerin yönetimi planlanmalýdýr. AIP’nin ve NHR’ nin özellikle kronik ve yanýtsýz süreçlerde deðerlendirilmesi her iki bozuklukta da yararlý olabilir. Gelecekteki çalýþmalarda, prospektif olarak tasarlanmýþ, hastalýðýn ciddiyetini izleyen, katýlýmcýlarýn KVH risk parametrelerini ve tedavilerini deðerlendiren geniþ ölçekli çalýþmalarýn yapýlmasý önerilmektedir.

Anahtar Kelimeler: Aterojenik katsayý, aterojenik plazma indeksi, Castelli risk indeksi, koroner arter hastalýðý, depresyon, lipid oranlarý.

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Assessment of Cardiovascular Risk Parameters in Unipolar and Bipolar Depression

Burcu Kök Kendirlioðlu¹, Ayse Ece Buyuksandalyaci Tunc¹, Hidayet Ece Arat Celik¹, Esma Corekli Kaymakcý¹, Elif Sude Erturan², Þevin Demir³, Suat Kucukgoncu^1
1Department of Psychiatry, Maltepe University Faculty of Medicine, Ýstanbul, Türkiye
²Maltepe University Faculty of Medicine, Ýstanbul, Türkiye
³Department of Family Medicine, Maltepe University Faculty of Medicine, Ýstanbul, Türkiye

INTRODUCTION: There is strong evidence that excess and early cardiovascular disease (CVD) occurs in patients with unipolar depression (UD) and bipolar disorder - depressive episode (BD-d). The aim of this study is to evaluate plasma atherogenic index (AIP), atherogenic coefficient (AC), Castelli risk index I-II (CRI-I and II) and high-density lipoprotein (HDL) related ratios in UD, BD-d and HC.
METHODS: The present study was designed as a retrospective and observational study. This study included 128 patients with UD, 184 individuals as a healthy control group and 34 patients with BD-d. AIP [log (TG/HDL)], AC [(TC-HDL)/HDL], CRI-I (TC/HDL) and II (LDL/HDL), MHR (monocyte/HDL), NHR (neutrophil/HDL), PHR (platelet/HDL) and LHR (lymphocyte/HDL) were calculated in these three groups. ANCOVA was used for age- and sex- adjusted means.
RESULTS: There were significant differences in fasting glucose (FG) (p=0.016), LDL (p=0.004), HDL (p<0.001), TG (p<0.001), TC (p=0.01), AIP (p<0.001), NHR (p<0.001), MHR (p=0.007), LHR (p<0.001), PHR (p<0.001) between three groups. All these metabolic parameters were correlated with duration of disorder.
DISCUSSION AND CONCLUSION: Along with the care of a depressive episode, the management of abnormal metabolic parameters should be planned during diagnosis, follow-up, and treatment. Assessment of AIP and NHR, especially in chronic and unresponsive processes, may be useful in both disorders. In future studies, it is recommended to conduct large-scale studies that are prospectively designed, that monitor the severity of the disease, and that evaluate the CVD risk parameters and treatment of the participants.

Keywords: Atherogenic coefficient, atherogenic index of plasma, Castelli risk index, coronary artery disease, depression, lipid ratios.

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