The Abnormalities of Lipid Metabolism in Children and Adolescents with Major Depressive Disorder and Relationship with Suicidal Ideation and Attempted Suicide

Background: Major depressive disorder (MDD) is a widespread health issue in many countries, which has an extremely negative impact on the health of children and adolescents in particular. In the context of depression and metabolic disorders, dyslipidemia and metabolism-related problems become more prominent comorbidities. However, they continue to be the main barrier to the successful recovery of the clinical progress. In this study we investigated the rate of dyslipidemia, additional risk factors among Chinese children and adolescents with MDD, and association of the suicidal behavior with lipid levels.

Methods: The study took 756 people from the Third People's Hospital of Fuyang between January 2020 and December 2021, aged between 8 and 18, with major depressive disorders diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). We determined the FBG (fasting blood glucose) and lipid parameters in all subjects and also investigated the history of suicidal ideation, the cases of attempted suicide, and the scores of depressive symptoms. Sociodemographic and clinical data were gathered and analyzed using the SPSS-23.0 version.

Results: The prevalence of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C were 5.42 % (41/756), 10.58 % (80/756), 3.84 % (29/756) and 5.42 % (41/756) respectively. For hypercholesterolemia and hypertriglyceridemia, they were positive associated with suicidal ideation and suicide attempts, and the positive correlation is shown between low HDL-C levels and suicide attempts. Nevertheless, non-ideation and inversely suicidal attempts were not discovered among high-LDL-C subjects. Logistic analysis showed that high levels of FBG ( = 2.86, : 1.31-6.25,  = 0.008) and worse LDL-C ( = 357.82, 66.16-1935.10,  < 0.001) are the independent associated factors for hypercholesterolemia. More hospitalizations ( = 1.89, : 1.07-3.35,  = 0.028), obesity ( = 2.55, : 1.25-5.18,  = 0.010), high levels of TC ( = 2.15, : 1.03-4.48,  = 0.042), and higher doses of antidepressants ( = 1.02, : 1.00-1.04,  = 0.029) were independently associated factors for hypertriglyceridemia, while high levels of HDL-C ( = 0.11, : 0.04-0.31,  < 0.001) were protective factors. In addition, high levels of TC ( = 113.94, : 20.01-648.85) were statistically different ( < 0.001) and suggested that the factor was significantly related to high LDL-C. Meanwhile, older age ( = 1.25, : 1.02-1.52,  = 0.030) and high levels of TG ( = 3.00, 1.98-4.55,  < 0.001) were independent factors contributing to low HDL-C.

Conclusion: The high prevalence of dyslipidemia in childhood and adolescence among children and adolescents with depressive disorder has become a public health issue. Hypercholesterolemia and hypertriglyceridemia showed a positive correlation with suicidal thoughts and suicidal attempts. Monitoring the incidence of suicidal thoughts and attempts among them would carry some predictor meaning in therapy and for jumping back to health.