Cardiovascular Diabetology (Nov 2020)

Depression and cardiovascular risk—association among Beck Depression Inventory, PCSK9 levels and insulin resistance

  • C. Macchi,
  • C. Favero,
  • A. Ceresa,
  • L. Vigna,
  • D. M. Conti,
  • A. C. Pesatori,
  • G. Racagni,
  • A. Corsini,
  • N. Ferri,
  • C. R. Sirtori,
  • M. Buoli,
  • V. Bollati,
  • M. Ruscica

DOI
https://doi.org/10.1186/s12933-020-01158-6
Journal volume & issue
Vol. 19, no. 1
pp. 1 – 11

Abstract

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Abstract Background Depression and cardiovascular disease (CVD) are among the most common causes of disability in high-income countries, depression being associated with a 30% increased risk of future CV events. Depression is twice as common in people with diabetes and is associated with a 60% rise in the incidence of type 2 diabetes, an independent CVD risk factor. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a key regulator of low-density lipoprotein cholesterol, has been related to a large number of CV risk factors, including insulin resistance. Aim of this study was to investigate whether the presence of depression could affect PCSK9 levels in a population of obese subjects susceptible to depressive symptoms and how these changes may mediate a pre-diabetic risk. Results In 389 obese individuals, the Beck Depression Inventory (BDI-II) was significantly associated with PCSK9 levels. For every one-unit increment in BDI-II score, PCSK9 rose by 1.85 ng/mL. Depression was associated also with the HOMA-IR (homeostatic model assessment index of insulin resistance), 11% of this effect operating indirectly via PCSK9. Conclusions This study indicates a possible mechanism linking depression and insulin resistance, a well-known CV risk factor, providing evidence for a significant role of PCSK9.

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