Effects of elevated emotional symptoms on metabolic disease development: a 10-year follow-up study

Yolanda Sanchez-Carro; Alejandro de la Torre-Luque; Christina Vassou; Pilar Lopez-Garcia; Ekavi Georgousopoulou; Christos Pitsavos; José Luis Ayuso-Mateos; Demóstenes Panagiotakos

doi:10.3389/fpsyt.2023.1148643

Effects of elevated emotional symptoms on metabolic disease development: a 10-year follow-up study

Front Psychiatry. 2023 Dec 4:14:1148643. doi: 10.3389/fpsyt.2023.1148643. eCollection 2023.

Authors

Yolanda Sanchez-Carro^{1

2

3}, Alejandro de la Torre-Luque^{3

4}, Christina Vassou⁵, Pilar Lopez-Garcia^{1

2

3}, Ekavi Georgousopoulou⁵, Christos Pitsavos⁶, José Luis Ayuso-Mateos^{1

2

3}, Demóstenes Panagiotakos⁵

Affiliations

¹ Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain.
² Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain.
³ Center for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain.
⁴ Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid, Spain.
⁵ School of Health Sciences and Education, Harokopio University, Athens, Greece.
⁶ First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece.

Abstract

Background: In recent decades, the relationship between emotional disorders (i.e., depression and anxiety) and alterations in physiological functions (i.e., inflammation or metabolism) have been well supported. However, studies on a symptom-based approach have provided mixed results. Our study aims to gain insight into how subclinical statuses, featured by elevated depressive and/or anxious symptoms, may influence immunometabolic alterations in the concurrent relationship; and the development of metabolic diseases at 10-year follow-up: diabetes, hypertension and hypercholesterolemia.

Methods: Data from 758 Greek adults [394 men (aged 41 ± 10 years) and 364 women (aged 37 ± 12 years)] were used. Four groups were created according to the levels of depressive and anxiety symptoms: (1) control group (CG), (2) depressive group (DG), (3) anxiety group (AG) and (4) depressive and anxiety group (DAG). Multi-indicator multi-causes (MIMIC) modeling was used to estimate metabolic function and inflammatory response scores, on a wide selection of blood biomarkers. Finally, a binary logistic regression was carried out to study the influence of symptoms on the development of the aforementioned metabolic diseases on a 10-year follow-up.

Results: Group membership was not associated with metabolic function score. Conversely, DAG membership was related with higher inflammatory response score (B = 0.20, CI₉₅ = 0.01, 0.40), with respect to the CG (p < 0.05). Both age and sex were significant variables in the calculation of both scores. Regarding disease at 10-year follow-up effect, risk of developing diabetes, hypertension and hypercholesterolemia was associated with age and socioeconomic status. Moreover, DG membership was significant for diabetes risk (OR = 2.08, CI₉₅ = 1.00, 4.22) and DAG for hypercholesterolemia (OR = 1.68, CI₉₅ = 1.16, 2.43).

Limitations: Data on anti-inflammatory drugs and psychopharmacological medication were not collected in this study.

Conclusions: Elevated symptoms of depression and anxiety accounts for inflammatory alterations at concurrent relationship and a higher risk of 10-year follow-up metabolic diseases.

Keywords: anxiety; depression; diabetes; hypercholesterolemia; hypertension; inflammation; metabolic syndrome.

Grants and funding

This study was supported by the Instituto de Salud Carlos III (grant ref.: PI20/00229) and co-funded by the European Regional Development Fund (ERDF). YS-C work was supported by the FPI pre-doctoral grant (FPI 2016/17) from the Universidad Autonoma de Madrid.