Delayed increase in LDL cholesterol following pentagastrin-induced panic attacks.
OBJECTIVE
Panic disorder (PD) has been associated with an increased risk for cardiovascular (CV) morbidity and mortality. There are inconsistent reports of increased low-density lipoprotein cholesterol (LDL-C) in patients with PD. Studies have reported a correlation between cholesterol levels and the intensity and frequency of panic attacks (PAs), suggesting that an elevation in cholesterol could be due to physiological and neurochemical changes that occur during and after a PA. The objective of our study was to show that the occurrence of a PA is associated with an increase in LDL-C.


METHODS
We used a double-blind, placebo-controlled crossover design with randomized injections of placebo and pentagastrin in 18 patients with PD (11 men, 7 women) and 33 healthy-control subjects (24 men, 9 women).


RESULTS
Pentagastrin-induced PAs were associated with a statistically significant 10.4% delayed (24 h) increase in LDL-C levels in male subjects. Such an effect was not observed in female subjects.


CONCLUSIONS
LDL-C levels are directly affected by the occurrence of a PA in males. These findings, in association with previous reports of increased cholesterol levels in PD patients, suggest that a chronic increase in LDL-C as a result of frequent PAs may be one of the mechanisms that contributes, at least in male patients, to previously reported increased CV risk in patients with PD. The gender difference and the temporal association between PAs and increased LDL-C may explain the inconsistency in the findings of previous investigations of cholesterol levels in PD patients.
Perez-Parada
Jorge
J
Department of Psychiatry, University of Alberta, 1E7.05 Mackenzie Centre, Edmonton, Alberta, Canada.
Jhangri
Gian S
GS
Lara
Nathalie
N
Chrapko
Wendy
W
Castillo Abadia
Maria Del Pilar
Mdel P
Gil
Lucas
L
Le Mellédo
Jean-Michel
JM
D000328:Adult; D008078:Cholesterol, LDL / Q000097:blood*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000097:blood* / Q000139:chemically induced; D010418:Pentagastrin / Q000009:adverse effects*
D008078:Cholesterol, LDL; D010418:Pentagastrin