Disturbed glucose disposal in patients with major depression; application of the glucose clamp technique.
OBJECTIVE
To assess the whole-body glucose disposal in patients with both typical and atypical depression and to characterize the neuroendocrine responses during a hyper-, eu-, hypoglycemic stepwise clamp experiment in patients with both subtypes of major depression. Depressive disorders and alterations in glucose metabolism are closely associated. The glucose clamp technique is considered to be the "gold standard" for the assessment of whole-body glucose disposal.


METHODS
We studied 19 patients with typical major depressive disorder (MDD), 7 patients with atypical major depression, and 30 men and women of a healthy comparator group using a stepwise glucose clamp procedure. Glucose disposal rates were assessed and concentrations of hormones involved in glucose allocation were measured.


RESULTS
Glucose disposal rates were lower by 19% in patients with typical MDD and 30% in patients with atypical MDD than in the group of healthy controls (3.2 +/- 0.8 and 2.8 +/- 0.7 versus 4.0 +/- 1.0 mmol h(-1) kg(-1)). C-peptide concentrations were 26% higher in patients with atypical MDD and similar in patients with typical MDD and healthy controls. Vascular endothelial growth factor concentrations were 30% higher in typical MDD and similar in atypical MDD and the control group.


CONCLUSIONS
Whole-body glucose disposal is reduced in patients with typical and atypical depression. The observed neuroendocrine responses suggest a hyperactive allocation system in typical depression and a hypoactive allocation system in atypical depression.
Schweiger
Ulrich
U
Department of Psychiatry, University of Luebeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany. ulrich.schweiger@psychiatrie.uk-sh.de
Greggersen
Wiebke
W
Rudolf
Sebastian
S
Pusch
Matthias
M
Menzel
Tilmann
T
Winn
Sebastian
S
Hassfurth
Jan
J
Fassbinder
Eva
E
Kahl
Kai G
KG
Oltmanns
Kerstin M
KM
Hohagen
Fritz
F
Peters
Achim
A
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000097:blood / Q000150:complications*; D005260:Female; D015309:Glucose Clamp Technique; D044882:Glucose Metabolism Disorders / Q000097:blood / Q000523:psychology*; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D009638:Norepinephrine / Q000097:blood; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
D042461:Vascular Endothelial Growth Factor A; D000324:Adrenocorticotropic Hormone; D013006:Growth Hormone; D006854:Hydrocortisone; D009638:Norepinephrine