title: Castelli risk indexes 1 and 2 are higher in major depression but other characteristics of the metabolic syndrome are not specific to mood disorders.
abstract: OBJECTIVE
  This study examined whether Castelli risk indexes 1 (total/high-density lipoprotein (HDL) cholesterol) and 2 (low density lipoprotein (LDL)/HDL cholesterol) and other shared metabolic disorders might underpin the pathophysiology of the metabolic syndrome, major depression or bipolar disorder.
  
  
  METHODS
  This cross-sectional study examined 92 major depressed, 49 bipolar depressed and 201 normal controls in whom the Castelli risk indexes 1 and 2 and key characteristics of the metabolic syndrome, i.e. waist/hip circumference, body mass index (BMI), systolic/diastolic blood pressure, total cholesterol, low-density lipoprotein (LDL) and HDL cholesterol, triglycerides, insulin, glucose, hemoglobin A1c (HbA1c) and homocysteine were assessed.
  
  
  RESULTS
  Castelli risk indexes 1 and 2 were significantly higher in major depressed patients than in bipolar disorder patients and controls. There were no significant differences in waist or hip circumference, total and LDL cholesterol, triglycerides, plasma glucose, insulin, homocysteine and HbA1c between depression and bipolar patients and controls. Bipolar patients had a significantly higher BMI than major depressed patients and normal controls.
  
  
  CONCLUSIONS
  Major depression is accompanied by increased Castelli risk indexes 1 and 2, which may be risk factors for cardiovascular disease. Other key characteristics of the metabolic syndrome, either metabolic biomarkers or central obesity, are not necessarily specific to major depression or bipolar disorder.
authors.affiliation: Department of Psychiatry, Health Sciences Center, Londrina State University, University Hospital, Av. Robert Koch, 60, ZIP: 86035-380 Londrina, Paraná, Brazil; Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, Campus Universitário/Cx., Postal 6001/ZIP 86051-990 Londrina, Paraná, Brazil.
authors.forename: Heber Odebrecht
authors.initials: HO
authors.lastname: Vargas
authors.affiliation: Department of Psychiatry, Health Sciences Center, Londrina State University, University Hospital, Av. Robert Koch, 60, ZIP: 86035-380 Londrina, Paraná, Brazil; Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, Campus Universitário/Cx., Postal 6001/ZIP 86051-990 Londrina, Paraná, Brazil.
authors.forename: Sandra Odebrecht Vargas
authors.initials: SO
authors.lastname: Nunes
authors.affiliation: Department of Clinical Analysis and Toxicology, State University of Londrina, Health Sciences Center, Paraná, Brazil.
authors.forename: Décio Sabbatini
authors.initials: DS
authors.lastname: Barbosa
authors.affiliation: Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, Campus Universitário/Cx., Postal 6001/ZIP 86051-990 Londrina, Paraná, Brazil.
authors.forename: Mateus Mendonca
authors.initials: MM
authors.lastname: Vargas
authors.affiliation: Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, Campus Universitário/Cx., Postal 6001/ZIP 86051-990 Londrina, Paraná, Brazil.
authors.forename: Ariane
authors.initials: A
authors.lastname: Cestari
authors.affiliation: Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia; School of Medicine, Deakin University, Geelong, Victoria, Australia; Barwon Health and the Geelong Clinic, Swanston Centre, Geelong, Victoria 3220, Australia.
authors.forename: Seetal
authors.initials: S
authors.lastname: Dodd
authors.affiliation: Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia; Barwon Health and the Geelong Clinic, Swanston Centre, Geelong, Victoria 3220, Australia.
authors.forename: Kamalesh
authors.initials: K
authors.lastname: Venugopal
authors.affiliation: Department of Psychiatry, Health Sciences Center, Londrina State University, University Hospital, Av. Robert Koch, 60, ZIP: 86035-380 Londrina, Paraná, Brazil; School of Medicine, Deakin University, Geelong, Victoria, Australia; Barwon Health and the Geelong Clinic, Swanston Centre, Geelong, Victoria 3220, Australia; Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand. Electronic address: dr.michaelmaes@hotmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Maes
authors.affiliation: Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia; School of Medicine, Deakin University, Geelong, Victoria, Australia; Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Australia; Barwon Health and the Geelong Clinic, Swanston Centre, Geelong, Victoria 3220, Australia; The Florey Institute for Neuroscience and Mental Health, Parkville, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000150:complications*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002784:Cholesterol
keywords: Antioxidants; Bipolar disorder; Cholesterol; Depression; HDL; Inflammation; Metabolic syndrome; Oxidative stress