title: Factors influencing insulin resistance in relation to atherogenicity in mood disorders, the metabolic syndrome and tobacco use disorder.
abstract: OBJECTIVE
  This study examines the effects of malondialdehyde (MDA) and uric acid on insulin resistance and atherogenicity in subjects with and without mood disorders, the metabolic syndrome (MetS) and tobacco use disorder (TUD).
  
  
  METHODS
  We included 314 subjects with depression and bipolar depression, with and without the MetS and TUD and computed insulin resistance using the updated homeostasis model assessment (HOMA2IR) and atherogenicity using the atherogenic index of plasma (AIP), that is log10 (triglycerides/high density lipoprotein (HDL) cholesterol.
  
  
  RESULTS
  HOMA2IR is correlated with body mass index (BMI) and uric acid levels, but not with mood disorders and TUD, while the AIP is positively associated with BMI, mood disorders, TUD, uric acid, MDA and male sex. Uric acid is positively associated with insulin and triglycerides and negatively with HDL cholesterol. MDA is positively associated with triglyceride levels. Comorbid mood disorders and TUD further increase AIP but not insulin resistance. Glucose is positively associated with increasing age, male gender and BMI.
  
  
  CONCLUSIONS
  The results show that mood disorders, TUD and BMI together with elevated levels of uric acid and MDA independently contribute to increased atherogenic potential, while BMI and uric acid are risk factors for insulin resistance. The findings show that mood disorders and TUD are closely related to an increased atherogenic potential but not to insulin resistance or the MetS. Increased uric acid is a highly significant risk factor for insulin resistance and increased atherogenic potential. MDA, a marker of lipid peroxidation, further contributes to different aspects of the atherogenic potential. Mood disorders and TUD increase triglyceride levels, lower HDL cholesterol and are strongly associated with the atherogenic, but not insulin resistance, component of the MetS.
authors: Health Sciences Postgraduate Program, State University of Londrina, Londrina, Paraná, Brazil; Impact Strategic Research Centre, Deakin University, Barwon Health, Geelong, VIC, Australia.
authors: Chiara Cristina
authors: CC
authors: Bortolasci
authors: Department of Psychiatry, State University of Londrina, Londrina, Paraná, Brazil.
authors: Heber Odebrecht
authors: HO
authors: Vargas
authors: Department of Psychiatry, State University of Londrina, Londrina, Paraná, Brazil.
authors: Sandra Odebrecht
authors: SO
authors: Vargas Nunes
authors: Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, University Campus, Londrina, Paraná, Brazil.
authors: Luiz Gustavo Piccoli
authors: LG
authors: de Melo
authors: Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, University Campus, Londrina, Paraná, Brazil.
authors: Márcia Regina Pizzo
authors: MR
authors: de Castro
authors: Department of Physiological Sciences, State University of Londrina, Londrina, Paraná, Brazil.
authors: Estefania Gastaldello
authors: EG
authors: Moreira
authors: Impact Strategic Research Centre, Deakin University, Barwon Health, Geelong, VIC, Australia; Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia.
authors: Seetal
authors: S
authors: Dodd
authors: Health Sciences Postgraduate Program, State University of Londrina, Londrina, Paraná, Brazil; Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, State University of Londrina, Londrina, Brazil.
authors: Décio Sabbatini
authors: DS
authors: Barbosa
authors: Impact Strategic Research Centre, Deakin University, Barwon Health, Geelong, VIC, Australia; Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia; Florey Institute for Neuroscience and Mental Health, Parkville, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.
authors: Michael
authors: M
authors: Berk
authors: Health Sciences Postgraduate Program, State University of Londrina, Londrina, Paraná, Brazil; Impact Strategic Research Centre, Deakin University, Barwon Health, Geelong, VIC, Australia; Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand. Electronic address: dr.michaelmaes@hotmail.com.
authors: Michael
authors: M
authors: Maes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood / Q000150:complications*; D015415:Biomarkers / Q000097:blood; D001714:Bipolar Disorder / Q000097:blood / Q000150:complications*; D001786:Blood Glucose; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D003863:Depression / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008315:Malondialdehyde; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications*; D008875:Middle Aged; D018384:Oxidative Stress; D012307:Risk Factors; D014029:Tobacco Use Disorder / Q000097:blood / Q000150:complications*; D014280:Triglycerides / Q000097:blood; D014527:Uric Acid / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides; D014527:Uric Acid; D008315:Malondialdehyde
keywords: Atherogenic; Bipolar disorder; Depression; Inflammation; Metabolic syndrome; Oxidative stress