Associations of serum cystatin C with depressive symptoms and suicidal ideation in major depressive disorder

Abstract

Background Individuals with major depressive disorder (MDD) have high suicidal ideation. There is evidence that serum cystatin C (Cys C) may be involved in the pathophysiology of MDD. The present study aimed to investigate Cys C concentration in patients with MDD and clarify its possible association with depressive symptoms and suicidal ideation. Methods An online cross-sectional survey of 159 patients diagnosed with MDD was conducted. Serum Cys C levels were measured using ADVIA 2400 biochemical analyzer. The 24-item Hamilton Depression Scale (HAMD-24) was administered to evaluate the depressive symptoms. Generalized linear regression, logistic regression and restricted cubic spline models were used to examine the association of serum Cys C levels with depressive symptoms and suicidal ideation. Results Serum Cys C levels were higher in MDD patients than in controls (p = 0.001) and were positively associated with scores on HAMD-24 in unadjusted (gender distribution, age, smoking, alcohol consumption, family history of depression and traumatic life events; (p = 0.003) and fully adjusted linear regression model (p = 0.005). The fully adjusted regression coefficient with 95% confidence intervals for serum Cys C levels and HAMD-24 score was 30.339 (9.602 to 51.077). The level of Cys C in the suicidal ideation (SI) group was significantly higher than that in the non-suicide ideation (non-SI) group (p = 0.001). Serum Cys C levels were positively associated with suicidal ideation in each logistic regression model (all p < 0.05). Conclusion Serum Cys C levels were elevated in MDD patients and appeared to be positively correlated with depressive symptoms and suicidal ideation. These findings suggest that the dysfunction of Cys C may be involved in the severity of depression and in the pathophysiological process of MDD. Thus, regulation of serum Cys C could potentially be an effective predictor of the severity of depression and potentially, play a role in reducing the risk of suicide in MDD patients.

Risk factor analysis and nomogram construction for predicting suicidal ideation in patients with cancer

“…History of mental illness was the strongest risk factor associated with SI [ 31 ]. Our study finding that demoralization and depression could accelerate SI in cancer patients, which is consistent with Wu and Sun [ 27 , 32 ]. Although the clinical manifestations of demoralization and depression are similar, there are differences between the two diagnoses.…”

Accelerated epigenetic aging and decreased natural killer cells based on DNA methylation in patients with untreated major depressive disorder

“…We found that DNAmADM, DNAmPAI-1, and DNAmTIMP-1 levels were increased and DNAmCystatinC is likely to increase in patients with untreated MDD, suggesting that these epigenetic markers may be useful in understanding the pathophysiology of MDD and as potential biomarkers. Previous studies have also reported an association between increased levels of DNAmCystatinC and MDD 21 , 23 , as well as higher serum cystatin C levels in individuals with depression 44 – 46 . Cystatin C inhibits endogenous cysteine protease activity, is an established marker of kidney function, and involved in immunomodulation and inflammation 47 , 48 .…”

Associations of Circulating Biomarkers with Disease Risks: a Two-Sample Mendelian Randomization Study

“…These results suggest that these relationships are likely to be of clinical significance and warrants further study. Although high cystatin C levels have been linked with major depressive disorder, 37 no studies, to the best of our knowledge, have demonstrated an association between cystatin C and bipolar disorder. Levels of Cystatin C, a natural inhibitor of cysteine proteases, are typically used clinically to assess kidney function.…”