Urinary Excretion of 5-Hydroxy-3-Indoleacetic Acid in Dystimic/Depressed, Adult Obese Women: What Correlations to Hepatic Steatosis?

Abstract

The synthesis of serotonin at eNS level is influenced by diet. Moreover, insulin resistance is associated with lower serotonin levels. Visceral obesity, strictly linked to hepatic steatosis is specifically associated with mild to severe somatic affective-depressive symptom clusters. Previous data support the view that depression involves serotonergic systems, reflecting low levels of urinary 5-hydroxy-3-indoleacetic acid (5-HIAA). The 24-h urinary excretion of 5-HIAA was evaluated in 76 dystimic/depressed, obese/ overweight females, divided into two groups, i.e., on a hyper-caloric diet, associated with a life style characterized by leisure time sedentary behavior (LTSB, 35 women), or on a normo-caloric diet, assisted by program-based strategies aimed at promoting physical activity participation (PAP, 41 women). Beck Depression Inventory (BDI) was carried out to score the severity of dystimia/depression. Anthropometric measures, metabolic indices, severity of hepatic steatosis at sonography and HOMA were studied. Urinary levels of 5-HIAA in controls and PAP groups were comparable with a great overlap, while in the LTSB group the urinary excretion of 5-HIAA was significantly reduced in respect to that of the PAP group and obviously compared to that of the control group, 3.4±1.4 mg/L versus 6.2±2.7 mg/L and 6.4±2.6 mg/L, respectively, ANOVA test, P= 0.001. Among metabolic indices, cholesterol, HDLcholesterol, triglycerides and uric acid were not able to predict urinary concentrations of 5-HIAA, which were not associated with hepatic steatosis; vice versa, ferritin levels, and mainly HOMA values, were independent predictors of the urinary excretion of 5-HIAA (P=O.235 and 0.45, respectively). Dystimia/ depression severity was negatively predicted by urinary 5-HIAA levels in the sense that the highest BDI values were forecast by the lowest values of urinary 5-HIAA (P= -O.72).The importance of measuring the 24-h urinary excretion of 5-HIAA in follow-ups could rely on a method simultaneously mirroring the well-being status, the adherence to physical activity, which leads to improved insulin sensitivity, and the eating habits acquired by dystimic/depressed overweight/obese patients. In contrast, the significance of the urinary 5-HIAA is reduced in evaluating the severity of hepatic steatosis, likely because it is a structured process.

Urinary metabolomics analysis identifies key biomarkers of different stages of nonalcoholic fatty liver disease

“…Interestingly, we also found that the level of indoleacetic acid was much higher in the NASH group compared with that in the NAFLD group. This was consistent with findings showing that the indoleacetic acid concentration correlates with liver damage[35]. …”

Characterization of IGF-II Isoforms in Binge Eating Disorder and Its Group Psychological Treatment

“…Others have reported that depression severity itself is negatively correlated with serotonin levels [13] and insulin resistance is known to be associated with low serotonin levels. In addition, treatment with serotonin selective reuptake inhibitors results not only in increases in serotonin, but also decreases in IGF II expression in both the hypothalamus and the pituitary in the rat model [14].…”

Expression of hippocampal serotonin receptors 5‐HT2C and 5‐HT5A in a rat model of diet‐induced obesity supplemented with tryptophan

“…In humans it has been observed that the synthesis of serotonin at central nervous system is influenced by diet in dystemic/depressed, overweight/obese females exposed to hyper-caloric diet and sedentary behavior showed a diminution in the levels of urinary 5-hydroxy-3-indoleacetic acid (5-HIAA) compared to a control group or aimed to physical activity participation. (Tarantino et al, 2011).…”