Jean-François Costemale-Lacoste1, Séverine Trabado2, Céline Verstuyft3, Khalil El Asmar4, Florence Butlen-Ducuing5, Romain Colle5, Florian Ferreri6, Mircea Polosan7, Emmanuel Haffen8, Beverley Balkau9, Bruno Falissard10, Bruno Feve11, Laurent Becquemont3, Emmanuelle Corruble5. 1. INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France. Electronic address: jean-francois.costemale-lacoste@aphp.fr. 2. Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; INSERM 1185, Faculté de Medicine Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre 94275, France. 3. INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre 94275, France; Centre de resources biologiques CRP Paris Sud Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France. 4. INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France. 5. INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France. 6. Université Pierre et Marie Curie, Paris, France; Service de Psychiatrie, Hôpital Saint-Antoine, Paris, France. 7. Department of Clinical Psychiatry, CIC-1431 INSERM, University Hospital of Besançon, France & EA 481 Neuroscience, University of Bourgogne Franche-Comté, Besançon, France. 8. EA 481 Laboratory of Integrative and Clinical Neuroscience, Université de Franche-Comté/SFR FED 4234, COMUE Bourgogne/Franche-Comté, France. 9. INSERM UMR 1178, CESP, Renal and Cardiovascular Epidemiology, UVSQ-UPS, Villejuif, France. 10. INSERM UMR 1178, CESP, Département de Biostatistiques, University Paris Sud, Hôpital Paul Brousse, Assistance Publique Hôpitaux de Paris, 94400 Villejuif, France. 11. Hôpital Saint-Antoine, Service d'Endocrinologie, Assistance Publique Hôpitaux de Paris, Paris, France; Sorbonne Universités, Université Paris 6, INSERM UMR S_938, Centre de Recherche Saint-Antoine, Paris, France.
Abstract
BACKGROUND: Hypertriglyceridemia (HTG) is a cardiovascular risk factor. In the general population, elevated fasting triglyceridemia (TG) is associated with insomnia. Since insomnia is a core symptom of Major Depressive Episodes (MDE), we studied the association of severe insomnia with HTG in major depression. METHODS: We used the baseline data of the METADAP cohort, comprising 624 patients with a current MDE in a context of Major Depressive Disorder treated in psychiatry settings, without current alcohol use disorders. Patients were screened for severe insomnia, defined by a score of four or more on the three Hamilton Depression Rating Scale (HDRS) sleep items, and for HTG characterised by TG≥200mg/dL. RESULTS: Severe insomnia was observed in 335(54%) patients with a current MDE, of whom 234(70%) were women; 49(8%) patients had HTG, of whom 25(51%) were women. 69(11%) patients were treated with lipid-lowering drugs. Severe insomnia was associated with a higher frequency of HTG in the whole sample (9.9% vs 5.6%, p=0.046) and in the subgroup of women (9.0% vs 2.0%, p=0.002). Multivariate logistic regression analyses adjusted for age, education levels, BMI and total HDRS scores confirmed the association between severe insomnia and HTG in the whole sample (OR=2.02, 95%CI [1.00-4.08], p=0.05) as well as in the subgroup of women (OR=4.82, 95%CI [1.5-15.5], p=0.008). No association was shown in men. PERSPECTIVES: HTG should be systematically investigated in depressed patients with severe insomnia and particularly in women. Further studies are needed to explain the association we observed between severe insomnia and HTG.
BACKGROUND:Hypertriglyceridemia (HTG) is a cardiovascular risk factor. In the general population, elevated fasting triglyceridemia (TG) is associated with insomnia. Since insomnia is a core symptom of Major Depressive Episodes (MDE), we studied the association of severe insomnia with HTG in major depression. METHODS: We used the baseline data of the METADAP cohort, comprising 624 patients with a current MDE in a context of Major Depressive Disorder treated in psychiatry settings, without current alcohol use disorders. Patients were screened for severe insomnia, defined by a score of four or more on the three Hamilton Depression Rating Scale (HDRS) sleep items, and for HTG characterised by TG≥200mg/dL. RESULTS: Severe insomnia was observed in 335(54%) patients with a current MDE, of whom 234(70%) were women; 49(8%) patients had HTG, of whom 25(51%) were women. 69(11%) patients were treated with lipid-lowering drugs. Severe insomnia was associated with a higher frequency of HTG in the whole sample (9.9% vs 5.6%, p=0.046) and in the subgroup of women (9.0% vs 2.0%, p=0.002). Multivariate logistic regression analyses adjusted for age, education levels, BMI and total HDRS scores confirmed the association between severe insomnia and HTG in the whole sample (OR=2.02, 95%CI [1.00-4.08], p=0.05) as well as in the subgroup of women (OR=4.82, 95%CI [1.5-15.5], p=0.008). No association was shown in men. PERSPECTIVES: HTG should be systematically investigated in depressedpatients with severe insomnia and particularly in women. Further studies are needed to explain the association we observed between severe insomnia and HTG.
Authors: Roger C M Ho; Anna C Chua; Bach X Tran; Carol C Choo; Syeda Fabeha Husain; Giang T Vu; Roger S McIntyre; Cyrus S H Ho Journal: Int J Environ Res Public Health Date: 2018-09-21 Impact factor: 3.390