LOWER SERUM HIGH-DENSITY-LIPOPROTEIN CHOLESTEROL (HDL-C) IN MAJOR DEPRESSION AND IN DEPRESSED MEN WITH SERIOUS SUICIDAL ATTEMPTS - RELATIONSHIP WITH IMMUNE-INFLAMMATORY MARKERS

Recently, there have been some reports that changes in serum lipid com position may be related to suicide, major depression and immune-inflam matory responses. Findings from our laboratory suggest that major depr ession is accompanied by reduced formation of cholesteryl esters and p erhaps by impairment of reverse cholesterol transport. The latter is r eportedly accompanied by lower serum high-density lipoprotein choleste rol (HDL-C). The aim of this study was to examine whether (i) major de pression is accompanied by lower serum HDL-C or by abnormal levels of serum total cholesterol, triglycerides, low-density lipoprotein-C (LDL -C) or vitamin E, (ii) suicidal attempts are related to lower serum HD L-C and (iii) there are significant associations between serum HDL-C a nd immune/inflammatory markers. A total of 36 subjects with major depr ession, of whom 28 patients showed treatment resistance, as well as 28 normal control subjects, had blood sampled for the assay of the above lipids, serum zinc (Zn), albumin (Alb) and now cytometric determinati on of the T-helper/T-suppressor (CD4+/CD8+) T-cell ratio. In total, 28 depressed subjects had repeated measures of these variables both befo re and after treatment with antidepressants. Serum HDL-C and total cho lesterol, as well as the HDL-C/cholesterol ratio, were significantly l ower in subjects with major depression than in normal controls. Serum HDL-C levels were significantly lower in depressed men who had at some time made serious suicidal attempts than in those without such suicid al behaviour. Treatment with antidepressants for 5 weeks did not signi ficantly alter either serum HDL-C or other lipid variables. Serum HDLC levels were significantly and negatively correlated with the (CD4+/CD 8+) T-cell ratio, and positively correlated with serum Alb and Zn. The se results suggest that (i) lower serum HDL-C levels are a marker for major depression and suicidal behaviour in depressed men, (ii) lower s erum HDL-C levels are probably induced by the immune/inflammatory resp onse in depression and (iii) there is impairment of reverse cholestero l transport from the body tissues to the liver.