The Relationship Between Serum Lipids and Depression

Keum Ji Jung; Yejin Mok; Hyoung Yoon Chang; Dongkoog Son; Eun-Jeong Han; Young Duk Yun; Sun Ha Jee

doi:10.12997/jla.2014.3.1.11

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Jung, Mok, Chang, Son, Han, Yun, and Jee: The Relationship Between Serum Lipids and Depression

Original Article

Journal of Lipid and Atherosclerosis 2014; 3(1): 11-19.

Published online: 30 June 2014

DOI: https://doi.org/10.12997/jla.2014.3.1.11

The Relationship Between Serum Lipids and Depression

Keum Ji Jung^1,², Yejin Mok^1,², Hyoung Yoon Chang^3,⁴, Dongkoog Son⁵, Eun-Jeong Han⁵, Young Duk Yun⁵, Sun Ha Jee^2,⁶

¹Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.

²Institute for Health Promotion, Graduate School of Public Health Yonsei University, Seoul, Korea.

³Department of Pediatrics, College of Medicine, Ulsan University, Seoul, Korea.

⁴Department of Psychiatry, College of Medicine, Yonsei University, Seoul, Korea.

⁵Health Insurance Policy Research Institute, National Health Insurance Service, Seoul, Korea.

⁶Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea.

Corresponding Author: Sun Ha Jee, Department of Epimdemiology and Health Promotion, Yonsei University, Graduate School of Public Health, Yonsei University, Yonsei-ro 50, Saedaemun-ku, Seoul 120-752, Korea. Tel: +82-2-2228-1523, Fax: +82-365-5118, jsunha@yuhs.ac

Received 18 July 2013 Revised 11 September 2013 Accepted 7 October 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

Low cholesterol is associated with depression among western countries. The objective of this study was to examine the relationship between cholesterol and depression in Korean population with low levels of serum cholesterol.

Methods

The data of about 740,000 individuals, aged 30-64 years at entry in the Korean Cancer Prevention Study, were used. Total cholesterol levels were measured in 1992. Depression was measured using the modified DSM-IV (Diagnostic Criteria of Major Depressive Episode in Diagnostic and Statistical Manual of Mental Disorders-IV) scale. Total cholesterol was classified into four groups (quartile). Odds Ratios of low level of cholesterol were evaluated using multi-variable logistic models.

Results

The prevalence of major depression was 7.7% in men and 10.4% in women. After adjustment for various confounding variables, an inverse association was detected between cholesterol levels and depression intensity among men and women. The odds ratio (95% confidence interval) of the lowest quartile of cholesterol was 1.16 (1.13-1.20) on major depression compared with the highest quartile of cholesterol in men. The corresponding odds ratio among women was 1.09 (1.04-1.15). The strongest association among 9 items of depression was found at "decreased appetite and lost weight" in both men (OR=1.68) and women (OR=1.43).

Conclusions

Low cholesterol is associated with major depression in men and women. Further studies are necessary to evaluate the cross-validation, to explore the biological mechanism, and to identify the clinical implication.

Keywords: Cholesterol, Depression, Epidemiology

Figures and Tables

Fig. 1

The relationship between serum total cholesterol and depression.

Table 1

Translated version of the depression questionnaire^‡ utilized in the Korean Cancer Prevention Study

^‡ Modified Diagnostic Criteria of Major Depressive Episode in Diagnostic and Statistical Manual of Mental Disorders-IV

^* was the number in the paper published by Chang et al. (2013).

^† ( ) was the number in original questionnaire in 1992.

Table 2

General characteristics of the study population

Data are presented as the Mean±SD, SD; standard deviation

Table 3

Odds Ratios for association between total cholesterol and subgroup according to total cholesterol in men

OR; Odds ratio

Table 4

Odds Ratios for association between total cholesterol and subgroup according to total cholesterol in women

OR; Odds ratio

Table 5

Odds Ratios for association between total cholesterol and questions of depression

1. I feel depressed with no particular reason.

2. I have lost interest, pleasure, and sexual desire in daily life.

3. I have decreased appetite and lost weight.

4. I have difficulty getting to sleep or staying asleep.

5. I feel agitated and restless.

6. Recently, there are times when I feel very tired without any particular reason.

7. I feel worthless or excessively guilty.

8. My memory is declining and I have difficulty concentrating.

9. I occasionally have thoughts about suicide.SD: standard deviation.

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