HF patients with metabolic dysfunction at high risk to develop depressive symptoms

In a study, obese patients with heart failure (HF) and concomitant diabetes had the highest risk not only for depression but also for severe forms of depression. In contrast, HF patients without metabolic disturbances showed either no or only mild forms of depression.

Depression and anxiety disorders are common in HF patients and are associated with adverse outcomes [1]. A study presented by Dr Adesegun Kuye (Kharkiv National Medical University, Ukraine) explored whether metabolic disturbances are associated with the risk of depression and its severity in HF patients [2]. The study included 154 participants with HF of ischaemic origin and divided them into 4 groups: group 1 (n=42) included patients with HF and concomitant diabetes mellitus and obesity; group 2 (n=46) included patients with HF and concomitant diabetes mellitus only; group 3 (n=36) comprised of obese patients with HF; and patients in group 4 (n=30) had HF without metabolic comorbidities. The Beck Depression Inventory (BDI) was used to estimate the presence and origin of depressive disorders.

The presence of metabolic dysfunctions was associated with the presence and severity of depressive symptoms. Only 4.8% of participants in group 1 had no symptoms of depression, 33.5% suffered from mild depression, 26.2% from moderate depression, 26% from moderately severe depression, and 9.5% from severe depression. HF patients with type 2 diabetes (group 2) had mild (52.2%), moderate (21.7%), moderately severe (15.2%), and severe (3.1%) depression. Obese HF patients (group 3) had mild (55.6%) or moderate (25%) depression. Lastly, 60% of HF patients without accompanying metabolic dysfunction had signs of mild depression only, and 40% did not show any signs of depression.

To estimate the impact of metabolic disorders on the development of depression, odds ratios (OR) were determined for each group: Those with both metabolic dysfunctions an OR of 30 (95% CI 4.47–200.97), those with type 2 diabetes an OR of 7.2 (95% CI 1.40–36.50), and obese HF patients had an OR of 2.7 (95% CI 0.60–12.50)  to develop depression. Although the link between metabolic factors and depression may be an association, the findings support the complexity of care in patients with more comorbidities.

1. Celano CM, et al. Harv Rev Psychiatry 2018;26:175-84.
2. Kuye AJ, et al. Severity of depressive disorders in chronic heart failure patients with ischemic heart disease depending on concomitant metabolic disturbances. Session e-Posters station 8, Heart Failure 2023, 20–23 May 2023, Prague, Czechia.

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Posted on 8 August, 20238 August, 2023