Insulin Resistance in Depression: A Large Meta-Analysis of Metabolic Parameters and Variation

Authors

Brisa S Fernandes
Estela Salagre
Nitesh Enduru
Iria Grande
Eduard Vieta
Zhongming Zhao

Publication Date

8-1-2022

Journal

Neuroscience & Biobehavioral Reviews

Abstract

Increased insulin resistance is recognized in psychiatric disorders, such as schizophrenia and bipolar disorder, but its occurrence in depression is less clear. Our aims were to verify if insulin resistance is altered in depression, to test the metabolic subgroup hypothesis of depression and if there are changes with antidepressants. Inclusion criteria were studies including adult subjects with depression and either a control group or follow-up after treatment with antidepressants, and assessing fasting insulin or glucose levels or the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index. Seventy studies with 240,704 participants were included. Both insulin levels and the HOMA-IR index were increased in acute depression. Neither insulin nor the HOMA-IR index were altered during remission. Insulin was increased in atypical, but not typical depression. There was higher variation in insulin in individuals with depression than in controls. Insulin resistance did not change with antidepressant treatment. Insulin resistance is increased in depression during acute episodes. Heterogeneity was high in most of the analyses. Laboratory assessment of insulin resistance might have clinical utility in people with depression for diagnosis of the metabolic subtype and treatment selection, following precision psychiatry standards.

Keywords

Adult, Antidepressive Agents, Bipolar Disorder, Depression, Humans, Insulin, Insulin Resistance, Precision psychiatry, Biomarker, Major depressive disorder, Depression, Systematic review, Meta-analysis

DOI

10.1016/j.neubiorev.2022.104758

PMID

35777578

PMCID

PMC11056930

PubMedCentral® Posted Date

4-29-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes