Suicidal ideation and metabolic biomarkers in patients with major depressive disorder: Investigation of FGF-21 and lipid profile

Objective:Thisstudywasconductedtoexaminetherelationshipbetweenthe presence of suicidalideation in patientswithmajordepressivedisorder (MDD) and FGF-21 and lipid profile parameters (HDL, LDL, triglycerides, total cholesterol), andtodeterminewhetherthesemarkersmayserve as potentialperipheralmetabolicbiomarkersfortheearlyidentification of suicide risk. MaterialsandMethods:Thestudyincluded 25 patientsdiagnosedwith MDD withsuicidalideation, 25 patientswith MDD withoutsuicidalideation, and 25 healthycontrols, alldiagnosedaccordingto DSM-5-TR criteria. A sociodemographic data form wascompletedforallparticipants, andthe Hamilton Depression Rating Scale (HAM-D), the Beck ScaleforSuicideIdeation, andtheBarrattImpulsiveness Scale-11 wereadministered. After 12 hours of fasting, 10 mL of venousbloodwasdrawnfromeachparticipant, and serum FGF-21, HDL, LDL, total cholesterol, andtriglyceridelevelsweremeasuredusingthe ELISA method. Results:Inthe MDD groupwithsuicidalideation, FGF-21, HDL, and TG levelsweresignificantlylower, whereas LDL and total cholesterollevelswerehigher. Correlationanalysesshowedthat, in thepatientgroups, FGF-21 levelswerepositivelycorrelatedwith HDL, total cholesterol, andtriglyceridelevels, and in the MDD groupwithoutsuicidalideation, FGF-21 wasnegativelycorrelatedwith LDL levels. Receiveroperatingcharacteristic (ROC) analysisrevealedthat FGF-21 had thehighestdiagnosticpower in distinguishingsuicidalideationfromhealthycontrols, andwhen MDD patientswithandwithoutsuicidalideationwerecompared, only FGF-21 levelsdemonstrated a significantdiscriminativevalue. Logisticregressionanalysisindicatedthat FGF-21 was a significant, although not independent, biomarkerforsuicidalideation. Conclusion:Ourfindingssuggestthatdecreased FGF-21 levelsmay be associatedwithsuicidalideation in majordepressivedisorderandthatevaluatingthisbiomarkertogetherwiththe lipid profile may be useful in predictingsuicide risk. Theresultsprovidenovelbiochemicalevidenceregardingtheneurometabolicunderpinnings of suicidalbehavior. Keywords:Majordepressivedisorder, Suicidalideation, FGF-21, Lipid profile, Biomarker