Metabolic pathways are associated with increased estimated cardiovascular risk in major depressive disorder: a QRISK3-based analysis

Background Depression and anxiety are among the most commonly encountered disorders in psychiatric practice. Previous studies have shown that both cardiovascular disease and cardiovascular risk are increased in these disorders. This study aimed to investigate the potential relationship between depression, anxiety, and cardiovascular risk by utilizing the QRISK3 cardiovascular risk algorithm. It also aimed to explore the potential explanatory roles of metabolic and inflammatory processes on cardiovascular risk.Methods After obtaining ethical approval, patients who met the inclusion criteria (n = 229) were divided into three groups: patients with depression (n = 78), patients with anxiety (n = 91), and a control group (n = 60) with no significant psychiatric disorder according to the Structured Clinical Interview for DSM-5. The laboratory parameters of the patients were evaluated, and their cardiovascular risks were determined according to the QRISK3 score.Results When the data were compared between the patient groups in pairs and trios, it was observed that the relative risk of QRISK3 was higher in the patient group with depression than in the other two groups. Exploratory mediation analyses suggested that metabolic markers, rather than inflammatory markers, were associated with higher estimated cardiovascular risk in the depression group.Conclusion The increased cardiovascular risk in depressed patients appears to be largely explained by metabolic factors such as the triglyceride/glucose index. Therefore, cardiovascular risk assessment is essential in patients with depression, a highly prevalent condition in psychiatric practice, and biochemical markers may be useful in this context.