Medical student Michael G. DeGroote School of Medicine Hamilton, Ontario, Canada
Background:
Background: Adolescents with major depressive disorder (MDD) are at increased risk of premature atherosclerosis and cardiovascular disease (CVD). The ability to identify MDD adolescents at increased CVD risk would facilitate personalized interventions and advance knowledge regarding the MDD-CVD association. Objective:
Objective: This study aimed to identify adolescent MDD endotypes of increased CVD risk. Design/Methods: Methods: Youth with MDD (n=189; 74% female, mean 15.03 ± 1.85 years) were recruited through an outpatient psychiatry program in a large urban hospital. Individual and family (demographics, depression, anxiety symptoms, family conflict), physical examination (vital signs, body mass index [BMI]) and laboratory measures (lipid profile, glucose, C-reactive protein) were collected. K-means clustering was performed using demographic, clinical, and laboratory data; a subsequent model included only lipids. Continuous and categorical measures were compared between clusters. Results:
Results: The all-variable model yielded one high and one low CVD risk cluster which differed significantly in ethnicity, anthropometrics, laboratory data, and family conflict, and not in depression or anxiety severity. The lipid-only model yielded two high and two low CVD risk clusters that differed significantly in sex, ethnicity, BMI lipids, depression, and anxiety severity. Among the two CVD risk clusters, one was indicative increased cardiometabolic risk while the other was comprised of MDD adolescents with high LDL and without other cardiovascular risk factors.
Conclusion(s):
Conclusion: Endotypes of adolescent MDD associated with varying levels of CVD risk were identified. Results highlight the heterogeneity of adolescent MDD and the need for precision medicine approaches in the management of MDD to improve both CVD and depression outcomes.
