Effect of serum lipid levels on depressive symptoms during adolescence and early adulthood

Abstract

INTRODUCTION: Increasing evidence suggests that serum lipids are associated with depressive symptoms. However, these associations are inconsistent according to age, sex and race. Thus, we aimed to investigate the association between baseline serum lipids and changes in serum lipids during adolescence on depressive symptoms in early adulthood in Korean young population. METHODS: This prospective cohort study included participants aged 20-26 years from the JS High School study (JSHS), a cohort study of Korean adolescents, with an average follow-up of 6 years. Participants were free of depression and major cardiovascular disease at baseline. A generalized linear model was used to estimate the association between serum lipids and depressive symptoms. Age, follow-up period, health behaviors, socioeconomic status, body mass index (BMI), and depressive symptoms at baseline were considered as covariates. RESULTS: After adjusting for age, follow-up period, health behaviors, socioeconomic status, BMI, and depressive symptoms at baseline, participants with increased levels of total cholesterol and triglycerides during follow-up experienced a significant increase in depressive symptoms (for males, β=4.02, p=0.013; for females, β=3.82, p=0.008). Only male participants with consistently high levels of total cholesterol and triglycerides reported higher depressive symptoms (β=4.51, p=0.014) than stable individuals. In addition, we found a U-shaped association in which males in the lowest and highest tertiles of total cholesterol reported higher depressive symptoms than males in the intermediate tertile. CONCLUSION: These findings suggest that both low and high cholesterol levels were associated with depressive symptoms in males and a large increase in total cholesterol was associated with depressive symptoms in both sexes. In addition, persistently high total cholesterol during adolescence predicts an increased risk of depressive symptoms in early adulthood in males. These findings suggest that different strategies to manage lipid risk factors by age and sex should be developed.