The interplay of serum cations, insulin resistance, and atherogenic indices in predicting depression in hypothyroid patients

Abstract

Background: A significant proportion of people with hypothyroidism (HT) is linked to affective disorders, including depression. The pathophysiology and factors affecting or predicating depression in HT patients is still to be elucidated. The current study intends to investigate serum levels of cations, insulin resistance parameters, trace elements and atherogenic indices, in HT+Dep, HT, and healthy control groups. Methods: We measured the biomarkers in the blood of sixty HT+Dep patients, sixty HT patients, and healthy controls who participated in the study. Selenium was measured using flameless atomic absorption spectrophotometry. While insulin level was measured using the ELISA technique. Results: We observed significant insulin resistance (IR) and dyslipidemia in HT patients, which were more pronounced in HT+Dep. Moreover, HT+Dep patients exhibited alterations in the blood concentrations of cations and trace elements. Artificial neural network analysis demonstrated that the atherogenic index of plasma (AIP) is the most precise predictor of depression in HT patients, with a success rate of 100%. This was followed by the distance from Castelli's risk index-I (CRI-I) (24.7%), ionized calcium (23.1%), the IR index (HOMA2IR) (22.4%), and the insulin sensitivity index (HOMA2S%) (21.8%). Selenium, conversely, was the most reliable biomarker for differentiating the HT group from the control group. Conclusion: Depression in HT patients is associated with alteration in the serum levels of cations, atherogenic indices, trace elements, and IR. AIP is the best predictor for depression in HT patients. It is essential to correct the amounts of blood biomarkers of HT patients to mitigate the severity of depression.