Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

A Nomothetic Network Model Disclosing the Comorbidity of Depression and Unstable Angina: Effects of Atherogenicity, Insulin Resistance, Immune Activation, Antioxidants, the Endogenous Opioid System, Trace Elements, and Macrominerals

Version 1 : Received: 1 September 2020 / Approved: 3 September 2020 / Online: 3 September 2020 (04:40:27 CEST)

How to cite: Mousa, R.; Smesam, H.; Qazmooz, H.; Al-Hakeim, H.; Maes, M. A Nomothetic Network Model Disclosing the Comorbidity of Depression and Unstable Angina: Effects of Atherogenicity, Insulin Resistance, Immune Activation, Antioxidants, the Endogenous Opioid System, Trace Elements, and Macrominerals. Preprints 2020, 2020090053 (doi: 10.20944/preprints202009.0053.v1). Mousa, R.; Smesam, H.; Qazmooz, H.; Al-Hakeim, H.; Maes, M. A Nomothetic Network Model Disclosing the Comorbidity of Depression and Unstable Angina: Effects of Atherogenicity, Insulin Resistance, Immune Activation, Antioxidants, the Endogenous Opioid System, Trace Elements, and Macrominerals. Preprints 2020, 2020090053 (doi: 10.20944/preprints202009.0053.v1).

Abstract

Background. There is strong comorbidity between atherosclerosis (ATS) and depression which is attributed to increased atherogenicity, insulin resistance (IR), and immune and oxidative stress.Aim of the study. To examine the role of the above pathways and mu opioid receptor (MOR), β-endorphin, zinc, copper, vitamin D3, calcium, and magnesium in depression due to ATS / unstable angina (UA).Methods. Biomarkers were assayed in 58 controls and 120 ATS patients divided into those with moderate and severe depression according to the Beck Depression Inventory (BDI)-II score > 19 and > 29, respectively. Results. Neural network and logistic regression models showed that severe depression due to ATS/UA was best predicted by IL-6, UA, MOR, zinc, β-endorphin, calcium and magnesium and that moderate depression was associated with IL-6, zinc, MOR, β-endorphin, UA, atherogenicity, IR, and calcium. These neural networks yielded a significant discrimination of severe and moderate depression with an area under the ROC curve of 0.831 and 0.931, respectively. Using Partial Least Squares analysis, 66.2% of the variance in a latent vector extracted from the ATS/UA clinical features, BDI-II scores, atherogenicity, and IR could be explained by the regression on IL-6, IL-10, zinc, copper, calcium, MOR, and age. The BDI-II scores increased from controls to ATS to UA class III to UA class IV.Conclusions. Depression due to ATS/UA is a reflective manifestation of increased atherogenicity and IR, which are modulated by immune activation, aberrations in the endogenous opioid system, antioxidants, trace elements, and macrominerals.

Subject Areas

unstable angina, inflammation, neuro-immune, major depression, oxidative stress, antioxidants, atherogenicity

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