Depression and cardiovascular risk—association among Beck Depression Inventory, PCSK9 levels and insulin resistance

C. Macchi, C. Favero, A. Ceresa, L. Vigna, D. M. Conti, A. C. Pesatori, G. Racagni, A. Corsini, N. Ferri, C. R. Sirtori, M. Buoli, V. Bollati, M. Ruscica

Research output: Contribution to journalArticlepeer-review


Background: Depression and cardiovascular disease (CVD) are among the most common causes of disability in high-income countries, depression being associated with a 30% increased risk of future CV events. Depression is twice as common in people with diabetes and is associated with a 60% rise in the incidence of type 2 diabetes, an independent CVD risk factor. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a key regulator of low-density lipoprotein cholesterol, has been related to a large number of CV risk factors, including insulin resistance. Aim of this study was to investigate whether the presence of depression could affect PCSK9 levels in a population of obese subjects susceptible to depressive symptoms and how these changes may mediate a pre-diabetic risk. Results: In 389 obese individuals, the Beck Depression Inventory (BDI-II) was significantly associated with PCSK9 levels. For every one-unit increment in BDI-II score, PCSK9 rose by 1.85 ng/mL. Depression was associated also with the HOMA-IR (homeostatic model assessment index of insulin resistance), 11% of this effect operating indirectly via PCSK9. Conclusions: This study indicates a possible mechanism linking depression and insulin resistance, a well-known CV risk factor, providing evidence for a significant role of PCSK9.

Original languageEnglish
Article number187
JournalCardiovascular Diabetology
Issue number1
Publication statusPublished - Dec 1 2020


  • Beck Depression Inventory
  • Cardiovascular risk
  • Depression
  • Framingham risk score
  • Obesity
  • Proprotein Converatse Subtilisin/Kexin type 9

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine


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