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

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. © 2020, The Author(s).
Original languageEnglish
JournalCardiovasc. Diabetol.
Issue number1
Publication statusPublished - 2020


  • Beck Depression Inventory
  • Cardiovascular risk
  • Depression
  • Framingham risk score
  • Obesity
  • Proprotein Converatse Subtilisin/Kexin type 9
  • antidepressant agent
  • antihypertensive agent
  • C reactive protein
  • proprotein convertase 9
  • serotonin noradrenalin reuptake inhibitor
  • serotonin uptake inhibitor
  • adult
  • Article
  • cardiovascular risk
  • controlled study
  • current smoker
  • depression
  • disease association
  • enzyme analysis
  • enzyme blood level
  • enzyme linked immunosorbent assay
  • female
  • homeostasis model assessment
  • human
  • hypertension
  • insulin resistance
  • major clinical study
  • male
  • obesity
  • retrospective study


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