European Journal of Cardiovascular Medicine

Menopause is the cessation of ovarian function, resulting in permanent amenorrhea. It typically takes place between the ages of 45 and 50, with an average age of 47 [1,2]. Postmenopausal problems, particularly hormonal changes, can occur due to decreasing estrogen levels, leading to adverse changes in the vagina and bladder [3,4]. Women spend one-third of their lives in the postmenopausal stage, experiencing depression, fatigue, hot flushes, night sweats, and reduced self-confidence and libido [1-4].

Post-menopausal women are at an increased risk of developing depression and dementia, which can have a significant impact on their quality of life [5]. Understanding the correlation between lipid profile, glucose levels, and depression/dementia in post-menopausal women is crucial for developing effective prevention and treatment strategies. Previous studies have shown a link between lipid profile and depression/dementia, but the relationship between glucose levels and these conditions in post-menopausal women is not well understood [6-8]. There is a lack of research exploring the correlation between lipid profile, glucose levels, and depression/dementia in post-menopausal women. This study aims to address the knowledge gap by investigating the relationship between lipid profile, glucose levels, and depression/dementia in post-menopausal women. Research question is what is the correlation between lipid profile, glucose levels, and depression/dementia in post-menopausal women? The aim of this study is to investigate the correlation between lipid profile, urea, creatinine, uric acid, and glucose levels, and depression/dementia in post-menopausal women. We hypothesize that there is a significant correlation between lipid profile and depression/dementia in post-menopausal women, and that glucose levels may also play a role in this correlation.

This cross-sectional comparative study was carried out by the Department of Biochemistry at SMS Medical College and Attached Hospitals, Jaipur, Rajasthan, India, in conjunction with the Departments of Gynecology and Obstetrics (Mahila Chikitsalaya) and Psychiatry. One hundred consecutive instances of postmenopausal depression were gathered from patients consulting with the Department of Gynecology and Obstetrics at Mahila Chikitsalaya, SMS Medical College and Hospital in Jaipur, India. These patients fulfilled the study's inclusion and exclusion criteria. After we got the participants' informed consent, we enrolled the cases. In order to screen the patients, we developed a screening tool that met all inclusion and exclusion criteria. As part of our study group, a consultant psychiatrist from the psychiatry department at SMS Medical College & Hospital in Jaipur made an ICD-10 depression diagnosis for the participants. Following the screening, this was executed. We evaluated the cognitive functioning of all individuals (patients and controls) and utilized Beck's depressive questionnaire, a self-assessment inventory in Hindi, to measure the degree of depression. Patients were categorized as either having dementia or not having dementia according to their HMSE scores. One hundred postmenopausal women in good health who were either social figures or patients served as the control group.

Evaluation Standards: Study Group: Ages 45 to 60 (postmenopausal) women are eligible to participate. Clinical depression was diagnosed using the International Classification of Diseases, 10th revision (ICD-10). It is important that patients who can read and write comprehend the essence of the evaluation. Only patients who express an interest in taking part in the study should be considered.

Exclusion criteria include patients with serious neurological or somatic disorders. Comorbid mental disorders other than depression and dementia must be present. Display symptoms consistent with a mental illness; a history of mental illnesses that do not include dementia and depression should be present. first-degree relative. The person is now receiving hormone treatment or has previously received hormone treatment.

As a baseline: Participants must meet the following inclusion and exclusion criteria: be 45-60 years old, normally functioning, healthy, and literate; and be willing to participate in the study.

Research tools: Documentation of authorization This form, written in Hindi, was given to the patient when they enrolled in the study. Each patient gave their written agreement in front of a witness so that we could emphasize that these were not ordinary examinations and that they needed to be completely honest (Appendix I). As shown in Appendix II, Performa screening entails asking patients a series of simple questions to establish inclusion and exclusion criteria. Here are the laboratory tests that were administered to all participants: We took 5 mL of anti-cubital vein venous blood in regular vials and 1 mL in EDTA and fluoride containing vials after a fast the night before. We used aseptic procedures. Total cholesterol, triglycerides, High Density lipoprotein (HDL), urea, creatinine, uric acid, and glucose were measured according to the procedures given in their respective kit methods. Measurements were taken in fully automated analyzer.

Statistical analysis:

The chi square test (χ2) was employed to compare the data of non-depressed postmenopausal women and depressed postmenopausal women. The descriptive variables were represented as mean, standard deviation, and percentages. In order to ascertain the statistical distinction between the categories, we implemented the student “t” test. Pearson correlation coefficients ® were implemented to perform correlation analysis. The results were considered significant when the p-values were less than 0.05. All calculations were conducted using the SPSS 10 computer software.

Depressed PMW had considerably lower HDL values and considerably higher serum total and LDL cholesterol. While both groups' blood urea and creatinine levels were similar, depressed PMW had much higher uric acid levels. The blood glucose levels of the two groups were not significantly different. (Table 1).

In depressed PMW, there was a strong positive association between Beck's score and total cholesterol levels. In depressed PMWs, there was a significant inverse correlation between serum HDL levels and Beck's score. Depressed PMWs showed a positive correlation between their serum LDL levels and Beck's score. In neither group did researchers discover a statistically significant relationship between serum VLDL, triglycerides, glucose levels, and Beck's score, respectively (Table 2). 

Table 1: Comparison of different hormones and calcium of Non-depressed PMW and Depressed PMW

Table 2: Correlation between Beck’s Score and hormones of Non depressed & Depressed group

Blood glucose levels were similar between healthy control patients and depressed PMW. In both the sad and non-depressed PMW groups, there was no statistically significant correlation between blood sugar levels and Beck's score. Our results don't line up with a study [9]. They [9] discovered that when our brains aren't getting enough oxygen, they can't produce the feel-good neurotransmitters that ordinarily put us at ease: serotonin, norepinephrine, dopamine, and acetylcholine. An immediate effect is an overabundance of stress chemicals in the body, which can have a negative impact on self-esteem. Many people understand this to suggest that depression stems from having a poor view of oneself.

Researchers [10] found a correlation between menopausal status, obesity, and fasting blood glucose levels in middle-aged women in their study. In women of menopausal age and younger, fasting blood glucose (FBG) levels were higher in the experimental group compared to the control group. Body mass index (BMI) and fasting blood glucose levels fluctuate significantly between pre- and post-menopausal women. 

The average values of the renal profile elements in both the control group and the depressed PMW group, including urea, creatinine, and uric acid. Although the two groups' serum urea and creatinine levels were similar, depressed PMW had much greater average uric acid levels than the healthy placebo group.

Our results are consistent with those of the study [11]. They [11] found a link between elevated serum uric acid levels and both natural and surgical menopause. The age of natural menopause is associated with a significant rise in serum uric acid levels in women [12].

Purine metabolism produces uric acid, one of the most important antioxidants in plasma. There is concordance between our results and those of [13-15]. Uric acid has antioxidant properties because it binds iron and copper ions in a way that doesn't speed up free radical processes, and because it scavenges oxidized species directly, including peroxy radicals, singlet O2, and HOCl. Due to its high concentration, urate may have a significant role in vivo as a hydroxyl radical scavenger. An important function of urate is to inhibit erythrocyte lipid peroxidation. Uric acid defends against the peroxidation-causing oxoheme oxidants. Urate and ascorbate provide protection against lipid peroxidation, which requires hemoglobin and peroxide [16]. Urate protects the DNA of macrophages, longer-lived T and B cells, and erythrocytes. One possible indicator of oxidative stress is elevated uric acid levels. According to [17], uric acid keeps the plasma membrane intact at the lipid-aqueous interface boundary, preventing oxidative stress from moving from the extracellular to the intracellular environment. However, elevated levels of uric acid, possibly due to the buildup of reactive oxygen species, could serve as an indicator of oxidative stress [18-20]. Antioxidant Defense System (AODS), UA can function as an antioxidant and a prooxidant simultaneously. The results reported by [21] do not align with our own. Researchers looked for a link between depressed individuals' blood uric acid levels and their depression symptoms, and they discovered that the depressed individuals had lower amounts of uric acid.

Oestrogens' effect on uric acid processing by the kidneys is one proposed biological mechanism that may explain the correlation between menopause and elevated blood uric acid levels [22]. The renal clearance of urate may be enhanced when women have estrogen levels similar to those before menopause [23].

The levels of blood total cholesterol and serum LDL were significantly higher in the control group than in the depressed PMW group, although the levels of serum triglycerides and VLDL were similar in both groups. Compared to healthy PMW (180.26 + 41.33 mg/dl), depressed PMW had significantly higher mean total cholesterol readings (208.02 + 56.88 mg/dl) (P <.001). There was a substantial association between serum total cholesterol and Beck's score in depressed PMW, no such link was detected in non-depressed PMW. Similarly, there is no statistically significant relationship between PMW's serum triglycerides and Beck's score, whether they are depressed or not.

On the other hand, there is a statistically significant negative link between serum HDL and Beck's score in the depressed group but no such correlation in the control group. Serum LDL and Beck's score showed a strong positive association in the depressed PMW group but no such correlation in the control group. We observed the association between Beck's score and serum VLDL of non-depressed and depressed PMW. Neither the group's VLDL nor Beck's score were significantly related.

Consistent with our findings, a study [24] examined the total cholesterol levels in the blood of people suffering from depression. They found that, compared to healthy controls, depressed patients had significantly higher total cholesterol levels, and this difference remained after accounting for potential confounds. The results were consistent with those of [25]. They discovered that PMW were more likely to experience depression and perspiration if their triglyceride levels were high. Measurement of serum cholesterol levels in depressed individuals may actually point towards hypothyroidism, according to another study [26].

Researchers [27] discovered that serum levels of low-density lipoprotein (LDL) cholesterol increased and levels of high density lipoprotein (HDL) cholesterol decreased in women who went through menopause without taking hormone replacement therapy compared to controls who did not experience menopause. The study conducted by [28] is supported by our results. According to their findings, hypercholesterolemia is associated with unfavorable treatment outcomes for severe depressive illness. Our results are consistent with those of a study [29] which found that serum cholesterol levels were much greater in postmenopausal women compared to premenopausal women. A study [30] found a link between lower cholesterol levels and higher levels of depression symptoms in postmenopausal women. Another study [31] found different results than us. We found that patients with severe depression had low total cholesterol. Consistent with the impact of increased androgens, elevated estradiol levels are linked to elevated triglycerides and ApoB and decreased HDL-cholesterol and ApoA. Among postmenopausal women with severe carotid atherosclerosis, a recent study found a clear positive correlation between estrone and total cholesterol and triglycerides [32]. Another study [33] in a small sample of healthy postmenopausal women, found the opposite to be true. They found that plasma estrone was positively associated with HDL cholesterol and negatively associated with triglycerides and very low-density lipoprotein cholesterol. In conclusion, several researchers have failed to find any evidence linking endogenous estrogens to cholesterol levels or other atherosclerosis indicators [34].

The study suggests a link between menopause and depression, but further research is needed to understand its underlying causes. Treatment options should focus on dietary intake and estrogens, and social networks.

Conflict of interest:

There is no conflict of interest among the present study authors.

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