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Cited by 19Treatment of Major DepressionLipoproteins and Cardiovascular HealthChild and Adolescent Psychosocial and Emotional Development

The abnormalities of lipid metabolism in children and adolescents with major depressive disorder and relationship with suicidal ideation and attempted suicide

Open access
Liu, Zhiwei, Sun, Liang, Sun, Feng, Zhang, Yulong, Wang, Juan, Zhang, Zhaokun, Sun, Guangying, Sun, Longlong +3 more·2024·Heliyon
DOI 10.1016/j.heliyon.2024.e30344PMC PMC11079100
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Abstract

Background Major depressive disorder (MDD) is a widespread health issue in many countries, which has an extremely negative impact on the health of children and adolescents in particular. In the context of depression and metabolic disorders, dyslipidemia and metabolism-related problems become more prominent comorbidities. However, they continue to be the main barrier to the successful recovery of the clinical progress. In this study we investigated the rate of dyslipidemia, additional risk factors among Chinese children and adolescents with MDD, and association of the suicidal behavior with lipid levels. Methods The study took 756 people from the Third People's Hospital of Fuyang between January 2020 and December 2021, aged between 8 and 18, with major depressive disorders diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). We determined the FBG (fasting blood glucose) and lipid parameters in all subjects and also investigated the history of suicidal ideation, the cases of attempted suicide, and the scores of depressive symptoms. Sociodemographic and clinical data were gathered and analyzed using the SPSS-23.0 version. Results The prevalence of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C were 5.42 % (41/756), 10.58 % (80/756), 3.84 % (29/756) and 5.42 % (41/756) respectively. For hypercholesterolemia and hypertriglyceridemia, they were positive associated with suicidal ideation and suicide attempts, and the positive correlation is shown between low HDL-C levels and suicide attempts. Nevertheless, non-ideation and inversely suicidal attempts were not discovered among high-LDL-C subjects. Logistic analysis showed that high levels of FBG ( OR = 2.86, 95 % CI : 1.31–6.25, P = 0.008) and worse LDL-C ( OR = 357.82, 95 % CI: 66.16–1935.10, P < 0.001) are the independent associated factors for hypercholesterolemia. More hospitalizations ( OR = 1.89, 95 % CI : 1.07–3.35, P = 0.028), obesity ( OR = 2.55, 95 % CI : 1.25–5.18, P = 0.010), high levels of TC ( OR = 2.15, 95 % CI : 1.03–4.48, P = 0.042), and higher doses of antidepressants ( OR = 1.02, 95 % CI : 1.00–1.04, P = 0.029) were independently associated factors for hypertriglyceridemia, while high levels of HDL-C ( OR = 0.11, 95 % CI : 0.04–0.31, P < 0.001) were protective factors. In addition, high levels of TC ( OR = 113.94, 95 % CI : 20.01–648.85) were statistically different ( P < 0.001) and suggested that the factor was significantly related to high LDL-C. Meanwhile, older age ( OR = 1.25, 95 % CI : 1.02–1.52, P = 0.030) and high levels of TG ( OR = 3.00, 95 % CI: 1.98–4.55, P < 0.001) were independent factors contributing to low HDL-C. Conclusion The high prevalence of dyslipidemia in childhood and adolescence among children and adolescents with depressive disorder has become a public health issue. Hypercholesterolemia and hypertriglyceridemia showed a positive correlation with suicidal thoughts and suicidal attempts. Monitoring the incidence of suicidal thoughts and attempts among them would carry some predictor meaning in therapy and for jumping back to health.

AI snapshot

Written from the paper’s full text.

TL;DR

In 756 Chinese children and adolescents hospitalized with DSM-5 major depressive disorder, dyslipidemia was common, and hypercholesterolemia/hypertriglyceridemia were positively associated with suicidal ideation and attempted suicide. Several metabolic, clinical, and medication factors were independently associated with specific lipid abnormalities.

Key findings

  • Prevalence of lipid abnormalities was hypercholesterolemia 5.42% (41/756), hypertriglyceridemia 10.58% (80/756), high LDL-C 3.84% (29/756), and low HDL-C 5.42% (41/756).
  • Spearman analyses reported positive associations of hypercholesterolemia and hypertriglyceridemia with suicidal ideation and attempted suicide, and of low HDL-C with attempted suicide. The paper’s narrative states high LDL-C was not associated with suicidal ideation/attempts, although Table 3 lists significant correlations for high LDL-C with suicidal ideation (0.091*) and attempted suicide (0.095).
  • Independent factors in logistic regression: hypercholesterolemia with high FBG (OR = 2.86, 95% CI 1.31–6.25, P = 0.008) and LDL-C (OR = 357.82, 95% CI 66.16–1935.10, P < 0.001); hypertriglyceridemia with more hospitalizations (OR = 1.89, 95% CI 1.07–3.35, P = 0.028), obesity (OR = 2.55, 95% CI 1.25–5.18, P = 0.010), high TC (OR = 2.15, 95% CI 1.03–4.48, P = 0.042), and higher antidepressant dose (OR = 1.02, 95% CI 1.00–1.04, P = 0.029), with high HDL-C protective (OR = 0.11, 95% CI 0.04–0.31, P < 0.001).
  • High LDL-C was independently associated with high TC (OR = 113.94, 95% CI 20.01–648.85, P < 0.001); low HDL-C was independently associated with older age (OR = 1.25, 95% CI 1.02–1.52, P = 0.030) and high TG (OR = 3.00, 95% CI 1.98–4.55, P < 0.001).

Methods

  • Cross-sectional study of 756 inpatients aged 8–18 years with DSM-5 major depressive disorder at the Third People’s Hospital of Fuyang, January 2020–December 2021. Of 786 initially included, 18 lacked scale evaluation and 12 lacked essential baseline clinical data.
  • Measured fasting blood glucose and lipid parameters (TC, TG, HDL-C, LDL-C); dyslipidemia defined per 2011 NHLBI guidelines: TC ≥5.18 mmol/L, TG ≥1.7 mmol/L, LDL-C ≥3.37 mmol/L, HDL-C ≤1.03 mmol/L. Collected demographic/clinical data, medication doses as fluoxetine equivalents and chlorpromazine equivalents, CGI-S, and self-reported self-injurious behavior, suicidal ideation, and attempted suicide in the last three months.
  • Analysis used SPSS 23.0: t-tests or Mann-Whitney U tests, chi-square tests, Spearman correlation, and multivariate logistic regression for variables with P < 0.05 in univariate analysis; significance set at α = 0.05.

Limitations

  • The paper states the cross-sectional design prevents causal inference; it cannot determine whether dyslipidemia causes suicidal thoughts/behavior or whether depression-related eating/weight changes cause lipid abnormalities.
  • The paper states there was no healthy control group, limiting interpretation, and that CGI-S is not an objective depression severity scale such as the Hamilton Depression Scale.
  • The paper also states a small sample size and limited continuous data may weaken the correlation between suicidal behavior and lipid metabolism. Evident from the text: the sample is single-center and inpatient, and there are inconsistencies between narrative statements and table results for high LDL-C and suicidal ideation/attempted suicide.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.heliyon.2024.e30344

Cites

55 of 57 references verified2 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 22 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    High fasting blood glucose is independently associated with hypercholesterolemia in patients with major depressive disorder (OR = 2.86, 95% CI: 1.31-6.25, P = 0.008).

    “Logistic analysis showed that high levels of FBG (OR = 2.86, 95 % CI: 1.31–6.25, P = 0.008) and worse LDL-C (OR = 357.82, 95 % CI: 66.16–1935.10, P < 0.001) are the independent associated factors for hypercholesterolemia.”
    • Also stated in: § Independently related factors for hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C in patients with MDD · plain
      “As shown in Table 4, hypercholesterolemia has independent associations with high levels of FBG (OR = 2.86, 95 % CI: 1.31–6.25, P = 0.008) and LDL-C (OR = 357.82, 95 % CI: 66.16–1935.10, P < 0.001).”
    Quote in the paperSubstantial claim
  • Findingown data

    Hypertriglyceridemia is positively associated with attempted suicide in children and adolescents with major depressive disorder.

    “For hypercholesterolemia and hypertriglyceridemia, they were positive associated with suicidal ideation and suicide attempts, and the positive correlation is shown between low HDL-C levels and suicide attempts. Nevertheless, non-ideation and inversely suicidal attempts were not discovered among high-LDL-C subjects.”
    • Also stated in: § Association of demographic data and clinical variables with hypercholesterolemia, hypertriglyceridemia, high LDL-C and low HDL-C · boosted
      “According to Spearman's correlation coefficients, a relationship between hypercholesterolemia, hypertriglyceridemia and suicidal ideation, as well as attempted suicide can be clearly seen, and the decrease in HDL-C levels was associated with attempted suicide (P < 0.05). Nevertheless, high LDL-C was not revealed to be feature of suicidal attempts or ideation.”
    Quote in the paperSubstantial claim
  • Findingown data

    High LDL-C is a risk factor for hypercholesterolemia in children and adolescents with MDD.

    “Through the binary logistic regression analysis, it was shown that the patients with high levels of FBG and LDL-C were at a higher risk of causing hypercholesterolemia.”
    Quote in the paperSubstantial claim
  • Findingown data

    Obesity is a significant risk factor for hypertriglyceridemia in children and adolescents with MDD.

    “The hospitalization, obesity, high TC level, and the level of antidepressants were found to be among the significant isolated risk factors of hypertriglyceridemia, while a high level of HDL-C was found to be a protective factor.”
    • Also stated in: § Independently related factors for hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C in patients with MDD · plain
      “Obesity (ref. No) | 0.936 | 0.362 | 0.010 | 2.55 | 1.25 | 5.18”
    Quote in the paperSubstantial claim
  • Findingown data

    The prevalence of hypercholesterolemia in children and adolescents with major depressive disorder was 5.42% (41/756).

    “The prevalence of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C were 5.42 % (41/756), 10.58 % (80/756), 3.84 % (29/756) and 5.42 % (41/756) respectively.”
    • Also stated in: § Demographic and clinical characteristics · plain
      “The cases of hypercholesterolemia, hypertriglyceridemia, high LDL-C and low HDL-C were found in 5.42 % (41/756), 10.58 % (80/756), 3.84 % (29/756) and 5.42 % (41/75).”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 24
  • May combine two claims. 6

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Thoughts of suicide are widely present in depressed adolescents.

    “The study has shown that thoughts of suicide are widely present in depressed adolescents [15], while it has also been documented that the levels of lipids have a strong bond with suicidal behaviors in depressed patients, with high risks of suicide taking more the patients with low total cholesterol level [16].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] Zhang, 2022, Association of thyroid-stimulating hormone and lipid levels with suicide attempts among adolescents with major depressive disorder in China, Front. Psychiatr.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The CGI Severity Inventory (CGI-S) was used to assess depression severity.

    “The CGI Severity Inventory (CGI-S) was used to assess depression severity [27].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Busner, 2007, The clinical global impressions scale: applying a research tool in clinical practice, Psychiatry (Edgmont).

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The association with suicidal behavior or attempts in patients with mental disorders is not clear.

    “Another research finding was that the level of lipids is not related to depressive symptoms in people [19], and also the association with suicidal behavior or attempts in patients with mental disorders is not clear [20,21].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [20] Capuzzi, 2018, Recent suicide attempts and serum lipid profile in subjects with mental disorders: a cross-sectional study, Psychiatr. Res. source

      Not checked in the free run.

    • cites [21] Bartoli, 2017, Association between total serum cholesterol and suicide attempts in subjects with major depressive disorder: exploring the role of clinical and biochemical confounding factors, Clin. Biochem. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    There could be a large coherence between elevated TG levels and a rise in the likelihood of getting depressed.

    “Moreover, there could be a large coherence between elevated TG levels and a rise in the likelihood of getting depressed [12].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Lee, 2022, The relationships between abnormal serum lipid levels, depression, and suicidal ideation according to sex, J. Clin. Med. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    High levels of triglycerides, cholesterol, and LDL-C are closely related to more severe depressive symptoms.

    “In such cases high levels of triglycerides, cholesterol, and LDL-C are closely related to more severe depressive symptoms [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Wagner, 2019, LDL cholesterol relates to depression, its severity, and the prospective course, Prog. Neuro-Psychopharmacol. Biol. Psychiatry source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Cholesterol deregulation may contribute to neuronal imbalance in the body and, in turn, expose individuals to depressed episodes.

    “Additionally, elevated lipid levels seem to increase the risk of depression among specific individuals [8], and cholesterol deregulation may contribute to neuronal imbalance in the body and, in turn, expose individuals to depressed episodes [9].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Cheon, 2023, Impaired cholesterol metabolism, neurons, and neuropsychiatric disorders, Exp. Neurobiol. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study was approved by the Medical Ethics Committee of the Third People's Hospital of Fuyang (grant number [2018]2018-340-10).

    “The study was conducted by the Medical Ethics Committee of the Third People's Hospital of Fuyang, which approved the study (granted number: [2018]2018-340-10).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    More severe depressive patients with psychiatric disorders had abnormal lipid metabolism.

    “Previous studies have been performed which demonstrated that more severe depressive patients with psychiatric disorders had abnormal lipid metabolism [10,11].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [10] Park, 2021, Association between the change of total cholesterol during adolescence and depressive symptoms in early adulthood, Eur. Child Adolesc. Psychiatr. source

      Not checked in the free run.

    • cites [11] Kułak-Bejda, 2021, Are lipids possible markers of suicide behaviors?, J. Clin. Med. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Four short questions were used to assess the presence of self-injurious behavior, suicidal ideation, and attempted suicide in the last three months.

    “The researchers used four short questions to assess the presence of self-injurious behavior, suicidal ideation, and attempted suicide in the last three months [26]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [26] Silverman, 2007, Rebuilding the tower of Babel: a revised nomenclature for the study of suicide and suicidal behaviors. Part 2: suicide-related ideations, communications, and behaviors, Suicide. Life. Threat, Beyond Behav.

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    The levels of lipids have a strong bond with suicidal behaviors in depressed patients, with high risks of suicide taking more the patients with low total cholesterol level.

    “The study has shown that thoughts of suicide are widely present in depressed adolescents [15], while it has also been documented that the levels of lipids have a strong bond with suicidal behaviors in depressed patients, with high risks of suicide taking more the patients with low total cholesterol level [16].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [16] Dimény, 2021, Low cholesterol level as a possible suicide risk factor, Orv. Hetil. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The study was conducted in accordance with the Declaration of Helsinki 1975.

    “The entire trials were done as a part of the instructions given in the Declaration of Helsinki 1975.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The level of lipids is not related to depressive symptoms in people.

    “Another research finding was that the level of lipids is not related to depressive symptoms in people [19], and also the association with suicidal behavior or attempts in patients with mental disorders is not clear [20,21].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Mulchandani, 2023, Relationship between serum lipids and depression: a cross sectional survey among adults in Haryana, India, Indian J. Psychiatr. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Of 786 patients who completed the scale evaluation, 18 failed to do so and 12 lacked essential baseline clinical data, leaving 756 patients in the final study.

    “The study included 786 patients who completed the scale evaluation, with the exception of 18 patients who failed to do so and 12 patients who lacked essential baseline clinical data (such as unmeasured blood glucose and lipid indices). Thus, we finalized the study with 756 patients.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisenone given

    Prior literature revealed a strong association between lipid levels and the occurrence of depressive disorder, severity of depressive symptoms, suicidal ideation, and suicidal behavior.

    “The historical literature revealed a strong association between lipid levels and the occurrence of depressive disorder, as well as the severity of depressive symptoms, suicidal ideation, and suicidal behavior.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The incidence of hypercholesterolemia among Chinese youth was 6.5% [4].

    “Previous studies revealed that the incidence of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C among Chinese youth was 6.5 %, 7.5 %, 5.2 %, and 9.1 % [4].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Riahi, 2019, Body weight misperception and psychological distress among children and adolescents: the CASPIAN-V study, osong. Public. Health, Res. Perspect.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The percentage of hypercholesterolemia among Chinese adolescents was 4.1% [6].

    “The findings from the meta-analysis reflected that the percentage of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C in Chinese adolescents was 4.1 %, 8.5 %, 5.3 %, and 6.8 % [6].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Ding, 2015, Prevalence of dyslipidemia in Chinese children and adolescents: a Meta-analysis, Zhonghua Liuxingbingxue Zazhi

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    It was not possible to conclude whether dyslipidemia causes suicidal thoughts or behavior, or whether depression causes eating abnormalities leading to lipid abnormalities.

    “Nevertheless, it was not possible to conclude whether dyslipidemia causes suicidal thoughts or behavior in such patients or whether depression causes inadequate eating, wasting, or obesity, which causes abnormality in blood lipid levels in patients with depression.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductreasoning

    No objective scale (e.g., Hamilton Depression Scale) was used to measure depression in patients.

    “There was no objective scale (Depression Hamilton Scale for instance) accepted worldwide to measure depression in patients.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study did not include a healthy control group, which hindered interpretation.

    “Moreover, this study was not designed with a healthy control group included, and the health control group's absence hindered any potential interpretation.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The percentage of high LDL-C among Chinese adolescents was 5.3% [6].

    “The findings from the meta-analysis reflected that the percentage of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C in Chinese adolescents was 4.1 %, 8.5 %, 5.3 %, and 6.8 % [6].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Ding, 2015, Prevalence of dyslipidemia in Chinese children and adolescents: a Meta-analysis, Zhonghua Liuxingbingxue Zazhi

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The incidence of low HDL-C among Chinese youth was 9.1% [4].

    “Previous studies revealed that the incidence of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C among Chinese youth was 6.5 %, 7.5 %, 5.2 %, and 9.1 % [4].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Riahi, 2019, Body weight misperception and psychological distress among children and adolescents: the CASPIAN-V study, osong. Public. Health, Res. Perspect.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The percentage of hypertriglyceridemia among Chinese adolescents was 8.5% [6].

    “The findings from the meta-analysis reflected that the percentage of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C in Chinese adolescents was 4.1 %, 8.5 %, 5.3 %, and 6.8 % [6].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Ding, 2015, Prevalence of dyslipidemia in Chinese children and adolescents: a Meta-analysis, Zhonghua Liuxingbingxue Zazhi

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The incidence of hypertriglyceridemia among Chinese youth was 7.5% [4].

    “Previous studies revealed that the incidence of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C among Chinese youth was 6.5 %, 7.5 %, 5.2 %, and 9.1 % [4].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Riahi, 2019, Body weight misperception and psychological distress among children and adolescents: the CASPIAN-V study, osong. Public. Health, Res. Perspect.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    CGI-S cannot be the instrument for measuring depression severity.

    “Even though we have studied the relation between lipid metabolism and depression symptoms and assessed the scale of symptom severity with the help of the CSI–S scale, CGI-S cannot be the instrument for measuring depression severity.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The percentage of low HDL-C among Chinese adolescents was 6.8% [6].

    “The findings from the meta-analysis reflected that the percentage of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C in Chinese adolescents was 4.1 %, 8.5 %, 5.3 %, and 6.8 % [6].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Ding, 2015, Prevalence of dyslipidemia in Chinese children and adolescents: a Meta-analysis, Zhonghua Liuxingbingxue Zazhi

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The incidence of high LDL-C among Chinese youth was 5.2% [4].

    “Previous studies revealed that the incidence of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C among Chinese youth was 6.5 %, 7.5 %, 5.2 %, and 9.1 % [4].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Riahi, 2019, Body weight misperception and psychological distress among children and adolescents: the CASPIAN-V study, osong. Public. Health, Res. Perspect.

      Not checked in the free run.

26 of 26

  • The paper relies on this without support.

    The inpatient sample of children and adolescents with major depressive disorder is representative of children and adolescents with major depressive disorder in the broader population.

    “The high prevalence of dyslipidemia in childhood and adolescence among children and adolescents with depressive disorder has become a public health issue.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Multiple epidemiological and clinical studies report an association between metabolic syndrome and suicidal attempts.

    “Multiple epidemiological and clinical studies have reported an association between metabolic syndrome and suicidal attempts (83–85), but the directionality and causality of this relationship remain unresolved.”

    From Exploring the neurobiological markers of suicidal behaviors in pediatric population: a narrative review (2026) · cites this paper as [85]

    The Discussion (page unavailable) reports an association between abnormal lipid levels and suicide attempts and says earlier literature links lipid levels with suicidal behavior. But the Methods define the condition studied as dyslipidemia, not metabolic syndrome; the paper does not establish the claimed association for metabolic syndrome as a whole. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Claim of no high LDL-C suicidality association contradicts Table 3

    Major

    In the passage describing Spearman correlations, the text denies an association for high LDL-C. Table 3 instead marks its correlations with suicidal ideation and attempted suicide as significant.

  • Claimed hypertriglyceridemia-suicidality correlations are not significant in Table 3

    Major

    The text says hypertriglyceridemia is associated with both suicidal ideation and attempts, but Table 3 marks neither of its corresponding correlations as significant.

  • Hypercholesterolemia self-injury percentage is incorrect

    Minor

    In the group of 41 patients, 26 reporting self-injury represent 63.4%, not 87.8%. The complementary entry, 15 (12.2), is also inconsistent with its count.

    Reported 87.8 · recomputed 63.414634

  • Low HDL-C prevalence uses the wrong denominator

    Minor

    The stated 5.42% is consistent with 41 of 756 patients, as reported elsewhere, but not with the printed denominator of 75.

    Reported 5.42 · recomputed 54.666667

  • CGI-S is described as both an eight-point and a seven-point scale

    Minor

    The methods specify eight points, from 0 to 7, whereas the limitations section calls CGI-S a seven-point scale.

  • Reported median falls below its 25th percentile

    Minor

    The stated format is median (25th percentile, 75th percentile), but this Table 2 entry gives a median of 100.0 and a 25th percentile of 150.0.

6 of 6

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Martínez-Carpio, 2009, Relation between cholesterol levels and neuropsychiatric disorders, Rev. Neurol., 48, 261

Cited by

Sorted by citations

Related

Authors
Liu, Z., Sun, L., Sun, F., Zhang, Y., Wang, J., Zhang, Z., Sun, G., Sun, L., Yang, R., Yao, G., & Liu, Y.
Affiliations
  • Anhui Medical University (CN)
  • University of Electronic Science and Technology of China (CN)
Corresponding author
  • Liu, Zhiwei
  • Liu, Yun
ORCID
Venue
Heliyon
Publisher
Elsevier BV
Published
2024-05
Volume
10
Issue
9
Pages
e30344
ISSN
2405-8440 (ISSN-L)
DOI
10.1016/j.heliyon.2024.e30344
PMC
PMC11079100
OpenAlex
W4396622806
Semantic Scholar
07b50ef6fb19a450dd37d55f5cfc48fa5606138e
Cited by
17
References
57
Citations by year
2026: 7 · 2025: 9 · 2024: 1
FWCI
4.83
Type
journal article
Language
en
Open access
Licence
Locations
  • Heliyon (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
major depressive disorder, children and adolescents, dyslipidemia, hypercholesterolemia, hypertriglyceridemia, LDL cholesterol, HDL cholesterol, fasting blood glucose, suicidal ideation, suicide attempts, metabolic comorbidities, obesity, hospitalization, Chinese youth, lipid metabolism disorders

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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