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Pyko A, Lind T, Mitkovskaya N, Ögren M, Östenson CG, Wallas A, Pershagen G, Eriksson C. Transportation noise and incidence of hypertension. Int J Hyg Environ Health 2018; 221:1133-1141. [DOI: 10.1016/j.ijheh.2018.06.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/21/2018] [Accepted: 06/22/2018] [Indexed: 11/28/2022]
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Dzhambov AM, Dimitrova DD. Residential road traffic noise as a risk factor for hypertension in adults: Systematic review and meta-analysis of analytic studies published in the period 2011-2017. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 240:306-318. [PMID: 29751327 DOI: 10.1016/j.envpol.2018.04.122] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/23/2018] [Accepted: 04/25/2018] [Indexed: 05/21/2023]
Abstract
Multiple cross-sectional studies indicated an association between hypertension and road traffic noise and they were recently synthetized in a WHO systematic evidence review. However, recent years have seen a growing body of high-quality, large-scale research, which is missing from the WHO review. Therefore, we aimed to close that gap by conducting an updated systematic review and meta-analysis on the exposure-response relationship between residential road traffic noise and the risk of hypertension in adults. Studies were identified by searching MEDLINE, EMBASE, the Internet, conference proceedings, reference lists, and expert archives in English, Russian, and Spanish through August 5, 2017. The risk of bias for each extracted estimate and the overall quality of evidence were evaluated using a list of predefined safeguards against bias related to different study characteristics and the Grading of Recommendations Assessment, Development and Evaluation system, respectively. The inverse variance heterogeneity (IVhet) model was used for meta-analysis. The possibility of publication bias was evaluated by funnel and Doi plots, and asymmetry in these was tested with Egger's test and the Luis Furuya-Kanamori index, respectively. Sensitivity analyses included leave-one-out meta-analysis, subgroup meta-analysis with meta-regressions, and non-linear exposure-response meta-analysis. Based on seven cohort and two case-control studies (n = 5 514 555; 14 estimates; Lden range ≈ 25-90 dB(A)), we found "low" evidence of RR per 10 dB(A) = 1.018 (95% CI: 0.984, 1.053), moderate heterogeneity (I2 = 46%), and no publication bias. In the subgroup of cohort studies, we found "moderate" evidence of RR per 10 dB(A) = 1.018 (95% CI: 0.987, 1.049), I2 = 31%, and no publication bias. In conclusion, residential road traffic noise was associated with higher risk of hypertension in adults, but the risk was lower than previously reported in the systematic review literature.
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Affiliation(s)
- Angel M Dzhambov
- Department of Hygiene and Ecomedicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria.
| | - Donka D Dimitrova
- Department of Health Management and Healthcare Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
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53
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McLachlan KJ, Gale CR. The effects of psychological distress and its interaction with socioeconomic position on risk of developing four chronic diseases. J Psychosom Res 2018; 109:79-85. [PMID: 29680578 PMCID: PMC5959313 DOI: 10.1016/j.jpsychores.2018.04.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/11/2018] [Accepted: 04/11/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To examine the relationship between psychological distress and risk of developing arthritis, cardiovascular disease, chronic obstructive pulmonary disease and diabetes across the range of distress severity, investigate the mediating roles of health behaviours and explore whether the associations vary with socioeconomic position. METHODS Participants were 16,485 adults from the UK Household Longitudinal Study We examined prospective relationships between psychological distress at baseline (measured using the 12-item General Health Questionnaire) and incidence of arthritis, cardiovascular disease, chronic obstructive pulmonary disease and diabetes (measured using self-report) over 3 years using logistic regression. We then examined the mediating effects of health behaviours and investigated whether the associations varied with socioeconomic position. RESULTS Distress significantly increased risk of incident arthritis, cardiovascular disease and chronic obstructive pulmonary disease in a dose-response pattern after controlling for age, sex, socioeconomic position, neighbourhood cohesion, marital status, BMI and baseline disease. High levels of distress (GHQ ≥ 7) increased risk of arthritis (OR 2.22; 1.58-2.13), cardiovascular disease (OR 3.06; 1.89-4.98) and chronic obstructive pulmonary disease (OR 3.25; 1.47-7.18). These associations were partially mediated by smoking status but remained significant after controlling for smoking status, diet and exercise. Distress significantly predicted incident diabetes in manual socioeconomic groups only. Effect sizes did not vary with socioeconomic position for arthritis, cardiovascular disease and chronic obstructive pulmonary disease. CONCLUSION Psychological distress increases risk of incident arthritis, cardiovascular disease and chronic obstructive pulmonary disease in a dose-response pattern, even at low and moderate distress levels. Future research should investigate the mediating role of inflammatory biomarkers.
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Affiliation(s)
- Kyle J.J. McLachlan
- Edinburgh Medical School, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Catharine R. Gale
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK,Corresponding author at: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, SO16 6YD, UK.
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Makrilakis K, Liatis S, Tsiakou A, Stathi C, Papachristoforou E, Perrea D, Katsilambros N, Kontodimopoulos N, Niakas D. Comparison of health-related quality of Life (HRQOL) among patients with pre-diabetes, diabetes and normal glucose tolerance, using the 15D-HRQOL questionnaire in Greece: the DEPLAN study. BMC Endocr Disord 2018; 18:32. [PMID: 29843700 PMCID: PMC5975583 DOI: 10.1186/s12902-018-0261-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 05/18/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Diabetes mellitus is usually preceded by a pre-diabetic stage before the clinical presentation of the disease, the influence of which on persons' quality of life is not adequately elucidated. The purpose of this study was to compare the Health-Related Quality of Life (HRQOL) of persons with pre-diabetes with that of diabetes or normal glucose tolerance (NGT), using the validated HRQOL-15D questionnaire. METHODS The HRQOL-15D scores of 172 people with pre-diabetes (108 with Impaired Fasting Glucose [IFG], 64 with Impaired Glucose Tolerance [IGT], aged 58.3 ± 10.3 years) and 198 with NGT (aged 54.4 ± 10.1 years) from the Greek part of the DEPLAN study (Diabetes in Europe - Prevention using Lifestyle, Physical Activity and Nutritional Intervention), were compared to 100 diabetes patients' scores (aged 60.9 ± 12.5 years, diabetes duration 17.0 ± 10.0 years, HbA1c 7.2 ± 1.2%), derived from the outpatient Diabetes Clinic of a University Hospital. RESULTS The diabetes patients' HRQOL-15D score (0.8605) was significantly lower than the pre-diabetes' (0.9008) and the controls' (0.9092) (p < 0.001). There were no differences in the total score between the controls and the group with pre-diabetes. However, examination of individual parameters of the score showed that people with IGT had lower scores compared to the control group, as related to the parameters of "mobility" and "psychological distress". No differences were found in any component of the HRQOL-15D score between the control group and the IFG group, nor between the two groups with pre-diabetes (IFG vs. IGT). CONCLUSIONS Persons with pre-diabetes had a similar HRQOL score with healthy individuals, and a higher score than persons with diabetes. Specific components of the score, however, were lower in the IGT group compared to the controls. These findings help clarify the issue of HRQOL of persons with pre-diabetes and its possible impact on prevention.
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Affiliation(s)
- Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Afroditi Tsiakou
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Chryssoula Stathi
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Eleftheria Papachristoforou
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
| | - Despoina Perrea
- Laboratory for Experimental Surgery and Surgical Research “Christeas Hall”, University of Athens Medical School, Athens, Greece
| | - Nicholas Katsilambros
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
- Laboratory for Experimental Surgery and Surgical Research “Christeas Hall”, University of Athens Medical School, Athens, Greece
| | | | - Dimitrios Niakas
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
- Hellenic Open University, Patras, Greece
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Abstract
We examined whether established metabolic risk genetic variants in the population confer a risk for increased waist circumference in patients with schizophrenia spectrum disorders and also an association with schizophrenia spectrum disorders irrespective of waist circumference.
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Rosedale MT, Strauss SM, Kaur N, Danoff A, Malaspina D. Identification of diabetes risk in dental settings: Implications for physical and mental health. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2018; 47:64-73. [DOI: 10.1080/00207411.2017.1377803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mary T. Rosedale
- Rory Meyers College of Nursing, New York University, New York, NY, USA
- New York University Langone Medical Center, New York, NY, USA
| | - Shiela M. Strauss
- Rory Meyers College of Nursing, New York University, New York, NY, USA
- New York University Langone Medical Center, New York, NY, USA
| | - Navjot Kaur
- New York University Langone Medical Center, New York, NY, USA
| | - Ann Danoff
- New York University Langone Medical Center, New York, NY, USA
| | - Dolores Malaspina
- Department of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, USA
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57
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Emerging role of amyloid beta in stress response: Implication for depression and diabetes. Eur J Pharmacol 2017; 817:22-29. [DOI: 10.1016/j.ejphar.2017.08.031] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/22/2017] [Accepted: 08/23/2017] [Indexed: 12/11/2022]
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58
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Akbaş-Şimşek T, Onat A, Kaya A, Tusun E, Yüksel H, Can G. Sex-dependent independent prediction of incident diabetes by depressive symptoms. Int J Geriatr Psychiatry 2017; 32:1425-1432. [PMID: 27891676 DOI: 10.1002/gps.4630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 10/22/2016] [Accepted: 10/26/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To study the predictive value of depressive symptoms (DeprSs) in a general population of Turkey for type 2 diabetes. METHODS Responses to three questions served to assess the sense of depression. Cox regression analyses were used regarding risk estimates for incident diabetes, after exclusion of prevalent cases of diabetes. Mean follow-up consisted of 5.15 (±1.4) years. RESULTS Depressive symptoms were present at baseline in 16.2% of the whole study sample, threefold in women than men. Reduced physical activity grade was the only significant covariate at baseline in men, while younger age and lower blood pressure were significantly different in women compared with those without DeprS. In men, presence of DeprS predicted incident diabetes at a significant 2.58-fold relative risk (95% confidence interval 1.03; 6.44), after adjustment for age, systolic blood pressure, and antidepressant drug usage. When further covariates were added, waist circumference remained the only significant predictor, while DepS was attenuated to a relative risk of 2.12 (95% confidence interval 0.83; 5.40). DeprS was not associated with diabetes in women, whereas antidepressant drug usage only tended to be positively associated. CONCLUSION Gender difference existed in the relationship between DeprS and incident diabetes. DeprS predicted subsequent development of diabetes in men alone, not in women. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Tuğba Akbaş-Şimşek
- Section of Internal Medicine, Bağcılar Educational Hospital, Istanbul, Turkey
| | - Altan Onat
- Department of Cardiology and Public Health, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Adnan Kaya
- Department of Cardiology and Public Health, Suruç State Hospital, Şanlıurfa, Turkey
| | - Eyyup Tusun
- Department of Cardiology, Şanlıurfa Educational Hospital, Şanlıurfa, Turkey
| | - Hüsniye Yüksel
- Department of Cardiology and Public Health, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Günay Can
- Department of Cardiology and Public Health, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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59
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Zhuang QS, Shen L, Ji HF. Quantitative assessment of the bidirectional relationships between diabetes and depression. Oncotarget 2017; 8:23389-23400. [PMID: 28177893 PMCID: PMC5410312 DOI: 10.18632/oncotarget.15051] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/09/2017] [Indexed: 01/07/2023] Open
Abstract
Diabetes and depression impose an enormous public health burden and the present study aimed to assess quantitatively the bidirectional relationships between the two disorders. We searched databases for eligible articles published until October 2016. A total of 51 studies were finally included in the present bidirectional meta-analysis, among which, 32 studies were about the direction of depression leading to diabetes, and 24 studies about the direction of diabetes leading to depression. Pooled results of the 32 eligible studies covering 1274337 subjects showed that depression patients were at higher risk for diabetes (odds ratio (OR) = 1.34, 95% confidence intervals (CI) = [1.23, 1.46]) than non-depressive subjects. Further gender-subgroup analysis found that the strength of this relationship was stronger in men (OR = 1.63, 95%CI = [1.48, 1.78]) than in women (OR = 1.29, 95%CI = [1.07, 1.51]). For the direction of diabetes leading to depression, pooled data of 24 articles containing 329658 subjects showed that patients with diabetes were at higher risk for diabetes (OR = 1.28, 95%CI = [1.15, 1.42]) than non-diabetic subjects. The available data supports that the relationships between diabetes and depression are bidirectional and the overall strengths are similar in both directions. More mechanistic studies are encouraged to explore the molecular mechanisms underlying the relationships between the two diseases.
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Affiliation(s)
- Qi-Shuai Zhuang
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, P. R. China
| | - Liang Shen
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, P. R. China
| | - Hong-Fang Ji
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, P. R. China
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60
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Pyko A, Eriksson C, Lind T, Mitkovskaya N, Wallas A, Ögren M, Östenson CG, Pershagen G. Long-Term Exposure to Transportation Noise in Relation to Development of Obesity—a Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:117005. [PMID: 29161230 PMCID: PMC5947937 DOI: 10.1289/ehp1910] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 10/05/2017] [Accepted: 10/09/2017] [Indexed: 05/20/2023]
Abstract
BACKGROUND Exposure to transportation noise is widespread and has been associated with obesity in some studies. However, the evidence from longitudinal studies is limited and little is known about effects of combined exposure to different noise sources. OBJECTIVES The aim of this longitudinal study was to estimate the association between exposure to noise from road traffic, railways, or aircraft and the development of obesity markers. METHODS We assessed individual long-term exposure to road traffic, railway, and aircraft noise based on residential histories in a cohort of 5,184 men and women from Stockholm County. Noise levels were estimated at the most exposed façade of each dwelling. Waist circumference, weight, and height were measured at recruitment and after an average of 8.9 y of follow-up. Extensive information on potential confounders was available from repeated questionnaires and registers. RESULTS Waist circumference increased 0.04 cm/y (95% CI: 0.02, 0.06) and 0.16 cm/y (95% CI: 0.14, 0.17) per 10 dB Lden in relation to road traffic and aircraft noise, respectively. No corresponding association was seen for railway noise. Weight gain was only related to aircraft noise exposure. A similar pattern occurred for incidence rate ratios (IRRs) of central obesity and overweight. The IRR of central obesity increased from 1.22 (95% CI: 1.08, 1.39) in those exposed to only one source of transportation noise to 2.26 (95% CI: 1.55, 3.29) among those exposed to all three sources. CONCLUSION Our results link transportation noise exposure to development of obesity and suggest that combined exposure from different sources may be particularly harmful. https://doi.org/10.1289/EHP1910.
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Affiliation(s)
- Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Charlotta Eriksson
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Tomas Lind
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Natalya Mitkovskaya
- Department of Cardiology and Internal Medicine, Belorussian State Medical University, Minsk, Belarus
| | - Alva Wallas
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Ögren
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
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61
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Abstract
Psychological stress is common in many physical illnesses and is increasingly recognized as a risk factor for disease onset and progression. An emerging body of literature suggests that stress has a role in the aetiology of type 2 diabetes mellitus (T2DM) both as a predictor of new onset T2DM and as a prognostic factor in people with existing T2DM. Here, we review the evidence linking T2DM and psychological stress. We highlight the physiological responses to stress that are probably related to T2DM, drawing on evidence from animal work, large epidemiological studies and human laboratory trials. We discuss population and clinical studies linking psychological and social stress factors with T2DM, and give an overview of intervention studies that have attempted to modify psychological or social factors to improve outcomes in people with T2DM.
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Affiliation(s)
- Ruth A Hackett
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
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Kumar P, Millischer V, Villaescusa JC, Nilsson IAK, Östenson CG, Schalling M, Ösby U, Lavebratt C. Plasma GDF15 level is elevated in psychosis and inversely correlated with severity. Sci Rep 2017; 7:7906. [PMID: 28801589 PMCID: PMC5554200 DOI: 10.1038/s41598-017-07503-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/27/2017] [Indexed: 12/20/2022] Open
Abstract
Accumulating evidence suggests that GDF15 is a biomarker for ageing and morbidity of many somatic disorders such as cancer and inflammatory disorders. Recently, elevated serum GDF15 level was proposed as a marker for mood disorder. However, psychosis severity was not investigated in relation to plasma GDF15 levels. In the present study we measured GDF15 levels in plasma of 120 psychosis patients compared to 120 age and gender matched healthy controls. Within the patient cohort GDF15 levels were evaluated for association with age, gender, lifestyle factors, C-reactive protein levels, psychosis severity and metabolic disorder. Psychosis patients had elevated GDF15 levels compared to controls (medianPsychosis = 744 ng/mL, mediancontrols = 516 ng/mL, p < 0.001). Within the psychosis cohort, GDF15 levels, when corrected for age, metabolic health and lifestyle factors, were negatively correlated with psychosis severity (β = −0.218, p = 0.012). While GDF15 levels were elevated in patients versus healthy controls, the negative correlation between psychosis severity and GDF15 suggests a loss of anti-inflammatory GDF15 mediated functionality in severe psychosis. Study replication in larger cohorts will be necessary to assess the potential of GDF15 as a prognostic biomarker in psychosis.
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Affiliation(s)
- Parvin Kumar
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. .,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
| | - Vincent Millischer
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - J Carlos Villaescusa
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ida A K Nilsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Urban Ösby
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Adult Psychiatry, PRIMA Barn och Vuxenpsykiatri AB, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. .,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
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Rautio N, Varanka-Ruuska T, Vaaramo E, Palaniswamy S, Nedelec R, Miettunen J, Karppinen J, Auvinen J, Järvelin MR, Keinänen-Kiukaanniemi S, Sebert S, Ala-Mursula L. Accumulated exposure to unemployment is related to impaired glucose metabolism in middle-aged men: A follow-up of the Northern Finland Birth Cohort 1966. Prim Care Diabetes 2017; 11:365-372. [PMID: 28456438 DOI: 10.1016/j.pcd.2017.03.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 03/20/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
Abstract
AIMS We explored whether registered unemployment is associated with impaired glucose metabolism in general population. METHODS Based on Northern Finland Birth Cohort 1966 at 46 years, we analyzed the oral glucose tolerance tests of 1970 men and 2544 women in relation to their preceding three-year employment records in three categories of unemployment exposure: no (employed), low (≤1-year) and high exposure (>1-year). RESULTS Among men, pre-diabetes was found in 19.2% of those with no unemployment, 23.0% with low and 27.0% with high exposure, the corresponding figures for screen-detected type 2 diabetes were 3.8%, 3.8% and 9.2% (p<0.01). Among women, analogous figures for pre-diabetes were 10.0%, 12.6% and 16.2% and for screen-detected type 2 diabetes 1.7%, 3.4% and 3.6% (p<0.01). Men with high exposure to unemployment had a higher risk for pre-diabetes (OR 1.61, CI 95% 1.03-2.51) and screen-detected type 2 diabetes (OR 2.58 95% CI 1.23-5.44) than employed men, after adjustment for education, smoking, alcohol intake, physical activity and body mass index. Among women, associations were attenuated in the adjusted models. CONCLUSIONS High exposure to unemployment may predispose to type 2 diabetes in middle-aged men. For clinicians, awareness of the patient's unemployment status may be helpful in recognizing undiagnosed cases.
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Affiliation(s)
- Nina Rautio
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Unit of Primary Health Care, Oulu University Hospital, OYS, P.O. Box 20, 90029 Oulu, Finland.
| | - Tuulia Varanka-Ruuska
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Kallio Primary Health Care Unit, Kirkkotie 4, 84100 Ylivieska, Finland.
| | - Eeva Vaaramo
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland.
| | - Saranya Palaniswamy
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Biocenter Oulu, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland.
| | - Rozenn Nedelec
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Biocenter Oulu, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland.
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland.
| | - Jaro Karppinen
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Finnish Institute of Occupational Health, Aapistie 1, 90220 Oulu, Finland.
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Unit of Primary Health Care, Oulu University Hospital, OYS, P.O. Box 20, 90029 Oulu, Finland.
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Unit of Primary Health Care, Oulu University Hospital, OYS, P.O. Box 20, 90029 Oulu, Finland; MRC-PHE Centre for Environment and Health, Imperial College London, Praed Street Wing, St. Mary's Campus, Paddington, W2 IPG London, United Kingdom; Biocenter Oulu, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Unit of Primary Health Care, Oulu University Hospital, OYS, P.O. Box 20, 90029 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland.
| | - Sylvain Sebert
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Biocenter Oulu, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Department of Genomics, Imperial College London, South Kensington Campus, SW7 London, United Kingdom.
| | - Leena Ala-Mursula
- Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland.
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Tan ML, Tan CS, Griva K, Lee YS, Lee J, Tai ES, Khoo EY, Wee HL. Factors associated with diabetes-related distress over time among patients with T2DM in a tertiary hospital in Singapore. BMC Endocr Disord 2017; 17:36. [PMID: 28645273 PMCID: PMC5481863 DOI: 10.1186/s12902-017-0184-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Persistent diabetes-related distress (DRD) is experienced by patients with Type 2 Diabetes Mellitus. Knowing factors associated with persistent DRD will aid clinicians in prioritising interventions efforts. METHODS A total of 216 patients were recruited from a tertiary hospital in Singapore, an Asian city state, and followed for 1.5 years (2011-2014). Data was collected by self-completed questionnaires assessing DRD (measured by the Problem Areas in Diabetes score) and other psychosocial aspects such as social support, presenteeism, depression, health-related quality of life (HRQoL) and excessive daytime sleepiness (EDS) at three time points. Clinical data (body-mass-index and glycated haemoglobin) was obtained from medical records. Change score was calculated for each clinical and psychosocial variable to capture changes in these variables from baseline. Generalized Linear Model with Generalized Estimating Equation method was used to assess whether baseline and change scores in clinical and psychosocial are associated with DRD over time. RESULTS Complete data was available for 73 patients, with mean age 44 (SD 12.5) years and 67% males. Persistent DRD was experienced by 21% of the patients. In the final model, baseline HRQoL (OR = 0.56, p < 0.05) and change score of EDS (OR = 1.22, p < 0.05) was significantly associated with DRD over time. CONCLUSIONS EDS might be a surrogate marker for persistent DRD and should be explored in larger samples of population to confirm the findings from this study.
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Affiliation(s)
- Maudrene L Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Chuen S Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Konstadina Griva
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Yung S Lee
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Paediatric Endocrinology and Diabetes, Khoo-Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Jeannette Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - E S Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Department of Medicine, National University Health System, Singapore, Singapore
| | - Eric Y Khoo
- Department of Medicine, National University Health System, Singapore, Singapore
| | - Hwee-Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
- Department of Pharmacy, National University of Singapore, 10 Kent Ridge Crescent, Singapore, 119260, Singapore.
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65
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Lukaschek K, Baumert J, Kruse J, Meisinger C, Ladwig KH. Sex differences in the association of social network satisfaction and the risk for type 2 diabetes. BMC Public Health 2017; 17:379. [PMID: 28464880 PMCID: PMC5414370 DOI: 10.1186/s12889-017-4323-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 04/27/2017] [Indexed: 11/15/2022] Open
Abstract
Background The role of an individual’s social network satisfaction (SNS) in the association of social isolation or living alone and incident type 2 diabetes (T2D) is unclear. We assessed the association of SNS with incident T2D and analysed potential modifications of the SNS-T2D association by social isolation or living alone. Methods The study population (N = 6839 aged 25–74 years without diabetes at baseline) derived from the prospective population-based MONICA/KORA study (1989–2009). Social network satisfaction was assessed by a single item. Cox regression was used to estimate hazard ratios (HR) for SNS separately in men and women. Results In men with low SNS, risk for incident T2D increased significantly (HR: 2.15, 95% CI: 1.33–3.48, p value 0.002). After additional adjustments for social isolation or living alone, the risk for incident T2D was still significant, albeit less pronounced (HRs 1.85 or 2.05, p values 0.001 or 0.004). The interaction analysis showed an increased T2D risk effect for low SNS compared to high SNS in women living in a partnership (HR: 2.11, 95% CI: 1.00–4.44, p value for interaction: 0.047) and for moderate SNS compared to high SNS in socially connected women (1.56, 1.01–2.39, 0.010). Conclusions Further research is needed to address the complexities of the perception of social relationships and social interactions, or interdependence, especially when another major public health issue such as T2D is concerned. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4323-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- K Lukaschek
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Mental Health Research Unit, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany.,German Center for Diabetes Research (DZD), Munich, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University of Gießen, Gießen, Germany
| | - J Baumert
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Mental Health Research Unit, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany.,German Center for Diabetes Research (DZD), Munich, Germany
| | - J Kruse
- German Center for Diabetes Research (DZD), Munich, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University of Gießen, Gießen, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University of Marburg, Marburg, Germany
| | - C Meisinger
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Mental Health Research Unit, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany.,MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany
| | - K H Ladwig
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Mental Health Research Unit, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany. .,German Center for Diabetes Research (DZD), Munich, Germany. .,Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
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66
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Gu C, Zhou W, Wang W, Xiang H, Xu H, Liang L, Sui H, Zhan L, Lu X. ZiBuPiYin recipe improves cognitive decline by regulating gut microbiota in Zucker diabetic fatty rats. Oncotarget 2017; 8:27693-27703. [PMID: 28099913 PMCID: PMC5438601 DOI: 10.18632/oncotarget.14611] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/04/2017] [Indexed: 12/14/2022] Open
Abstract
Numerous researches supported that microbiota can influence behavior and modulate cognitive function through "microbiota-gut-brain" axis. Our previous study has demonstrated that ZiBuPiYin recipe (ZBPYR) possesses excellent pharmacological effects against diabetes-associated cognitive decline. To elucidate the role of ZBPYR in regulating the balance of gut microbiota to improve psychological-stress-induced diabetes-associated cognitive decline (PSDACD), we compared blood glucose, behavioral and cognitive functions and diversity of the bacterial community among experimental groups. The Zucker diabetic fatty (ZDF) rats with PSDACD exhibited behavioral and cognitive anomalies showing as increased anxiety- and depression-like behaviors and decreased learning and memory abilities. High-throughput sequencing of the bacterial 16S rRNA gene revealed that Roseburia and Coprococcus were decreased in ZDF rats with PSDACD compared with control group. Notably, these changes were reversed by ZBPYR treatment. Our findings indicate that ZBPYR might prevent PSDACD by maintaining the compositions of gut microbiota, which could be developed as a new therapy for T2D with PSDACD.
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MESH Headings
- Animals
- Bacteria/drug effects
- Bacteria/genetics
- Bacteria/isolation & purification
- Blood Glucose/analysis
- Cognition/drug effects
- Cognitive Dysfunction/blood
- Cognitive Dysfunction/drug therapy
- Cognitive Dysfunction/etiology
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/genetics
- Disease Models, Animal
- Drugs, Chinese Herbal/pharmacology
- Drugs, Chinese Herbal/therapeutic use
- Gastrointestinal Microbiome/drug effects
- High-Throughput Nucleotide Sequencing
- Humans
- Intestinal Mucosa/microbiology
- Male
- Maze Learning/drug effects
- Medicine, Chinese Traditional
- Mutation
- RNA, Ribosomal, 16S/isolation & purification
- Rats
- Rats, Zucker
- Receptors, Leptin/genetics
- Sequence Analysis, RNA
- Spatial Memory/drug effects
- Stress, Psychological/complications
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Affiliation(s)
- Chunyan Gu
- School of Medicine and Life Science, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Wen Zhou
- Basic Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Wang Wang
- School of Medicine and Life Science, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Hong Xiang
- The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Huiying Xu
- Basic Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Lina Liang
- Institute of Integrative Medicine, Dalian Medical University, Dalian, Liaoning, China
| | - Hua Sui
- Institute of Integrative Medicine, Dalian Medical University, Dalian, Liaoning, China
| | - Libin Zhan
- Basic Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Xiaoguang Lu
- Department of Emergency Medicine, Zhongshan Hospital, Dalian University, Dalian, Liaoning, China
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The relationship between acquired premature ejaculation and metabolic syndrome: a prospective, comparative study. Int J Impot Res 2017; 29:105-109. [PMID: 28179637 DOI: 10.1038/ijir.2017.3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 11/07/2016] [Accepted: 01/04/2017] [Indexed: 02/08/2023]
Abstract
The aim of this study was to investigate the relationship between metabolic syndrome (MetS) and acquired premature ejaculation (PE). A total of 100 patients with acquired PE and 100 control cases were enrolled in the study. After obtaining a detailed medical history, anthropometric (weight, height and waist circumference) and blood pressure measurements were performed. Ejaculation and erection functions were evaluated by Premature Ejaculation Diagnostic Tool (PEDT) and International Index of Erectile Function-5 (IIEF-5), respectively. Self-estimated intravaginal ejaculatory latency time (IELT) of the participants was recorded. Fasting blood samples were taken for biochemical and hormonal work-up. The median PEDT scores were 16 (9-22) and 4.5 (2-8) in acquired PE and control groups, respectively (P<0.001). The mean estimated IELT values in PE patients and controls were 36.1±46.5 versus 488.2±313.8 s (P<0.001). MetS was diagnosed in 51 patients (51%) in the PE group and 24 (24%) participants in the control group (P<0.001). A significant negative correlation was observed between the components of MetS and estimated IELT, except for diastolic blood pressure. Moreover, there was a significant positive correlation between the all components of MetS and total PEDT score, except for fasting blood glucose and high-density lipoprotein cholesterol (HDL) levels. Logistic regression analysis revealed that, except blood pressure and HDL levels, MetS components were significant risk factors for PE after adjusting for age and total testosterone. In conclusion, MetS is associated with acquired PE.
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Khambaty T, Callahan CM, Perkins AJ, Stewart JC. Depression and Anxiety Screens as Simultaneous Predictors of 10-Year Incidence of Diabetes Mellitus in Older Adults in Primary Care. J Am Geriatr Soc 2017; 65:294-300. [PMID: 27641686 PMCID: PMC5311025 DOI: 10.1111/jgs.14454] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To examine depression and anxiety screens and their individual items as simultaneous predictors of incident diabetes mellitus. DESIGN Ten-year follow-up study of individuals screened for the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) trial. SETTING Two large urban primary care clinics in Indianapolis, Indiana. PARTICIPANTS Diverse sample (53% African American, 80% of lower socioeconomic status) of 2,156 older adults initially free of diabetes mellitus. MEASUREMENTS Depression and anxiety screens were completed during routine primary care visits between 1999 and 2001. Incident diabetes mellitus data were obtained from an electronic medical record system and the Centers for Medicare and Medicaid Services analytical files though 2009. RESULTS Over the 10-year period, 558 (25.9%) participants had diabetes mellitus onset. Cox proportional hazards models adjusted for demographic and diabetes mellitus risk factors revealed that a positive screen for anxiety, but not for depression, predicted incident diabetes mellitus when entered into separate models (anxiety: hazard ratio (HR) = 1.36, 95% confidence interval (CI) = 1.15-1.61, P < .001; depression: HR = 1.18, 95% CI = 0.95-1.46, P = .13) and when entered simultaneously into one model (anxiety: HR = 1.35, 95% CI = 1.12-1.61, P < .001; depression: HR = 1.04, 95% CI = 0.83-1.31, P = .73). The feeling anxious (P = .03) and the worry (P = .02) items predicted incident diabetes mellitus independent of the depression screen. CONCLUSION These findings suggest that screening positive for anxiety is a risk factor for diabetes mellitus in older adults independent of depression and traditional diabetes mellitus risk factors. Anxiety requires greater consideration and awareness in the context of diabetes mellitus risk assessment and primary prevention.
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Affiliation(s)
| | - Christopher M. Callahan
- Indiana University Center for Aging Research, Indiana University School of Medicine, Indianapolis, IN
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
- Regenstrief Institute, Inc., Indianapolis, IN
| | - Anthony J. Perkins
- Indiana University Center for Aging Research, Indiana University School of Medicine, Indianapolis, IN
- Regenstrief Institute, Inc., Indianapolis, IN
| | - Jesse C. Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN
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69
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Lašaitė L, Dobrovolskienė R, Danytė E, Stankutė I, Ražanskaitė-Virbickienė D, Schwitzgebel V, Marčiulionytė D, Verkauskienė R. Diabetes distress in males and females with type 1 diabetes in adolescence and emerging adulthood. J Diabetes Complications 2016; 30:1500-1505. [PMID: 27613444 DOI: 10.1016/j.jdiacomp.2016.08.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 08/12/2016] [Accepted: 08/14/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Age and gender are important factors in the adjustment and psychological well-being of patients with chronic physical illness. AIM To explore the gender and age differences in diabetes distress between adolescents and emerging adults with type 1 diabetes (T1D). SUBJECTS AND METHODS Diabetes distress was compared in 255 adolescents and 283 emerging adults with T1D using Problem Areas in Diabetes scale. RESULTS High diabetes distress level was found in 22.8% of participants. Lack of confidence in self-care (6.0 vs 3.0, p=0.002), negative emotional consequences (10.0 vs 6.0, p=0.004), and overall score (18.75 vs 11.25, p=0.002) were higher in adult than in adolescent males, when adjusted for age at T1D onset. Negative emotional consequences (13.0 vs 10.0, p=0.005) and overall score (25.0 vs 20.0, p=0.016) were higher in adult compared to adolescent females, when adjusted for age at T1D onset. Lack of confidence in self-care (6.0 vs 3.0, p=0.002), negative emotional consequences (10.0 vs 6.0, p=0.015), and overall score (20.0 vs 11.2, p=0.005) were higher in adolescent females compared to males, when adjusted for age at T1D onset. Negative emotional consequences score was higher in adult females compared to males (13.0 vs 10.0, p=0.029), when adjusted for age at T1D onset. In conclusion, our findings show that patients with T1D have greater burden of diabetes distress in emerging adulthood than in adolescence and add to evidence suggesting the importance of addressing diabetes distress in clinical care and the necessity of wider picture beyond the physical manifestation of diabetes to be taken into consideration.
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Affiliation(s)
- Lina Lašaitė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Rimantė Dobrovolskienė
- Department of Endocrinology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Kaunas, Lithuania
| | - Evalda Danytė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ingrida Stankutė
- Department of Endocrinology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Kaunas, Lithuania
| | | | - Valerie Schwitzgebel
- Department of Child and Adolescent, University Hospital of Geneva, Geneva, Switzerland; Diabetes Center, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Dalia Marčiulionytė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rasa Verkauskienė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Abstract
Type 2 diabetes is a chronic disease that is increasing in prevalence globally. Cardiovascular disease is a major cause of mortality and morbidity in diabetes, and lifestyle and clinical risk factors do not fully account for the link between the conditions. This article provides an overview of the evidence concerning the role of psychosocial stress factors in diabetes risk, as well as in cardiovascular complications in people with existing diabetes. Several types of psychosocial factors are discussed including depression, other types of emotional distress, exposure to stressful conditions, and personality traits. The potential behavioral and biological pathways linking psychosocial factors to diabetes are presented and implications for patient care are highlighted.
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Affiliation(s)
- Ruth A. Hackett
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
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71
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Deschênes SS, Burns RJ, Graham E, Schmitz N. Prediabetes, depressive and anxiety symptoms, and risk of type 2 diabetes: A community-based cohort study. J Psychosom Res 2016; 89:85-90. [PMID: 27663115 DOI: 10.1016/j.jpsychores.2016.08.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/01/2016] [Accepted: 08/27/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the potential synergistic associations between prediabetes, depressive and anxiety symptoms, and the risk of incident type 2 diabetes. METHODS Data were from the Emotional Well-Being, Metabolic Factors and Health Status (EMHS) study and included 2486 adults between 40 and 69years without diabetes at baseline. Hemoglobin A1c levels and measures of depressive and anxiety symptoms were collected at baseline and mutually exclusive groups were formed based on the presence/absence of prediabetes and high/low depressive and anxiety symptoms. A follow-up telephone interview conducted approximately 4.6years later inquired about new diabetes diagnoses. RESULTS 86 participants developed diabetes during the follow-up period. After accounting for sociodemographic, lifestyle, and metabolic characteristics, participants with prediabetes and elevated depressive symptoms had an increased risk of developing diabetes compared to those without prediabetes and with low depressive symptoms (OR=10.65, 95% CI=4.60, 24.66). The joint effect of prediabetes and depressive symptoms on diabetes risk was synergistic (Synergy Index=2.57, 95% CI=1.02, 6.49). Similar results were found for participants with prediabetes and high symptoms of anxiety (OR=8.95, 95% CI=3.54, 22.63), however the joint effect of prediabetes and anxiety symptoms did not significantly exceed additive risk after adjusting for covariates (Synergy Index=2.39, 95% CI=0.83, 6.87). CONCLUSION The combination of prediabetes and depressive or anxiety symptoms was associated with an increased risk of developing diabetes. This study underscores the importance of mental health in the progression from prediabetes to type 2 diabetes.
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Affiliation(s)
- Sonya S Deschênes
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
| | - Rachel J Burns
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Eva Graham
- Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Norbert Schmitz
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
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72
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Juul KV, Jessen N, Bliwise DL, van der Meulen E, Nørgaard JP. Delaying time to first nocturnal void may have beneficial effects on reducing blood glucose levels. Endocrine 2016; 53:722-9. [PMID: 27003433 DOI: 10.1007/s12020-016-0920-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/09/2016] [Indexed: 11/29/2022]
Abstract
Experimental studies disrupting sleep and epidemiologic studies of short sleep durations indicate the importance of deeper and longer sleep for cardiometabolic health. We examined the potential beneficial effects of lengthening the first uninterrupted sleep period (FUSP) on blood glucose. Long-term data (≥3 months of treatment) were derived from three clinical trials, testing low-dose (10-100 µg) melt formulations of desmopressin in 841 male and female nocturia patients (90 % of which had nocturnal polyuria). We performed post hoc multiple regression with non-fasting blood glucose as dependent variable and the following potential covariates/factors: time-averaged change of FUSP since baseline, age, gender, race, ethnicity, baseline glucose, baseline weight, change in weight, patient metabolic status (normal, metabolic syndrome, type II diabetes), dose, follow-up interval, and time of random glucose sampling. Increases in FUSP resulted in statistically significant reductions in blood glucose (p = 0.0131), even after controlling for all remaining covariates. Per hour increase in time to first void was associated with glucose decreases of 1.6 mg/dL. This association was more pronounced in patients with increased baseline glucose levels (test of baseline glucose by FUSP change interaction: p < 0.0001). Next to FUSP change, other statistically significant confounding factors/covariates also associated with glucose changes were gender, ethnicity, metabolic subgroup, and baseline glucose. These analyses indicate that delaying time to first void may have beneficial effects on reducing blood glucose in nocturia patients. These data are among the first to suggest that improving sleep may have salutary effects on a cardiometabolic measure.
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Affiliation(s)
- Kristian Vinter Juul
- Faculty of Medicine and Health Sciences, University of Ghent, 9000, Ghent, Belgium.
| | - Niels Jessen
- Department for Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Donald L Bliwise
- Program in Sleep, Aging and Chronobiology, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Jens Peter Nørgaard
- Faculty of Medicine and Health Sciences, University of Ghent, 9000, Ghent, Belgium
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73
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Lu J, Liu KC, Schulz N, Karampelias C, Charbord J, Hilding A, Rautio L, Bertolino P, Östenson CG, Brismar K, Andersson O. IGFBP1 increases β-cell regeneration by promoting α- to β-cell transdifferentiation. EMBO J 2016; 35:2026-44. [PMID: 27516442 PMCID: PMC5116948 DOI: 10.15252/embj.201592903] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 06/27/2016] [Indexed: 01/09/2023] Open
Abstract
There is great interest in therapeutically harnessing endogenous regenerative mechanisms to increase the number of β cells in people with diabetes. By performing whole‐genome expression profiling of zebrafish islets, we identified 11 secreted proteins that are upregulated during β‐cell regeneration. We then tested the proteins' ability to potentiate β‐cell regeneration in zebrafish at supraphysiological levels. One protein, insulin‐like growth factor (Igf) binding‐protein 1 (Igfbp1), potently promoted β‐cell regeneration by potentiating α‐ to β‐cell transdifferentiation. Using various inhibitors and activators of the Igf pathway, we show that Igfbp1 exerts its regenerative effect, at least partly, by inhibiting Igf signaling. Igfbp1's effect on transdifferentiation appears conserved across species: Treating mouse and human islets with recombinant IGFBP1 in vitro increased the number of cells co‐expressing insulin and glucagon threefold. Moreover, a prospective human study showed that having high IGFBP1 levels reduces the risk of developing type‐2 diabetes by more than 85%. Thus, we identify IGFBP1 as an endogenous promoter of β‐cell regeneration and highlight its clinical importance in diabetes.
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Affiliation(s)
- Jing Lu
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden
| | - Ka-Cheuk Liu
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden
| | - Nadja Schulz
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden
| | - Christos Karampelias
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden
| | - Jérémie Charbord
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Hilding
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - Linn Rautio
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden
| | - Philippe Bertolino
- Centre de Recherche en Cancérologie de Lyon, Inserm U1052, CNRS UMR5286, Université Lyon 1, Lyon, France
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - Kerstin Brismar
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - Olov Andersson
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden
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Twig G, Gerstein HC, Fruchter E, Shina A, Afek A, Derazne E, Tzur D, Cukierman-Yaffe T, Amital D, Amital H, Tirosh A. Self-Perceived Emotional Distress and Diabetes Risk Among Young Men. Am J Prev Med 2016; 50:737-745. [PMID: 26810356 DOI: 10.1016/j.amepre.2015.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 10/29/2015] [Accepted: 12/14/2015] [Indexed: 02/09/2023]
Abstract
INTRODUCTION There are mixed data regarding the effect of emotional distress on diabetes risk, especially among young adults. This study assessed the effect of self-perceived emotional distress on diabetes incidence among young men. METHODS Incident diabetes during a mean follow-up of 6.3 (4.3) years was assessed among 32,586 men (mean age, 31.0 [5.6] years) of the Metabolic, Lifestyle, and Nutrition Assessment in Young Adults cohort with no history of diabetes between 1995 and 2011. Emotional distress was assessed by asking participants as part of a computerized questionnaire: Are you preoccupied by worries or concerns that affect your overall wellbeing? Time-dependent Cox models were applied. Data analysis took place between 2014 and 2015. RESULTS There were 723 cases of diabetes during 206,382 person-years. The presence of distress was associated with a 53% higher incidence of diabetes (95% CI=1.08, 2.18, p=0.017) after adjustment for age, BMI, fasting plasma glucose, family history of diabetes, triglyceride and high-density lipoprotein cholesterol levels, education, cognitive performance, white blood cell count, physical activity, and sleep quality. These results persisted when distress, BMI, physical activity, and smoking status were treated as time-dependent variables (hazard ratio=1.66, 95% CI=1.21, 2.17, p=0.002). An adjusted hazard ratio of 2.14 (95% CI=1.04, 4.47, p=0.041) for incident diabetes was observed among participants persistently reporting emotional distress compared with those persistently denying it. CONCLUSIONS Sustained emotional distress contributes to the development of diabetes among young and apparently healthy men in a time-dependent manner. These findings warrant awareness by primary caregivers when stratifying diabetes risk.
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Affiliation(s)
- Gilad Twig
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel; The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; The Israel Defense Forces Medical Corps, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Hertzel C Gerstein
- Division of Endocrinology and Metabolism, and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | | | - Avi Shina
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; The Israel Defense Forces Medical Corps, Israel; Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - Arnon Afek
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Israel Ministry of Health, Jerusalem, Israel
| | - Estela Derazne
- The Israel Defense Forces Medical Corps, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorit Tzur
- The Israel Defense Forces Medical Corps, Israel
| | - Tali Cukierman-Yaffe
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel
| | - Daniela Amital
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychiatry B, Ness Ziona Mental Health Center, Ness Ziona, Israel
| | - Howard Amital
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Tirosh
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; Department of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel; Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Association of Psychosocial Work Hazards With Depression and Suboptimal Health in Executive Employees. J Occup Environ Med 2016; 58:728-36. [PMID: 27206130 DOI: 10.1097/jom.0000000000000760] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aims to investigate whether psychosocial work-related hazards, measured by workplace justice and employment insecurity, are associated with depression and suboptimal health status in Taiwan's executive-level employees. METHODS There were 365 executives who have received a series of cardiovascular health examinations, blood sampling, and self-reported questionnaires, which included the psychosocial work-related hazards and the CES-D scale. Suboptimal health status was defined as the presence of dyslipidemia or prediabetes. RESULTS Executive-level employees perceived lower workplace justice and higher employment insecurity and had a significantly higher risk of depression (CES-D scores ≥16 or ≥23). However, workplace justice was identified as a significant determinant factor that was negative for dyslipidemia but protective for prediabetes. CONCLUSION This study supports the fact that psychosocial work-related hazards can independently contribute to the risk of developing depression, prediabetes, and dyslipemia in executives.
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Majzoub A, Arafa M, Al-Said S, Dabbous Z, Aboulsoud S, Khalafalla K, Elbardisi H. Premature ejaculation in type II diabetes mellitus patients: association with glycemic control. Transl Androl Urol 2016; 5:248-54. [PMID: 27141454 PMCID: PMC4837318 DOI: 10.21037/tau.2016.03.11] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Premature ejaculation (PE) is a highly prevalent sexual dysfunction among patients with diabetes mellitus (DM). Despite this, the underlying mechanism of this association is poorly understood. In this study, we aimed to investigate the prevalence of PE in a group of patients with DM and explore possible associations linking both conditions together. Methods This was a prospective study of subjects recruited with advertisement pamphlets and whose sexual function was assessed using the international index of erectile function-5 (IIEF-5) and the Arabic index of premature ejaculation (AIPE) questionnaires together with stopwatch measured intravaginal ejaculatory latency time (ELT). Participants were divided into two groups; group A subjects had DM and group B were healthy adult males. Results A total of 488 subjects were recruited. Group A included 199 (40.8%) subjects, while group B included 289 (59.2%). The prevalence of PE and ED was significantly higher in group A subjects (P<0.001). Mean ELT ± standard deviation (SD) was 3.6±2.7 in group A versus 4.3±2.8 in group B (P<0.014). Diabetic patients with erectile dysfunction (ED) showed a significantly higher incidence of PE with significantly shorter ELT. Conclusions PE is more prevalent in diabetic patients. DM is a multi-systemic disorder with complications that could help explain the pathophysiology of PE.
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Affiliation(s)
- Ahmad Majzoub
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Arafa
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Sami Al-Said
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Zeinab Dabbous
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Samar Aboulsoud
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Kareim Khalafalla
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Haitham Elbardisi
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
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Wagner H, Alvarsson M, Mannheimer B, Degerblad M, Östenson CG. No Effect of High-Dose Vitamin D Treatment on β-Cell Function, Insulin Sensitivity, or Glucose Homeostasis in Subjects With Abnormal Glucose Tolerance: A Randomized Clinical Trial. Diabetes Care 2016; 39:345-52. [PMID: 26786573 DOI: 10.2337/dc15-1057] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 12/04/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There has been conflicting evidence regarding the potential role of vitamin D in glucose homeostasis. This study was designed to investigate the effect of high-dose vitamin D3 treatment on β-cell function, insulin sensitivity, and glucose tolerance in subjects with prediabetes or diet-treated type 2 diabetes. RESEARCH DESIGN AND METHODS Subjects (n = 44) were randomized to 30,000 IU vitamin D3 once weekly or placebo for 8 weeks. Hyperglycemic clamp assessed first-phase (0-12 min) and second-phase (12-120 min) insulin response, insulin sensitivity, and disposition index (DI). An oral glucose tolerance test assessed glucose tolerance and glycosylated hemoglobin assessed glycemic control. RESULTS A total of 21 (vitamin D) and 22 (placebo) subjects completed the study, respectively. Season-adjusted 25-OH-vitamin D [25(OH)D] levels were doubled in the active treated group (43-82 nmol/L). No effect of vitamin D treatment, compared with placebo, was seen on first-phase or second-phase insulin secretion. There were no group differences in insulin sensitivity, DI, or any measures of glycemic control. No hypercalcemia or other adverse effects of vitamin D treatment were seen compared with placebo. Subgroup analyses of those with the lowest basal and greatest increase in 25(OH)D levels did not change these results. CONCLUSIONS This study gives no support for any substantial effect of high-dose vitamin D treatment for 8 weeks in prediabetes or diet-treated type 2 diabetes on β-cell function, insulin sensitivity, or glycemic control.
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Affiliation(s)
- Henrik Wagner
- Endocrinology and Diabetes Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Michael Alvarsson
- Endocrinology and Diabetes Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Buster Mannheimer
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Marie Degerblad
- Endocrinology and Diabetes Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Claes-Göran Östenson
- Endocrinology and Diabetes Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Åberg MAI, Torén K, Nilsson M, Henriksson M, Kuhn HG, Nyberg J, Rosengren A, Åberg ND, Waern M. Nonpsychotic Mental Disorders in Teenage Males and Risk of Early Stroke: A Population-Based Study. Stroke 2016; 47:814-21. [PMID: 26846861 PMCID: PMC4760382 DOI: 10.1161/strokeaha.115.012504] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 01/04/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Although the incidence of stroke is on the decline worldwide, this is not the case for early stroke. We aimed to determine whether nonpsychotic mental disorder at the age of 18 years is a risk factor for early stroke, and if adolescent cardiovascular fitness and intelligence quotient might attenuate the risk. METHOD Population-based Swedish cohort study of conscripts (n=1 163 845) who enlisted during 1968 to 2005. At conscription, 45 064 males were diagnosed with nonpsychotic mental disorder. Risk of stroke during follow-up (5-42 years) was calculated with Cox proportional hazards models. Objective baseline measures of fitness and cognition were included in the models in a second set of analyses. RESULTS There were 7770 first-time stroke events. In adjusted models, increased risk for stroke was observed in men diagnosed with depressive/neurotic disorders (hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.11-1.37), personality disorders (HR, 1.52; 95% CI, 1.29-1.78), and alcohol/substance use disorders (HR, 1.61; 95% CI, 1.41-1.83) at conscription. Corresponding figures for fatal stroke were HR, 1.38; 95% CI, 1.06 to 1.79; HR, 2.26; 95% CI, 1.60 to 3.19; and HR, 2.20; 95% CI, 1.63 to 2.96. HRs for stroke were attenuated when fitness level and intelligence quotient were introduced. Associations remained significant for personality disorders and alcohol/substance use in the fully adjusted models. The interaction term was statistically significant for fitness but not for intelligence quotient. CONCLUSIONS Our findings suggest that fitness may modify associations between nonpsychotic disorders and stroke. It remains to be clarified whether interventions designed to improve fitness in mentally ill youth can influence future risk of early stroke.
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Affiliation(s)
- Maria A I Åberg
- From the Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology (M.A.I.Å., M.N., M.H., H.G.K., J.N.), Department of Primary Health Care (M.A.I.Å., M.H.), Occupational and Environmental Medicine (K.T.), Departments of Molecular and Clinical Medicine (A.R.), Department of Internal Medicine (N.D.Å.), Institute of Medicine, Neuropsychiatric Epidemiology Unit, and Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (M.W.) Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia (M.N.).
| | - Kjell Torén
- From the Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology (M.A.I.Å., M.N., M.H., H.G.K., J.N.), Department of Primary Health Care (M.A.I.Å., M.H.), Occupational and Environmental Medicine (K.T.), Departments of Molecular and Clinical Medicine (A.R.), Department of Internal Medicine (N.D.Å.), Institute of Medicine, Neuropsychiatric Epidemiology Unit, and Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (M.W.) Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia (M.N.)
| | - Michael Nilsson
- From the Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology (M.A.I.Å., M.N., M.H., H.G.K., J.N.), Department of Primary Health Care (M.A.I.Å., M.H.), Occupational and Environmental Medicine (K.T.), Departments of Molecular and Clinical Medicine (A.R.), Department of Internal Medicine (N.D.Å.), Institute of Medicine, Neuropsychiatric Epidemiology Unit, and Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (M.W.) Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia (M.N.)
| | - Malin Henriksson
- From the Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology (M.A.I.Å., M.N., M.H., H.G.K., J.N.), Department of Primary Health Care (M.A.I.Å., M.H.), Occupational and Environmental Medicine (K.T.), Departments of Molecular and Clinical Medicine (A.R.), Department of Internal Medicine (N.D.Å.), Institute of Medicine, Neuropsychiatric Epidemiology Unit, and Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (M.W.) Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia (M.N.)
| | - H Georg Kuhn
- From the Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology (M.A.I.Å., M.N., M.H., H.G.K., J.N.), Department of Primary Health Care (M.A.I.Å., M.H.), Occupational and Environmental Medicine (K.T.), Departments of Molecular and Clinical Medicine (A.R.), Department of Internal Medicine (N.D.Å.), Institute of Medicine, Neuropsychiatric Epidemiology Unit, and Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (M.W.) Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia (M.N.)
| | - Jenny Nyberg
- From the Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology (M.A.I.Å., M.N., M.H., H.G.K., J.N.), Department of Primary Health Care (M.A.I.Å., M.H.), Occupational and Environmental Medicine (K.T.), Departments of Molecular and Clinical Medicine (A.R.), Department of Internal Medicine (N.D.Å.), Institute of Medicine, Neuropsychiatric Epidemiology Unit, and Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (M.W.) Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia (M.N.)
| | - Annika Rosengren
- From the Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology (M.A.I.Å., M.N., M.H., H.G.K., J.N.), Department of Primary Health Care (M.A.I.Å., M.H.), Occupational and Environmental Medicine (K.T.), Departments of Molecular and Clinical Medicine (A.R.), Department of Internal Medicine (N.D.Å.), Institute of Medicine, Neuropsychiatric Epidemiology Unit, and Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (M.W.) Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia (M.N.)
| | - N David Åberg
- From the Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology (M.A.I.Å., M.N., M.H., H.G.K., J.N.), Department of Primary Health Care (M.A.I.Å., M.H.), Occupational and Environmental Medicine (K.T.), Departments of Molecular and Clinical Medicine (A.R.), Department of Internal Medicine (N.D.Å.), Institute of Medicine, Neuropsychiatric Epidemiology Unit, and Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (M.W.) Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia (M.N.)
| | - Margda Waern
- From the Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology (M.A.I.Å., M.N., M.H., H.G.K., J.N.), Department of Primary Health Care (M.A.I.Å., M.H.), Occupational and Environmental Medicine (K.T.), Departments of Molecular and Clinical Medicine (A.R.), Department of Internal Medicine (N.D.Å.), Institute of Medicine, Neuropsychiatric Epidemiology Unit, and Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (M.W.) Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia (M.N.)
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Lašaitė L, Ostrauskas R, Žalinkevičius R, Jurgevičienė N, Radzevičienė L. Diabetes distress in adult type 1 diabetes mellitus men and women with disease onset in childhood and in adulthood. J Diabetes Complications 2016; 30:133-7. [PMID: 26490756 DOI: 10.1016/j.jdiacomp.2015.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 09/21/2015] [Accepted: 09/22/2015] [Indexed: 01/09/2023]
Abstract
THE AIM To determine whether or not diabetes distress varies by age of type 1 diabetes mellitus (T1DM) onset and/or gender. SUBJECTS AND METHODS A total of 700 adult T1DM patients were randomly selected from the Lithuanian Diabetes Registry; 214 of them (30.6%) agreed to participate and were recruited for the study. Diabetes distress (emotional burden, physician-related distress, regimen-related distress, interpersonal distress) was compared in 105 (42 men and 63 women) patients with T1DM diagnosed during 0-18years of life, and in 109 (61 men and 48 women) with T1DM diagnosed in adulthood, using Diabetes Distress Scale (DDS). RESULTS Adult childhood-onset T1DM women have higher regimen-related distress (36.3±21.3 vs 26.6±16.2, p=0.016) than adulthood-onset women. Adult childhood-onset T1DM women experience higher diabetes distress (higher emotional burden (27.0±22.0 vs 15.6±16.4, p=0.006), physician-related distress (34.4±33.9 vs 20.7±29.4, p=0.024), total diabetes distress (41.2±13.6 vs 34.8±10.9, p=0.011)) than childhood-onset men. Adulthood-onset T1DM women experience higher physician-related distress (39.2±37.6 vs 23.4±32.5, p=0.013), but lower regimen-related distress (26.6±16.2 vs 35.8±21.6, p=0.014) than adulthood-onset men. In conclusion our findings reinforce the interdependence of psychological and biomedical factors in influencing health outcomes and support the need to provide psychological assessment and support to patients with T1DM.
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Affiliation(s)
- Lina Lašaitė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Rytas Ostrauskas
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Nijolė Jurgevičienė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Lina Radzevičienė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Tsutsui H, Nomura K, Kusunoki M, Ishiguro T, Ohkubo T, Oshida Y. Gender differences in the perception of difficulty of self-management in patients with diabetes mellitus: a mixed-methods approach. Diabetol Int 2015; 7:289-298. [PMID: 30603276 DOI: 10.1007/s13340-015-0249-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 12/13/2015] [Indexed: 10/22/2022]
Abstract
Aim The aim of this study was to examine the challenges of self-management of diabetes comparing gender. Methods Sixty-four women and 129 men (mean age 63 vs. 60 years) with diabetes mellitus (DM) were interviewed using 12 categories (classification codes b1300, d240, d570, d620, d845, d920, e410 + e414, e420, e425, e465, e560) related to self-care management selected from 99 categories of the International Classification of Functioning, Disability and Health (ICF) Core Set for DM. In a mixed-methods analysis, interviews were analyzed according to the Grounded Theory approach, and gender effects on ICF categories related to self-care management were investigated using logistic models. Results In quantitative data, compared with men, women tended to experience greater difficulty obtaining foods/ingredients for well-balanced meals to maintain appropriate glucose level (P = 0.004); handling stress and other psychological demands around diabetes treatment (P = 0.034); and social norms, practices, and ideologies that defined an experience of unpleasant treatment after disclosure of DM diagnosis to close family and friends (P = 0.023). Qualitative data shows that women perceived prejudice against people with DM from close family, friends, and neighbors. In contrast, men reported excessive media information on diabetes treatment, which induced prejudice by family members and at the workplace. Conclusions Women were more likely to be sensitive to attention from close family and friends, whereas men were more likely to be occupied by work and daily living concerns. Health professionals should pay attention to such gender differences in a patient-professional relationship.
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Affiliation(s)
- Hideyo Tsutsui
- 1General Medical Education and Research Center, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605 Japan.,2Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605 Japan.,3Research Center of Health, Physical Fitness, and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601 Japan
| | - Kyoko Nomura
- 2Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605 Japan
| | - Masataka Kusunoki
- 3Research Center of Health, Physical Fitness, and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601 Japan
| | - Tetsuya Ishiguro
- 3Research Center of Health, Physical Fitness, and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601 Japan.,Ishiguro Internal Medical Clinic, 1-11-1 Asamiya-cho, Kasugai, 486-0846 Japan
| | - Takayoshi Ohkubo
- 2Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605 Japan
| | - Yoshiharu Oshida
- 3Research Center of Health, Physical Fitness, and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601 Japan
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Innes KE, Selfe TK. Yoga for Adults with Type 2 Diabetes: A Systematic Review of Controlled Trials. J Diabetes Res 2015; 2016:6979370. [PMID: 26788520 PMCID: PMC4691612 DOI: 10.1155/2016/6979370] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 08/19/2015] [Accepted: 08/26/2015] [Indexed: 12/29/2022] Open
Abstract
A growing body of evidence suggests yogic practices may benefit adults with type 2 diabetes (DM2). In this systematic review, we evaluate available evidence from prospective controlled trials regarding the effects of yoga-based programs on specific health outcomes pertinent to DM2 management. To identify qualifying studies, we searched nine databases and scanned bibliographies of relevant review papers and all identified articles. Controlled trials that did not target adults with diabetes, included only adults with type 1 diabetes, were under two-week duration, or did not include quantitative outcome data were excluded. Study quality was evaluated using the PEDro scale. Thirty-three papers reporting findings from 25 controlled trials (13 nonrandomized, 12 randomized) met our inclusion criteria (N = 2170 participants). Collectively, findings suggest that yogic practices may promote significant improvements in several indices of importance in DM2 management, including glycemic control, lipid levels, and body composition. More limited data suggest that yoga may also lower oxidative stress and blood pressure; enhance pulmonary and autonomic function, mood, sleep, and quality of life; and reduce medication use in adults with DM2. However, given the methodological limitations of existing studies, additional high-quality investigations are required to confirm and further elucidate the potential benefits of yoga programs in populations with DM2.
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Affiliation(s)
- Kim E. Innes
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV 26506, USA
- Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, Charlottesville, VA 22903, USA
| | - Terry Kit Selfe
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV 26506, USA
- Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, Charlottesville, VA 22903, USA
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Anothaisintawee T, Reutrakul S, Van Cauter E, Thakkinstian A. Sleep disturbances compared to traditional risk factors for diabetes development: Systematic review and meta-analysis. Sleep Med Rev 2015; 30:11-24. [PMID: 26687279 DOI: 10.1016/j.smrv.2015.10.002] [Citation(s) in RCA: 362] [Impact Index Per Article: 40.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 10/11/2015] [Accepted: 10/12/2015] [Indexed: 01/04/2023]
Abstract
Sleep disturbances [short (<6 h) and long (>8 h) sleeping time, insomnia (initiating or maintaining sleep), obstructive sleep apnea (OSA) and abnormal sleep timing] have been associated with increased diabetes risk but the effect size relative to that of traditional risk factors is unknown. We conducted a systematic review and meta-analysis to compare the risk associated with sleep disturbances to traditional risk factors. Studies were identified from Medline and Scopus. Cohort studies measuring the association between sleep disturbances and incident diabetes were eligible. For traditional risk factors (i.e., overweight, family history, and physical inactivity), systematic reviews with or without meta-analysis were included. Thirty-six studies (1,061,555 participants) were included. Pooled relative risks (RRs) of sleep variables were estimated using a random-effect model. Pooled RRs of sleeping ≤5 h, 6 h, and ≥9 h/d were respectively 1.48 (95%CI:1.25,1.76), 1.18 (1.10,1.26) and 1.36 (1.12,1.65). Poor sleep quality, OSA and shift work were associated with diabetes with a pooled RR of 1.40 (1.21,1.63), 2.02 (1.57, 2.61) and 1.40 (1.18,1.66), respectively. The pooled RRs of being overweight, having a family history of diabetes, and being physically inactive were 2.99 (2.42,3.72), 2.33 (1.79,2.79), and 1.20 (1.11,1.32), respectively. In conclusion, the risk of developing diabetes associated with sleep disturbances is comparable to that of traditional risk factors. Sleep disturbances should be considered in clinical guidelines for type 2 diabetes screening.
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Affiliation(s)
- Thunyarat Anothaisintawee
- Department of Family Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; Section for Clinical Epidemiology and Biostatistics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sirimon Reutrakul
- Division of Endocrinology and Metabolism, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Eve Van Cauter
- Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, and Sleep, Metabolism and Health Center, Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Ammarin Thakkinstian
- Section for Clinical Epidemiology and Biostatistics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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84
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Accumulation of Major Life Events in Childhood and Adult Life and Risk of Type 2 Diabetes Mellitus. PLoS One 2015; 10:e0138654. [PMID: 26394040 PMCID: PMC4578856 DOI: 10.1371/journal.pone.0138654] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 09/02/2015] [Indexed: 12/01/2022] Open
Abstract
Background The aim of the study was to estimate the effect of the accumulation of major life events (MLE) in childhood and adulthood, in both the private and working domains, on risk of type 2 diabetes mellitus (T2DM). Furthermore, we aimed to test the possible interaction between childhood and adult MLE and to investigate modification of these associations by educational attainment. Methods The study was based on 4,761 participants from the Copenhagen City Heart Study free of diabetes at baseline and followed for 10 years. MLE were categorized as 0, 1, 2, 3 or more events. Multivariate logistic regression models adjusted for age, sex, education and family history of diabetes were used to estimate the association between MLE and T2DM. Results In childhood, experiencing 3 or more MLE was associated with a 69% higher risk of developing T2DM (Odds Ratio (OR) 1.69; 95% Confidence Interval (CI) 1.60, 3.27). The accumulation of MLE in adult private (p-trend = 0.016) and work life (p-trend = 0.049) was associated with risk of T2DM in a dose response manner. There was no evidence that experiencing MLE in both childhood and adult life was more strongly associated with T2DM than experiencing events at only one time point. There was some evidence that being simultaneously exposed to childhood MLE and short education (OR 2.28; 95% C.I. 1.45, 3.59) and work MLE and short education (OR 2.86; 95% C.I. 1.62, 5.03) was associated with higher risk of T2DM, as the joint effects were greater than the sum of their individual effects. Conclusions Findings from this study suggest that the accumulation of MLE in childhood, private adult life and work life, respectively, are risk factors for developing T2DM.
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85
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Korek MJ, Bellander TD, Lind T, Bottai M, Eneroth KM, Caracciolo B, de Faire UH, Fratiglioni L, Hilding A, Leander K, Magnusson PKE, Pedersen NL, Östenson CG, Pershagen G, Penell JC. Traffic-related air pollution exposure and incidence of stroke in four cohorts from Stockholm. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2015; 25:517-23. [PMID: 25827311 PMCID: PMC4648059 DOI: 10.1038/jes.2015.22] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 02/23/2015] [Accepted: 02/23/2015] [Indexed: 05/19/2023]
Abstract
We investigated the risk of stroke related to long-term ambient air pollution exposure, in particular the role of various exposure time windows, using four cohorts from Stockholm County, Sweden. In total, 22,587 individuals were recruited from 1992 to 2004 and followed until 2011. Yearly air pollution levels resulting from local road traffic emissions were assessed at participant residences using dispersion models for particulate matter (PM10) and nitrogen oxides (NOX). Cohort-specific hazard ratios were estimated for time-weighted air pollution exposure during different time windows and the incidence of stroke, adjusted for common risk factors, and then meta-analysed. Overall, 868 subjects suffered a non-fatal or fatal stroke during 238,731 person-years of follow-up. An increment of 20 μg/m(3) in estimated annual mean of road-traffic related NOX exposure at recruitment was associated with a hazard ratio of 1.16 (95% CI 0.83-1.61), with evidence of heterogeneity between the cohorts. For PM10, an increment of 10 μg/m(3) corresponded to a hazard ratio of 1.14 (95% CI 0.68-1.90). Time-window analyses did not reveal any clear induction-latency pattern. In conclusion, we found suggestive evidence of an association between long-term exposure to NOX and PM10 from local traffic and stroke at comparatively low levels of air pollution.
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Affiliation(s)
- Michal J Korek
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Karolinska Institutet, Institute of Environmental Medicine, Nobels väg 13 Box 210, Stockholm, SE-171 77, Sweden. Tel.: +46 8 524 87457. Fax: +46 8 304571. E-mail:
| | - Tom D Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Tomas Lind
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Matteo Bottai
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Barbara Caracciolo
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Ulf H de Faire
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Laura Fratiglioni
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
- Division of Clinical Geriatrics, Karolinska University Hospital, Stockholm, Sweden
| | - Agneta Hilding
- Department of Molecular Medicine and Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistcs, Karolinska Institutet, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistcs, Karolinska Institutet, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Johanna C Penell
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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86
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Depression and Risk for Diabetes: A Meta-Analysis. Can J Diabetes 2015; 39:266-72. [DOI: 10.1016/j.jcjd.2014.11.006] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 11/28/2014] [Accepted: 11/28/2014] [Indexed: 12/20/2022]
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McCurley JL, Mills PJ, Roesch SC, Carnethon M, Giacinto RE, Isasi CR, Teng Y, Sotres-Alvarez D, Llabre MM, Penedo FJ, Schneiderman N, Gallo LC. Chronic stress, inflammation, and glucose regulation in U.S. Hispanics from the HCHS/SOL Sociocultural Ancillary Study. Psychophysiology 2015; 52:1071-9. [PMID: 25898909 PMCID: PMC4640890 DOI: 10.1111/psyp.12430] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 02/06/2015] [Indexed: 12/12/2022]
Abstract
Diabetes prevalence is rising rapidly, and diabetes disproportionately affects Hispanics and other underserved groups. Chronic stress may contribute to diabetes risk, but few studies have examined this relationship in U.S. Hispanics. We examined associations of chronic stress with fasting glucose, glucose tolerance, and glycosylated hemoglobin (HbA1c) in Hispanics without diabetes, and also assessed indirect effects of stress through inflammation (CRP). Participants were 3,923 men and women, aged 18-74, without diabetes, from the four U.S. field centers (Bronx, NY; Chicago, IL; Miami, FL; San Diego, CA) of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary study. Participants completed a measure of chronic life stress and a physical exam with oral glucose tolerance test. In a multivariate regression analysis with adjustment for demographic and health covariates, higher chronic stress was related to higher fasting glucose (standardized regression coefficient: β = .09, p < .01), postload glucose (β = .07, p < .05), and HbA1c levels (β = .08, p < .01). However, there was no indirect effect of stress through inflammation. Findings suggest that higher chronic stress is associated with poorer glucose regulation in Hispanics, prior to the onset of a clinical diabetes diagnosis.
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Affiliation(s)
- Jessica L. McCurley
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, University of California, San Diego
| | - Paul J. Mills
- Department of Psychiatry, University of California, San Diego
| | | | - Mercedes Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University
| | | | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine
| | - Yanping Teng
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | | | - Frank J. Penedo
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
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Pyko A, Eriksson C, Oftedal B, Hilding A, Östenson CG, Krog NH, Julin B, Aasvang GM, Pershagen G. Exposure to traffic noise and markers of obesity. Occup Environ Med 2015; 72:594-601. [PMID: 26009579 DOI: 10.1136/oemed-2014-102516] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 02/02/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Limited evidence suggests adverse effects of traffic noise exposure on the metabolic system. This study investigates the association between road traffic noise and obesity markers as well as the role of combined exposure to multiple sources of traffic noise. METHODS In a cross-sectional study performed in 2002-2006, we assessed exposure to noise from road traffic, railways and aircraft at the residences of 5075 Swedish men and women, primarily from suburban and semirural areas of Stockholm County. A detailed questionnaire and medical examination provided information on markers of obesity and potential confounders. Multiple linear and logistic regression models were used to assess associations between traffic noise and body mass index (BMI), waist circumference and waist-hip ratio using WHO definitions of obesity. RESULTS Road traffic noise was significantly related to waist circumference with a 0.21 cm (95% CI 0.01 to 0.41) increase per 5 dB(A) rise in L(den). The OR for central obesity among those exposed to road traffic noise ≥ 45 dB(A) was 1.18 (95% CI 1.03 to 1.34) in comparison to those exposed below this level. Similar results were seen for waist-hip ratio (OR 1.29; 95% CI 1.14 to 1.45) but not for BMI (OR 0.89; 95% CI 0.76 to 1.04). Central obesity was also associated with exposure to railway and aircraft noise, and a particularly high risk was seen for combined exposure to all three sources of traffic noise (OR 1.95; 95% CI 1.24 to 3.05). CONCLUSIONS Our results suggest that traffic noise exposure can increase the risk of central obesity. Combined exposure to different sources of traffic noise may convey a particularly high risk.
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Affiliation(s)
- Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Charlotta Eriksson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | | | - Agneta Hilding
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | | | - Bettina Julin
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
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Rosedale M, Strauss SM, Knight C, Malaspina D. Awareness of Prediabetes and Diabetes among Persons with Clinical Depression. Int J Endocrinol 2015; 2015:839152. [PMID: 26060495 PMCID: PMC4427826 DOI: 10.1155/2015/839152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 04/03/2015] [Indexed: 01/30/2023] Open
Abstract
Background. Major depressive disorder (MDD) is highly comorbid with diabetes, a relationship underappreciated by clinicians. Purpose. Examine the proportion of nonpregnant individuals ≥20 years with MDD and elevated glucose and the demographic and clinical characteristics associated with unrecognized elevated glucose. Methods. 14,373 subjects who participated in the National Health and Nutrition Examination Survey (2007-2012) completed the PHQ-9 depression screen and had hemoglobin A1C (HbA1c) measured. PHQ-9 scores ≥10 and HbA1c scores ≥5.7% were defined as MDD and elevated HbA1c, respectively. Data were analyzed using complex survey sampling software. Results. 38.4% of the sample with MDD had elevated HbA1c readings. Compared with nondepressed subjects, they were significantly more likely to have elevated glucose readings (P = 0.003) and to be aware of their elevated glucose levels if they had a higher body mass index, family history of diabetes, more doctor visits in the past year, a usual care source, health insurance, or were taking hypertension or hypercholesterolemia medications. Conclusions. Many adults with MDD have elevated HbA1c levels, have never been advised of elevated HbA1c, have not received diabetes screening, and have minimal contact with a healthcare provider. Additional opportunities for diabetes risk screening in people with MDD are needed.
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Affiliation(s)
- Mary Rosedale
- New York University College of Nursing, New York, NY 10010, USA
- NYU Langone Medical Center, New York, NY 10016, USA
| | | | - Candice Knight
- New York University College of Nursing, New York, NY 10010, USA
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No impact of vitamin D on the CYP3A biomarker 4β-hydroxycholesterol in patients with abnormal glucose regulation. PLoS One 2015; 10:e0121984. [PMID: 25835492 PMCID: PMC4383380 DOI: 10.1371/journal.pone.0121984] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 02/04/2015] [Indexed: 01/21/2023] Open
Abstract
Purpose To investigate the effect of vitamin D3 on hepatic Cytochrome P450 enzyme (CYP) 3A4 in patients with abnormal glucose regulation using the endogenous marker 4β-hydroxycholesterol (4β-OHC):cholesterol ratio. Methods The present study took advantage of a trial primarily aiming to investigate the effect of vitamin D3 on beta cell function and insulin sensitivity in patients with abnormal glucose regulation. 44 subjects were randomized to receive vitamin D3, 30000 IU given orally once weekly or placebo for 8 weeks. The two sample t-test was used to test the means of the intra-individual differences of 4β-OHC:cholesterol ratio between the two groups. Results Mean (SD) 4β-OHC in the whole group of patients before and after the intervention was 26 (11) ng/ml and 26 (12). Mean (SD) 4β-OHC:cholesterol ratio in the whole group of patients before and after the intervention was 0.12 (0.046) and 0.13 (0.047). In the Vitamin D group mean (SD) serum 25-OH-vitamin D3 increased from 46 (16) to 85nM (13) during the corresponding time period. To investigate the impact of vitamin D3 on hepatic CYP3A4 we calculated the mean intra-individual differences in 4β-OHC:cholesterol ratio (delta 4β-OHC:cholesterol ratio) before versus after the intervention in the two treatment groups. The difference (95% CI) between delta 4β-OHC:cholesterol ratio in the control group and intervention group was -0.0010 (-0.0093, 0.0072), a difference being not statistically significant (p = 0.80). Conclusions We provide further evidence that vitamin D3 may not substantially affect hepatic CYP3A4. This does not exclude the possibility of an impact of intestinal first-pass metabolism of orally administered drugs which should be investigated. Trial Registration ClinicalTrials.gov NCT01497132
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91
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92
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Liang H, Cheng J, Shen X, Chen P, Tong G, Chai J, Li K, Xie S, Shi Y, Wang D, Sun Y. Relationships between stressful life events and impaired fasting glucose among left-behind farmers in rural China. J Psychosom Res 2015; 78:178-83. [PMID: 25477301 DOI: 10.1016/j.jpsychores.2014.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 10/05/2014] [Accepted: 10/22/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study aims at examining the effects of stressful life events on risk of impaired fasting glucose among left-behind farmers in rural China. METHODS The study collected data about stressful life events, family history of diabetes, lifestyle, demographics and minimum anthropometrics from left-behind famers aged 40-70 years. Calculated life event index was applied to assess the combined effects of stressful life events experienced by the left-behind farmers and its association with impaired fasting glucose was estimated using binary logistic regression models. RESULTS The prevalence of abnormal fasting glucose was 61.4% by American Diabetes Association (ADA) standard and 32.4% by World Health Organization (WHO) standard. Binary logistic regression analysis revealed a coefficient of 0.033 (P<.001) by ADA standard or 0.028 (P<.001) by WHO standard between impaired fasting glucose and life event index. The overall odds ratios of impaired glucose for the second, third and fourth (highest) versus the first (lowest) quartile of life event index were 1.419 [95% CI=(1.173, 1.717)], 1.711 [95% CI=(1.413, 2.071)] and 1.957 [95% CI=(1.606, 2.385)] respectively by ADA standard. When more and more confounding factors were controlled for, these odds ratios remained statistically significant though decreased to a small extent. CONCLUSIONS The left-behind farmers showed over two-fold prevalence rate of pre-diabetes than that of the nation's average and their risk of impaired fasting glucose was positively associated with stressful life events in a dose-dependent way. Both the population studied and their life events merit special attention.
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Affiliation(s)
- Han Liang
- School of Health Service Management, Anhui Medical University, Hefei, China.
| | - Jing Cheng
- School of Health Service Management, Anhui Medical University, Hefei, China; Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei, China.
| | - Xingrong Shen
- School of Health Service Management, Anhui Medical University, Hefei, China.
| | - Penglai Chen
- School of Health Service Management, Anhui Medical University, Hefei, China.
| | - Guixian Tong
- School of Health Service Management, Anhui Medical University, Hefei, China.
| | - Jing Chai
- School of Health Service Management, Anhui Medical University, Hefei, China.
| | - Kaichun Li
- Lu'an Center for Diseases Prevention and Control, Lu'an, China.
| | - Shaoyu Xie
- Lu'an Center for Diseases Prevention and Control, Lu'an, China.
| | - Yong Shi
- Lu'an Center for Diseases Prevention and Control, Lu'an, China.
| | - Debin Wang
- School of Health Service Management, Anhui Medical University, Hefei, China.
| | - Yehuan Sun
- Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei, China.
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93
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Kelly SJ, Ismail M. Stress and type 2 diabetes: a review of how stress contributes to the development of type 2 diabetes. Annu Rev Public Health 2015; 36:441-62. [PMID: 25581145 DOI: 10.1146/annurev-publhealth-031914-122921] [Citation(s) in RCA: 145] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Current policy and research around type 2 diabetes (T2D) interventions largely invoke a behavioral model. We suggest that activation of the physiologic stress response (PSR) from chronic exposure to stressors, low socioeconomic status (SES), severe mental health problems, or aggressive behavior increases the risk of T2D. This article is a comprehensive review of the literature on the link between T2D and psychosocial factors focusing on prospective studies of the risk for developing diabetes. The review found an increased risk for T2D in people: exposed to stressful working conditions or traumatic events; with depression; with personality traits or mental health problems that put them in conflict with others; of low SES, either currently or in childhood; and in racial/ethnic minority populations, independent of current SES. This review suggests that T2D prevention research would be more effective if (a) the PSR to psychosocial factors (especially social disparities) was recognized and (b) intervention programs evaluated reduction in social disparities as part of a comprehensive approach.
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Affiliation(s)
- Shona J Kelly
- Center for Health and Social Care Research, Sheffield Hallam University, Sheffield S10 2BP, United Kingdom;
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94
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Olsson E, Westman J, Sudic Hukic D, Eriksson SV, Edman G, Bodén R, Jedenius E, Reutfors J, Berntsson A, Hilding A, Schalling M, Östenson CG, Ösby U. Diabetes and glucose disturbances in patients with psychosis in Sweden. BMJ Open Diabetes Res Care 2015; 3:e000120. [PMID: 26468398 PMCID: PMC4600183 DOI: 10.1136/bmjdrc-2015-000120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 07/31/2015] [Accepted: 08/25/2015] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE The objectives of this study were to (1) analyze the prevalence of diabetes, prediabetes, and antidiabetic medication in patients with psychosis compared with control subjects and (2) determine what factors in patients with psychosis were associated with antidiabetic medication. METHOD We studied 977 patients with psychosis recruited from outpatient clinics in Stockholm County, Sweden, and they were compared with 3908 non-psychotic control subjects for fasting plasma glucose levels; prevalence of diabetes, prediabetes, antidiabetic treatment, and tobacco use; and blood pressure, weight, height, and waist circumference. Group differences were evaluated with analysis of variance and χ(2) test, and factors associated with antidiabetic treatment were evaluated with logistic regression. RESULTS Diabetes was observed in 94 (10%) patients with psychosis, 2.7 times the prevalence observed in control subjects. Among patients with psychosis, 87 (10%) had prediabetes (fasting glucose, 6.1-6.9 mmol/L) compared with 149 (3.8%) control subjects. Most patients with psychosis (77%) who had prediabetes fulfilled criteria for metabolic syndrome. In patients with psychosis, both lipid-lowering medication and fasting glucose were significantly associated with antidiabetic treatment. There was no significant relation between antidiabetic treatment and lifestyle factors such as smoking or degree of psychiatric illness. CONCLUSIONS The high prevalence of impaired fasting glucose and metabolic syndrome in patients with psychosis warrants further clinical research in preventing or delaying the onset of diabetes in these patients by pharmacotherapy and/or lifestyle intervention.
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Affiliation(s)
- Eric Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Adult Psychiatry, PRIMA Barn och Vuxenpsykiatri AB, Stockholm, Sweden
| | - Jeanette Westman
- Department of Neurobiology, Care Sciences and Society, Centre of Family Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Dzana Sudic Hukic
- Department of Adult Psychiatry, PRIMA Barn och Vuxenpsykiatri AB, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Sven V Eriksson
- Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
| | - Gunnar Edman
- Department of Neurobiology, Care Sciences and Society, Centre of Family Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden
| | - Robert Bodén
- Department of Medicine Solna, Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Erik Jedenius
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Johan Reutfors
- Department of Medicine Solna, Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Anders Berntsson
- Department of Adult Psychiatry, PRIMA Barn och Vuxenpsykiatri AB, Stockholm, Sweden
| | - Agneta Hilding
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Martin Schalling
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Urban Ösby
- Department of Neurobiology, Care Sciences and Society, Centre of Family Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden
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Hilding A, Shen C, Östenson CG. Social network and development of prediabetes and type 2 diabetes in middle-aged Swedish women and men. Diabetes Res Clin Pract 2015; 107:166-77. [PMID: 25458340 DOI: 10.1016/j.diabres.2014.09.057] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 06/18/2014] [Accepted: 09/14/2014] [Indexed: 12/21/2022]
Abstract
AIM Explore if social network affects development of prediabetes and type 2 diabetes. METHODS Individuals with normal glucose tolerance at baseline, 2924 women and 2039 men, aged 35-56 years, were followed-up 8-10 years later by an oral glucose tolerance test. Prediabetes and type 2 diabetes was then evident in 168 and 50 women and in 236 and 93 men, respectively. Measures of social network (AVSI-index (availability of social integration), civil status and participation in social activities), recorded by questionnaire at baseline, were evaluated by logistic regression. RESULTS Having AVSI scores in the highest tertile was associated with a decreased risk to develop type 2 diabetes in women (age-adjusted odds ratio 0.41 [95% CI: 0.19-0.88]) less significant after full adjustment (0.50 [0.22-1.16]). Contrary, in men AVSI was associated with an increased risk to develop type 2 diabetes (1.93 [1.03-3.60]) after full adjustment. Participation in social activities decreased the risk to develop prediabetes and type 2 diabetes in women, (age-adjusted 0.65 [0.46-0.91] and 0.43 [0.24-0.77], respectively), less significant when adjusted for confounders (0.78 [0.54-1.12] and 0.59 [0.31-1.13]). In men a decreased risk was observed for prediabetes (0.59 [0.43-0.82] multi-adjusted model). Being married or living with a partner decreased type 2 diabetes risk only in men (0.57 [0.33-0.97] and 0.61 [0.34-1.08] age- and multi-adjusted models, respectively). CONCLUSIONS Individuals having a social network seemed less likely to develop abnormal glucose regulation. Contradictory to an overall protective pattern of having a social network, high AVSI-index in men increased the risk to develop type 2 diabetes.
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Affiliation(s)
- Agneta Hilding
- Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, Stockholm, Solna, Sweden.
| | - Chong Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, Stockholm, Solna, Sweden
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96
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Okasha T, Radwan AS. The bidirectional relation between psychiatric disorders with selected cardiovascular and endocrinal diseases: an Egyptian perspective. Curr Psychiatry Rep 2015; 17:528. [PMID: 25413635 DOI: 10.1007/s11920-014-0528-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Cardiovascular and endocrine diseases may act as burdens for individuals suffering from one of these medical illnesses, and whether through the ensuing psychological distress, or some biological mechanisms, these medical diseases can eventually lead to the development of psychiatric morbidities. Moreover, psychiatric morbidities negatively affect the prognosis of both cardiovascular and endocrine diseases. Despite transcultural differences, Egyptian patients with ischemic heart diseases (ISHD), heart failure (HF), diabetes mellitus (DM), or thyroid diseases (TD) endure the same psychological distress as their Western counterparts. Psychiatric assessment and evaluation should be regularly repeated among patients with cardiovascular and endocrinal diseases, and patients who are at risk should be closely followed up.
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Affiliation(s)
- Tarek Okasha
- Institute of Psychiatry, Ain Shams University, Cairo, Egypt,
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97
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Carvalho LA, Urbanova L, Hamer M, Hackett RA, Lazzarino AI, Steptoe A. Blunted glucocorticoid and mineralocorticoid sensitivity to stress in people with diabetes. Psychoneuroendocrinology 2015; 51:209-18. [PMID: 25462894 PMCID: PMC4275581 DOI: 10.1016/j.psyneuen.2014.09.023] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 09/02/2014] [Accepted: 09/19/2014] [Indexed: 12/01/2022]
Abstract
Psychological stress may contribute to type 2 diabetes but mechanisms are still poorly understood. In this study, we examined whether stress responsiveness is associated with glucocorticoid and mineralocorticoid sensitivity in a controlled experimental comparison of people with type 2 diabetes and non-diabetic participants. Thirty-seven diabetes patients and 37 healthy controls underwent psychophysiological stress testing. Glucocorticoid (GR) and mineralocorticoid sensitivity (MR) sensitivity were measured by dexamethasone- and prednisolone-inhibition of lipopolysaccharide (LPS)-induced interleukin (IL) 6 levels, respectively. Blood pressure (BP) and heart rate were monitored continuously, and we periodically assessed salivary cortisol, plasma IL-6 and monocyte chemotactic protein (MCP-1). Following stress, both glucocorticoid and mineralocorticoid sensitivity decreased among healthy controls, but did not change in people with diabetes. There was a main effect of group on dexamethasone (F(1,74)=6.852, p=0.013) and prednisolone (F(1,74)=7.295, p=0.010) sensitivity following stress at 45 min after tasks. People with diabetes showed blunted stress responsivity in systolic BP, diastolic BP, heart rate, IL-6, MCP-1, and impaired post-stress recovery in heart rate. People with Diabetes had higher cortisol levels as measured by the total amount excreted over the day and increased glucocorticoid sensitivity at baseline. Our study suggests that impaired stress responsivity in type-2 diabetes is in part due to a lack of stress-induced changes in mineralocorticoid and glucocorticoid sensitivity.
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Affiliation(s)
- Livia A. Carvalho
- Corresponding author. Tel.: +44 20 7679 5973; fax: +44 20 7813 0242.
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98
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Bergh C, Udumyan R, Fall K, Nilsagård Y, Appelros P, Montgomery S. Stress resilience in male adolescents and subsequent stroke risk: cohort study. J Neurol Neurosurg Psychiatry 2014; 85:1331-6. [PMID: 24681701 PMCID: PMC4251543 DOI: 10.1136/jnnp-2013-307485] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Exposure to psychosocial stress has been identified as a possible stroke risk, but the role of stress resilience which may be relevant to chronic exposure is uncertain. We investigated the association of stress resilience in adolescence with subsequent stroke risk. METHODS Register-based cohort study. Some 237 879 males born between 1952 and 1956 were followed from 1987 to 2010 using information from Swedish registers. Cox regression estimated the association of stress resilience with stroke, after adjustment for established stroke risk factors. RESULTS Some 3411 diagnoses of first stroke were identified. Lowest stress resilience (21.8%) compared with the highest (23.7%) was associated with increased stroke risk, producing unadjusted HR (with 95% CIs) of 1.54 (1.40 to 1.70). The association attenuated slightly to 1.48 (1.34 to 1.63) after adjustment for markers of socioeconomic circumstances in childhood; and after further adjustment for markers of development and disease in adolescence (blood pressure, cognitive function and pre-existing cardiovascular disease) to 1.30 (1.18 to 1.45). The greatest reduction followed further adjustment for markers of physical fitness (BMI and physical working capacity) in adolescence to 1.16 (1.04 to 1.29). The results were consistent when stroke was subdivided into fatal, ischaemic and haemorrhagic, with higher magnitude associations for fatal rather than non-fatal, and for haemorrhagic rather than ischaemic stroke. CONCLUSIONS Stress susceptibility and, therefore, psychosocial stress may be implicated in the aetiology of stroke. This association may be explained, in part, by poorer physical fitness. Effective prevention might focus on behaviour/lifestyle and psychosocial stress.
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Affiliation(s)
- Cecilia Bergh
- Department of Physiotherapy, Örebro University Hospital, Örebro, Sweden School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Ruzan Udumyan
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden Department of Clinical Epidemiology and Biostatistics, Örebro University Hospital, Örebro, Sweden
| | - Katja Fall
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden Department of Clinical Epidemiology and Biostatistics, Örebro University Hospital, Örebro, Sweden
| | - Ylva Nilsagård
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden Centre for Health Care Sciences, Örebro County Council, Örebro, Sweden
| | - Peter Appelros
- Department of Neurology, Örebro University Hospital, Örebro, Sweden
| | - Scott Montgomery
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden Department of Clinical Epidemiology and Biostatistics, Örebro University Hospital, Örebro, Sweden Department of Epidemiology and Public Health, University College London, London, UK Cinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
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99
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Almgren M, Atkinson RL, Hilding A, He J, Brismar K, Schalling M, Ostenson CG, Lavebratt C. Human adenovirus-36 is uncommon in type 2 diabetes and is associated with increased insulin sensitivity in adults in Sweden. Ann Med 2014; 46:539-46. [PMID: 25045929 DOI: 10.3109/07853890.2014.935469] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Human adenovirus-36 (Adv36) increases adiposity, but also upregulates distal insulin signaling in vitro in human adipose and muscle tissue and in vivo in the rodent independently of adiposity. Accordingly, healthy adults and children with antibodies against Adv36 had increased insulin sensitivity and reduced hepatic lipid accumulation. We hypothesized that Adv36 infection would be less frequent in individuals with type 2 diabetes or impaired glycemic control. METHODS Presence of antibodies against Adv36 was analyzed for association to type 2 diabetes or impaired glycemic control in a two-wave population-based sample of well-characterized adults (n = 1734). Indices of impaired glycemic control included oral glucose tolerance, and circulating fasting levels of glucose, insulin, and insulin-like growth factor binding protein-1 (IGFBP-1). RESULTS Adv36 seropositivity was more common in those with normal glucose tolerance (NGT) than in those with diabetes (females: OR 17.2, 95% CI 4.0-74.3; males: OR 3.5, 95% CI 1.8-6.7). Also, females with NGT had higher frequency of Adv36 seropositivity than females with prediabetes (impaired glucose tolerance and/or impaired fasting glucose; OR 1.8, 95% CI 1.1-3.1). Within the female prediabetes group Adv36 seropositivity was associated with higher insulin sensitivity reflected by reduced HOMA-IR and increased IGFBP-1. CONCLUSION Adv36 infection is associated with lower occurrence of type 2 diabetes and better insulin sensitivity in adults, particularly among females.
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Affiliation(s)
- Malin Almgren
- Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , Sweden
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100
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Medeiros C, Bruin V, Férrer D, Paiva T, Montenegro Júnior R, Forti A, Bruin P. Excessive daytime sleepiness in type 2 diabetes. ACTA ACUST UNITED AC 2014; 57:425-30. [PMID: 24030181 DOI: 10.1590/s0004-27302013000600003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 05/29/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To examine excessive daytime sleepiness (EDS) in type 2 diabetes. SUBJECTS AND METHODS Patients (N = 110) were evaluated regarding Epworth Sleepiness Scale (EDS), sleep quality (Pittsburgh Sleep Quality Index), depressive symptoms (Beck Depression Inventory), Restless Legs Syndrome (RLS), risk of obstructive sleep apnea (OSA) (Berlin questionnaire), and comorbidity severity (Charlson Comorbidity Index). Patients were compared with individuals with arterial hypertension and without diabetes. RESULTS Diabetic patients had more EDS, depressive symptoms, and higher comorbidity severity than hypertensive patients (p < 0.005). In diabetic patients, poor quality sleep (53.3%), and high risk of OSA (40.9%) and RLS (14.5%) were found; EDS (55.5%) was associated with depressive symptoms present in 44.5% individuals (OR = 1.08; 95% CI: 1.01-1.15), and remained so after data were controlled for age, gender, body mass index, and glycated hemoglobin (OR = 2.27; 95% CI 1.03-5.03). CONCLUSIONS Sleep abnormalities are frequent. EDS affects most of the patients and is independently associated with depressive symptoms. Adequate antidepressant therapy should be tested for the effects on EDS.
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