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Wu W, Zeng C, Wu C, Wu T, Pang J, Zhou P, Cao Y. Antidepressant effect of carvedilol on streptozotocin-induced diabetic peripheral neuropathy mice by altering gut microbiota. Biochem Biophys Res Commun 2024; 730:150374. [PMID: 38986219 DOI: 10.1016/j.bbrc.2024.150374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 07/05/2024] [Accepted: 07/08/2024] [Indexed: 07/12/2024]
Abstract
RATIONALE Although diabetic peripheral neuropathic pain (DPNP) and depression have been recognized for many years, their co-morbidity relationship and effective treatment choices remain uncertain. OBJECTIVES To evaluate the antidepressant effect of carvedilol on streptozotocin-induced DPNP mice, and the relationship with gut microbiota. METHODS The hyperalgesia and depressive behaviors of mice with comorbidity of DPNP and depression were confirmed by pain threshold of the mechanical sensitivity test (MST), immobility time of the tail suspension test (TST) and the forced swimming test (FST). The anti-depressive effect and fecal gut microbiota composition were studied in DPNP mice treated with carvedilol (10 mg/kg/day), and the relationships between them were analyzed by Spearman's correlation. RESULTS Depression was successfully induced in DPNP mice. Carvedilol can reverse the decreased mechanical pain threshold and relieve the depressive behaviors of DPNP mice, while increasing the abundance of Prevotella, Ruminococcus, Helicobacter and Desulfovibrio, and decreasing the abundance of Akkermansia and Allobaculum. CONCLUSIONS Carvedilol can alleviate the mechanical hyperalgesia and alter gut microbiota to ameliorate the depression-like behaviors which induced by DPNP.
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Affiliation(s)
- Weifeng Wu
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
| | - Chao Zeng
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
| | - Caineng Wu
- Department of Anesthesia, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ting Wu
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
| | - Jianxin Pang
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
| | - Pingzheng Zhou
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China.
| | - Ying Cao
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China; Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
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Liu L, Wu KCH, Cai A, Xu A, Cheung BMY. Childhood psychosocial adjustment and midlife obesity, diabetes and hypertension: prospective study from two birth cohorts. Br J Psychiatry 2024:1-9. [PMID: 39387221 DOI: 10.1192/bjp.2024.133] [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] [Indexed: 10/15/2024]
Abstract
BACKGROUND Understanding how childhood psychosocial adjustment (CPA) influences later life health outcomes is crucial for developing interventions to mitigate the long-term risk of cardiometabolic diseases (CMDs). AIMS To investigate the association between CPA and incident CMDs in mid-life, and the mediating roles of educational attainment, smoking habits and depression during young adulthood. METHOD A prospective cohort study utilised data from the 1958 National Child Development Study (NCDS; 1958-2013) and the 1970 British Cohort Study (BCS70; 1970-2018), encompassing 22 012 participants assessed for CPA in childhood, who were subsequently evaluated for educational attainment, smoking habits and depression in young adulthood, followed by assessments for CMDs in mid-life. CPA was assessed using the Bristol Social Adjustment Guides in the NCDS and the Rutter Child Behaviour Scale in the BCS70, with higher scores indicating poorer psychosocial adjustment. The primary outcomes were the mid-life incidences of hypertension, diabetes and obesity. RESULTS Compared with children in the lowest tertile for CPA scores, those in the middle tertile had an adjusted odds ratio for hypertension of 0.98 (95% CI 0.90-1.06), whereas those in the highest tertile had an odds ratio of 1.17 (95% CI 1.08-1.26). For diabetes, the corresponding odds ratios (95% CI) were 1.15 (0.98-1.35) and 1.39 (1.19-1.62). For obesity, the corresponding odds ratios (95% CI) were 1.08 (1.00-1.16) and 1.18 (1.09-1.27). These associations were partially mediated by educational attainment (2.4-13.9%) and depression during young adulthood (2.5-14.9%). CONCLUSIONS Poorer CPA is correlated with the development of hypertension, diabetes and obesity in mid-life. Interventions aimed at improving CPA may help in reducing the burden of these diseases in later life.
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Affiliation(s)
- Lin Liu
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Kevin Chun Hei Wu
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Anping Cai
- Hypertension Research Laboratory, Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Aimin Xu
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China; and State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Bernard M Y Cheung
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China; State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Pokfulam, Hong Kong, China; and Institute of Cardiovascular Science and Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
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Andersson P, Linge J, Gurholt TP, Sønderby IE, Hindley G, Andreassen OA, Dahlqvist Leinhard O. Poor muscle health and cardiometabolic risks associated with antidepressant treatment. Obesity (Silver Spring) 2024; 32:1857-1869. [PMID: 39315407 DOI: 10.1002/oby.24085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/26/2024] [Accepted: 05/01/2024] [Indexed: 09/25/2024]
Abstract
OBJECTIVE This study aims to investigate whether antidepressant users display differences in fat distribution and muscle composition relative to non-users and to explore risk factors for developing cardiovascular disease (CVD) and type 2 diabetes. METHODS The study used quantitative adipose and muscle tissue measures derived from magnetic resonance imaging data from UK Biobank (N = 40,174). Fat distribution and muscle composition of selective serotonin reuptake inhibitor (SSRI) and tricyclic antidepressant (TCA) users were compared with sex-, age-, and BMI-matched control individuals. Cox regression models were used to test for increased risk of developing CVD and type 2 diabetes. RESULTS SSRI users had more visceral fat, smaller muscle volume, and higher muscle fat infiltration compared with matched control individuals. Female users showed a larger increase in BMI over time compared with male users. However, male users displayed an unhealthier body composition profile. Male SSRI users also had an increased risk of developing CVD. Both male and female TCA users showed lower muscle volume and an increased risk of developing type 2 diabetes. CONCLUSIONS Adverse changes in body composition of antidepressant users are not captured by tracking the body weight or the BMI of the patients. These changes may lead to a worsened cardiometabolic risk profile.
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Affiliation(s)
| | - Jennifer Linge
- AMRA Medical AB, Linköping, Sweden
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Tiril P Gurholt
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Ida E Sønderby
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, University of Oslo, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Guy Hindley
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Olof Dahlqvist Leinhard
- AMRA Medical AB, Linköping, Sweden
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
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Zhao K, Xiang X, Sun Z. Insights for Using Jinlida in Diabetes Prevention. JAMA Intern Med 2024:2824126. [PMID: 39348150 DOI: 10.1001/jamainternmed.2024.4992] [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: 10/01/2024]
Affiliation(s)
- Kun Zhao
- Department of PET-CT Imaging Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai, China
| | - Xiqiao Xiang
- Department of PET-CT Imaging Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai, China
| | - Zhenliang Sun
- Department of Clinical Drug Research Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai, China
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Perez N, He N, Wright F, Condon E, Weiser S, Aouizerat B. Social determinants of inflammatory markers linking depression and type 2 diabetes among women: A scoping review. J Psychosom Res 2024; 184:111831. [PMID: 38905780 DOI: 10.1016/j.jpsychores.2024.111831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/03/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVE Inflammation is implicated in the pathophysiology of depression and type 2 diabetes (T2D) and is linked to social determinants of health (SDoH) associated with socioeconomic disadvantage. The objective of this review is to identify and map the range of SDoHs associated with inflammation in depression, T2D, or their co-occurrence among women. METHODS PubMed, CINAHL, PsychINFO, and Web of Science were searched March-July 2023 to identify studies where 1) an SDoH was a predictor or independent variable, 2) depression or T2D was a clinical focus, 3) inflammatory markers were collected, and 4) analysis was specific to women. We used the National Institute on Minority Health and Health Disparities research framework to guide searching SDoHs, organize findings, and identify gaps. RESULTS Of the 1135 studies retrieved, 46 met criteria. Within the reviewed studies, the most used inflammatory measures were C-reactive protein, interleukin-6, and tumor necrosis factor-α, and the most studied SDoHs were early life stress and socioeconomic status. Individual and interpersonal-level variables comprised the bulk of SDoHs in the included studies, while few to no studies examined built environment (n = 6) or health system level (n = 0) factors. Disadvantageous SDoHs were associated with higher levels of inflammation across the included studies. CONCLUSION The scope and intersection of depression and T2D represent a syndemic that contributes to and results from socioeconomic inequities and disproportionately affects women. Simultaneous inclusion of social and inflammatory measures, particularly understudied SDoHs, is needed to clarify potent targets aimed at advancing health and equity.
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Affiliation(s)
- Nicole Perez
- New York University, Rory Meyers College of Nursing, 433 1(st) Ave, New York, NY 10010, USA.
| | - Ning He
- New York University, Silver School of Social Work, 1 Washington Squire North, New York, NY 10003, United States of America.
| | - Fay Wright
- Northwell Health Northern Westchester Hospital, 400 East Main Street, Mt Kisco, NY 10549, United States of America.
| | - Eileen Condon
- University of Connecticut, College of Nursing, 231 Glenbrook Rd, Storrs, CT 06269, United States of America.
| | - Sheri Weiser
- University of San Francisco, School of Medicine, 533 Parnassus Ave, San Francisco, CA 94143, United States of America.
| | - Brad Aouizerat
- New York University, College of Dentistry, 345 E 24th St, New York, NY 10010, United States of America; University of San Francisco, School of Pharmacy, 513 Parnassus Ave, San Francisco, CA 94143, United States of America.
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Huang ZP, Chen YB, Wen BB, Guan HX, Wu B. Effects of Comorbid Depressive Symptoms and Diabetes Mellitus on Functional Dyspepsia in Older Patients. ALPHA PSYCHIATRY 2024; 25:465-471. [PMID: 39360307 PMCID: PMC11443295 DOI: 10.5152/alphapsychiatry.2024.241584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/23/2024] [Indexed: 10/04/2024]
Abstract
Objective Diabetes mellitus (DM) is a global epidemic; comorbid depressive symptoms are highly prevalent worldwide and commonly manifests as physical symptoms, including functional dyspepsia (FD), a gastrointestinal psychosomatic disorder. This study aimed to explore the effects of comorbid depressive symptoms and DM on FD in older patients. Methods In total, 420 older patients with DM completed measures of depression, anxiety, and FD. Relevant demographic characteristics and medical information were self-reported and obtained from the hospital information system. Results Among older patients with DM, 30.48% had depressive symptoms. Patients with depressive symptoms were more likely to have FD than those without (42.19% vs. 20.21%, P = .000). Dyspepsia symptoms were more frequent in patients with depression (P = .022). The greater the amount of dyspepsia symptoms, the higher the depression symptoms score (P = .000). Furthermore, dyspepsia symptoms were positively correlated with depressive symptoms (r values were 0.292, 0.311, 0.297, 0.369; all had P < .05). Both FD subtypes, postprandial distress, and epigastric pain syndromes affected depressive symptoms (P < .05). Smoking was significantly associated with FD (P < .05). Diabetes mellitus complications, such as diabetic neuropathy, different therapeutic methods, and anxiety symptoms, influenced FD overlap (x 2 values were 6.298, 16.314, and 30.744; P < .05). Anxiety (odds ratio = 1.832, 95% Confidence Intervals (CI) 1.185-2.834) was a risk factor for FD in comorbid depressive symptoms and diabetes (P < .05). Conclusion Comorbid depressive symptoms and DM overlapped with physical symptoms, such as FD, in older patients with DM. Lifestyle, diabetic factors, and anxiety were the associated risk factors.
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Affiliation(s)
- Zhen-Peng Huang
- Faculty of Nursing, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Yan-Bin Chen
- Faculty of Nursing, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Bin-Bin Wen
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
- Faculty of Nursing, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Hui-Xian Guan
- Faculty of Nursing, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Bin Wu
- Faculty of Nursing, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
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Al-Jabi SW. Emerging global interest: Unraveling the link between diabetes mellitus and depression. World J Psychiatry 2024; 14:1127-1139. [PMID: 39050204 PMCID: PMC11262933 DOI: 10.5498/wjp.v14.i7.1127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 06/03/2024] [Accepted: 06/19/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Studies have shown a strong bidirectional association between diabetes and depression, with diabetes increasing the risk of developing depression and vice versa. Depression among patients with diabetes is associated with poor glycemic control, complications, and poor self-care. AIM To explore the present state of research globally concerning diabetes and depression, to aid understanding the current research landscape and identify potential future areas of research. METHODS A bibliometric approach was used, utilizing the Scopus database to gather pertinent research articles released from 2004 to 2023. Analyses encompassed publication patterns, significant contributors, research focal points, prevalent themes, and the most influential articles, aimed at discerning emerging research subjects. RESULTS A total of 3229 publications that met the search criteria were identified. A significant increase in the number of publications related to diabetes and depression has been observed in the past two decades. The most productive nation was the USA (n = 1015; 31.43%), followed by China (n = 325; 10.07%), the UK (n = 236; 7.31%), and Germany (n = 218; 6.75%). Three principal themes in research on depression and diabetes were delineated by the analysis. First, the exploration of the elevated prevalence and etiology of this comorbidity; second, the focus on interventions, particularly randomized controlled trials, aimed at enhancing diabetes management among individuals with depression; and finally, the investigation of the involved risk factors and biological mechanisms underlying this bidirectional relationship. CONCLUSION There has been a recent surge of interest in the relationship between diabetes and depression. This could aid researchers to identify areas lacking in the literature and shape future research.
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Affiliation(s)
- Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
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8
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Yoon YJ. Depressive symptom trajectory of older adults with diabetes: exploring the role of physical activities using latent growth modeling. Aging Ment Health 2024; 28:1041-1049. [PMID: 38353514 DOI: 10.1080/13607863.2024.2313722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/25/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES The literature highlights the role of physical activities in reducing depression, primarily in clinical samples and international longitudinal studies on older adults with diabetes. Based on Andersen's Behavioral Model, this study aims to describe the trajectory of depressive symptoms in this population and examine whether physical activities are associated with this trajectory. METHODS This study used a longitudinal survey design, utilizing three waves of data from the Health and Retirement Study. The respondents were adults aged 50 or older (N = 4,278) with diabetes. After conducting descriptive analyses, latent growth modeling was performed including unconditional and conditional models. RESULTS The overall trajectory of depressive symptoms in adults with diabetes decreased over a 4-year period. Physical activities were significantly associated with the variance in the intercept of the trajectory (p < .05), but not associated with the variance in the slope (p > .05). Additionally, this study identified factors significantly associated with the variance in the intercept (e.g. age, gender, race, marriage, education, income, self-reported health) or the slope (e.g. race, marriage, education, self-reported health) of the depressive symptom trajectory (p < .05). CONCLUSION The findings underscore the importance of implementing targeted interventions to encourage and promote physical activities among older adults with diabetes, recognizing the potential benefits for managing their mental health.
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Affiliation(s)
- Young Ji Yoon
- Department of Social Work, Colorado State University Pueblo, Pueblo, USA
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Safiri S, Mousavi SE, Nejadghaderi SA, Noori M, Sullman MJM, Kolahi AA, Shekarriz-Foumani R. The burden of major depressive disorder in the Middle East and North Africa region, 1990-2019. Acta Neuropsychiatr 2024; 36:139-152. [PMID: 37690795 DOI: 10.1017/neu.2023.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is one of the leading causes of disability. We aimed to report the MDD-attributable prevalence, incidence and years lived with disability (YLDs) in the Middle East and North Africa (MENA) region from 1990 to 2019 by age, sex and socio-demographic index (SDI). METHODS Publicly available data on the burden of MDD were retrieved from the Global Burden of Disease (GBD) study 2019 for the 21 countries in MENA. The counts and age-standardised rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals. RESULTS In 2019, MDD had an age-standardised point prevalence of 3322.1 and an incidence rate of 4921.7 per 100,000 population in MENA. Furthermore, there were 4.1 million YLDs in 2019. However, there were no substantial changes in the MDD burden over the period 1990-2019. In 2019, Palestine had the highest burden of MDD. The highest prevalence, incidence and YLDs attributable to MDD were found in the 35-39 age group. In 2019, the YLD rate in MENA was higher than the global rate for almost all age groups. Furthermore, there was a broadly negative association between the YLD rate and SDI. CONCLUSION The study highlights the need to prevent the disorder using a multidisciplinary approach and for the provision of cost-effective treatments for those affected, in order to increase their quality of life.
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Affiliation(s)
- Saeid Safiri
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Ehsan Mousavi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Aria Nejadghaderi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Shekarriz-Foumani
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Albai O, Timar B, Braha A, Timar R. Predictive Factors of Anxiety and Depression in Patients with Type 2 Diabetes Mellitus. J Clin Med 2024; 13:3006. [PMID: 38792547 PMCID: PMC11122043 DOI: 10.3390/jcm13103006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/09/2024] [Accepted: 05/18/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Diabetes mellitus (DM) is a chronic condition associated with multiple complications and comorbidities. Some of these comorbidities are anxiety and depression, with a negative impact on the quality of life, non-adherence to treatment, and poor prognosis. The main aim of this study was to evaluate depression and anxiety in a group of patients with DM and their impact on quality of life and identify factors that improve the prognosis and increase the life expectancy and quality of life of patients with DM. Methods: A total of 209 patients with type 2 DM (T2DM) were enrolled cross-sectionally. Patients were screened for psychiatric disorders, cognitive impairment, and metabolic parameters. Results: Included patients had a median age of 66.0 (58; 70) years, a median DM duration of 9 (6; 15) years, and a suboptimal glycemic control reflected by a median HbA1c of 7.8 (7; 9.2) mg/dL. Patients presented anxiety at different stages in 51.5% of cases, and similarly, depression in 37.5% of cases. Age, duration of DM, HbA1c, and postprandial hyperglycemia (PPG) were predictive factors for anxiety and depression in patients with T2DM. An age > 57 years (sensitivity 84.3, specificity 33.7, AUROC 0.621, p = 0.002) and an HbA1c > 8.5% (sensitivity 45.8, specificity 83.1, AUROC = 0.635, p < 0.0001) predict a higher rate of anxiety, respectively, of depression in these patients. Conclusions: Patients with T2DM have an increased rate of anxiety and depression due to persistent hyperglycemia and aging, which is expressed in a lower quality of life.
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Affiliation(s)
- Oana Albai
- Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.A.); (A.B.); (R.T.)
- Department of Diabetes, Nutrition and Metabolic Diseases Clinic, “Pius Brînzeu” Emergency Clinical County University Hospital, 300723 Timisoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease/MOL-NEPHRO-VASC, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Bogdan Timar
- Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.A.); (A.B.); (R.T.)
- Department of Diabetes, Nutrition and Metabolic Diseases Clinic, “Pius Brînzeu” Emergency Clinical County University Hospital, 300723 Timisoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease/MOL-NEPHRO-VASC, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Adina Braha
- Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.A.); (A.B.); (R.T.)
- Department of Diabetes, Nutrition and Metabolic Diseases Clinic, “Pius Brînzeu” Emergency Clinical County University Hospital, 300723 Timisoara, Romania
| | - Romulus Timar
- Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.A.); (A.B.); (R.T.)
- Department of Diabetes, Nutrition and Metabolic Diseases Clinic, “Pius Brînzeu” Emergency Clinical County University Hospital, 300723 Timisoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease/MOL-NEPHRO-VASC, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Zhao P, Ying Z, Yuan C, Zhang H, Dong A, Tao J, Yi X, Yang M, Jin W, Tian W, Karasik D, Tian G, Zheng H. Shared genetic architecture highlights the bidirectional association between major depressive disorder and fracture risk. Gen Psychiatr 2024; 37:e101418. [PMID: 38737893 PMCID: PMC11086190 DOI: 10.1136/gpsych-2023-101418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/28/2024] [Indexed: 05/14/2024] Open
Abstract
Background There is limited evidence suggesting that osteoporosis might exacerbate depressive symptoms, while more studies demonstrate that depression negatively affects bone density and increases fracture risk. Aims To explore the relationship between major depressive disorder (MDD) and fracture risk. Methods We conducted a nested case-control analysis (32 670 patients with fracture and 397 017 individuals without fracture) and a matched cohort analysis (16 496 patients with MDD and 435 492 individuals without MDD) in the same prospective UK Biobank data set. Further, we investigated the shared genetic architecture between MDD and fracture with linkage disequilibrium score regression and the MiXeR statistical tools. We used the conditional/conjunctional false discovery rate approach to identify the specific shared loci. We calculated the weighted genetic risk score for individuals in the UK Biobank and logistic regression was used to confirm the association observed in the prospective study. Results We found that MDD was associated with a 14% increase in fracture risk (hazard ratio (HR) 1.14, 95% CI 1.14 to 1.15, p<0.001) in the nested case-control analysis, while fracture was associated with a 72% increase in MDD risk (HR 1.72, 95% CI 1.64 to 1.79, p<0.001) in the matched cohort analysis, suggesting a longitudinal and bidirectional relationship. Further, genetic summary data suggested a genetic overlap between MDD and fracture. Specifically, we identified four shared genomic loci, with the top signal (rs7554101) near SGIP1. The protein encoded by SGIP1 is involved in cannabinoid receptor type 1 signalling. We found that genetically predicted MDD was associated with a higher risk of fracture and vice versa. In addition, we found that the higher expression level of SGIP1 in the spinal cord and muscle was associated with an increased risk of fracture and MDD. Conclusions The genetic pleiotropy between MDD and fracture highlights the bidirectional association observed in the epidemiological analysis. The shared genetic components (such as SGIP1) between the diseases suggest that modulating the endocannabinoid system could be a potential therapeutic strategy for both MDD and bone loss.
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Affiliation(s)
- Pianpian Zhao
- The Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou,Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China
| | - Zhimin Ying
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chengda Yuan
- Department of Dermatology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
| | - Haisheng Zhang
- The Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou,Zhejiang, China
| | - Ao Dong
- The Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou,Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China
| | - Jianguo Tao
- The Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou,Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China
| | - Xiangjiao Yi
- The Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou,Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China
| | - Mengyuan Yang
- The Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou,Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China
| | - Wen Jin
- The Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou,Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China
| | - Weiliang Tian
- Department of Global Statistics, Eli Lilly and Company, Branchburg, New Jersey, USA
| | - David Karasik
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Geng Tian
- Binzhou Medical University, Yantai, Shandong, China
| | - Houfeng Zheng
- The Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou,Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China
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12
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Stecher C, Cloonan S, Domino ME. The Economics of Treatment for Depression. Annu Rev Public Health 2024; 45:527-551. [PMID: 38100648 DOI: 10.1146/annurev-publhealth-061022-040533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
The global prevalence of depression has risen over the past three decades across all socioeconomic groups and geographic regions, with a particularly rapid increase in prevalence among adolescents (aged 12-17 years) in the United States. Depression imposes large health, economic, and societal costs, including reduced life span and quality of life, medical costs, and reduced educational attainment and workplace productivity. A wide range of treatment modalities for depression are available, but socioeconomic disparities in treatment access are driven by treatment costs, lack of culturally tailored options, stigma, and provider shortages, among other barriers. This review highlights the need for comparative research to better understand treatments' relative efficacy, cost-effectiveness, scalability, and potential heterogeneity in efficacy across socioeconomic groups and country and cultural contexts. To address the growing burden of depression, mental health policy could consider reducing restrictions on the supply of providers, implementing digital interventions, reducing stigma, and promoting healthy lifestyles.
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Affiliation(s)
- Chad Stecher
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA;
- The Center for Health Information and Research, Arizona State University, Phoenix, Arizona, USA
| | - Sara Cloonan
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Marisa Elena Domino
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA;
- The Center for Health Information and Research, Arizona State University, Phoenix, Arizona, USA
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13
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Zhang X, Valeri J, Eladawi MA, Gisabella B, Garrett MR, Vallender EJ, McCullumsmith R, Pantazopoulos H, O’Donovan SM. Differentially Altered Metabolic Pathways in the Amygdala of Subjects with Schizophrenia, Bipolar Disorder and Major Depressive Disorder. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.17.24305854. [PMID: 38699334 PMCID: PMC11065019 DOI: 10.1101/2024.04.17.24305854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Background and hypothesis A growing number of studies implicate a key role for metabolic processes in psychiatric disorders. Recent studies suggest that ketogenic diet may be therapeutically effective for subgroups of people with schizophrenia (SCZ), bipolar disorder (BPD) and possibly major depressive disorder (MDD). Despite this promise, there is currently limited information regarding brain energy metabolism pathways across these disorders, limiting our understanding of how brain metabolic pathways are altered and who may benefit from ketogenic diets. We conducted gene expression profiling on the amygdala, a key region involved in in the regulation of mood and appetitive behaviors, to test the hypothesis that amygdala metabolic pathways are differentially altered between these disorders. Study Design We used a cohort of subjects diagnosed with SCZ, BPD or MDD, and non-psychiatrically ill control subjects (n=15/group), together with our bioinformatic 3-pod analysis consisting of full transcriptome pathway analysis, targeted pathway analysis, leading-edge gene analysis and iLINCS perturbagen analysis. Study Results We identified differential expression of metabolic pathways in each disorder. Subjects with SCZ displayed downregulation of mitochondrial respiration and nucleotide metabolism pathways. In comparison, we observed upregulation of mitochondrial respiration pathways in subjects with MDD, while subjects with BPD displayed enrichment of pathways involved in carbohydrate metabolism. Several pathways associated with brain metabolism including immune system processes and calcium ion transport were also differentially altered between diagnosis groups. Conclusion Our findings suggest metabolic pathways are differentially altered in the amygdala in these disorders, which may impact approaches for therapeutic strategies.
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Affiliation(s)
- Xiaolu Zhang
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center, Shreveport, LA
| | - Jake Valeri
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
- Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS
| | | | - Barbara Gisabella
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
- Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS
| | - Michael R. Garrett
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, MS
| | - Eric J Vallender
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
- Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS
| | - Robert McCullumsmith
- Department of Neurosciences, University of Toledo, Toledo, OH
- Promedica Neuroscience Institute, Toledo, OH
| | - Harry Pantazopoulos
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
- Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS
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14
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Kalyani RR, Allende-Vigo MZ, Antinori-Lent KJ, Close KL, Das SR, Deroze P, Edelman SV, El Sayed NA, Kerr D, Neumiller JJ, Norton A. Prioritizing Patient Experiences in the Management of Diabetes and Its Complications: An Endocrine Society Position Statement. J Clin Endocrinol Metab 2024; 109:1155-1178. [PMID: 38381587 DOI: 10.1210/clinem/dgad745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Indexed: 02/23/2024]
Abstract
Diabetes can be an arduous journey both for people with diabetes (PWD) and their caregivers. While the journey of every person with diabetes is unique, common themes emerge in managing this disease. To date, the experiences of PWD have not been fully considered to successfully implement the recommended standards of diabetes care in practice. It is critical for health-care providers (HCPs) to recognize perspectives of PWD to achieve optimal health outcomes. Further, existing tools are available to facilitate patient-centered care but are often underused. This statement summarizes findings from multistakeholder expert roundtable discussions hosted by the Endocrine Society that aimed to identify existing gaps in the management of diabetes and its complications and to identify tools needed to empower HCPs and PWD to address their many challenges. The roundtables included delegates from professional societies, governmental organizations, patient advocacy organizations, and social enterprises committed to making life better for PWD. Each section begins with a clinical scenario that serves as a framework to achieve desired health outcomes and includes a discussion of resources for HCPs to deliver patient-centered care in clinical practice. As diabetes management evolves, achieving this goal will also require the development of new tools to help guide HCPs in supporting PWD, as well as concrete strategies for the efficient uptake of these tools in clinical practice to minimize provider burden. Importantly, coordination among various stakeholders including PWD, HCPs, caregivers, policymakers, and payers is critical at all stages of the patient journey.
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Affiliation(s)
- Rita R Kalyani
- Division of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | | | | | | | - Sandeep R Das
- Division of Cardiology, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Phyllisa Deroze
- dQ&A, The Diabetes Research Company, San Francisco, CA 94117, USA
| | - Steven V Edelman
- Division of Endocrinology, Diabetes & Metabolism at the University of California at San Diego, San Diego, CA 92103, USA
| | - Nuha A El Sayed
- American Diabetes Association, Harvard Medical School, Boston, MA 02215, USA
| | - David Kerr
- Director of Digital Health, Diabetes Technology Society, Santa Barbara, CA 94010, USA
| | - Joshua J Neumiller
- Department of Pharmacotherapy, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA 99202, USA
| | - Anna Norton
- DiabetesSisters, #180, 1112 W Boughton Road, Bolingbrook, IL 60440, USA
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15
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Sperling JD, Frikke-Schmidt R, Scheike T, Kessing LV, Miskowiak K, Vinberg M. APOE Genotype, ApoE Plasma Levels, Lipid Metabolism, and Cognition in Monozygotic Twins with, at Risk of, and without Affective Disorders. J Clin Med 2024; 13:2361. [PMID: 38673634 PMCID: PMC11051543 DOI: 10.3390/jcm13082361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/01/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Lipids influence brain function and mental health. Understanding the role of apolipoproteins in affective disorders could provide valuable insights and potentially pave the way for novel therapeutic approaches. Methods: We examined the apolipoprotein E genotype and ApoE-levels, lipid profiles, and the correlation with cognition in 204 monozygotic (MZ) twins with unipolar or bipolar disorder in remission or partial remission (affected, AT), their unaffected co-twins (high-risk, HR), and twins with no personal or family history of affective disorder (low-risk, LR). Results: The APOE genotype was not associated with affective disorders. No significant group differences in ApoE levels were found between the three risk groups. Post hoc analysis group-wise comparisons showed higher ApoE levels in the AT than HR twins and in the concordant AT twin pairs relative to the discordant twin pairs. Within the discordant twin pairs, higher ApoE levels were observed in the affected twins (AT = 39.4 mg/L vs. HR = 36.8 mg/L, p = 0.037). Limitations: The present study could benefit from a larger sample size. We did not assess dietary habits. Conclusions: The results did not support our main hypothesis. However, exploratory post hoc analysis suggests a role for plasma ApoE and triglycerides in affective disorders. Future research is needed.
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Affiliation(s)
- Jon Dyg Sperling
- The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Mental Health Centre, Northern Zealand, Copenhagen University Hospital—Mental Health Services CPH, 3400 North Zealand, Denmark;
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark (L.V.K.)
| | - Ruth Frikke-Schmidt
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark (L.V.K.)
- Department of Clinical Biochemistry Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Thomas Scheike
- Department of Biostatistics, University of Copenhagen, 1353 Copenhagen, Denmark
| | - Lars Vedel Kessing
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark (L.V.K.)
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, 2000 Frederiksberg, Denmark
| | - Kamilla Miskowiak
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark (L.V.K.)
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, 2000 Frederiksberg, Denmark
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Department of Psychology, University of Copenhagen, and Mental Health Services, Capital Region of Denmark, 2000 Frederiksberg, Denmark
| | - Maj Vinberg
- The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Mental Health Centre, Northern Zealand, Copenhagen University Hospital—Mental Health Services CPH, 3400 North Zealand, Denmark;
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark (L.V.K.)
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16
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Lau SCL, Zhang G, Rueschman M, Li X, Irwin MR, Krafty RT, McCall WV, Skidmore E, Patel SR, Redline S, Smagula SF. Sleep-wake behavioral characteristics associated with depression symptoms: findings from the Multi-Ethnic Study of Atherosclerosis. Sleep 2024; 47:zsae045. [PMID: 38394355 PMCID: PMC11009024 DOI: 10.1093/sleep/zsae045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/19/2024] [Indexed: 02/25/2024] Open
Abstract
STUDY OBJECTIVES To help prioritize target/groups for experimental intervention studies, we characterized cross-sectional associations between 24-hour sleep-wake measures and depression symptoms, and evaluated if similar sleep-wake-depression relationships existed in people with and without higher insomnia severity. METHODS Participants had ≥3 days of actigraphy data (n = 1884; mean age = 68.6/SD = 9.1; 54.1% female). We extracted 18 sleep, activity, timing, rhythmicity, and fragmentation measures from actigraphy. We used individual and multivariable regressions with the outcome of clinically significant depression symptoms (Center for Epidemiologic Studies Depression Scale ≥ 16). We conducted sensitivity analyses in people with higher insomnia severity (top quartile of the Women's Health Initiative Insomnia Rating Scale total score). RESULTS From separate models in the overall sample, the odds of having depression symptoms were higher with: later timing (e.g. activity onset time odds ratio [OR]/1 SD = 1.32; 95% confidence interval [CI]: 1.16 to 1.50), lower rhythmicity (e.g. pseudo-F OR/1 SD = 0.75; 95% CI: 0.66 to 0.85), less activity (e.g. amplitude OR/1 SD = 0.83; 95% CI: 0.72 to 0.95), and worse insomnia (OR/1 SD = 1.48, 95% CI: 1.31 to 1.68). In multivariable models conducted among people with lower insomnia severity, later timing, lower rhythmicity, and higher insomnia severity were independent correlates of depression. In people with higher insomnia symptom severity, measures of later timing were most strongly associated with depression symptoms. CONCLUSIONS These correlative observations suggest that experimental studies are warranted to test if: broadly promoting 24-hour sleep-wake functioning reduces depression even in people without severe insomnia, and if advancing timing leads to depression symptom reductions in people with insomnia.
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Affiliation(s)
- Stephen C L Lau
- Department of Occupational Therapy, School of Health and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Gehui Zhang
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael Rueschman
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Xiaoyu Li
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michael R Irwin
- Norman Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Robert T Krafty
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - William V McCall
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Elizabeth Skidmore
- Department of Occupational Therapy, School of Health and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sanjay R Patel
- Center for Sleep and Cardiovascular Outcomes Research, University of Pittsburgh, Pittsburgh, PA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Stephen F Smagula
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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17
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Ma LL, Chen N, Zhang Y, Feng XM, Gong M, Yan YX. Association of phenotypic frailty and frailty index with type 2 diabetes and dyslipidemia in middle-aged and elderly Chinese: A longitudinal cohort study. Arch Gerontol Geriatr 2024; 119:105311. [PMID: 38101111 DOI: 10.1016/j.archger.2023.105311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/29/2023] [Accepted: 12/10/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Frailty, type 2 diabetes (T2D) and dyslipidemia are highly prevalent in middle-aged and elderly populations. However, evidence on the longitudinal association of frailty with T2D and dyslipidemia is limited. The aim of our study was to explore the cross-sectional and longitudinal effects of frailty levels on T2D and dyslipidemia in combination with phenotypic frailty and frailty index (FI). MATERIALS AND METHODS Multivariate logistic regression model was used to explore the association of frailty status with T2D and dyslipidemia. Area under curve (AUC) of the receiver operating characteristic curve (ROC) to estimate the predictive values of phenotypic frailty and frailty index for T2D and dyslipidemia. In addition, depressive symptom was used as a mediating variable to examine whether it mediates the association between frailty and T2D or dyslipidemia. RESULTS 10,203 and 9587 participants were chosen for the longitudinal association analysis of frailty with T2D and dyslipidemia. Frailty was associated with T2D (phenotypic frailty: OR=1.50, 95 %CI=1.03, 2.17; FI: OR=1.17, 95 %CI=1.08, 1.26) and dyslipidemia (phenotypic frailty: OR=1.56, 95 %CI=1.16, 2.10; FI: OR=1.17, 95 %CI=1.10, 1.25). Phenotypic frailty and frailty index significantly improved the risk discrimination of T2D and dyslipidemia (p<0.05). Depressive symptoms played a mediating role in the association between frailty and long-term T2D or dyslipidemia (p<0.05). CONCLUSION Frailty had adverse effects on type 2 diabetes and dyslipidemia, with depressive symptoms acting as the mediator.
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Affiliation(s)
- Lin-Lin Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing 100069, China
| | - Ning Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing 100069, China
| | - Yu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing 100069, China
| | - Xu-Man Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing 100069, China
| | - Miao Gong
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing 100069, China
| | - Yu-Xiang Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing 100069, China; Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
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18
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Chourpiliadis C, Zeng Y, Lovik A, Wei D, Valdimarsdóttir U, Song H, Hammar N, Fang F. Metabolic Profile and Long-Term Risk of Depression, Anxiety, and Stress-Related Disorders. JAMA Netw Open 2024; 7:e244525. [PMID: 38564219 PMCID: PMC10988352 DOI: 10.1001/jamanetworkopen.2024.4525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/02/2024] [Indexed: 04/04/2024] Open
Abstract
Importance Biomarkers of lipid, apolipoprotein, and carbohydrate metabolism have been previously suggested to be associated with the risk for depression, anxiety, and stress-related disorders, but results are inconsistent. Objective To examine whether the biomarkers of carbohydrate, lipid, and apolipoprotein metabolism are associated with the risk of depression, anxiety, and stress-related disorders. Design, Setting, and Participants This population-based cohort study with longitudinal data collection assessed 211 200 participants from the Apolipoprotein-Related Mortality Risk (AMORIS) cohort who underwent occupational health screening between January 1, 1985, and December 31, 1996, mainly in the Stockholm region in Sweden. Statistical analysis was performed during 2022 to 2023. Exposures Lipid, apolipoprotein, and carbohydrate biomarkers measured in blood. Main Outcomes and Measures The associations between biomarker levels and the risk of developing depression, anxiety, and stress-related disorders through the end of 2020 were examined using Cox proportional hazards regression models. In addition, nested case-control analyses were conducted within the cohort, including all incident cases of depression, anxiety, and stress-related disorders, and up to 10 control individuals per case who were individually matched to the case by year of birth, sex, and year of enrollment to the AMORIS cohort, using incidence density sampling. Population trajectories were used to illustrate the temporal trends in biomarker levels for cases and controls. Results A total of 211 200 individuals (mean [SD] age at first biomarker measurement, 42.1 [12.6] years; 122 535 [58.0%] male; 188 895 [89.4%] born in Sweden) participated in the study. During a mean (SD) follow-up of 21.0 (6.7) years, a total of 16 256 individuals were diagnosed with depression, anxiety, or stress-related disorders. High levels of glucose (hazard ratio [HR], 1.30; 95% CI, 1.20-1.41) and triglycerides (HR, 1.15; 95% CI, 1.10-1.20) were associated with an increased subsequent risk of all tested psychiatric disorders, whereas high levels of high-density lipoprotein (HR, 0.88; 95% CI, 0.80-0.97) were associated with a reduced risk. These results were similar for male and female participants as well as for all tested disorders. The nested case-control analyses demonstrated that patients with depression, anxiety, or stress-related disorders had higher levels of glucose, triglycerides, and total cholesterol during the 20 years preceding diagnosis, as well as higher levels of apolipoprotein A-I and apolipoprotein B during the 10 years preceding diagnosis, compared with control participants. Conclusions and Relevance In this cohort study of more than 200 000 participants, high levels of glucose and triglycerides and low levels of high-density lipoprotein were associated with future risk of depression, anxiety, and stress-related disorders. These findings may support closer follow-up of individuals with metabolic dysregulations for the prevention and diagnosis of psychiatric disorders.
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Affiliation(s)
| | - Yu Zeng
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Anikó Lovik
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Dang Wei
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Unnur Valdimarsdóttir
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center of Public Health Sciences, University of Iceland, Reykjavik, Iceland
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Niklas Hammar
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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19
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Gliozzi M, Coppoletta AR, Cardamone A, Musolino V, Carresi C, Nucera S, Ruga S, Scarano F, Bosco F, Guarnieri L, Macrì R, Mollace R, Belzung C, Mollace V. The dangerous "West Coast Swing" by hyperglycaemia and chronic stress in the mouse hippocampus: Role of kynurenine catabolism. Pharmacol Res 2024; 201:107087. [PMID: 38301816 DOI: 10.1016/j.phrs.2024.107087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Abstract
Growing epidemiological studies highlight a bi-directional relationship between depressive symptoms and diabetes mellitus. However, the detrimental impact of their co-existence on mental health suggests the need to treat this comorbidity as a separate entity rather than the two different pathologies. Herein, we characterized the peculiar mechanisms activated in mouse hippocampus from the concurrent development of hyperglycaemia, characterizing the different diabetes subtypes, and chronic stress, recognized as a possible factor predisposing to major depression. Our work demonstrates that kynurenine overproduction, leading to apoptosis in the hippocampus, is triggered in a different way depending on hyperglycaemia or chronic stress. Indeed, in the former, kynurenine appears produced by infiltered macrophages whereas, in the latter, peripheral kynurenine preferentially promotes resident microglia activation. In this scenario, QA, derived from kynurenine catabolism, appears a key mediator causing glutamatergic synapse dysfunction and apoptosis, thus contributing to brain atrophy. We demonstrated that the coexistence of hyperglycaemia and chronic stress worsened hippocampal damage through alternative mechanisms, such as GLUT-4 and BDNF down-expression, denoting mitochondrial dysfunction and apoptosis on one hand and evoking the compromission of neurogenesis on the other. Overall, in the degeneration of neurovascular unit, hyperglycaemia and chronic stress interacted each other as the partners of a "West Coast Swing" in which the leading role can be assumed alternatively by each partner of the dance. The comprehension of these mechanisms can open novel perspectives in the management of diabetic/depressed patients, but also in the understanding the pathogenesis of other neurodegenerative disease characterized by the compromission of hippocampal function.
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Affiliation(s)
- Micaela Gliozzi
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy.
| | - Anna Rita Coppoletta
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - Antonio Cardamone
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - Vincenzo Musolino
- Laboratory of Pharmaceutical Biology, Department of Health Sciences, Institute of Research for Food Safety & Health IRC-FSH, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.
| | - Cristina Carresi
- Veterinary Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Saverio Nucera
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - Stefano Ruga
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - Federica Scarano
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - Francesca Bosco
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Lorenza Guarnieri
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Roberta Macrì
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - Rocco Mollace
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | - Catherine Belzung
- UMR 1253, iBrain, Inserm, Université de Tours, CEDEX 1, 37032 Tours, France
| | - Vincenzo Mollace
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
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20
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Zhu Y, Yin Y, Huang F, Liu Y, Xia Y, Zhang M, Wang Y, Jin L. Transition in metabolic health phenotypes across general adiposity categories and association with the risk of depression: a prospective analysis. Eur Psychiatry 2024; 67:e26. [PMID: 38418418 PMCID: PMC10988159 DOI: 10.1192/j.eurpsy.2024.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND The association between obesity and depression may partly depend on the contextual metabolic health. The effect of change in metabolic health status over time on subsequent depression risk remains unclear. We aimed to assess the prospective association between metabolic health and its change over time and the risk of depression across body mass index (BMI) categories. METHODS Based on a nationally representative cohort, we included participants enrolled at the wave 2 (2004-2005) of the English Longitudinal Study of Ageing and with follow-up for depression at wave 8 (2016-2017). Participants were cross-classified by BMI categories and metabolic health (defined by the absence of hypertension, diabetes, and hypercholesterolemia) at baseline or its change over time (during waves 3-6). Logistic regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of depression at follow-up stratified by BMI category and metabolic health status with adjustment for potential confounders. RESULTS The risk of depression was increased for participants with metabolically healthy obesity compared with healthy nonobese participants, and the risk was highest for those with metabolically unhealthy obesity (OR 1.62, 95% CI 1.18-2.20). Particularly hypertension and diabetes contribute most to the increased risk. The majority of metabolically healthy participants converted to unhealthy metabolic phenotype (50.1% of those with obesity over 8 years), which was associated with an increased risk of depression. Participants who maintained metabolically healthy obesity were still at higher risk (1.99, 1.33-2.72), with the highest risk observed for those with stable unhealthy metabolic phenotypes. CONCLUSIONS Obesity remains a risk factor for depression, independent of whether other metabolic risk factors are present or whether participants convert to unhealthy metabolic phenotypes over time. Long-term maintenance of metabolic health and healthy body weight may be beneficial for the population mental well-being.
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Affiliation(s)
- Yunyi Zhu
- Suzhou Hospital of Traditional Chinese Medicine, Endocrinology and Metabolic Diseases Department, Suzhou, China
| | - Yuan Yin
- Suzhou Hospital of Traditional Chinese Medicine, Endocrinology and Metabolic Diseases Department, Suzhou, China
| | - Fei Huang
- Suzhou Hospital of Traditional Chinese Medicine, Endocrinology and Metabolic Diseases Department, Suzhou, China
| | - Yuanjun Liu
- Suzhou Hospital of Traditional Chinese Medicine, Endocrinology and Metabolic Diseases Department, Suzhou, China
| | - Yuge Xia
- The Second Affiliated Hospital of Anhui University of Chinese Medicine, Geriatric Department, Hefei, China
| | - Mingying Zhang
- Suzhou Hospital of Traditional Chinese Medicine, Endocrinology and Metabolic Diseases Department, Suzhou, China
| | - Yunhe Wang
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Lijuan Jin
- Suzhou Hospital of Traditional Chinese Medicine, Endocrinology and Metabolic Diseases Department, Suzhou, China
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21
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Meshkat S, Liu Y, Jung H, Tassone VK, Pang H, Janssen-Aguilar R, Lou W, Bhat V. Temporal associations of BMI and glucose parameters with depressive symptoms among US adults. Psychiatry Res 2024; 332:115709. [PMID: 38211470 DOI: 10.1016/j.psychres.2023.115709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/20/2023] [Accepted: 12/30/2023] [Indexed: 01/13/2024]
Abstract
As the prevalence of obesity, diabetes, and depression increases, it is important to examine how their associations are changing overtime. We investigated the temporal trends in the association between depressive symptoms, body mass index (BMI) and glucose profile parameters using data from 2005 to 2018 National Health and Nutrition Examination Survey. Depressive symptoms were assessed using the Patient Health Questionnaire. A total of 32,653 participants were included. Risk of depressive symptoms increased with higher BMI (aOR = 1.586, 95 % CI [1.364, 1.843]), insulin (aOR = 1.327, 95 % CI [1.159, 1.519]), HbA1c (aOR = 1.330, 95 % CI [1.116, 1.585]), or fasting glucose (aOR = 1.565, 95 % CI [1.247, 1.964]) levels compared to those with low levels. Sex differences were found, as overweight males had lower odds of depressive symptoms compared to healthy males, while overweight and obese females had higher odds compared to healthy females. High BMI and glucose parameters were consistently associated with higher depressive symptoms prevalence over time. Temporal variations were observed in the depressive symptoms-BMI and depressive symptoms-HbA1c associations, particularly at the 2007-2008 cycle. This study provides analytic insights into population level trends concerning physical and mental health problems.
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Affiliation(s)
- Shakila Meshkat
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Yuqing Liu
- Department of Biostatistics, University of Toronto, Toronto, Ontario, Canada
| | - Hyejung Jung
- Department of Biostatistics, University of Toronto, Toronto, Ontario, Canada
| | - Vanessa K Tassone
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Hilary Pang
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - Wendy Lou
- Department of Biostatistics, University of Toronto, Toronto, Ontario, Canada
| | - Venkat Bhat
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Mental Health and Addictions Services, St. Michael's Hospital, Toronto, Ontario, Canada.
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22
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Saha CK, Shubrook JH, Guyton Hornsby W, Yang Z, Pillay Y, Mather KJ, de Groot M. Program ACTIVE II: 6- and 12-month outcomes of a treatment approach for major depressive disorder in adults with type 2 diabetes. J Diabetes Complications 2024; 38:108666. [PMID: 38266570 PMCID: PMC10922820 DOI: 10.1016/j.jdiacomp.2023.108666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/12/2023] [Accepted: 12/17/2023] [Indexed: 01/26/2024]
Abstract
AIMS To evaluate the long-term effects of behavioral treatments on glycemic and psychological outcomes for patients with major depressive disorder (MDD) and type 2 diabetes (T2D). METHODS Program ACTIVE II was a multicenter randomized controlled comparative effectiveness trial of cognitive behavioral therapy (CBT), exercise (EXER), combination treatment (CBT + EXER) and usual care (UC) for adults with MDD and T2D. RESULTS Primary outcomes: change in A1c and depressive symptoms at 6- (N = 87) and 12-months (N = 75) from baseline. In those with a baseline A1c ≥7.0 %, CBT + EXER showed lasting A1c benefit at 6- (-1.2 %; SE: 0.6; p = 0.032) and 12-months (-1.4 %; SE: 0.6; p = 0.025) compared to UC. All groups had clinically significant improvements in depressive symptoms. At 6 months, CBT + EXER had significant improvements in diabetes-related distress regimen burden (p = 0.005); and social support (CIRS, p = 0.043) compared to UC. CONCLUSIONS The Program ACTIVE II CBT + EXER intervention demonstrated a sustained improvement in A1c for a subgroup of study participants with a baseline A1c ≥7.0 %. However, this finding should be considered preliminary because of small sample size. All 3 behavioral intervention groups demonstrated improvements in psychosocial outcomes one-year post-intervention. These findings point to the enduring benefits of community-based interventions to extend the availability of depression treatment for T2D patients.
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Affiliation(s)
- Chandan K Saha
- Indiana University School of Medicine, United States of America
| | | | - W Guyton Hornsby
- West Virginia University School of Medicine, United States of America
| | - Ziyi Yang
- Indiana University School of Medicine, United States of America
| | | | - Kieren J Mather
- Indiana University School of Medicine, United States of America
| | - Mary de Groot
- Indiana University School of Medicine, United States of America.
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23
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Wicke FS, Otten D, Schulz A, Wild PS, Lackner KJ, Münzel T, König J, Ernst M, Wiltink J, Reiner I, Ghaemi Kerahrodi J, Pfeiffer N, Beutel ME. Current and past depression as risk factors for incident type 2 diabetes mellitus and pre-diabetes in men and women: evidence from a longitudinal community cohort. Diabetol Metab Syndr 2024; 16:34. [PMID: 38303090 PMCID: PMC10832228 DOI: 10.1186/s13098-024-01273-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/21/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Depression is associated with an increased risk for type 2 diabetes mellitus. However, depression may take different courses, and it is not fully understood how these affect the development of diabetes. It is further to be determined whether sex modifies the association between depression and type 2 diabetes. METHODS We analyzed data from the Gutenberg Health Study, a longitudinal and population-based cohort study (N = 15,010) in Germany. Depressive symptoms (measured by PHQ-9), history of depression, diabetes mellitus, and relevant covariates were assessed at baseline, and the outcomes of prediabetes and type 2 diabetes mellitus were evaluated 5 years later. Logistic regression was used to estimate odds ratios of incident prediabetes and type 2 diabetes mellitus, adjusting for potential confounders as identified in a Directed Acyclic Graph. RESULTS In the confounder adjusted model, current depression (PHQ-9 ≥ 10 at baseline; OR = 1.79, 95% CI = 1.11 to 2.74, p = 0.011), and persistent depression had a statistically significant (OR = 2.44, 95% CI = 1.62 to 3.54, p = 0.005) effect on incident type 2 diabetes mellitus. A history of depression without current depression had no statistically significant effect on type 2 diabetes (OR = 1.00, 95% CI = 0.68 to 1.43, p = 0.999). The effect of depression on incident diabetes did not differ significantly between women (OR = 2.02; 95% CI = 1.32 to 3.09) and men (OR = 2.16; 95% CI = 1.41 to 3.31; p-value for interaction on the multiplicative scale p = 0.832 and on the additive scale p = 0.149). Depression did not have a significant effect on incident prediabetes. CONCLUSION This study shows how the history and trajectory of depression shape the risk for diabetes. This raises interesting questions on the cumulative effects of depression trajectories on diabetes and body metabolism in general. Depression can negatively affect physical health, contributing to increased morbidity and mortality in people with mental disorders.
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Affiliation(s)
- Felix S Wicke
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Daniëlle Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | - Karl J Lackner
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
- Center for Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Iris Reiner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Faculty of Social Work, Darmstadt University of Applied Sciences, Darmstadt, Germany
| | - Jasmin Ghaemi Kerahrodi
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Zhan T, Tang S, Du J, Liu J, Yu B, Yang Y, Xie Y, Qiu Y, Li G, Gao Y. Implication of lncRNA MSTRG.81401 in Hippocampal Pyroptosis Induced by P2X7 Receptor in Type 2 Diabetic Rats with Neuropathic Pain Combined with Depression. Int J Mol Sci 2024; 25:1186. [PMID: 38256257 PMCID: PMC10816120 DOI: 10.3390/ijms25021186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/02/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
Major depressive disorder (MDD) is a common complication of diabetes and is often observed alongside diabetic neuropathic pain (DNP) as a comorbidity in diabetic patients. Long non-coding RNA (lncRNA) plays an important role in various pathophysiological processes. The P2X7 receptor is responsible for triggering inflammatory responses, such as pyroptosis, linked to pain and depression. The aim of this study was to investigate the effect of lncRNA MSTRG.81401 on hippocampal pyroptosis induced by the P2X7 receptor in diabetic rats with DNP combined with MDD (DNP + MDD). Our results showed that the expression of lncRNA MSTRG.81401 was significantly elevated in the hippocampus of DNP + MDD rats compared with the control group. Following the administration of shRNA targeting lncRNA MSTRG.81401, a notable elevation in mechanical and thermal pain thresholds was observed in rats with comorbid DNP and MDD. Additionally, significant improvements in depression-like behaviors were evident in the open-field test (OFT), sucrose preference test (SPT), and forced swim test (FST). In the DNP + MDD rats, elevated levels in hippocampal P2X7 receptor mRNA and protein were observed, along with increased co-expression of P2X7 and the astrocytic marker glial fibrillary acidic protein (GFAP). Meanwhile, in DNP + MDD rats, the heightened mRNA expression of NOD-like receptor protein 3 (NLRP3), apoptosis-associated speck-like protein (ASC), pyroptosis-related protein Gasdermin D (GSDMD), caspase-1, IL-1β, IL-18, and TNF-α was detected, in addition to increased serum levels of IL-1β, IL-18 and TNF-α. After shRNA treatment with lncRNA MSTRG.81401, the above abnormal changes in indicators for pyroptosis and inflammation were improved. Therefore, our study demonstrates that shRNA of lncRNA MSTRG.81401 can alleviate the pain and depression-like behaviors in diabetic rats associated with the comorbidity of DNP and MDD by inhibiting the hippocampal P2X7 receptor-mediated pyroptosis pathway and pro-inflammatory responses. This suggests that the P2X7R/NLRP3/caspase-1 implicated pyroptosis and inflammatory scenario may serve as a potential target for the management of comorbid DNP and MDD in diabetes.
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Affiliation(s)
- Ting Zhan
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang 330006, China; (T.Z.); (S.T.); (J.D.); (Y.Y.); (Y.X.); (Y.Q.); (G.L.)
| | - Shanshan Tang
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang 330006, China; (T.Z.); (S.T.); (J.D.); (Y.Y.); (Y.X.); (Y.Q.); (G.L.)
| | - Junpei Du
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang 330006, China; (T.Z.); (S.T.); (J.D.); (Y.Y.); (Y.X.); (Y.Q.); (G.L.)
| | - Jingshuang Liu
- Joint Program of Nanchang University and Queen Mary University of London, Nanchang University, Nanchang 330006, China;
| | - Bodong Yu
- Second Clinical Medical College, Nanchang University, Nanchang 330006, China;
| | - Yuxin Yang
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang 330006, China; (T.Z.); (S.T.); (J.D.); (Y.Y.); (Y.X.); (Y.Q.); (G.L.)
| | - Yuting Xie
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang 330006, China; (T.Z.); (S.T.); (J.D.); (Y.Y.); (Y.X.); (Y.Q.); (G.L.)
| | - Yanting Qiu
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang 330006, China; (T.Z.); (S.T.); (J.D.); (Y.Y.); (Y.X.); (Y.Q.); (G.L.)
| | - Guodong Li
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang 330006, China; (T.Z.); (S.T.); (J.D.); (Y.Y.); (Y.X.); (Y.Q.); (G.L.)
| | - Yun Gao
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang 330006, China; (T.Z.); (S.T.); (J.D.); (Y.Y.); (Y.X.); (Y.Q.); (G.L.)
- Jiangxi Provincial Key Laboratory of Autonomic Nervous Function and Disease, Nanchang 330006, China
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25
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Arinami H, Suzuki Y, Watanabe Y, Tajiri M, Tsuneyama N, Someya T. Association between insulin resistance and serum insulin-like growth factor 1 levels in patients with non-remitting major depressive disorder. J Affect Disord 2024; 344:612-616. [PMID: 37802324 DOI: 10.1016/j.jad.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/30/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is linked to an increased risk of diabetes; however, the underlying pathomechanism remains unknown. Although insulin-like growth factor 1 (IGF-1) is involved in the pathogenesis of both insulin resistance (IR) and MDD, no studies have investigated the relationship between IGF-1 and IR in patients with MDD. METHODS We recruited 120 patients with MDD (84 non-remitting patients and 36 remitting patients) and 99 control participants. Blood samples were collected after overnight fasting to investigate associations between serum and clinical factors, such as serum IGF-1 levels and homeostasis model assessment-insulin resistance (HOMA-IR). RESULTS Serum IGF-1 levels were higher in patients with non-remitting MDD than in control participants and patients with remitting MDD (P = 0.001 and P = 0.007, respectively). There were no significant differences in HOMA-IR between the three groups. HOMA-IR was positively correlated with serum IGF-1 levels in patients with non-remitting MDD (R = 0.355; P= 0.001) but not in control participants or patients with remitting MDD. A stepwise multiple regression analysis with various clinical factors revealed a positive association of serum IGF-1 levels and body mass index with HOMA-IR in patients with non-remitting MDD. LIMITATIONS This is a cross-sectional study and therefore we cannot draw firm conclusions about causal associations. CONCLUSIONS Serum IGF-1 levels may play a role in IR in patients with MDD who fail to achieve remission. Further studies, including longitudinal studies, are needed to determine the relationship between high serum IGF-1 levels and subsequent IR and diabetes risk.
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Affiliation(s)
- Hiroshi Arinami
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata 951-8510, Japan
| | - Yutaro Suzuki
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata 951-8510, Japan.
| | - Yuichiro Watanabe
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata 951-8510, Japan
| | - Misuzu Tajiri
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata 951-8510, Japan
| | - Nobuto Tsuneyama
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata 951-8510, Japan
| | - Toshiyuki Someya
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata 951-8510, Japan
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Mikkonen U, Voutilainen A, Mikola T, Roponen J, Rajapolvi S, Lehto SM, Ruusunen A, Mäntyselkä P. The effects of motivational self-care promotion on depressive symptoms among adults with type 2 diabetes: A systematic review and meta-analysis. Prev Med Rep 2023; 36:102431. [PMID: 37771374 PMCID: PMC10523005 DOI: 10.1016/j.pmedr.2023.102431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023] Open
Abstract
In individuals with type 2 diabetes (T2D), comorbid depression leads to increased health care costs and unsatisfactory treatment outcomes. Supporting healthy behaviors and self-efficacy might provide means to prevent depressive symptoms. We assessed the effects of motivational interviewing (MI) - based self-care promotion that specifically targets health behaviors, on depressive symptoms in adults with T2D. We followed PRISMA guidelines and searched Pubmed, Scopus, PsycINFO, Cinahl, and Cochrane Library to find randomized controlled trials (RCTs) published up to February 2023. Eligible RCTs had to target the T2D adult population, examine MI-based interventions that focus on multiple health behaviors, and measure depressive symptoms on a validated scale. Standardized mean differences (SMD) with 95% confidence intervals were calculated using a random-effects model. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the certainty of the evidence. After the screening, eleven studies with 2,682 individuals were eligible for the narrative synthesis. A meta-analysis of nine studies favored interventions with a pooled SMD of -0.19 (95% Cl = -0.34 to -0.05, p = 0.008, I2 = 52%). Due to the indirectness and imprecision of the evidence, we assessed the certainty of evidence based on GRADE as low. MI-based self-care promotion with a focus on health behaviors and implemented by a well MI-trained person had a preventive effect on depressive symptoms among adults with T2D. However, the certainty of evidence remained low. In future trials, the effect of MI-based self-care promotion on depression should be studied in clinically depressed populations.
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Affiliation(s)
- Ulla Mikkonen
- Institute Of Public Health and Clinical Nutrition, University Of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
- Primary Health Care Center, Wellbeing Services County of North Savo, P.O. Box 1711, FI-70211 Kuopio, Finland
| | - Ari Voutilainen
- Institute Of Public Health and Clinical Nutrition, University Of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Tuomas Mikola
- Institute Of Clinical Medicine, University Of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Johanna Roponen
- Institute Of Public Health and Clinical Nutrition, University Of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Sanna Rajapolvi
- Institute Of Public Health and Clinical Nutrition, University Of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Soili M. Lehto
- Institute Of Clinical Medicine, University Of Oslo, P.O. Box 1171 - Blindern, 0318 Oslo, Norway
- R&D Department, Division Of Mental Health Services, Akershus University Hospital, 1478 Lørenskog, Norway
- Department Of Psychiatry, University Of Helsinki, P.O. Box 22, FI-00014 University Of Helsinki, Finland
| | - Anu Ruusunen
- Institute Of Public Health and Clinical Nutrition, University Of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
- Department Of Psychiatry, Kuopio University Hospital, Wellbeing Services County of North Savo, P.O. Box 1711, FI-70211 Kuopio, Finland
- Deakin University, Institute For Mental And Physical Health And Clinical Translation (IMPACT), Food & Mood Centre, School Of Medicine, Barwon Health, P.O. Box 281 Geelong, Victoria 3220, Australia
| | - Pekka Mäntyselkä
- Institute Of Public Health and Clinical Nutrition, University Of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
- Clinical Research And Trials Centre, Kuopio University Hospital, Wellbeing Services County Of North Savo, P.O. Box 1711, FI-70211 Kuopio, Finland
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27
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Liu J, Yao C, Wang Y, Zhao J, Luo H. Non-drug interventions of traditional Chinese medicine in preventing type 2 diabetes: a review. Chin Med 2023; 18:151. [PMID: 37964315 PMCID: PMC10644617 DOI: 10.1186/s13020-023-00854-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/23/2023] [Indexed: 11/16/2023] Open
Abstract
Traditional Chinese medicine (TCM) is increasingly used to manage type 2 diabetes and its nonpharmacological interventions are showing potential for preventing type 2 diabetes. This study mainly reviews relevant research. The most mentioned non-drug treatments for preventing type 2 diabetes in TCM are healthy diet, physical activity, emotional therapy, and acupuncture. In most studies, blood glucose status in patients with prediabetes and type 2 diabetes was significantly improved after TCM non-drug interventions, and there was no significant difference between the adverse effect of TCM and control groups or other intervention groups, while the methodological quality of the clinical trials involving TCM generally kept a low level. The effectiveness of TCM in preventing type 2 diabetes has yet to be validated in large randomized controlled trials and the underlying mechanism also needs further exploration.
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Affiliation(s)
- Jingying Liu
- Macau Centre for Research and Development in Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, 999078, People's Republic of China
| | - Chun Yao
- Guangxi University of Chinese Medicine, Nanning, 530001, People's Republic of China
| | - Yitao Wang
- Macau Centre for Research and Development in Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, 999078, People's Republic of China
| | - Jinmin Zhao
- College of Pharmacy, Guangxi Medical University, Nanning, 530021, People's Republic of China.
| | - Hua Luo
- Macau Centre for Research and Development in Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, 999078, People's Republic of China.
- College of Pharmacy, Guangxi Medical University, Nanning, 530021, People's Republic of China.
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Basiri R, Seidu B, Rudich M. Exploring the Interrelationships between Diabetes, Nutrition, Anxiety, and Depression: Implications for Treatment and Prevention Strategies. Nutrients 2023; 15:4226. [PMID: 37836510 PMCID: PMC10574484 DOI: 10.3390/nu15194226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/23/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
Across the world, diabetes, depression, and anxiety symptoms have gained widespread recognition as significant public health issues. Recent research has unveiled a mutually influential relationship between diabetes and these two mental health conditions, where each disorder impacts the course and outcomes of the others. The role of nutrition emerges as pivotal in preventing and treating depression, anxiety, and diabetes. A thorough literature review was undertaken to investigate the reciprocal effects between anxiety, depression, and diabetes, including their impact on the development and severity of each condition. Additionally, the effects of nutrition on the prevention and management of depression, anxiety, diabetes, and related complications in at-risk individuals were assessed. Our findings show that mental disorders, such as depression and anxiety, increase the risk of developing type 2 diabetes and are associated with poorer glycemic control, increased diabetes-related complications, and higher mortality rates. Conversely, diabetes is also linked with an increased risk of developing depression and anxiety. The biological, psychological, and social factors that contribute to the comorbidity between these two conditions are complex and multifaceted. Therefore, an integrated approach to the management of both conditions is critical for improving patient outcomes and reducing the overall burden of disease. Nutritional interventions should be utilized to reduce the risk of diabetes in patients with anxiety and depression as well as enhance mental health in patients with diabetes.
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Affiliation(s)
- Raedeh Basiri
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
- Institute for Biohealth Innovation, George Mason University, Fairfax, VA 22030, USA
| | - Blessing Seidu
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
| | - Mark Rudich
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
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Balasundaram BS, Mohan AR, Subramani P, Ulagamathesan V, Tandon N, Sridhar GR, Sosale AR, Shankar R, Sagar R, Rao D, Chwastiak L, Mohan V, Ali MK, Patel SA. The Impact of a Collaborative Care Model on Health Trajectories among Patients with Co-Morbid Depression and Diabetes: The INDEPENDENT Study. Indian J Endocrinol Metab 2023; 27:410-420. [PMID: 38107735 PMCID: PMC10723617 DOI: 10.4103/ijem.ijem_348_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 12/19/2023] Open
Abstract
Context Collaborative care models for depression have been successful in a variety of settings, but their success may differ by patient engagement. We conducted a post-hoc analysis of the INDEPENDENT trial to investigate the role of differential engagement of participants on health outcomes over 3 years. Settings and Design INDEPENDENT study was a parallel, single-blinded, randomised clinical trial conducted at four socio-economically diverse clinics in India. Participants were randomised to receive either active collaborative care or usual care for 12 months and followed up for 24 months. Method We grouped intervention participants by engagement, defined as moderate (≤7 visits) or high, (8 or more visits) and compared them with usual care participants. Improvements in composite measure (depressive symptoms and at least one of three cardio-metabolic) were the primary outcome. Statistical Analysis Mean levels of depression and cardio-metabolic measures were analysed over time using computer package IBM SPSS Statistics 25. Results The composite outcome was sustained the highest in the moderate engagers [27.5%, 95% confidence interval (CI): 19.5, 36.7] and the lowest in high engagers (15.8%, 95% CI: 8.1, 26.8). This pattern was observed for individual parameters - depressive symptoms and glycosylated haemoglobin. Progressive reductions in mean depressive symptom scores were observed for moderate engagers and usual care group from baseline to 36 months. However, in high engagers of collaborative care, mean depressive symptoms were higher at 36 months compared to 12 months. Conclusion Sustained benefits of collaborative care were larger in participants with moderate engagement compared with high engagement, although a majority of participants relapsed on one or more outcome measures by 36 months. High engagers of collaborative care for co-morbid depression and diabetes may need light touch interventions for longer periods to maintain health and reduce depressive symptoms.
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Affiliation(s)
| | - Anjana Ranjit Mohan
- Department of Clinical Trials, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Poongothai Subramani
- Department of Clinical Trials, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | | | - Nikhil Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, Delhi, India
| | | | | | - Radha Shankar
- Department of Clinical Trials, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India
| | - Deepa Rao
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Department of Global Health, University of Washington, Seattle, USA
| | - Lydia Chwastiak
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Department of Global Health, University of Washington, Seattle, USA
| | - Viswanathan Mohan
- Department of Clinical Trials, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
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Yorke E, Boima V, Ganu V, Tetteh J, Twumasi L, Ekem‐Ferguson G, Kretchy I, Mate‐Kole CC. The mediating role of quality of life on depression and medication adherence among patients with type 2 diabetes mellitus: A cross-sectional study. Health Sci Rep 2023; 6:e1539. [PMID: 37662538 PMCID: PMC10469042 DOI: 10.1002/hsr2.1539] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/27/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
Background and Aim Patients living with diabetes mellitus have a high burden of psychological distress such as depression and anxiety as well as impaired quality of life, which may negatively impact their adherence to medications, glucose control, and health-related costs.This study assessed the impact of quality of life and depression on medication adherence among patients with type 2 diabetes (type 2 diabetes mellitus [T2DM]) in a tertiary care setting in Ghana. Methods The study was a cross-sectional study involving 238 patients with diabetes aged 18 years and above. Validated tools were used to assess medication adherence, depressive symptoms, and quality of life. Structural Equation Modeling was adopted to examine the mediation effect of quality of life on the relationship between depression and medication adherence among participants. Results The mean age of the participants was 58.82 ± 13.49, and 169 (71.0%) out of a total of 238 respondents were females. Depression had a significant direct relationship with the quality of life of respondents [aβ (95% confidence interval, CI) = -0.20 (-0.03, -0.00), p < 0.05; -0.21 (-0.41, -0.01) p < 0.05, respectively] and indirect relationship with quality of life [aβ (95% CI) = -0.01 (-0.02, -0.004) p < 0.001]. Educational status and religion both showed a significant indirect relationship with quality of life [aβ (95% CI) = 0.06 (0.07, 0.12), p < 0.05; 0.18 (0.01, 0.35) p < 0.05, respectively]. The mediating effect of quality of life on the relationship between depression and medication adherence was significant (Sobel = -3.19, p < 0.001). Conclusion Depression, medication adherence, and quality of life were higher among older adults with T2DM. Depression was also found to have a strong negative association with both medication adherence and quality of life. Interventions to screen for depression and to improve the quality of life in patients living with diabetes are also recommended and this should go beyond the provision of standard treatments to explore further the mechanisms of this relationships.
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Affiliation(s)
- Ernest Yorke
- Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | - Vincent Boima
- Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | - Vincent Ganu
- Department of Medicine and Cardiothoracic UnitKorle‐Bu Teaching HospitalAccraGhana
| | - John Tetteh
- Department of Community Health, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | | | - George Ekem‐Ferguson
- Department of PsychologyUniversity of GhanaAccraGhana
- National Cardiothoracic CenterKorle Bu Teaching HospitalAccraGhana
- Department of Psychiatry, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | - Irene Kretchy
- Department of PsychologyUniversity of GhanaAccraGhana
| | - Christopher C. Mate‐Kole
- Department of PsychologyUniversity of GhanaAccraGhana
- Department of Psychiatry, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
- Center for Ageing Studies, College of HumanitiesUniversity of Ghana
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Possidente C, Fanelli G, Serretti A, Fabbri C. Clinical insights into the cross-link between mood disorders and type 2 diabetes: A review of longitudinal studies and Mendelian randomisation analyses. Neurosci Biobehav Rev 2023; 152:105298. [PMID: 37391112 DOI: 10.1016/j.neubiorev.2023.105298] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 07/02/2023]
Abstract
Mood disorders and type 2 diabetes mellitus (T2DM) are prevalent conditions that often co-occur. We reviewed the available evidence from longitudinal and Mendelian randomisation (MR) studies on the relationship between major depressive disorder (MDD), bipolar disorder and T2DM. The clinical implications of this comorbidity on the course of either condition and the impact of antidepressants, mood stabilisers, and antidiabetic drugs were examined. Consistent evidence indicates a bidirectional association between mood disorders and T2DM. T2DM leads to more severe depression, whereas depression is associated with more complications and higher mortality in T2DM. MR studies demonstrated a causal effect of MDD on T2DM in Europeans, while a suggestive causal association in the opposite direction was found in East Asians. Antidepressants, but not lithium, were associated with a higher T2DM risk in the long-term, but confounders cannot be excluded. Some oral antidiabetics, such as pioglitazone and liraglutide, may be effective on depressive and cognitive symptoms. Studies in multi-ethnic populations, with a more careful assessment of confounders and appropriate power, would be important.
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Affiliation(s)
- Chiara Possidente
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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32
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An JH, Han KD, Jeon HJ. Higher metabolic variability increases the risk of depressive disorder in type 2 diabetes mellitus: a longitudinal nationwide cohort study. Front Psychiatry 2023; 14:1217104. [PMID: 37555004 PMCID: PMC10405173 DOI: 10.3389/fpsyt.2023.1217104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/05/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND AND OBJECTIVES While variabilities in metabolic parameters (METv) have been linked to adverse health outcomes in type 2 DM, their association with depression is yet to be studied. This research aimed to investigate the association between METv and depressive disorder in patients with type 2 DM. METHODS The study involved a nationwide cohort of 1,119,631 type 2 DM patients who had undergone three or more serial health examinations between 2005 and 2012. At each visit, body mass index (BMI), fasting glucose (FG), systolic blood pressure (BP), and total cholesterol (TC) were measured and stratified into quartiles, with Q4 being the highest and Q1 the lowest. The risk of depressive disorder was evaluated using Cox proportional hazard regression models, which accounted for METs in the indexes, after adjusting for sex, income status, lifestyle habits, medical comorbidities, DM severity, and baseline levels of BMI, FG, BP, and TC. RESULTS During a mean follow-up period of 6.00 ± 2.42 years, 239,477 (21.4%) cases of type 2 DM patients developed depressive disorder. The risk of developing depressive disorder was gradually increased as the number of METv increased (HR 1.18; 95% CI 1.13, 1.23 for the group with the highest METv in all parameters compared to those with the lowest METv in all parameters). In the subgroup analysis, the risk of developing depressive disorder was 43% higher in men (HR 1.43; 95% CI 1.34, 1.51), and 31% higher in those younger than 65 years of age (HR 1.31; 95% CI 1.23, 1.39) in the group with the highest number of METv compared to the group with the lowest number of METv. CONCLUSION In type 2 DM, higher METv was an independent risk factor for depressive disorder. This risk is notably elevated in men and individuals under the age of 65 years.
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Affiliation(s)
- Ji Hyun An
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung-do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Health Sciences and Technology, Department of Medical Device Management and Research, Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
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Feng Z, Tong WK, Zhang X, Tang Z. Prevalence of depression and association with all-cause and cardiovascular mortality among individuals with type 2 diabetes: a cohort study based on NHANES 2005-2018 data. BMC Psychiatry 2023; 23:490. [PMID: 37430235 DOI: 10.1186/s12888-023-04999-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/04/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Individuals with diabetes have increased risk of depression, but there are limited nationally representative studies on this topic. We aimed to investigate the prevalence and predictors of depression, as well as its impact on all-cause and cardiovascular mortality in adults with type 2 diabetes (T2DM) using a prospective cohort study and a representative sample of the U.S. POPULATION METHODS We analyzed National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018 and linked it with the most recent publicly available National Death Index (NDI) data. Individuals aged 20 years or old who had depression measurements were included. Depression was defined as a Patient Health Questionnaire (PHQ-9) score ≥ 10, and categorized into moderate (10-14 points) and moderately severe to severe (≥ 15 points). Cox proportional hazard models were used to estimate the association between depression and mortality. RESULTS Among 5695 participants with T2DM, 11.6% had depression. Depression was associated with female gender, younger age, overweight, lower education, being unmarried, smoking, and a history of coronary heart disease and stroke. During a mean follow-up period of 78.2 months, 1161 all-cause deaths occurred. Total depression and moderately severe to severe depression significantly increased all-cause mortality (adjusted hazard ratio [aHR] 1.36, 95% CI [1.09-1.70]; 1.67 [1.19-2.34]) and non-cardiovascular mortality (aHR 1.36, 95% CI [1.04-1.78]; 1.78, 95% CI [1.20-2.64]), but not cardiovascular mortality. Subgroup analysis showed a significant association between total depression and all-cause mortality in males (aHR 1.46, 95% CI [1.08-1.98]) and those aged 60 years or older (aHR 1.35, 95% CI [1.02-1.78]). Any severity of depression was not significantly associated with cardiovascular mortality in age- or gender- stratified subgroups. CONCLUSIONS In a nationally representative sample of U.S. adults with T2DM, approximately 10% experienced depression. Depression did not significantly associate with cardiovascular mortality. However, comorbid depression in T2DM patients increased the risk of all-cause and non-cardiovascular mortality. The impact of depression on mortality varied across subgroups. Therefore, healthcare providers should consider incorporating depression screening and management into routine care, especially for subgroups with specific risk factors, due to the increased risk of all-cause mortality in T2DM patients with depression.
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Affiliation(s)
- Zhen Feng
- Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, 826 Zhangheng Rd, Shanghai, 201203, China
- Department of Pharmacy, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Xuzhou, 221002, China
| | - Wai Kei Tong
- Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, 826 Zhangheng Rd, Shanghai, 201203, China
| | - Xinyue Zhang
- Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, 826 Zhangheng Rd, Shanghai, 201203, China
| | - Zhijia Tang
- Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, 826 Zhangheng Rd, Shanghai, 201203, China.
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Morales M, Ingram M, Sepulveda R, Nuño T, Wilkinson-Lee AM, Guernsey De Zapien JE, Carvajal S. Risk Factors Associated with Diabetes among Mexican-Origin Adults in Southern Arizona. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6126. [PMID: 37372712 DOI: 10.3390/ijerph20126126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
Diabetes is the seventh leading cause of death in the United States, and it is particularly problematic among the Latine population. This study employed multivariable logistic regression models to examine how hypertension, depression, and sociodemographics were associated with diabetes in a cross-sectional sample of Mexican-origin adults living in three counties of Southern Arizona. The overall prevalence of diabetes from this primary care sample was 39.4%. Holding covariates at fixed values, individuals having hypertension were 2.36 (95% CI: 1.15, 4.83) times more likely to have diabetes, when compared to individuals not having hypertension. The odds of having diabetes for individuals with ≥12 years of educational attainment were 0.29 (95% CI: 0.14, 0.61) times the corresponding odds of individuals with <12 years of educational attainment. For individuals with depression, the odds of having diabetes for those who were born in Mexico and had <30 years living in the US were 0.04 (95% CI: 0, 0.42) times the corresponding odds of individuals without depression and who were born in the US. Findings suggest clinical and public health systems should be aware of the potential increased risk of diabetes among Mexican-origin adults with hypertension and lower educational attainment.
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Affiliation(s)
- Mario Morales
- Arizona Prevention Research Center, Health Promotion Sciences Department, Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA
| | - Maia Ingram
- Arizona Prevention Research Center, Health Promotion Sciences Department, Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA
| | - Ramses Sepulveda
- Arizona Prevention Research Center, Health Promotion Sciences Department, Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA
| | - Thomas Nuño
- Arizona Prevention Research Center, Health Promotion Sciences Department, Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA
| | - Ada M Wilkinson-Lee
- Arizona Prevention Research Center, Health Promotion Sciences Department, Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA
- Department of Mexican American Studies, The University of Arizona, Tucson, AZ 85724, USA
| | - Jill E Guernsey De Zapien
- Arizona Prevention Research Center, Health Promotion Sciences Department, Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA
| | - Scott Carvajal
- Arizona Prevention Research Center, Health Promotion Sciences Department, Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA
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de Groot M. Diabetes and Depression: Strategies to Address a Common Comorbidity Within the Primary Care Context. AMERICAN JOURNAL OF MEDICINE OPEN 2023; 9:100039. [PMID: 39035059 PMCID: PMC11256228 DOI: 10.1016/j.ajmo.2023.100039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/19/2023] [Indexed: 07/23/2024]
Abstract
Diabetes and depression represent a prevalent, bidirectional, and impactful comorbidity that affects patient and family quality of life, glycemic self-management, long-term diabetes complications, usage of medical services, medical costs, and early mortality. Primary care providers (PCPs) are frequently the first medical providers to observe changes in mood and diabetes management, as well as the primary point of contact for making referrals to specialty providers (e.g. endocrinology, psychiatry). PCPs play a critical role in screening, evaluating, and treating these conditions. Critical to fostering and maintaining a position of trust and patient engagement in medication recommendations is the use of person-centered, nonjudgmental language used by the provider within the clinical encounter. Key strategies for the management of these conditions include the following: routine screening for depressive symptoms, securing access to behavioral health professionals, either within or beyond the primary care setting, collaboration with diabetes care and education specialists to support problem-solving of diabetes self-management, and monitoring the use and effectiveness of antidepressant medications.
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Affiliation(s)
- Mary de Groot
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Indiana University School of Medicine, Indianapolis
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Mayhew M, Smith N, Fortmann SP, Fitzpatrick SL. Mental health diagnosis attenuates weight loss among older adults in a digital diabetes prevention program. Obes Sci Pract 2023; 9:320-326. [PMID: 37287521 PMCID: PMC10242247 DOI: 10.1002/osp4.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 06/09/2023] Open
Abstract
Objective Diabetes Prevention Programs (DPP) are effective at reducing diabetes incidence via clinically significant weight loss. Co-morbid mental health condition(s) may reduce the effect of DPP administered in-person and telephonically but this has not been assessed for digital DPP. This report examines the moderating effect of mental health diagnosis on weight change among individuals who enrolled in digital DPP (enrollees) at 12 and 24 months. Methods Secondary analysis of prospective, electronic health record data from a study of digital DPP among adults (N = 3904) aged 65-75 with prediabetes (HbA1c 5.7%-6.4%) and obesity (BMI ≥30 kg/m2). Results Mental health diagnosis only moderated the effect of digital DPP on weight change during the first 7 months (p = 0.003) and the effect attenuated at 12 and 24 months. Results were unchanged after adjusting for psychotropic medication use. Among those without a mental health diagnosis, digital DPP enrollees lost more weight than non-enrollees: -4.17 kg (95% CI, -5.22 to -3.13) at 12 months and -1.88 kg (95% CI, -3.00 to -0.76) at 24 months, whereas among individuals with a mental health diagnosis, there was no difference in weight loss between enrollees and non-enrollees at 12 and 24 months (-1.25 kg [95% CI, -2.77 to 0.26] and 0.02 kg [95% CI, -1.69-1.73], respectively). Conclusions Digital DPP appears less effective for weight loss among individuals with a mental health condition, similar to prior findings for in-person and telephonic modalities. Findings suggest a need for tailoring DPP to address mental health conditions.
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Affiliation(s)
- Meghan Mayhew
- Kaiser Permanente Center for Health Research Northwest in PortlandPortlandOregonUSA
| | - Ning Smith
- Kaiser Permanente Center for Health Research Northwest in PortlandPortlandOregonUSA
| | - Stephen P. Fortmann
- Kaiser Permanente Center for Health Research Northwest in PortlandPortlandOregonUSA
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Bauermeister SD, Ben Yehuda M, Reid G, Howgego G, Ritchie K, Watermeyer T, Gregory S, Terrera GM, Koychev I. Insulin resistance, age and depression's impact on cognition in middle-aged adults from the PREVENT cohort. BMJ MENTAL HEALTH 2023; 26:e300665. [PMID: 37236657 PMCID: PMC10231438 DOI: 10.1136/bmjment-2023-300665] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/12/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Alzheimer's disease (AD), type 2 diabetes mellitus (characterised by insulin resistance) and depression are significant challenges facing public health. Research has demonstrated common comorbidities among these three conditions, typically focusing on two of them at a time. OBJECTIVE The goal of this study, however, was to assess the inter-relationships between the three conditions, focusing on mid-life (defined as age 40-59) risk before the emergence of dementia caused by AD. METHODS In the current study, we used cross-sectional data from 665 participants from the cohort study, PREVENT. FINDINGS Using structural equation modelling, we showed that (1) insulin resistance predicts executive dysfunction in older but not younger adults in mid-life, that (2) insulin resistance predicts self-reported depression in both older and younger middle-aged adults and that (3) depression predicts deficits in visuospatial memory in older but not younger adults in mid-life. CONCLUSIONS Together, we demonstrate the inter-relations between three common non-communicable diseases in middle-aged adults. CLINICAL IMPLICATIONS We emphasise the need for combined interventions and the use of resources to help adults in mid-life to modify risk factors for cognitive impairment, such as depression and diabetes.
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Affiliation(s)
- Sarah D Bauermeister
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Michael Ben Yehuda
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Graham Reid
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Gregory Howgego
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Karen Ritchie
- INSERM, Institut des Neurosciences de Montpellier, Montpellier, France
| | - Tam Watermeyer
- Edinburgh Dementia Prevention, The University of Edinburgh Centre for Clinical Brain Sciences, Edinburgh, UK
| | - Sarah Gregory
- Edinburgh Dementia Prevention, The University of Edinburgh Centre for Clinical Brain Sciences, Edinburgh, UK
| | - Graciela Muniz Terrera
- Edinburgh Dementia Prevention, The University of Edinburgh Centre for Clinical Brain Sciences, Edinburgh, UK
| | - Ivan Koychev
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
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Zou L, Tian Y, Wang Y, Chen D, Lu X, Zeng Z, Chen Z, Lin C, Liang Y. High-cholesterol diet promotes depression- and anxiety-like behaviors in mice by impact gut microbe and neuroinflammation. J Affect Disord 2023; 327:425-438. [PMID: 36738999 DOI: 10.1016/j.jad.2023.01.122] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
Neuropsychiatric disorders, including anxiety and depression, are one of the most common mental illnesses worldwide. A growing body of evidence shows that there is a complex relationship between dietary patterns and mental health. In our study, C57BL/6J mice were divided into three groups: control diet group (CON, 10 % kcal fat), high-cholesterol diet model group (HCD, 42.0 % kcal fat + 1.25 % kcal Cholesterol), and chronic restraint stress group (CRS, 10 % kcal fat) which as a positive control group for the depression model. Six weeks later, depressive- and anxiety-like behavior were evaluated for using the OFT, SPT and TST. Glucose intolerance and liver fat were detected by IGTT and liver lipid kit. The expression of peripheral and central inflammation was detected by LEGEND plex kits. 5-HT (also named 5-hydroxytryptamine, 5-HT) and related receptors expression were monitored by ELISA, RT-PCR and Western blot. Meantime, gut microbe of stool samples was performed by 16S rRNA gene sequencing. Similar to CRS model, short-term HCD intervention induced anxiety and depression-like behavior behavioral abnormalities in mice. HCD consumption resulted in significantly increased body weight, liver fat (LDL-C, TC, TG), peripheral inflammation (IL-1β, MCP-1, IL-17A) and neuroinflammation (MCP-1). The concentration of 5-HT increased in the hippocampus, meanwhile, the expression of 5-HT receptor HTR2A was distinct in different regions of the brain tissue. More importantly, we found that compared with the CON diet, HCD induced the decrease of intestinal flora diversity, especially the decrease the relative abundance of Akkermansia_muciniphila, which was statistically significant. Further, Pearson correlation analysis showed that Akkermansia_muciniphila was significantly negatively correlated with the concentration of MCP-1, IL-17A in serum and 5-HT in hippocampus. Therefore, we speculated that the disorder of neuroinflammation induced by HCD consumption promotes depression- and anxiety-like behaviors in mice through the gut microbe.
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Affiliation(s)
- Lili Zou
- School of Medicine, Jinan University, No. 601 Huangpu Avenue West, Guangzhou, Guangdong 510632, China
| | - Yaling Tian
- School of Medicine, Jinan University, No. 601 Huangpu Avenue West, Guangzhou, Guangdong 510632, China
| | - Yuanfei Wang
- School of Nursing, Jinan University, No. 601 Huangpu Avenue West, Guangzhou, Guangdong 510632, China
| | - Dongliang Chen
- School of Nursing, Jinan University, No. 601 Huangpu Avenue West, Guangzhou, Guangdong 510632, China
| | - Xiaomin Lu
- School of Nursing, Jinan University, No. 601 Huangpu Avenue West, Guangzhou, Guangdong 510632, China
| | - Ze Zeng
- School of Nursing, Jinan University, No. 601 Huangpu Avenue West, Guangzhou, Guangdong 510632, China
| | - Zumin Chen
- School of Nursing, Jinan University, No. 601 Huangpu Avenue West, Guangzhou, Guangdong 510632, China
| | - Chenli Lin
- School of Medicine, Jinan University, No. 601 Huangpu Avenue West, Guangzhou, Guangdong 510632, China; Health Science Center, Jinan University, No. 601 Huangpu Avenue West, Guangzhou, Guangdong 510632, China.
| | - Yinji Liang
- School of Nursing, Jinan University, No. 601 Huangpu Avenue West, Guangzhou, Guangdong 510632, China; Health Science Center, Jinan University, No. 601 Huangpu Avenue West, Guangzhou, Guangdong 510632, China.
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Alenazi AM, Alhowimel AS, Alshehri MM, Alqahtani BA, Alhwoaimel NA, Segal NA, Kluding PM. Osteoarthritis and Diabetes: Where Are We and Where Should We Go? Diagnostics (Basel) 2023; 13:diagnostics13081386. [PMID: 37189487 DOI: 10.3390/diagnostics13081386] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 05/17/2023] Open
Abstract
Diabetes mellitus (DM) and osteoarthritis (OA) are chronic noncommunicable diseases that affect millions of people worldwide. OA and DM are prevalent worldwide and associated with chronic pain and disability. Evidence suggests that DM and OA coexist within the same population. The coexistence of DM in patients with OA has been linked to the development and progression of the disease. Furthermore, DM is associated with a greater degree of osteoarthritic pain. Numerous risk factors are common to both DM and OA. Age, sex, race, and metabolic diseases (e.g., obesity, hypertension, and dyslipidemia) have been identified as risk factors. These risk factors (demographics and metabolic disorder) are associated with DM or OA. Other possible factors may include sleep disorders and depression. Medications for metabolic syndromes might be related to the incidence and progression of OA, with conflicting results. Given the growing body of evidence indicating a relationship between DM and OA, it is vital to analyze, interpret, and integrate these findings. Therefore, the purpose of this review was to evaluate the evidence on the prevalence, relationship, pain, and risk factors of both DM and OA. The research was limited to knee, hip, and hand OA.
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Affiliation(s)
- Aqeel M Alenazi
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Ahmed S Alhowimel
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Mohammed M Alshehri
- Departement of Physical Therapy, Jazan University, Jazan 45142, Saudi Arabia
| | - Bader A Alqahtani
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Norah A Alhwoaimel
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Neil A Segal
- Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, MI 66160, USA
| | - Patricia M Kluding
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, MI 66160, USA
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Ding H, Xie M, Wang J, Ouyang M, Huang Y, Yuan F, Jia Y, Zhang X, Liu N, Zhang N. Shared genetics of psychiatric disorders and type 2 diabetes:a large-scale genome-wide cross-trait analysis. J Psychiatr Res 2023; 159:185-195. [PMID: 36738649 DOI: 10.1016/j.jpsychires.2023.01.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 12/31/2022] [Accepted: 01/26/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND Individuals with psychiatric disorders have elevated rates of type 2 diabetes comorbidity. Although little is known about the shared genetics and causality of this association. Thus, we aimed to investigate shared genetics and causal link between different type 2 diabetes and psychiatric disorders. METHODS We conducted a large-scale genome-wide cross-trait association study(GWAS) to investigate genetic overlap between type 2 diabetes and anorexia nervosa, attention deficit/hyperactivity disorder, autism spectrum disorder, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, schizophrenia, anxiety disorders and Tourette syndrome. By post-GWAS functional analysis, we identify variants genes expression in various tissues. Enrichment pathways, potential protein interaction and mendelian randomization also provided to research the relationship between type 2 diabetes and psychiatric disorders. RESULTS We discovered that type 2 diabetes and psychiatric disorders had a significant correlation. We identified 138 related loci, 32 were novel loci. Post-GWAS analysis revealed that 86 differentially expressed genes were located in different brain regions and peripheral blood in type 2 diabetes and related psychiatric disorders. MAPK signaling pathway plays an important role in neural development and insulin signaling. In addition, there is a causal relationship between T2D and mental disorders. In PPI analysis, the central genes of the DEG PPI network were FTO and TCF7L2. CONCLUSION This large-scale genome-wide cross-trait analysis identified shared genetics andpotential causal links between type 2 diabetes and related psychiatric disorders, suggesting potential new biological functions in common among them.
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Affiliation(s)
- Hui Ding
- The Affiliated Nanjing Brain Hospital of Nanjing Medical Univesity, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, PR China
| | - Minyao Xie
- The Affiliated Nanjing Brain Hospital of Nanjing Medical Univesity, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, PR China
| | - Jinyi Wang
- The Affiliated Nanjing Brain Hospital of Nanjing Medical Univesity, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, PR China
| | - Mengyuan Ouyang
- The Affiliated Nanjing Brain Hospital of Nanjing Medical Univesity, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, PR China
| | - Yanyuan Huang
- The Affiliated Nanjing Brain Hospital of Nanjing Medical Univesity, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, PR China
| | - Fangzheng Yuan
- School of Psychology, Nanjing Normal University, Nanjing, 210023, PR China
| | - Yunhan Jia
- School of Psychology, Nanjing Normal University, Nanjing, 210023, PR China
| | - Xuedi Zhang
- The Affiliated Nanjing Brain Hospital of Nanjing Medical Univesity, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, PR China
| | - Na Liu
- Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, PR China.
| | - Ning Zhang
- The Affiliated Nanjing Brain Hospital of Nanjing Medical Univesity, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, PR China.
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Wu CY, Cogo-Moreira H, MacIntosh BJ, Edwards JD, Krance SH, Eid M, Schreiner PJ, Launer LJ, Swardfager W. Dynamic relationships between depressive symptoms and insulin resistance over 20 years of adulthood. Psychol Med 2023; 53:1458-1467. [PMID: 36470626 PMCID: PMC10009397 DOI: 10.1017/s0033291721003032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/06/2021] [Accepted: 07/12/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Bidirectional longitudinal relationships between depression and diabetes have been observed, but the dominant direction of their temporal relationships remains controversial. METHODS The random-intercept cross-lagged panel model decomposes observed variables into a latent intercept representing the traits, and occasion-specific latent 'state' variables. This permits correlations to be assessed between the traits, while longitudinal 'cross-lagged' associations and cross-sectional correlations can be assessed between occasion-specific latent variables. We examined dynamic relationships between depressive symptoms and insulin resistance across five visits over 20 years of adulthood in the population-based Coronary Artery Risk Development in Young Adults (CARDIA) study. Possible differences based on population group (Black v. White participants), sex and years of education were tested. Depressive symptoms and insulin resistance were quantified using the Center for Epidemiologic Studies Depression (CES-D) scale and the homeostatic model assessment for insulin resistance (HOMA-IR), respectively. RESULTS Among 4044 participants (baseline mean age 34.9 ± 3.7 years, 53% women, 51% Black participants), HOMA-IR and CES-D traits were weakly correlated (r = 0.081, p = 0.002). Some occasion-specific correlations, but no cross-lagged associations were observed overall. Longitudinal dynamics of these relationships differed by population groups such that HOMA-IR at age 50 was associated with CES-D score at age 55 (β = 0.076, p = 0.038) in White participants only. Longitudinal dynamics were consistent between sexes and based on education. CONCLUSIONS The relationship between depressive symptoms and insulin resistance was best characterized by weak correlations between occasion-specific states and enduring traits, with weak evidence that insulin resistance might be temporally associated with subsequent depressive symptoms among White participants later in adulthood.
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Affiliation(s)
- Che-Yuan Wu
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Hugo Cogo-Moreira
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Education, ICT and Learning, Østfold University College, Halden, Norway
| | - Bradley J. MacIntosh
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
- Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Jodi D. Edwards
- University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
| | - Saffire H. Krance
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Michael Eid
- Department of Educational Science and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Pamela J. Schreiner
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minnesota, USA
| | - Lenore J. Launer
- Laboratory of Epidemiology and Population Sciences, National Institutes of Health, Bethesda, Maryland, USA
| | - Walter Swardfager
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada
- KITE UHN Toronto Rehabilitation Institute, Toronto, Ontario, Canada
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Franquez RT, de Souza IM, Bergamaschi CDC. Interventions for depression and anxiety among people with diabetes mellitus: Review of systematic reviews. PLoS One 2023; 18:e0281376. [PMID: 36758047 PMCID: PMC9910656 DOI: 10.1371/journal.pone.0281376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 01/20/2023] [Indexed: 02/10/2023] Open
Abstract
This review of systematic reviews of randomized clinical trials summarized the available evidence regarding the effectiveness and safety of interventions to treat depression and/or anxiety in people with type 1 and type 2 diabetes. The sources of information searched were the Cochrane Library, MEDLINE, EMBASE, Web of Science and LILACS, until up to December 1st, 2022. The interventions were compared with placebo, active control or usual care. The measured primary outcomes were improvement in depression and anxiety remission, reduction of diabetes-specific emotional distress; and improvement in quality of life. Two reviewers, independently, selected the reviews, extracted their data, and assessed their methodological quality using AMSTAR-2. A narrative synthesis of the findings was performed, according to the type of intervention and type of diabetes. Thirteen systematic reviews that included 28,307 participants were analyzed. The reviews had at least one critical methodological flaw. Cognitive Behavioral Therapy improved the mainly depression, glycemic values (n = 5 reviews) and anxiety (n = 1), in adults and elderly with diabetes. Collaborative care (n = 2) and health education (n = 1) improved depression and glycemic values, in adults with diabetes. Pharmacological treatment (n = 2) improved depression outcomes only. The quality of the evidence was low to moderate, when reported. The interventions reported in literature and mainly the Cognitive Behavioral Therapy can be effective to treat people with diabetes and depression; however, some findings must be confirmed. This study can guide patients, their caregivers and health professionals in making decisions concerning the use of these interventions in the mental healthcare of people with diabetes. Protocol Registration: PROSPERO (CRD42021224587).
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Affiliation(s)
| | - Isabela Muniz de Souza
- Pharmaceutical Sciences Graduate Course, University of Sorocaba, Sorocaba, São Paulo, Brazil
- Dental School, University of Sorocaba, Sorocaba, São Paulo, Brazil
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Denche-Zamorano A, Perez-Gomez J, Barrios-Fernandez S, Oliveira R, Adsuar JC, Brito JP. Relationships between Physical Activity Frequency and Self-Perceived Health, Self-Reported Depression, and Depressive Symptoms in Spanish Older Adults with Diabetes: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2857. [PMID: 36833555 PMCID: PMC9958756 DOI: 10.3390/ijerph20042857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Diabetes is one of the most prevalent noncommunicable diseases in the world. This disease can affect both physical and mental health in the population. This study analyzed the prevalence of Self-Perceived Health (SPH), self-reported depression, and depressive symptoms in comparison with the Physical Activity Frequency (PAF) reported by Spanish older adults with diabetes. A cross-sectional study was carried out with data from 2799 self-reported diabetic participants, all of whom were residents of Spain, aged 50-79 years, and included in the European Health Surveys carried out in Spain (EHIS) both in 2014 and 2020. The relationships between the variables were analysed with a chi-squared test. A z-test for independent proportions was performed to analyze differences in proportions between the sexes. A multiple binary logistic regression was carried out on the prevalence of depression. Linear regressions were performed on depressive symptoms and SPH. Dependent relationships were found between the SPH, self-reported depression, and depressive symptoms with PAF. Most of the very active participants reported a higher prevalence of self-reported depression. Physical inactivity increased the risk of depression, major depressive symptoms, and negative SPH.
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Affiliation(s)
- Angel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Jorge Perez-Gomez
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Sabina Barrios-Fernandez
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain
| | - Rafael Oliveira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
| | - Jose C. Adsuar
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - João Paulo Brito
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
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Cyranka K, Matejko B, Chrobak A, Dudek D, Kieć-Wilk B, Cyganek K, Witek P, Lushchyk M, Krzyżowska S, Małecki MT, Klupa T. Assessment of the spectrum of depression and bipolarity in patients with type 1 diabetes. Diabetes Metab Res Rev 2023; 39:e3583. [PMID: 36270020 DOI: 10.1002/dmrr.3583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 07/08/2022] [Accepted: 09/23/2022] [Indexed: 01/10/2023]
Abstract
AIMS The aim of the study was to check the prevalence of unipolarity (depression), bipolarity, as well as the quality of sleep and temperament traits in patients with type 1 diabetes (T1DM) who are provided with optimal conditions of diabetes care and to identify possible risk factors connected with affective traits. MATERIALS AND METHODS Out of the 107 T1DM patients, 78 (54 females, 24 males) were included for the analysis (HbA1c [%] 7.11 ± 1.0, BMI [kg/m2 ] 25.3 ± 5.6; Years of disease duration [N] 13.7 ± 8.3). The patients filled in a set of questionnaires during their regular visit to the outpatient clinic. Three patients from the whole group were on intensive insulin therapy with Multiple Daily Injections (MDI) and Self-Monitoring of Blood Glucose (SMBG), all the rest were on various types of personal insulin pumps (years on insulin pump [N] 9.1 ± 4.5). All the patients were on regular diabetologist care, with regular visits in a Centre for Advanced Technologies in Diabetes (at least every 6 months). RESULTS In QIDS-S (full explanation and abbreviation 26 patients (33.8%) were screened positive for depression, in PHQ (full explanation and ab 57.7% of the patients (45 patients) had symptoms of depression (age was negatively correlated with PHQ score [r = -0.26; p = 0.023]). In CES-D 16 (20%) of the patients assessed their present affect as depressed. None of the analysed clinical variables correlated with depression scores. In the Mood Disorder Questionnaire (MDQ), 16 patients reported having symptoms of bipolarity (20.5% vs. 79.5%). Hypomania Checklist (HCL) analysis indicated 10 patients with bipolar traits (>14) (14.9% vs. 85.1%). None of the analysed clinical variables correlated with HCL results. 11.5% of patients were indicated to be of morning type. Morningness was more often seen in younger patients (r = 0.39; p = 0.001). As many as 46.6% declared that they had poor sleep quality. The temperament traits analysis correlated with clinical parameters: Cyclothymic temperament trait was negatively correlated with age (r = -0.30; p = 0.007) and positively with HbA1c level (r = 0.30; p = 0.025). Hyperthymic temperament was positively correlated with (BMI r = 0.28; p = 0.016). Quality of sleep was highly correlated with depressive symptoms CESD (r = 0.61, p = 0.001), PHQ Score (r = 0.62; p = 0.001), QISD (r = 0.68; p = 0.001) and bipolarity MDQ (p = 0.50, p = 0.001) and HCL (r = 0.42, p = 0.001). In addition, QIDS was shown to be correlated with the following features of temperament: depressive factor (r = 0.41; p = 0.001), irritable factor (r = 0.53; p = 0.001), cyclothymic factor (r = 0.59; p = 0.001), anxious factor (r = 0.58, p = 0.001). CONCLUSIONS The prevalence of affective disorders and poor sleep quality in the examined T1DM patients was much higher than in the general population. Even if the patients have in general good glycaemic control, their mental health condition should not be neglected. Well organised cooperation between patients, diabetologists, psychiatrists and psychotherapists is needed (Clinical Trials Identifier: NCT04616391).
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Affiliation(s)
- Katarzyna Cyranka
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
- Department of Adult Psychiatry, Jagiellonian University Medical College, Kraków, Poland
- University Hospital in Krakow, Kraków, Poland
| | - Bartlomiej Matejko
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
- University Hospital in Krakow, Kraków, Poland
| | - Adrian Chrobak
- Department of Adult Psychiatry, Jagiellonian University Medical College, Kraków, Poland
- University Hospital in Krakow, Kraków, Poland
| | - Dominika Dudek
- Department of Adult Psychiatry, Jagiellonian University Medical College, Kraków, Poland
- University Hospital in Krakow, Kraków, Poland
| | - Beata Kieć-Wilk
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
- University Hospital in Krakow, Kraków, Poland
| | - Katarzyna Cyganek
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
- University Hospital in Krakow, Kraków, Poland
| | - Przemysław Witek
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
- University Hospital in Krakow, Kraków, Poland
| | - Maxim Lushchyk
- Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
| | | | - Maciej Tadeusz Małecki
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
- University Hospital in Krakow, Kraków, Poland
| | - Tomasz Klupa
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
- University Hospital in Krakow, Kraków, Poland
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Shepherd-Banigan M, Miller KEM, Hastings SN, Schleiden LJ, Thorpe JM. Use of high cost care among Veterans with comorbid mental illness and Alzheimer's Disease and related dementias. PLoS One 2023; 18:e0282071. [PMID: 37172031 PMCID: PMC10180599 DOI: 10.1371/journal.pone.0282071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/07/2023] [Indexed: 05/14/2023] Open
Abstract
INTRODUCTION/OBJECTIVE Alzheimer's Disease and Other Related Dementias (AD/ADRD) leads to frequent emergency department (ED) and inpatient use. Mental health symptoms among persons with AD/ADRD increases cognitive and functional disabilities and could contribute to these high rates of intensive health care use. The objective of this paper is to assess the relationship of mental illness on 12-month patterns in hospitalization and ED use among Veterans aged 65 and over with a new AD/ADRD diagnosis. METHODS We used an existing dataset of administrative electronic health record data of Veterans with AD/ADRD from the US Veterans Health Administration linked with Medicare claims data from 2011-2015. We use multivariable logistic regression to examine the association between no pre-existing mental illness, pre-existing mental illness (e.g., major depressive disorder, generalized anxiety disorder, or post-traumatic stress disorder), and pre-existing severe mental illness-or SMI-(e.g., bipolar disorder, major depressive disorder with psychosis, or schizophrenia) and 12- month ED and hospitalization use and readmissions among Veterans who had an initial hospitalization visit. We estimated predicted probabilities, differential effect, and associated 95% confidence intervals. RESULTS In our sample, 1.4% had SMI and 11% had non-SMI mental illness. The unadjusted percentage with inpatient and ED use was higher among Veterans with SMI (34% and 26%, respectively) and Veterans with non-SMI mental illness (20%, 16%) compared with Veterans without pre-existing mental illness (12%, 9%). Compared to individuals with no pre-existing mental illness, having a pre-existing mental illness (1.27 percentage points, 95% CI: 0.76, 1.78) and a pre-existing SMI (7.17 percentage points, 95% CI: 5.66, 8.69) were both associated with an increased likelihood of ED use. The same pattern was observed for any inpatient use (mental illness 2.18, 95% CI: 1.59, 2.77; SMI 9.91, 95% CI: 8.21, 11.61). Only pre-existing SMI was associated higher hospitalization readmission. DISCUSSION Pre-existing mental illness increases use of high cost, intensive health care and this association is higher of more severe mental health conditions. We also show that pre-existing mental illness exerts a unique influence, above and beyond other comorbidities, such as diabetes, on ED and inpatient visits. More needs to be done to increase recognition of the unique risks of this combination of health conditions and encourage strategies to address them. Developing, testing, and implementing comprehensive strategies that address the intersection of ADRD and mental illness is promising approach that requires more focused attention.
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Affiliation(s)
- Megan Shepherd-Banigan
- Durham VA Health Care System, Durham, NC, United States of America
- Department of Population Health Sciences, Duke University, Durham, NC, United States of America
- Duke-Margolis Center for Health Policy, Durham, NC, United States of America
- Hopkins Economics of Alzheimer's Disease and Services Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Katherine E M Miller
- Hopkins Economics of Alzheimer's Disease and Services Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Division of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States of America
| | - S Nicole Hastings
- Durham VA Health Care System, Durham, NC, United States of America
- Department of Population Health Sciences, Duke University, Durham, NC, United States of America
- Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Health Care System, Durham, NC, United States of America
- Center for the Study of Aging, Duke University School of Medicine, Durham, NC, United States of America
- Division of Geriatrics, Department of Medicine, Duke University School of Medicine, Durham, NC, United States of America
| | - Loren J Schleiden
- Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, United States of America
| | - Joshua M Thorpe
- Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, United States of America
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States of America
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Emmert-Fees KM, Laxy M, Patel SA, Singh K, Poongothai S, Mohan V, Chwastiak L, Narayan KV, Sagar R, Sosale AR, Anjana RM, Sridhar GR, Tandon N, Ali MK. Cost-Effectiveness of a Collaborative Care Model Among Patients With Type 2 Diabetes and Depression in India. Diabetes Care 2023; 46:11-19. [PMID: 36383487 PMCID: PMC9797643 DOI: 10.2337/dc21-2533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 10/10/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the cost-effectiveness of collaborative versus usual care in adults with poorly controlled type 2 diabetes and depression in India. RESEARCH DESIGN AND METHODS We performed a within-trial cost-effectiveness analysis of a 24-month parallel, open-label, pragmatic randomized clinical trial at four urban clinics in India from multipayer and societal perspectives. The trial randomly assigned 404 patients with poorly controlled type 2 diabetes (HbA1c ≥8.0%, systolic blood pressure ≥140 mmHg, or LDL cholesterol ≥130 mg/dL) and depressive symptoms (9-item Patient Health Questionnaire score ≥10) to collaborative care (support from nonphysician care coordinators, electronic registers, and specialist-supported case review) for 12 months, followed by 12 months of usual care or 24 months of usual care. We calculated incremental cost-effectiveness ratios (ICERs) in Indian rupees (INR) and international dollars (Int'l-$) and the probability of cost-effectiveness using quality-adjusted life-years (QALYs) and depression-free days (DFDs). RESULTS From a multipayer perspective, collaborative care costed an additional INR309,558 (Int'l-$15,344) per QALY and an additional INR290.2 (Int'l-$14.4) per DFD gained compared with usual care. The probability of cost-effectiveness was 56.4% using a willingness to pay of INR336,000 (Int'l-$16,654) per QALY (approximately three times per-capita gross domestic product). The willingness to pay per DFD to achieve a probability of cost-effectiveness >95% was INR401.6 (Int'l-$19.9). From a societal perspective, cost-effectiveness was marginally lower. In sensitivity analyses, integrating collaborative care in clinical workflows reduced incremental costs by ∼47% (ICER 162,689 per QALY, cost-effectiveness probability 89.4%), but cost-effectiveness decreased when adjusting for baseline values. CONCLUSIONS Collaborative care for patients with type 2 diabetes and depression in urban India can be cost-effective, especially when integrated in clinical workflows. Long-term cost-effectiveness might be more favorable. Scalability across lower- and middle-income country settings depends on heterogeneous contextual factors.
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Affiliation(s)
- Karl M.F. Emmert-Fees
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Hubert Department of Global Health, Emory University, Atlanta, GA
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Sports and Health Sciences, Technical University of Munich, Munich, Germany
| | - Michael Laxy
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Hubert Department of Global Health, Emory University, Atlanta, GA
- Department of Sports and Health Sciences, Technical University of Munich, Munich, Germany
| | - Shivani A. Patel
- Hubert Department of Global Health, Emory University, Atlanta, GA
| | - Kavita Singh
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India and Centre for Chronic Disease Control, New Delhi, India
| | - Subramani Poongothai
- Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Lydia Chwastiak
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
| | | | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Aravind R. Sosale
- Diabetes Care and Research Center, DIACON Hospital, Bangalore, Karnataka, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | | | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi
| | - Mohammed K. Ali
- Hubert Department of Global Health, Emory University, Atlanta, GA
- Department of Family and Preventive Medicine, Emory University, Atlanta, GA, United States
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Battini V, Van Manen RP, Gringeri M, Mosini G, Guarnieri G, Bombelli A, Pozzi M, Nobile M, Radice S, Clementi E, Carnovale C. The potential antidepressant effect of antidiabetic agents: New insights from a pharmacovigilance study based on data from the reporting system databases FAERS and VigiBase. Front Pharmacol 2023; 14:1128387. [PMID: 36873988 PMCID: PMC9981969 DOI: 10.3389/fphar.2023.1128387] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/01/2023] [Indexed: 02/19/2023] Open
Abstract
Background: Growing evidence supports a bidirectional association between diabetes and depression; promising but limited and conflicting data from human studies support the intriguing possibility that antidiabetic agents may be used to relieve effectively depressive symptoms in diabetic patients. We investigated the potential antidepressant effects of antidiabetic drugs in a high-scale population data from the two most important pharmacovigilance databases, i.e., the FDA Adverse Event Reporting System (FAERS) and the VigiBase. Material and methods: From the two primary cohorts of patients treated with antidepressants retrieved from FDA Adverse Event Reporting System and VigiBase we identified cases (depressed patients experiencing therapy failure) and non-cases (depressed patients experiencing any other adverse event). We then calculated the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Empirical Bayes Geometric Mean (EBGM), and Empirical Bayes Regression-Adjusted Mean (ERAM) for cases versus non-cases in relation with the concurrent exposure to at least one of the following antidiabetic agent: A10BA Biguanides; A10BB Sulfonylureas; A10BG Thiazolidinediones; A10BH DPP4-inhibitors; A10BJ GLP-1 analogues; A10BK SGLT2 inhibitors (i.e., those agents for which preliminary evidence from literature supports our pharmacological hypothesis). Results: For GLP-1 analogues, all the disproportionality scores showed values <1, i.e., statistically significant, in both analyses [from the FAERS: ROR confidence interval of 0.546 (0.450-0.662); PRR (p-value) of 0.596 (0.000); EBGM (CI) of 0.488 (0.407-0.582); ERAM (CI) of 0.480 (0.398-0.569) and VigiBase: ROR (CI) of 0.717 (0.559-0.921); PRR (p-value) of 0.745 (0.033); EBGM (CI) of 0.586 (0.464-0.733); ERAM of (CI): 0.515 (0.403-0.639)]. Alongside GLP-1 analogues, DPP-4 Inhibitors and Sulfonylureas showed the greatest potential protective effect. With regard to specific antidiabetic agents, liraglutide and gliclazide were associated with a statistically significant decrease in all disproportionality scores, in both analyses. Conclusion: The findings of this study provide encouraging results, albeit preliminary, supporting the need for further clinical research for investigating repurposing of antidiabetic drugs for neuropsychiatric disorders.
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Affiliation(s)
- Vera Battini
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital, Università degli Studi di Milano, Milan, Italy
| | | | - Michele Gringeri
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Giulia Mosini
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Greta Guarnieri
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Anna Bombelli
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Marco Pozzi
- Scientific Institute, IRCCS E Medea, Bosisio Parini, Italy
| | - Maria Nobile
- Scientific Institute, IRCCS E Medea, Bosisio Parini, Italy
| | - Sonia Radice
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Emilio Clementi
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital, Università degli Studi di Milano, Milan, Italy.,Scientific Institute, IRCCS E Medea, Bosisio Parini, Italy
| | - Carla Carnovale
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital, Università degli Studi di Milano, Milan, Italy
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Identification of lncRNAs Associated with the Pathogenesis of Diabetic Retinopathy: From Sequencing Analysis to Validation via In Vivo and In Vitro Experiments. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:1755945. [PMID: 36299680 PMCID: PMC9592201 DOI: 10.1155/2022/1755945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022]
Abstract
This study is aimed at screening for differentially expressed long noncoding RNAs (lncRNAs) associated with the pathogenesis of diabetic retinopathy and verifying the role of lncZNRD1 in high glucose-induced injury of retinal microvascular endothelial cells. The retinal tissues of normal and diabetic rats were collected for high-throughput sequencing of differentially expressed lncRNAs. Retinal microvascular endothelial cells were treated with 50 mM glucose for 4 h, 8 h, 24 h, 48 h, and 72 h. Our results showed that compared with the control group, there were 736 differentially expressed lncRNAs in the retina tissue of the model group, including 226 upregulated genes and 736 downregulated genes. Based on the differentially expressed lncRNAs, Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis indicated that the ErbB signaling pathway, transforming growth factor- (TGF-) β signaling pathway, PI3K − Akt signaling pathway, cyclic adenosine 3,5-monophosphate (cAMP) signaling pathway, mitogen-activated protein kinase (MAPK) signaling pathway, and hypoxia-inducible factor-1 (HIF-1) signaling pathway were likely involved in the regulation of diabetic retinopathy. Compared with the control group, the expression of lncZNRD1-AS1 was significantly increased in retinal microvascular endothelial cells after treatment with high glucose for 24 h. Silencing lncZNRD1 promoted high glucose-induced apoptosis of microvascular endothelial cells. Additionally, silencing lncZNRD1 increased the expression levels of ALDH7A1 and ALDH3A2. In conclusion, lncZNRD1-AS1 demonstrated potentially beneficial function against high glucose-induced retina cell injury by regulating ALDH7A1 and ALDH3A2 expressions.
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Sun XJ, Zhang GH, Guo CM, Zhou ZY, Niu YL, Wang L, Dou GR. Associations between psycho-behavioral risk factors and diabetic retinopathy: NHANES (2005-2018). Front Public Health 2022; 10:966714. [PMID: 36187629 PMCID: PMC9521717 DOI: 10.3389/fpubh.2022.966714] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 08/19/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Diabetes mellitus (DM) and diabetic retinopathy (DR) increase the global burden. Since their pathogenesis is complex, it is necessary to use the biopsychosocial model to discover the most effective strategies. The study is aimed to investigate the psycho-behavioral factors of DR and confirm the discrepancies from previous studies. Research design and methods The study comprised seven cycles of cross-sectional data of the National Health and Nutrition Examination Survey (NHANES) from 2005-2006 to 2017-2018. Samples of DM were selected from this complex multi-stage probability sample and divided into the non-DR and DR groups, where 4,426 samples represented 18,990,825 individuals after weighting. This study comprehensively explored the biological, social, and psychological risk factors of DR, among which the biological factors included blood pressure, blood routine, HbA1c%, blood glucose, the duration of DM, family history, comorbidities, and treatment methods. Social aspects include gender, education, income, insurance, smoking, drinking, sleep habits, and recreational activities. The Patient Health Questionnaire-9 (PHQ-9) was used to assess the psychological state. Taylor series regression was used to examine the connection between factors and DR. Results Men accounted for 55.5% of the DR group (P = 0.0174). Lymphocyte count, insulin treatment, heart failure, stroke, liver condition, and renal failure showed significant differences in DR (P < 0.05). The incidence of depression in DR was 40.5%. Mild to moderate depression [odds ratio was associated with DR [(OR) = 1.37, 95% confidence interval (CI): 1.06-1.79], but there was no statistical difference in severe depression (OR = 1.34, 95% CI: 0.83-2.17). Although ≤ 6 h of sleep was associated with DR (OR = 1.38, 95% CI: 1.01-1.88), we found no statistical differences in alcohol consumption, recreational activities, or sedentary time between the two groups in our current study (P > 0.05). Conclusions The biological risk factors of DR are significant. It showed that stroke is associated with DR, and retinal exams have the potential value as a screening tool for the brain. Besides, psycho-behavioral risk factors of DR should also be paid attention. Our study highlights that mild and moderate depression and ≤6 h of sleep are distinguishably associated with DM complicated with DR. It indicates that psycho-behavioral risk factors confer a vital influence on diabetic health care and DR.
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Affiliation(s)
- Xiao-Jia Sun
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Guo-Heng Zhang
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Chang-Mei Guo
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zi-Yi Zhou
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ya-Li Niu
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ling Wang
- Department of Health Statistics, Faculty of Preventive Medicine, Fourth Military Medical University, Xi'an, China,Ling Wang
| | - Guo-Rui Dou
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, China,*Correspondence: Guo-Rui Dou
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Thangiah G, Johar H, Ismail R, Reininghaus U, Bärnighausen T, Thurairajasingam S, Reidpath D, Su TT. Diabetes Treatment and Mental Illness: A Call for an Integrated Health Care System in Underserved Semi-Rural Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10015. [PMID: 36011650 PMCID: PMC9408510 DOI: 10.3390/ijerph191610015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
Diabetes mellitus (DM) management imposes a tremendous psychological burden on patients. The study investigates the association between DM treatment with blood glucose (BG) control and common mental health conditions. A cross-sectional study was conducted among 1821 individuals with DM in a community-based survey conducted in 2013. Information on respondents’ sociodemographic, mental health, DM treatment, and BG levels was collected. Multinomial logistic regression was employed to examine the association of diabetes treatment with controlled BG levels (<11.1 mmol/L) (42.5%, n = 774) or uncontrolled BG levels (34.3%, n = 625) compared with those not undergoing treatment (23.2%, n = 422) on depression anxiety, and stress. Having DM treatment and controlled BG was associated with high depressive symptoms (Relative Risk Ratio, RRR: 2.42; 95% CI 1.33−4.41) and high anxiety symptoms (1.66; 1.08−2.56) but not with perceived stress. However, treated DM with uncontrolled BG was associated with anxiety (high: 1.64; 1.05−2.56; low: 2.59; 1.10−6.09) but not depression or perceived stress. Our results suggest that being treated for DM, regardless of glucose control status, was associated with anxiety symptoms, whereas being treated with controlled BG was associated with high depressive symptoms. This situation highlights the need for integrative, multidisciplinary care for DM patients with mental health comorbidities.
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Affiliation(s)
- Govindamal Thangiah
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia
| | - Hamimatunnisa Johar
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia
- Department of Psychosomatic Medicine and Psychotherapy, University of Giessen and Marburg, 35392 Giessen, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, 85764 Munich, Germany
| | - Roshidi Ismail
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159 Mannheim, Germany
- ESRC Centre for Society and Mental Health, King’s College London, London WC2R 2LS, UK
- Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine, University of Heidelberg, 69117 Heidelberg, Germany
| | - Sivakumar Thurairajasingam
- Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Johor Bahru 80100, Malaysia
| | - Daniel Reidpath
- Institute for Global Health and Development, Queen Margaret University, Edinburgh EH21 6UU, UK
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia
- Heidelberg Institute of Global Health, Faculty of Medicine, University of Heidelberg, 69117 Heidelberg, Germany
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