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Yi X, Zhu X, Zhou Y, Zhang D, Li M, Zhu Y, Guo X. The Combination of Insulin Resistance and Serum Interleukin-1β Correlates with Post-Stroke Depression in Patients with Acute Ischemic Stroke. Neuropsychiatr Dis Treat 2021; 17:735-746. [PMID: 33727817 PMCID: PMC7955751 DOI: 10.2147/ndt.s291164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/07/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Previous studies have shown that insulin resistance and inflammation may be associated with the pathophysiological mechanisms of mood disorders. Here, we investigated whether homeostatic model assessment of insulin resistance (HOMA-IR) and serum interleukin-1β (IL-1β) in acute ischemic stroke patients might be associated with post-stroke depression (PSD). MATERIALS AND METHODS The prospective study was conducted in China from February 2019 to September 2020. HOMA-IR and clinical data were collected at the time of admission. Serum levels of IL-1β were determined with enzyme-linked immunosorbent assays. Symptoms of depression and anxiety were screened by using the Hamilton Depression and Anxiety Scale at 6 months after stroke, and PSD was diagnosed on the basis of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria. The association of potential risk factors with PSD was analyzed with multivariate logistic regression analysis. Finally, the ability of HOMA-IR and IL-1β to predict PSD was assessed with receiver operating characteristic curve. RESULTS A total of 305 people was included in the study; 65% were male, and the median age was 69.5±11.8 years. At the 6-month follow-up, 113 patients (37.5%) showed depressive symptoms. In multivariate logistic regression analysis, HOMA-IR and IL-1β as graded variables were associated with an increased risk of PSD (P < 0.05). Receiver operating characteristic curve analysis indicated the highest sensitivity and specificity when the HOMA-IR and IL-1β were 1.96 and 38.71 pg/mL, respectively (P < 0.001). IL-1β improved the ability of HOMA-IR to diagnose PSD combined model area under the curve (AUC): 0.78; 95% CI: 0.72-0.83; P < 0.001). CONCLUSION This study suggests that HOMA-IR and IL-1β are strongly associated with PSD at 6 months after stroke in patients with acute ischemic stroke. These two factors together improve the ability for early PSD assessment.
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Affiliation(s)
- Xiaoyi Yi
- Deparment of Neurology, Affiliated Hospital 2 of Nantong University, Nantong, People's Republic of China
| | - Xiangyang Zhu
- Deparment of Neurology, Affiliated Hospital 2 of Nantong University, Nantong, People's Republic of China
| | - Yong Zhou
- Deparment of Neurology, Affiliated Hospital 2 of Nantong University, Nantong, People's Republic of China
| | - Dongmei Zhang
- Clinical Research Center, Affiliated Hospital 2 of Nantong University, Nantong, People's Republic of China
| | - Mengmeng Li
- Clinical Research Center, Affiliated Hospital 2 of Nantong University, Nantong, People's Republic of China
| | - Yuting Zhu
- Deparment of Neurology, Affiliated Hospital 2 of Nantong University, Nantong, People's Republic of China
| | - Xiaoming Guo
- Deparment of Neurology, Affiliated Hospital 2 of Nantong University, Nantong, People's Republic of China
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Calderón-Garcidueñas L, Torres-Solorio AK, Kulesza RJ, Torres-Jardón R, González-González LO, García-Arreola B, Chávez-Franco DA, Luévano-Castro SC, Hernández-Castillo A, Carlos-Hernández E, Solorio-López E, Crespo-Cortés CN, García-Rojas E, Mukherjee PS. Gait and balance disturbances are common in young urbanites and associated with cognitive impairment. Air pollution and the historical development of Alzheimer's disease in the young. ENVIRONMENTAL RESEARCH 2020; 191:110087. [PMID: 32890478 PMCID: PMC7467072 DOI: 10.1016/j.envres.2020.110087] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 05/03/2023]
Abstract
To determine whether gait and balance dysfunction are present in young urbanites exposed to fine particular matter PM2.5 ≥ annual USEPA standard, we tested gait and balance with Tinetti and Berg tests in 575 clinically healthy subjects, age 21.0 ± 5.7 y who were residents in Metropolitan Mexico City, Villahermosa and Reynosa. The Montreal Cognitive Assessment was also applied to an independent cohort n:76, age 23.3 ± 9.1 y. In the 575 cohort, 75.4% and 34.4% had abnormal total Tinetti and Berg scores and high risk of falls in 17.2% and 5.7% respectively. BMI impacted negatively Tinetti and Berg performance. Gait dysfunction worsen with age and males performed worse than females. Gait and balance dysfunction were associated with mild cognitive impairment MCI (19.73%) and dementia (55.26%) in 57/76 and 19 cognitively intact subjects had gait and balance dysfunction. Seventy-five percent of urbanites exposed to PM2.5 had gait and balance dysfunction. For MMC residents-with historical documented Alzheimer disease (AD) and CSF abnormalities, these findings suggest Alzheimer Continuum is in progress. Early development of a Motoric Cognitive Risk Syndrome ought to be considered in city dwellers with normal cognition and gait dysfunction. The AD research frame in PM2.5 exposed young urbanites should include gait and balance measurements. Multicity teens and young adult cohorts are warranted for quantitative gait and balance measurements and neuropsychological and brain imaging studies in high vs low PM2.5 exposures. Early identification of gait and balance impairment in young air pollution-exposed urbanites would facilitate multidisciplinary prevention efforts for modifying the course of AD.
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Affiliation(s)
| | | | - Randy J Kulesza
- Auditory Research Center, Lake Erie College of Osteopathic Medicine, Erie, PA, 16509, USA
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Lamar M, Barnes LL, Leurgans SE, Fleischman DA, Farfel JM, Bennett DA, Marquez DX. Acculturation in Context: The Relationship Between Acculturation and Socioenvironmental Factors With Level of and Change in Cognition in Older Latinos. J Gerontol B Psychol Sci Soc Sci 2020; 76:e129-e139. [PMID: 32918471 DOI: 10.1093/geronb/gbaa156] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Latinos are 1.5 times as likely to develop Alzheimer's dementia as non-Latino Whites. This health disparity may arise from multiple influences with culturally relevant factors receiving increasing attention. Models of acculturation stress the importance of considering acculturation-related factors within the context of socioenvironmental factors to better capture the Latino experience in the United States. METHODS We measured 10 acculturation and contextually-related variables in 199 Latinos (age 69.7 years) without dementia participating in Rush Alzheimer's Disease Center studies. We tested the relationship between these variables via Principal Component Analysis (PCA), then investigated how resulting components associated with level of and longitudinal change in global and domain-specific cognition using separate linear mixed-effects models adjusted for relevant confounders and their interactions with time. RESULTS The PCA revealed a 3-factor unrotated solution (variance explained ~70%). Factor 1, representing acculturation-related aspects of nativity, language- and social-based acculturation, was positively associated with level, but not change, in global cognition, semantic memory, and perceptual speed. Factor 2, representing contextually-related socioenvironmental experiences of discrimination, social isolation, and social networks, was negatively associated with level of global cognition, episodic and working memory, and faster longitudinal decline in visuospatial ability. Factor 3 (familism only) did not associate with level or change in any cognitive outcome. DISCUSSION Acculturation- and contextually-related factors differentiated from each other and differentially contributed to cognition and cognitive decline in older Latinos. Providers should query acculturation and lived experiences when evaluating cognition in older Latinos.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Debra A Fleischman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Jose M Farfel
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - David X Marquez
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Kinesiology and Nutrition, University of Illinois at Chicago
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Kusnanto, Widyanata KAJ, Suprajitno, Arifin H. DM-calendar app as a diabetes self-management education on adult type 2 diabetes mellitus: a randomized controlled trial. J Diabetes Metab Disord 2019; 18:557-563. [PMID: 31890682 DOI: 10.1007/s40200-019-00468-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 11/05/2019] [Indexed: 01/11/2023]
Abstract
Purpose Era Disruption 4.0 demands development in the management of Diabetes Mellitus (DM) by using application-based intervention that can facilitate nursing intervention. The aim was to evaluate the effect of diabetes mellitus calendar app as a Diabetes Self-Management Education (DSME) program on self-efficacy, HbA1c levels, lipid profile, and insulin in adult type 2 diabetes mellitus (T2DM). Methods It was randomized experimental design - simple random sampling used with a total sample of 30 respondents. The instruments used diabetes management self-efficacy scales and standard of operational procedure blood sampling. The statistical tests used were a Paired t-test, Wilcoxon, and an Independent t-test. Results DSME with an Android-based DM calendar affected self-efficacy (p < 0.001), HbA1c levels (p = 0.005), cholesterol (p = 0.009), triglyceride (p = 0.000), HDL-c (p = 0.048), LDL-c (p = 0.010), and insulin (p = 0.000) compared with the control group. Education with these electronic media has increased the perception of self-efficacy and improved the behavior of good self-management that can be seen from changes in controlled HbA1c level, lipid profile and insulin. Conclusion The results of this study can be used as a reference for providing educational experimental in patients with Type 2 Diabetes Mellitus (T2DM).
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Affiliation(s)
- Kusnanto
- 1Department of Fundamental, Critical, and Medical-Surgical Nursing, Faculty of Nursing, Universitas Airlangga, Kampus C Mulyorejo, Surabaya, East Java 60115 Indonesia
| | - Komang Agus Jerry Widyanata
- 1Department of Fundamental, Critical, and Medical-Surgical Nursing, Faculty of Nursing, Universitas Airlangga, Kampus C Mulyorejo, Surabaya, East Java 60115 Indonesia
| | - Suprajitno
- School of Nursing, Patria Husada Blitar, East Java, Indonesia
| | - Hidayat Arifin
- 1Department of Fundamental, Critical, and Medical-Surgical Nursing, Faculty of Nursing, Universitas Airlangga, Kampus C Mulyorejo, Surabaya, East Java 60115 Indonesia
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