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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] [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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Varghese SM, Patel S, Nandan A, Jose A, Ghosh S, Sah RK, Menon B, K V A, Chakravarty S. Unraveling the Role of the Blood-Brain Barrier in the Pathophysiology of Depression: Recent Advances and Future Perspectives. Mol Neurobiol 2024:10.1007/s12035-024-04205-5. [PMID: 38730081 DOI: 10.1007/s12035-024-04205-5] [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: 08/03/2023] [Accepted: 04/19/2024] [Indexed: 05/12/2024]
Abstract
Depression is a highly prevalent psychological disorder characterized by persistent dysphoria, psychomotor retardation, insomnia, anhedonia, suicidal ideation, and a remarkable decrease in overall well-being. Despite the prevalence of accessible antidepressant therapies, many individuals do not achieve substantial improvement. Understanding the multifactorial pathophysiology and the heterogeneous nature of the disorder could lead the way toward better outcomes. Recent findings have elucidated the substantial impact of compromised blood-brain barrier (BBB) integrity on the manifestation of depression. BBB functions as an indispensable defense mechanism, tightly overseeing the transport of molecules from the periphery to preserve the integrity of the brain parenchyma. The dysfunction of the BBB has been implicated in a multitude of neurological disorders, and its disruption and consequent brain alterations could potentially serve as important factors in the pathogenesis and progression of depression. In this review, we extensively examine the pathophysiological relevance of the BBB and delve into the specific modifications of its components that underlie the complexities of depression. A particular focus has been placed on examining the effects of peripheral inflammation on the BBB in depression and elucidating the intricate interactions between the gut, BBB, and brain. Furthermore, this review encompasses significant updates on the assessment of BBB integrity and permeability, providing a comprehensive overview of the topic. Finally, we outline the therapeutic relevance and strategies based on BBB in depression, including COVID-19-associated BBB disruption and neuropsychiatric implications. Understanding the comprehensive pathogenic cascade of depression is crucial for shaping the trajectory of future research endeavors.
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Affiliation(s)
- Shamili Mariya Varghese
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, 682 041, India
| | - Shashikant Patel
- Applied Biology Division, CSIR-Indian Institute of Chemical Technology, Tarnaka, Uppal Road, Hyderabad, Telangana, 500007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Amritasree Nandan
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, 682 041, India
| | - Anju Jose
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, 682 041, India
| | - Soumya Ghosh
- Applied Biology Division, CSIR-Indian Institute of Chemical Technology, Tarnaka, Uppal Road, Hyderabad, Telangana, 500007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Ranjay Kumar Sah
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, 682 041, India
| | - Bindu Menon
- Department of Psychiatry, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, 682 041, India
| | - Athira K V
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, 682 041, India.
| | - Sumana Chakravarty
- Applied Biology Division, CSIR-Indian Institute of Chemical Technology, Tarnaka, Uppal Road, Hyderabad, Telangana, 500007, India.
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India.
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Ali SA, Salih SM, Abdelmola A, Makeen AM, Solan YM, Mohammed Ali MM. Association of Anxiety and Depressive Symptoms and Treatment Adherence Among Patients With Type 2 Diabetes Mellitus in Jazan, Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e56068. [PMID: 38618389 PMCID: PMC11009697 DOI: 10.7759/cureus.56068] [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] [Accepted: 03/07/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Diabetes mellitus is a serious public health concern. It is associated with many psychological problems, such as depression, anxiety, and eating disorders. These co-morbidities are associated with improper adherence to treatment, self-care, poor glycemic control, more complications, and worse outcomes. METHODS This study aimed to measure the level of medication adherence among type 2 diabetics in Jazan, Saudi Arabia, and to find its association with their psychological status (specifically, depression and anxiety). A cross-sectional descriptive design was used among adults with type 2 diabetes at the Diabetes and Endocrinology Center in Jazan, Saudi Arabia. The estimated sample size was 480 patients. The General Medication Adherence Scale and Patient Health Questionnaire-4 (PHQ-4) were used as tools to achieve the study objectives. RESULTS A total of 449 diabetic patients completed the survey (93.5% response rate). Patients with poor, low, and partial adherence account for 337 (75%) of patients and only 112 (25%) have good and high medication adherence. Employment and duration of illness were highly significant with a positive relationship to treatment adherence (p = 0.010 and 0.000, respectively). On the other hand, age and disease duration had a significant relationship with psychological disorders (p = 0.029 and 0.002, respectively). Of the patients, 64 (14.3%) had high scores on the PHQ-4, with depressive symptoms in 46 (10.24%) and anxiety symptoms in 75 (16.7%). Correlation analysis reveals that there is a highly significant negative correlation between psychological disorders and adherence to medications (r = -0.288, p = 0.000). CONCLUSION A negative correlation between psychological disorders and adherence to medications was found. The findings indicate the importance of psychological support for diabetic patients for better treatment adherence.
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Affiliation(s)
- Suhaila A Ali
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Sarah M Salih
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Amani Abdelmola
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Anwar M Makeen
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Yahia M Solan
- Department of Family Medicine, Jazan Diabetes and Endocrinology Center, Jazan, SAU
| | - Mona M Mohammed Ali
- Department of Pediatric Endocrinology, Jazan Diabetes and Endocrinology Center, Jazan, SAU
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Réus GZ, Manosso LM, Quevedo J, Carvalho AF. Major depressive disorder as a neuro-immune disorder: Origin, mechanisms, and therapeutic opportunities. Neurosci Biobehav Rev 2023; 155:105425. [PMID: 37852343 DOI: 10.1016/j.neubiorev.2023.105425] [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: 06/20/2023] [Revised: 08/16/2023] [Accepted: 10/12/2023] [Indexed: 10/20/2023]
Abstract
Notwithstanding advances in understanding the pathophysiology of major depressive disorder (MDD), no single mechanism can explain all facets of this disorder. An expanding body of evidence indicates a putative role for the inflammatory response. Several meta-analyses showed an increase in systemic peripheral inflammatory markers in individuals with MDD. Numerous conditions and circumstances in the modern world may promote chronic systemic inflammation through mechanisms, including alterations in the gut microbiota. Peripheral cytokines may reach the brain and contribute to neuroinflammation through cellular, humoral, and neural pathways. On the other hand, antidepressant drugs may decrease peripheral levels of inflammatory markers. Anti-inflammatory drugs and nutritional strategies that reduce inflammation also could improve depressive symptoms. The present study provides a critical review of recent advances in the role of inflammation in the pathophysiology of MDD. Furthermore, this review discusses the role of glial cells and the main drivers of changes associated with neuroinflammation. Finally, we highlight possible novel neurotherapeutic targets for MDD that could exert antidepressant effects by modulating inflammation.
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Affiliation(s)
- Gislaine Z Réus
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.
| | - Luana M Manosso
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - João Quevedo
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil; Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - André F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
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Alruwaili NS, Al-Kuraishy HM, Al-Gareeb AI, Albuhadily AK, Ragab AE, Alenazi AA, Alexiou A, Papadakis M, Batiha GES. Antidepressants and type 2 diabetes: highways to knowns and unknowns. Diabetol Metab Syndr 2023; 15:179. [PMID: 37653558 PMCID: PMC10470155 DOI: 10.1186/s13098-023-01149-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: 04/26/2023] [Accepted: 08/09/2023] [Indexed: 09/02/2023] Open
Abstract
Type 2 diabetes (T2D) is a metabolic disease caused by the development of insulin resistance (IR), relative insulin deficiency, and hyperglycemia. Hyperglycemia-induced neurochemical dysregulation activates the progression of depression in T2D patients. Therefore, management of depression by antidepressant agents improves glucose homeostasis and insulin sensitivity. However, prolong use of antidepressant drugs may increase the risk for the development of T2D. However, there is strong controversy concerning the use of antidepressant drugs in T2D. Therefore, this review try to elucidate the potential effects of antidepressant drugs in T2D regarding their detrimental and beneficial effects.
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Affiliation(s)
- Nahi Sabih Alruwaili
- Eradah Complex of Mental Health -Northern Border Region, Ministry of Health, Al Bahah, Saudi Arabia
| | - Hayder M Al-Kuraishy
- Department of Clinical pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Ali K Albuhadily
- Department of Clinical pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Amany E Ragab
- Department of Pharmacognosy, Faculty of Pharmacy, Tanta University, Tanta, Egypt.
| | | | - Athanasios Alexiou
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, NSW, 2770, Australia
- AFNP Med, Wien, 1030, Austria
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, Wuppertal, 42283, Germany.
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, AlBeheira, 22511, Egypt
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Wang Y, Guo D, Wang M, Hu M, Zhu D, Yu Q, Li Z, Zhang X, Ding R, Zhao M, He P. Community-based integrated care for patients with diabetes and depression (CIC-PDD): study protocol for a cluster randomized controlled trial. Trials 2023; 24:550. [PMID: 37608381 PMCID: PMC10464429 DOI: 10.1186/s13063-023-07561-0] [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: 04/02/2023] [Accepted: 08/02/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Managing the multimorbidity of diabetes and depression remains a clinical challenge for patients and healthcare professionals due to the fragmented healthcare delivery system. To effectively cope with multimorbidity, there is an urgent need for the health system to transform into people-centered integrated care (PCIC) system globally. Therefore, this paper describes the protocol of community-based integrated care for patients with diabetes and depression (CIC-PDD) project, an integrated and shared-care intervention project. METHODS/DESIGN CIC-PDD project is conducted in two phases, namely "care model development" and "implementation and evaluation." In the first phase, CIC-PDD model was designed and developed based on the four criteria of collaborative care model (CCM) and was subsequently adjusted to align with the context of China. The second phase entails a pragmatic, two-arm, cluster randomized controlled implementation trial, accompanied by parallel mixed-methods process evaluation and cost-effectiveness analysis. DISCUSSION We anticipate CIC-PDD project will facilitate the development and innovation of PCIC model and related theories worldwide, particularly in low- and middle-income countries (LMICs). In addition, CIC-PDD project will contribute to the exploration of primary health care (PHC) in addressing the multimorbidity of physical and mental health issues. TRIAL REGISTRATION ClinicalTrials.gov registration ChiCTR2200065608 (China Clinical Trials Registry https://www.chictr.org.cn ). Registered on November 9, 2022.
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Affiliation(s)
- Yanshang Wang
- School of Public Health, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
- China Center for Health Development Studies, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
| | - Dan Guo
- China Center for Health Development Studies, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
| | - Ming Wang
- School of Public Health, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
- China Center for Health Development Studies, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
| | - Mingzheng Hu
- School of Public Health, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
- China Center for Health Development Studies, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
| | - Qianqian Yu
- School of Management, Weifang Medical University, Weicheng District, 7166 Baotong Street, Weifang, 261053, Shandong, China
| | - Zhansheng Li
- Health Commission of Weifang, 6396 Dongfeng East Street, Weifang, 261061, Shandong, China
| | - Xiaoyi Zhang
- Health Commission of Weifang, 6396 Dongfeng East Street, Weifang, 261061, Shandong, China
| | - Ruoxi Ding
- China Center for Health Development Studies, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
| | - Miaomiao Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Xuhui District, 600 Wanping South Street, Shanghai, 200030, China
- Center for Mental Health Management, China Hospital Development Institute, Shanghai Jiao Tong University, Xuhui District, 600 Wanping South Street, Shanghai, 200030, China
| | - Ping He
- China Center for Health Development Studies, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China.
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Li Y, Buys N, Ferguson S, Li Z, Shi YC, Li L, Sun J. The evaluation of cognitive-behavioral therapy-based intervention on type 2 diabetes patients with comorbid metabolic syndrome: a randomized controlled trial. Diabetol Metab Syndr 2023; 15:158. [PMID: 37461057 PMCID: PMC10351126 DOI: 10.1186/s13098-023-01100-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/27/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Cognitive behavior therapy (CBT) has been applied in intervention research in diabetes patients with satisfying results. However, there was no research on type 2 diabetes (T2DM) patients with comorbidities. This study aimed to investigate the effectiveness of CBT on psychological variables, behavior variables, quality of life, sleep quality, and physical variables among adult T2DM patients with comorbid metabolic syndrome (MS). METHODS 281 patients aged 18-75 years were recruited from Ningbo First Hospital in China from October 2021 to March 2022. Patients were randomized to the intervention group (IG, N = 148) or control group (CG, N = 133). Patients in the IG received 12 CBT-based sessions during a six-month intervention time. Patients in the CG received the usual care only. Univariate General Linear Model was used to analyze the effect of CBT-based interventions. The analysis was conducted by SPSS Version 28. RESULTS Results indicated that CBT-based intervention was superior in the following aspects: relieving depression symptoms: IG (4.11 ± 4.35 vs. 1.99 ± 2.12), CG (3.40 ± 3.26 vs. 2.32 ± 1.88), interaction effect (F = 4.074, P = 0.044); enhancing diabetes self-care behaviors: IG (26.79 ± 12.18 vs. 37.49 ± 10.83), CG (25.82 ± 13.71 vs. 31.96 ± 11.72), interaction effect (F = 5.242, P = 0.022); promoting the efficacy of CBT: IG (47.45 ± 6.83 vs. 50.76 ± 4.98), CG (46.74 ± 6.94 vs. 47.87 ± 5.11), interaction effect (F = 5.198, P = 0.023); improving subjective sleep quality: IG (0.93 ± 0.68 vs. 0.69 ± 0.63), CG (1.03 ± 0.72 vs. 1.01 ± 0.68), interaction effect (F = 3.927, P = 0.048). CONCLUSIONS The CBT-based intervention was beneficial in improving depression symptoms, diabetes self-care behaviors, the efficacy of CBT, and sleep quality in T2DM patients with comorbid MS. The downtrend of body mass index, systolic blood pressure, diastolic pressure, and glycated hemoglobin was larger in the intervention group but not to a significant level. TRIAL REGISTRATION This study has been prospectively registered at Australia New Zealand Clinical Trials Registry (Registration ID: ACTRN12621001348842 website: https://www.anzctr.org.au/trial/MyTrial.aspx ).
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Affiliation(s)
- Yanni Li
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Q4222, Australia
| | - Nicholas Buys
- Griffith Health, Griffith University, Gold Coast, QLD, Australia
| | | | - Zhiyong Li
- School of Mechanical, Medical & Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Yan-Chuan Shi
- Neuroendocrinology Group, Garvan Institute of Medical Research, Faculty of Medicine and Health, University of New South Wales, 384 Victoria St, Darlinghurst, Australia
| | - Li Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, 315010, Zhejiang Province, China.
| | - Jing Sun
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Q4222, Australia.
- Institute for Integrated Intelligence and Systems, Griffith University, Gold Coast, QLD, Australia.
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
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Dehghani Firouzabadi M, Sheikhy A, Poopak A, Esteghamati A, Mechanick JI, Dehghani Firouzabadi F. Challenges to Lifestyle Medicine for Type 2 Diabetes in Iran: A Synoptic Review. Am J Lifestyle Med 2023. [DOI: 10.1177/15598276231167787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Type 2 diabetes (T2D) is a major public health issue in Iran. The principal context for T2D management is the prevention of cardiovascular disease development and progression. These preventive strategies can be enhanced with routine implementation of comprehensive lifestyle modification, guideline-directed medical therapies, and creation of infrastructure that considers social determinants of health, ethnocultural variables, and financial challenges. In this synoptic review, scientific evidence sourced from Iran is analyzed to identify tactics to optimize the lifestyle medicine component of T2D care in Iran. Important evidence-based factors gleaned from the literature were curated into 9 categories: self-care, dietary adherence, mental health, self-comparison, transcultural adaptation, family support and community engagement, physical activity, the global pandemic, and service delivery. These categories were then assigned to 1 of 4 a priori aspects challenging diabetes care in Iran: behavioral factors, belief system, drivers, and implementation. By codifying discussion points and individual tactics, the improvement and optimization of T2D care in Iran can be facilitated. This reductionist model of approaching lifestyle medicine and complex chronic disease such as T2D can be applied to other ethnocultural populations.
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Affiliation(s)
- Mohammad Dehghani Firouzabadi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheikhy
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Poopak
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Jeffrey I. Mechanick
- Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart and the Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Fatemeh Dehghani Firouzabadi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
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9
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Tegegne KD, Gebeyehu NA, Kassaw MW. Depression and determinants among diabetes mellitus patients in Ethiopia, a systematic review and meta-analysis. BMC Psychiatry 2023; 23:209. [PMID: 36991387 PMCID: PMC10052826 DOI: 10.1186/s12888-023-04655-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 03/06/2023] [Indexed: 03/31/2023] Open
Abstract
INTRODUCTION Primary studies have estimated the prevalence of depression and its determinants among diabetes patients. However, studies synthesizing this primary evidence are limited. Hence, this systematic review aimed to determine the prevalence of depression and identify determinants of depression among diabetes in Ethiopia. METHODS This systematic review and meta-analysis included a search of PubMed, Google Scholar, Scopus, Science Direct, PsycINFO, and Cochrane library. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Data were pooled using a random-effects model. Forest plots, and Egger's regression test were all used to check for publication bias. Heterogeneity (I)2 was computed. Subgroup analysis was done by region, publication year, and depression screening instrument. In addition, the pooled odds ratio for determinants was calculated. RESULTS Sixteen studies, including 5808 participants were analyzed. The prevalence of depression in diabetes was estimated to be 34.61% (95% CI: 27.31-41.91). According to subgroup analysis by study region, publication year, and screening instrument, the highest prevalence was observed in Addis Ababa (41.98%), studies published before 2020 (37.91%), and studies that used Hospital Anxiety and Depression Scale (HADS-D) (42.42%,) respectively. Older age > 50 years (AOR = 2.96; 95% CI: 1.71-5.11), being women (AOR = 2.31; 95% CI: 1.57, 3.4), longer duration with diabetes (above 5 years) (AOR = 1.98; 95% CI: 1.03-3.8), and limited social support (AOR = 2.37; 95% CI: 1.68-3.34), were the determinants of depression in diabetic patients. CONCLUSION The results of this study suggest that the prevalence of depression in diabetes is substantial. This result underscores the importance of paying particular attention to prevent depression among diabetes. Being older, not attending formal education, longer duration with diabetes, having comorbidity, and low adherence to diabetes management were all associated. These variables may help clinicians identify patients at high risk of depression. Future studies focusing on the causal association between depression and diabetes are highly recommended.
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Affiliation(s)
- Kirubel Dagnaw Tegegne
- Department of Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
| | - Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolita Sodo, Ethiopia
| | - Mesfin Wudu Kassaw
- School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
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Yang J, Li X, Mao L, Dong J, Fan R, Zhang L. Path Analysis of Influencing Factors of Depression in Middle-Aged and Elderly Patients with Diabetes. Patient Prefer Adherence 2023; 17:273-280. [PMID: 36741813 PMCID: PMC9896971 DOI: 10.2147/ppa.s392508] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
PURPOSE This study aimed to assess the prevalence of depression in middle-aged and elderly patients with diabetes in China, determine the risk factors of depression in these patients, and explore the internal relationship between influencing factors and depression by constructing a pathway model. METHODS Data were collected from the 2018 China Health and Retirement Longitudinal Study (CHRLS). We included 1743 patients with diabetes who were assessed using the CES-D10, which is used to measure depressive symptoms in Chinese older adults. Based on the theory of psychological stress, data were analyzed using SPSS software version 22.0 and MPLUS 8.0. A correlation analysis was used to explore the relationship between the variables and depression scores. A path model was constructed to explore the interrelationships between variables and verify the relationships between variables and depression in patients with diabetes. RESULTS The prevalence of depression among patients with diabetes was 42.5%. The path analysis results showed that income, diabetes duration, sleep duration, pain distress, self-rated health, and glycemic control directly affected depression, and self-rated health had the largest effect value. With self-rated health and glycemic control as mediator variables, income, diabetes duration, sleep duration, pain distress, glycemic control, and insulin use had indirect effects on depression by influencing self-rated health. Age, frequency of blood glucose monitoring, and exercise glycemic control awareness indirectly affected depression by affecting glycemic control, self-rated health status, and depression. CONCLUSION We found that the path analysis model could construct the interaction between the influencing factors and explore the potential interrelationship between the influencing factors and diabetes-related depression. Patients with diabetes must adhere to regular medication, maintain a healthy lifestyle, and have effective glycemic control. Diabetes depression can be effectively prevented by making psychological knowledge publicly available, providing health education, and establishing corresponding for diabetes.
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Affiliation(s)
- Jielin Yang
- Department of Public Health, Shihezi University School of Medicine, Xinjiang, People’s Republic of China
| | - XiaoJu Li
- Department of Public Health, Shihezi University School of Medicine, Xinjiang, People’s Republic of China
- Correspondence: XiaoJu Li, Email
| | - Lu Mao
- Department of Public Health, Shihezi University School of Medicine, Xinjiang, People’s Republic of China
| | - Jiaxin Dong
- Department of Public Health, Shihezi University School of Medicine, Xinjiang, People’s Republic of China
| | - Rong Fan
- Department of Public Health, Shihezi University School of Medicine, Xinjiang, People’s Republic of China
| | - Liwen Zhang
- Department of Social Work, The First Affiliated Hospital of Shihezi University Medical College, Xinjiang, People’s Republic of China
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Bilu C, Einat H, Zimmet P, Kronfeld-Schor N. Circadian rhythms-related disorders in diurnal fat sand rats under modern lifestyle conditions: A review. Front Physiol 2022; 13:963449. [PMID: 36160856 PMCID: PMC9489903 DOI: 10.3389/fphys.2022.963449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
Modern lifestyle reduces environmental rhythmicity and may lead to circadian desynchrony. We are exposed to poor day-time lighting indoors and excessive night-time artificial light. We use air-conditioning to reduce ambient temperature cycle, and food is regularly available at all times. These disruptions of daily rhythms may lead to type 2 diabetes mellitus (T2DM), obesity, cardiometabolic diseases (CMD), depression and anxiety, all of which impose major public health and economic burden on societies. Therefore, we need appropriate animal models to gain a better understanding of their etiologic mechanisms, prevention, and management.We argue that the fat sand rat (Psammomys obesus), a diurnal animal model, is most suitable for studying the effects of modern-life conditions. Numerous attributes make it an excellent model to study human health disorders including T2DM, CMD, depression and anxiety. Here we review a comprehensive series of studies we and others conducted, utilizing the fat sand rat to study the underlying interactions between biological rhythms and health. Understanding these interactions will help deciphering the biological basis of these diseases, which often occur concurrently. We found that when kept in the laboratory (compared with natural and semi-wild outdoors conditions where they are diurnal), fat sand rats show low amplitude, nocturnal or arrhythmic activity patterns, dampened daily glucose rhythm, glucose intolerance, obesity and decreased survival rates. Short photoperiod acclimation exacerbates these pathologies and further dampens behavioral and molecular daily rhythms, resulting in CMD, T2DM, obesity, adipocyte dysfunction, cataracts, depression and anxiety. Increasing environmental rhythmicity by morning bright light exposure or by access to running wheels strengthens daily rhythms, and results in higher peak-to-trough difference in activity, better rhythmicity in clock genes expression, lower blood glucose and insulin levels, improved glucose tolerance, lower body and heart weight, and lower anxiety and depression. In summary, we have demonstrated that fat sand rats living under the correspondent of “human modern lifestyle” conditions exhibit dampened behavioral and biological rhythms and develop circadian desynchrony, which leads to what we have named “The Circadian Syndrome”. Environmental manipulations that increase rhythmicity result in improvement or prevention of these pathologies. Similar interventions in human subjects could have the same positive results and further research on this should be undertaken.
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Affiliation(s)
- Carmel Bilu
- School of Zoology, Tel-Aviv University, Tel Aviv, Israel
- *Correspondence: Carmel Bilu,
| | - Haim Einat
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel-Aviv, Israel
| | - Paul Zimmet
- Department of Diabetes, Monash University, Melbourne, VIC, Australia
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12
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Liu X, Li Y, Guan L, He X, Zhang H, Zhang J, Li J, Zhong D, Jin R. A Systematic Review and Meta-Analysis of the Prevalence and Risk Factors of Depression in Type 2 Diabetes Patients in China. Front Med (Lausanne) 2022; 9:759499. [PMID: 35620713 PMCID: PMC9127805 DOI: 10.3389/fmed.2022.759499] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background The prevalence of type 2 diabetes mellitus (T2DM) is increasing in China. Depression in patients with T2DM interferes with blood glucose management, leads to poor treatment outcomes, and has a high risk of dementia and cardiovascular event. We conducted this systematic review and meta-analysis to evaluate the prevalence of depression in patients with T2DM in China and explore potential risk factors associated with depression in T2DM. Methods We conducted a literature search in MEDLINE/PubMed, EMBASE, the Cochrane Library, the Chinese Biomedical Literature Database (CBM), the China National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP), and the Wanfang Database from their inception to February 25, 2022 to include population-based, cross-sectional surveys that investigated the prevalence of depression in Chinese T2DM patients and studied possible risk factors. Gray literature and reference lists were also manually searched. We used the Agency for Healthcare Research and Quality methodology checklist to assess the risk of bias in the included studies. Two reviewers screened studies, extracted data, and evaluated the risk of bias independently. The primary outcome was the pooled prevalence of depression in Chinese T2DM patients, and the secondary outcomes included potential risk factors for depression in T2DM patients. R (version 3.6.1) and Stata (version 12.0) software were used for data synthesis. Results We included 48 reports that identified 108,678 subjects. Among the included reports, 4 were rated as low risk of bias, 40 moderate risks of bias, and 4 high risks of bias. The prevalence of depression in T2DM patients in China was 25.9% (95% CI 20.6%-31.6%). The prevalence of depression was higher in women (OR = 1.36, 95% CI 1.19-1.54), subjects ≥60 years (OR = 1.56, 95% CI 1.14-2.14), with a primary school or lower education (vs. middle or high school education (OR = 1.49, 95% CI 1.16 - 1.92); vs. college degree or higher education (OR = 1.84, 95% CI 1.16 - 2.92), with a duration of T2DM ≥ 10 years (OR = 1.68, 95% CI 1.11-2.54), with complications (OR = 1.90, 95% CI 1.53-2.36), insulin users (OR = 1.46, 95% CI 1.09-1.96) and individuals living alone (OR = 2.26, 95% CI 1.71-2.98). T2DM patients with current alcohol use had a lower prevalence of depression (OR = 0.70, 95% CI 0.58-0.86). Prevalence varied from 0.8 to 52.6% according to different instruments used to detect depression. Conclusion The prevalence of depression in T2DM patients is remarkable in China. Potential risk factors of depression in T2DM patients included women, age ≥ 60 years, low educational level, complications, duration of diabetes ≥ 10 years, insulin use, and living alone. High-quality epidemiological investigations on the prevalence of depression in Chinese T2DM patients are needed to better understand the status of depression in T2DM. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020182979.
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Affiliation(s)
- Xiaobo Liu
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuxi Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Li Guan
- Department of Rehabilitation, Fushun County People's Hospital, Zigong, China
| | - Xia He
- Affiliated Rehabilitation Hospital of Chengdu University of Traditional Chinese Medicine /Sichuan Province Rehabilitation Hospital, Chengdu, China
| | - Huiling Zhang
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jun Zhang
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Juan Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongling Zhong
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rongjiang Jin
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Rodríguez-Gutiérrez R, Millan-Alanis JM, Barrera FJ, McCoy RG. Value of Patient-Centered Glycemic Control in Patients with Type 2 Diabetes. Curr Diab Rep 2021; 21:63. [PMID: 34902079 PMCID: PMC8693335 DOI: 10.1007/s11892-021-01433-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Present the value of a person-centered approach in diabetes management and review current evidence supporting its practice. RECENT FINDINGS Early evidence from glycemic control trials in diabetes resulted in most practice guidelines adopting a glucose-centric intensive approach for management of the disease, consistently relying on HbA1c as a marker of metabolic control and success. This paradigm has been recently dispelled by new evidence that shows that intensive glycemic control does not provide a significant benefit regarding patient-important microvascular and macrovascular hard outcomes when compared to moderate glycemic targets. The goals of diabetes therapy are to reduce the risks of acute and chronic complications and increase quality of life while incurring least burden of treatment and disruption to the patient's life. A person-centered approach to diabetes management is achieved through shared decision making, integration of evidence-based care and patient´s needs, values and preferences, and minimally disruptive approaches to diabetes care and at the same time offer practical guidance to clinicians and patients on achieving this type of care.
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Affiliation(s)
- René Rodríguez-Gutiérrez
- Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Monterrey, Mexico.
- Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Francisco I. Madero y Av. Gonzalitos s/n, Mitras Centro, Monterrey, 64460, México.
- Knowledge and Evaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, MN, USA.
| | - Juan Manuel Millan-Alanis
- Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Francisco J Barrera
- Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Rozalina G McCoy
- Knowledge and Evaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, MN, USA
- Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 200 First Street SW, Rochester, MN, 55905, USA
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Liu X, Dong C, Jiang H, Zhong D, Li Y, Zhang H, Zhang J, Fan J, Li J, Guan L, Jin R. Prevalence and risk factors of depression in Chinese patients with type 2 diabetes mellitus: a protocol of systematic review and meta-analysis. Syst Rev 2021; 10:302. [PMID: 34823606 PMCID: PMC8620640 DOI: 10.1186/s13643-021-01855-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes mellitus (T2DM) is growing in China. Depression is a significant complication of T2DM, leading to poor management of T2DM. Thus, early detection and treatment of depression in patients with T2DM are essential and effective. Therefore, we plan to conduct a systematic review and meta-analysis to evaluate the prevalence of depression in Chinese patients with T2DM and explore potential risk factors of depression in T2DM. METHODS We will search literatures recorded in MEDLINE, EMBASE, the Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), and WanFang Database from their inception onwards. We will manually search gray literatures, reference lists of identified studies, relevant websites, and consult experts in this field. We will include population-based, cross-sectional surveys that investigated the prevalence of depression in Chinese patients with T2DM or/and the possible risk factors of depression in T2DM. Two reviewers will screen studies, extract data, and evaluate risk of bias independently. Agency for Healthcare Research and Quality methodology checklist will be used to assess the risk of bias. If feasible, we will conduct random effects meta-analysis of observational data to summarize the pooled prevalence, and use odds ratio for categorical data to explore potential risk factors. Prevalence estimates will be stratified according to age, gender, and other factors. Statistical heterogeneity will be estimated using Cochran's Q and I2 index. We will conduct meta-regression to investigate the potential sources of heterogeneity, sensitivity analyses to assess robustness of the synthesized results, and funnel plots and Egger's test to assess publication bias. DISCUSSION This systematic review and meta-analysis will provide comprehensive evidence of the prevalence and potential risk factors of depression in Chinese patients with T2DM. We expect to provide evidence for healthcare practitioners and policy makers to pay attention to the mental health of patients with T2DM. Our data will highlight the need and importance of early detection and intervention for depression in patients with T2DM. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020182979.
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Affiliation(s)
- Xiaobo Liu
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chao Dong
- The General Hospital of Western Theater Command, Chengdu, China
| | - Hong Jiang
- Department of Rehabilitation, Xichong County People's Hospital, Nanchong, China
| | - Dongling Zhong
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuxi Li
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huiling Zhang
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jun Zhang
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jin Fan
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Juan Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Li Guan
- Department of Rehabilitation, Fushun County People's Hospital, Zigong, China.
| | - Rongjiang Jin
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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Han KM, Ham BJ. How Inflammation Affects the Brain in Depression: A Review of Functional and Structural MRI Studies. J Clin Neurol 2021; 17:503-515. [PMID: 34595858 PMCID: PMC8490908 DOI: 10.3988/jcn.2021.17.4.503] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/30/2021] [Accepted: 08/30/2021] [Indexed: 12/27/2022] Open
Abstract
This narrative review discusses how peripheral and central inflammation processes affect brain function and structure in depression, and reports on recent peripheral inflammatory marker-based functional and structural magnetic resonance imaging (MRI) studies from the perspective of neural-circuit dysfunction in depression. Chronic stress stimulates the activity of microglial cells, which increases the production of pro-inflammatory cytokines in the brain. In addition, microglial activation promotes a shift from the synthesis of serotonin to the synthesis of neurotoxic metabolites of the kynurenine pathway, which induces glutamate-mediated excitotoxicity in neurons. Furthermore, the region specificity of microglial activation is hypothesized to contribute to the vulnerability of specific brain regions in the depression-related neural circuits to inflammation-mediated brain injury. MRI studies are increasingly investigating how the blood levels of inflammatory markers such as C-reactive protein, interleukin (IL)-1β, IL-6, and tumor necrosis factor-α are associated with functional and structural neuroimaging markers in depression. Functional MRI studies have found that peripheral inflammatory markers are associated with aberrant activation patterns and altered functional connectivity in neural circuits involved in emotion regulation, reward processing, and cognitive control in depression. Structural MRI studies have suggested that peripheral inflammatory markers are related to reduced cortical gray matter and subcortical volumes, cortical thinning, and decreased integrity of white matter tracts within depression-related neural circuits. These neuroimaging findings may improve our understanding of the relationships between neuroinflammatory processes at the molecular level and macroscale in vivo neuralcircuit dysfunction in depression.
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Affiliation(s)
- Kyu Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Byung Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
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Melanson B, Leri F. Effect of ketamine on the physiological responses to combined hypoglycemic and psychophysical stress. IBRO Neurosci Rep 2021; 11:81-87. [PMID: 34485972 PMCID: PMC8406162 DOI: 10.1016/j.ibneur.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/20/2021] [Indexed: 12/01/2022] Open
Abstract
There is evidence that hypoglycemic stress can interact with other stressors, and that ketamine can mitigate the impact of these stressors on behavior and physiology. The current study in male Sprague-Dawley rats investigated whether pre-treatment with 0, 10, or 20 mg/kg ketamine could modulate the interaction between hypoglycemia induced by 0 or 300 mg/kg 2-deoxy-D-glucose (2-DG) and the psychophysical stress of forced swimming (FSS; 6 sessions, 10 min/session) on serum concentrations of corticosterone (CORT) and the pro-inflammatory cytokine, tumor necrosis factor (TNF)-α. It was found that 2-DG enhanced the CORT response to an initial session of FSS, and this effect dissipated after multiple sessions. More importantly, animals displayed significantly higher levels of CORT and lower levels of TNF-α in response to a drug-free test swim conducted 1 week after exposure to the combined stressors, and these responses were not observed in rats that were pre-treated with ketamine. Overall, these findings indicate that ketamine has the potential to reduce the negative impact of interacting stressors on the biological reactivity of the hypothalamic-pituitary-adrenal axis and the immune system.
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Affiliation(s)
- Brett Melanson
- Department of Psychology and Collaborative Neuroscience, Program University of Guelph, Guelph, ON, Canada
| | - Francesco Leri
- Department of Psychology and Collaborative Neuroscience, Program University of Guelph, Guelph, ON, Canada
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Activation of Hippocampal IR/IRS-1 Signaling Contributes to the Treatment with Zuogui Jiangtang Jieyu Decoction on the Diabetes-Related Depression. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6688723. [PMID: 34149862 PMCID: PMC8195672 DOI: 10.1155/2021/6688723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 05/25/2021] [Indexed: 11/17/2022]
Abstract
Background Zuogui Jiangtang Jieyu decoction (ZJJ) is mainly used for the treatment of diabetes-related depression in current clinical applications and research. This study aims to investigate whether the brain IR/IRS-1 signaling pathway is involved in the therapeutic effect of ZJJ on depression-like behavior in diabetic rats. Methods Sprague–Dawley rats were fed with high-fat diet and subjected to streptozotocin injection to establish the diabetes animal model. After treatment with different doses of ZJJ (20.530 g/kg or 10.265 g/kg) for 4 weeks, the blood glucose level and peripheral insulin resistance were measured. The forced-swimming test (FST) and Morris water maze test (MWMT) were applied for the mood and cognitive function assessment. Then, the Western blot method was used to analyze the protein levels of insulin receptor (IR), insulin receptor substrate-1 (IRS-1), phosphatidylonositol-3-kinase (PI3K), and protein kinase B (PKB, also as known as AKT) in the hippocampus of diabetic rats. Meanwhile, the immunofluorescence method was performed to analyze the above proteins' expression in the neuron and astrocyte. At last, the levels of glycogen, lactate, and ATP were tested by the ELISA method. Additionally, the insulin-sensitive glucose transporter 4 (GLUT4) and the lactate transporter monocarboxylate transporter 4 (MCT4) were analyzed by the Western blot method. Results ZJJ administration significantly decreased the level of blood glucose and improved the peripheral insulin resistance in diabetic rats. Besides, ZJJ attenuated the depression-like behavior and the cognitive dysfunction in rats with diabetes. Furthermore, we found the upregulation of protein expression of phospho-IR, phospho-IRS-1, phospho-PI3K, and phospho-AKT in the hippocampus of diabetic rats after being treated with ZJJ. Moreover, the above proteins are increased not only in the neuron but also in the astrocyte after ZJJ administration. In addition, ZJJ increased the content of ATP, glycogen, and lactate, as well as the expression of GLUT4 and MCT4 in the hippocampus of diabetic rats. Conclusions These findings suggest that ZJJ improves the depression-like behavior of diabetic rats by activating the IR/IRS-1 signaling pathway in both hippocampal neuron and astrocyte. And the brain IR/IRS-1 signaling pathway plays an important role in astrocyte-neuron metabolic coupling, providing a potential mechanism by which the IR/IRS-1 signaling pathway may contribute to the treatment of ZJJ on diabetes-related depression.
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Takahashi K, Kamino T, Yasuda T, Suganuma A, Sakane N. Association Between Psychological Distress and Stress-Related Symptoms and Increased Risk of Type 2 Diabetes in Male Individuals: An Observational Study. J Clin Med Res 2020; 12:816-823. [PMID: 33447316 PMCID: PMC7781282 DOI: 10.14740/jocmr4392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/04/2020] [Indexed: 11/30/2022] Open
Abstract
Background This study evaluated the association between psychological distress and development of type 2 diabetes (T2D) among male individuals in the workplace. Methods This observational cohort study enrolled 6,326 male participants aged 18 - 65 years (mean age 47.4 ± 9.5 years, body mass index 23.4 ± 3.4 kg/m2, hemoglobin A1c 5.5±0.3%), who received annual health checkups from April 2016 to March 2017. Those who had a hemoglobin A1c level ≥ 6.5%, previous history of diabetes, or used diabetes medication were excluded from the analysis. Psychological distress was measured using the Brief Job Stress Questionnaire. Multivariate Cox proportional hazard regression models were used to estimate the development of T2D in relation to psychological distress and stress-related symptoms. The calculated hazard ratio (aHR) was adjusted for age, body mass index, and hemoglobin A1c level. Results During a mean follow-up period of 1.9 years, the incidence rate of new-onset T2D was 2.0%. Baseline psychological parameters did not differ between participants with or without new-onset T2D. Depression was associated with an increased risk of T2D (aHR = 1.54, 95% confidence interval (CI): 1.07 - 2.22), whereas vigor, irritation, fatigue, and anxiety were not. Moreover, inability to handle work (aHR = 2.18, 95% CI: 1.14 - 4.19), sadness (aHR = 1.93, 95% CI: 1.14 - 3.26), headache (aHR = 1.98, 95% CI: 1.18 - 3.34), shoulder stiffness (aHR = 1.56, 95% CI: 1.10 - 2.23), and constipation/diarrhea (aHR = 1.71, 95% CI: 1.04 - 2.80) were associated with T2D incidence. Conclusions Depression and stress-related symptoms were associated with an increased risk of T2D. Industrial physicians and health care providers should evaluate these factors during health checkups to lower the T2D incidence in this population
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Affiliation(s)
- Kaoru Takahashi
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.,Hyogo Health Service Association, Hyogo, Japan
| | | | - Toshinari Yasuda
- Hyogo Health Service Association, Hyogo, Japan.,Hyogo College Of Medicine, Hyogo, Japan
| | - Akiko Suganuma
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Naoki Sakane
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Zandifar A, Badrfam R, Yazdani S, Arzaghi SM, Rahimi F, Ghasemi S, Khamisabadi S, Mohammadian Khonsari N, Qorbani M. Prevalence and severity of depression, anxiety, stress and perceived stress in hospitalized patients with COVID-19. J Diabetes Metab Disord 2020; 19:1431-1438. [PMID: 33145259 PMCID: PMC7594988 DOI: 10.1007/s40200-020-00667-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/19/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE COVID-19, a disease that can be transmitted from person to person and with serious health problems, can be associated with mental health disorders. In this study, we evaluated the prevalence and severity of depression, anxiety, stress, and stress perception among a group of patients with COVID-19 who were hospitalized. METHODS In this cross-sectional study, 106 inpatients with COVID-19 who had stable clinical conditions were evaluated psychologically by two questionnaires: Depression, Anxiety and Stress Scales-21 (DASS-21) and Perceived Stress Scale (PSS-4). RESULTS More than one third of patients had underlying disease. Overall, 97.2% of patients with COVID-19 had some degree of depression. Severity of depression, according to the DASS questionnaire, was 85.8%. All patients (100%) had severe (0.9%) and very severe (99.1%) anxiety. Regarding to stress levels, 97.1% of patients had some degree of stress. In the severity of stress category, 84.9% of patients had severe and very severe stress. In terms of perceived stress, 73.6% of patients had high levels and 22.6% had moderate levels. A positive strong correlation was found between depression and perceived stress (Coefficient: 0.33, P-value: 0.001). Correlation between anxiety and perceived stress was statistically significant (Coefficient: 0.2, P-value: 0.04). CONCLUSIONS The existence of such a high prevalence and severity of psychiatric disorders among hospitalized patients with COVID-19 underscores the need for serious attention to the mental health status of these patients. It seems that health policymakers need to have coherent plans for screening cases and managing related situations.
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Affiliation(s)
- Atefeh Zandifar
- Cardiovascular Research Center, Shahid Rajaei Educational & Medical Center, Alborz University of Medical Sciences, Karaj, Iran
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Rahim Badrfam
- Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrooz Yazdani
- Cardiovascular Research Center, Shahid Rajaei Educational & Medical Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Rahimi
- Cardiovascular Research Center, Shahid Rajaei Educational & Medical Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Somayeh Ghasemi
- Clinical Research Development Unit, Shahid Rajaei Educational & Medical Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Somayeh Khamisabadi
- Clinical Research Development Unit, Shahid Rajaei Educational & Medical Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Hasanpour Dehkordi A, Chin YF, Huang TT, Ebadi A, Ghanei Gheshlagh R. Psychometric evaluation of the Farsi version of the diabetes foot self-care bahavior scale. J Foot Ankle Res 2020; 13:68. [PMID: 33256822 PMCID: PMC7708251 DOI: 10.1186/s13047-020-00437-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/23/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Diabetes foot self-care is one of the self-management behaviors of diabetic patients leading to a reduction in the incidence of pressure ulcers and amputation. Having a valid, reliable, simple and comprehensive tool is essential in measuring the self-care behavior of diabetic patients. The aim of this study was to evaluate the psychometric properties of the Farsi version of the diabetes foot self-care bahavior scale (DFSBS) in Iran. METHODS In this cross-sectional and methodological study, 500 patients with type 2 diabetes were recruited by convenience sampling. Construct validity was assessed by exploratory factor analysis (over 300 patients) and confirmatory factor analysis (over 200 patients). Internal consistency was calculated by Cronbach's alpha coefficient and its stability was calculated by intraclass correlation coefficient (ICC). RESULTS In the exploratory factor analysis, two self-care factors related to feet and shoes were extracted which had specific values of 38.49 and 1.24, respectively, and were able to account for 56.22% of the total self-care variance of diabetes foot. Confirmatory factor analysis had excellent fit model. The internal consistency and ICC of the whole instrument were 0.83 and 0.791 (95% CI: 0.575-0.925; P < 0.001), respectively. CONCLUSIONS The Farsi version of DFSBS (F-DFSBS) has good validity and reliability, and due to its appropriate psychometric properties, this tool can be used in future studies.
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Affiliation(s)
- Ali Hasanpour Dehkordi
- Social Determinants of Health Research Center, School of Allied Medical Sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Yen-Fan Chin
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Tzu-Ting Huang
- Healthy Aging Research Center, and School of Nursing, Chang Gung University, Taoyuan City, Taiwan
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Reza Ghanei Gheshlagh
- Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Jiang CH, Zhu F, Qin TT. Relationships between Chronic Diseases and Depression among Middle-aged and Elderly People in China: A Prospective Study from CHARLS. Curr Med Sci 2020; 40:858-870. [PMID: 33123901 DOI: 10.1007/s11596-020-2270-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/03/2020] [Indexed: 12/18/2022]
Abstract
Given the rapid increase in the prevalence of chronic diseases in aging populations, this prospective study including 17 707 adults aged ≥45 years from China Health and Retirement Longitudinal Study was used to estimate the associations between chronic disease, multimorbidity, and depression among middle-aged and elderly adults in China, and explore the mediating factors. Depressive symptoms were assessed using the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) questionnaire. Twelve chronic physical conditions, including hypertension, diabetes, dyslipidemia, cancer, chronic lung disease, liver disease, heart failure, stroke, kidney disease, arthritis or rheumatism, asthma, digestive disease were assessed. The prevalence rates for physical multimorbidity and depression (CES-D-10 ≥10) were 43.23% and 36.62%, respectively. Through multivariable logistic models and generalized estimating equation (GEE) models, we found all 12 chronic physical conditions, and multimorbidity were significantly associated with depression. Both mobility problems and chronic pain explained more than 30% of the association for all chronic conditions, with particularly high percentages for stroke (51.56%) and cancer (51.06%) in mobility problems and cancer (53.35%) in chronic pain. Limited activities of daily living (ADL) explained 34.60% of the stroke-cancer relationship, while sleep problems explained between 10.15% (stroke) and 14.89% (chronic lung disease) of the association. Individuals with chronic diseases or multimorbidity are significantly more likely to be depressed. Functional symptoms involving limitations of ADL and mobility difficulties mediated much of the association between chronic diseases and incident depression. These symptoms could be targeted for interventions to ameliorate the incidence of depression among individuals with chronic conditions.
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Affiliation(s)
- Chun-Hong Jiang
- School of Management, Hubei University of Education, Wuhan, 430205, China
| | - Feng Zhu
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ting-Ting Qin
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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