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Chae WR, Kohring C, Rohde C, Köhler-Forsberg O, Otte C, Holstiege J. Eight-year nationwide study of the bidirectional association between type 2 diabetes and depression in nearly 8 million German outpatients. BMJ Open Diabetes Res Care 2024; 12:e003903. [PMID: 38719506 PMCID: PMC11085903 DOI: 10.1136/bmjdrc-2023-003903] [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: 11/09/2023] [Accepted: 03/23/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Research linking type 2 diabetes and depression mostly relied on hospital-based diagnoses or prescription data, overlooking many outpatient diagnoses. We aimed to quantify the risks of depression in individuals newly diagnosed with type 2 diabetes, and type 2 diabetes in those newly diagnosed with depression, while exploring potential risk differences depending on age, sex, and follow-up time. RESEARCH DESIGN AND METHODS We conducted a matched cohort study using German nationwide outpatient claims data from 2012 to 2022. Participants were individuals newly diagnosed with type 2 diabetes (N=294 642) or depression (N=1 271 537) in 2015, matched in a 1:4 ratio to controls without these conditions by age, sex, and region. The bidirectional risk was evaluated over an 8-year period using mixed-effects Cox proportional hazards models, adjusting for the Charlson Comorbidity Index, urbanicity, and area-level deprivation. RESULTS New type 2 diabetes diagnosis was associated with higher depression risk over 8 years (N=54 561 with depression, HR=1.23, 99% CI=1.21 to 1.24). Similarly, depression diagnosis was linked to an increased type 2 diabetes risk (N=71 848 with type 2 diabetes, HR=1.15, 99% CI=1.14 to 1.17). The association between depression and type 2 diabetes was stronger in younger age groups, especially under 34 years. Findings held across sex-stratified analyses. Time stratification showed a more pronounced association between type 2 diabetes and depression risk during the earlier follow-up quarters, whereas the risk of developing type 2 diabetes after depression diagnosis remained constant throughout the follow-up period. CONCLUSIONS Our findings confirm a bidirectional link between type 2 diabetes and depression, particularly in younger individuals. As type 2 diabetes and depression are frequent, future research needs to study whether preventive approaches can reduce the risk of developing this comorbidity.
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Affiliation(s)
- Woo Ri Chae
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Neurosciences, Campus Benjamin Franklin, Berlin, Germany
- DZPG, German Center for Mental Health, partner site Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
| | - Claudia Kohring
- Central Research Institute of Ambulatory Health Care in Germany (Zi), Department of Epidemiology and Health Care Atlas, Berlin, Germany
| | - Christopher Rohde
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ole Köhler-Forsberg
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
| | - Christian Otte
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Neurosciences, Campus Benjamin Franklin, Berlin, Germany
- DZPG, German Center for Mental Health, partner site Berlin, Germany
| | - Jakob Holstiege
- Central Research Institute of Ambulatory Health Care in Germany (Zi), Department of Epidemiology and Health Care Atlas, Berlin, Germany
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Busch A, Roy S, Helbing DL, Colic L, Opel N, Besteher B, Walter M, Bauer M, Refisch A. Gut microbiome in atypical depression. J Affect Disord 2024; 349:277-285. [PMID: 38211751 DOI: 10.1016/j.jad.2024.01.060] [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: 09/11/2023] [Revised: 12/15/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Recent studies showed that immunometabolic dysregulation is related to unipolar major depressive disorder (MDD) and that it more consistently maps to MDD patients endorsing an atypical symptom profile, characterized by energy-related symptoms including increased appetite, weight gain, and hypersomnia. Despite the documented influence of the microbiome on immune regulation and energy homeostasis, studies have not yet investigated microbiome differences among clinical groups in individuals with MDD. METHODS Fifteen MDD patients with atypical features according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)-5, forty-four MDD patients not fulfilling the DSM-5 criteria for the atypical subtype, and nineteen healthy controls were included in the study. Participants completed detailed clinical assessment and stool samples were collected. Samples were sequenced for the prokaryotic 16S rRNA gene, in the V3-V4 variable regions. Only samples with no antibiotic exposure in the previous 12 months and a minimum of >2000 quality-filtered reads were included in the analyses. RESULTS There were no statistically significant differences in alpha- and beta-diversity between the MDD groups and healthy controls. However, within the atypical MDD group, there was an increase in the Verrucomicrobiota phylum, with Akkermansia as the predominant bacterial genus. LIMITATIONS Cross-sectional data, modest sample size, and significantly increased body mass index in the atypical MDD group. CONCLUSIONS There were no overall differences among the investigated groups. However, differences were found at several taxonomic levels. Studies in larger longitudinal samples with relevant confounders are needed to advance the understanding of the microbial influences on the clinical heterogeneity of depression.
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Affiliation(s)
- Anne Busch
- Theoretical Microbial Ecology, Friedrich Schiller University Jena, Jena, Germany; Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany; Cluster of Excellence Balance of the Microverse, Friedrich Schiller University Jena, Jena, Germany.
| | - Sagnik Roy
- Theoretical Microbial Ecology, Friedrich Schiller University Jena, Jena, Germany
| | - Dario Lucas Helbing
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany; Leibniz Institute on Aging-Fritz Lipmann Institute, 07745 Jena, Germany; Institute of Molecular Cell Biology, Jena University Hospital, Friedrich Schiller University Jena, 07745 Jena, Germany
| | - Lejla Colic
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany; Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany
| | - Nils Opel
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany; German Center for Mental Health (DZPG), Germany
| | - Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany; German Center for Mental Health (DZPG), Germany; Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany; Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Michael Bauer
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany; Cluster of Excellence Balance of the Microverse, Friedrich Schiller University Jena, Jena, Germany
| | - Alexander Refisch
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany.
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Sayed Ahmed HA, Abo El-Ela SG, Joudeh AI, Moawd SM, El Hayek S, Shah J, Eldahshan NA. Prevalence and Correlates of Night Eating Syndrome, Insomnia, and Psychological Distress in Primary Care Patients with Obesity: A Cross-Sectional Study. Obes Facts 2024; 17:274-285. [PMID: 38484714 PMCID: PMC11149973 DOI: 10.1159/000538341] [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: 06/11/2023] [Accepted: 03/05/2024] [Indexed: 06/06/2024] Open
Abstract
INTRODUCTION Management of obesity is challenging for both patients and healthcare workers. Considering the low success rate of current interventions, this study aimed to explore the prevalence and associated factors of night eating syndrome (NES), insomnia, and psychological distress among individuals with obesity in order to plan comprehensive obesity management interventions. METHODS A cross-sectional study on a convenient sample from five primary healthcare centers in Port Said, Egypt, was conducted from November 2020 to March 2021. Sociodemographic and clinical characteristics were collected in addition to the assessment of NES, insomnia, and psychological distress using the Arabic versions of the Night Eating Diagnostic Questionnaire (NEQ), the Insomnia Severity Index (ISI), and the Patient Health Questionnaire-4 (PHQ-4) scales, respectively. Associations of NES, insomnia, and psychological distress were assessed by multiple regression analysis. We performed Bonferroni adjustments for multiple comparisons. RESULTS We included 425 participants with obesity with a mean age of 45.52 ± 6.96 years. In all, 54.4% were females and the mean body mass index (BMI) was 35.20 ± 4.41 kg/m2. The prevalence rates of NES, insomnia, and psychological distress were 21.6% (95% CI: 17.7-25.6%), 15.3% (95% CI: 11.9-18.7%), and 18.8% (95% CI: 15.1-22.6%), respectively. NES was significantly associated with younger age (OR 0.974, p = 0.016), physical inactivity (OR 0.485, p = 0.010), insomnia (OR 2.227, p = 0.014), and psychological distress (OR 2.503, p = 0.002). Insomnia showed strong associations with NES (OR 2.255, p = 0.015) and psychological distress (OR 5.990, p < 0.001). Associated factors of psychological distress symptoms included insomnia (OR 6.098, p < 0.001) and NES (OR 2.463, p = 0.003). CONCLUSION The prevalence rates of NES, insomnia, and psychological distress were high among primary care patients with obesity, and these conditions were interrelated. Optimal obesity management necessitates individualized and targeted multidisciplinary care plans that take into consideration individual patients' mental, behavioral, and dietary habits needs.
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Affiliation(s)
- Hazem A Sayed Ahmed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Sohila G Abo El-Ela
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Anwar I Joudeh
- Internal Medicine Department, Al-Khor Hospital, Hamad Medical Corporation, Doha, Qatar
- Internal Medicine Department, College of Medicine, University of Qatar, Doha, Qatar
| | - Sally M Moawd
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Samer El Hayek
- Medical Department, Erada Center for Treatment and Rehabilitation in Dubai, Dubai, United Arab Emirates
| | - Jaffer Shah
- Weill Cornell Medicine, New York, New York, USA
| | - Nahed Amen Eldahshan
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Mohd Tamil A, Ismail NH, Jaafar MH, Md Isa Z, Ismail R, Mat Nasir N, Miskan M, Zainol Abidin N, Ab Razak NH, Joundi R, Yusof KH. Depressive symptoms among adults: Baseline findings of PURE Malaysia cohort study. Heliyon 2024; 10:e23042. [PMID: 38192831 PMCID: PMC10772557 DOI: 10.1016/j.heliyon.2023.e23042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction In Malaysia, the prevalence of depression has increased from 1.8 % to 2.3 % within a decade. Thus, this study was performed to identify depressive symptoms and its associated factors among Malaysian adults. Methods A cross-sectional study was conducted among the adult population aged 35-70 residing in rural and urban areas in Malaysia. Depressive symptoms were assessed using the short form Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Composite International Diagnostic Interview (CIDI) questionnaire. Logistic regression models were fitted to identify the associated factors related to depressive symptoms. Results About 3.7 % (95 % CI: 2.33-4.83) of the respondents reported having depressive symptoms. Younger adults aged 35-40 years old (AOR: 3.087; 95 % CI: 2.021-4.717), females (AOR: 2.318; 95 % CI: 1.669-3.219), widows and divorcees (AOR: 2.294; 95 % CI: 1.085-4.848), smokers (AOR: 1.843; 95 % CI: 1.334-2.545) and alcohol consumers (AOR: 1.843; 95 % CI: 1.264-2.688) showed a higher odds compared to their other counterparts. Underweight individuals (AOR: 1.899; 95 % CI: 1.177-3.065) and those diagnosed either with hypertension (AOR: 1.442; 95 % CI: 1.11-1.873), diabetes (AOR: 1.554; 95 % CI: 1.133-2.13), angina (AOR: 2.73; 95 % CI: 1.596-4.67), COPD (AOR: 4.187; 95 % CI: 1.528-11.472) or asthma (AOR: 1.906; 95 % CI: 1.309-2.774) were more likely to have depressive symptoms. Additionally, individuals with difficulty trusting people (AOR: 1.477; 95 % CI: 1.024-2.13) and those reported to experience either home or work-related stress (AOR: 2.584; 95 % CI: 2.003-3.331) were more prone to have depressive symptoms. Conclusion In this broad population-based study, about 3.7 % (95 % CI: 2.33-4.83) of respondents reported having depressive symptoms. Timely and well targeted collaborative intervention on the identified risk factors by the relevant authorities, would mitigate their effect on the quality of life and retard the progression into depression, especially among younger adults.
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Affiliation(s)
- Azmi Mohd Tamil
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Noor Hassim Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Mohd Hasni Jaafar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Zaleha Md Isa
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Rosnah Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Nafiza Mat Nasir
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor Branch, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia
| | - Maizatullifah Miskan
- Department of Primary Care Medicine, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Sungai Besi, 57000 Kuala Lumpur, Malaysia
| | - Najihah Zainol Abidin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
- Department of Diagnostic and Allied Health Science, Faculty of Health and Life Sciences, Management and Science University, 40100 Shah Alam, Selangor, Malaysia
| | - Nurul Hafiza Ab Razak
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Raed Joundi
- Division of Neurology, Hamilton Health Sciences, McMaster University and Population Health Research Institute, Hamilton General Hospital, Hamilton, ON, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Khairul Hazdi Yusof
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
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Huang X, Sun Y, Zhang X. Overweight or Obesity Rate and Risk Factors in First-Episode and Drug-Naïve Patients with Major Depressive Disorder with Comorbid Abnormal Lipid Metabolism: A Large-Scale Cross-Sectional Study. Metabolites 2023; 14:26. [PMID: 38248829 PMCID: PMC10819232 DOI: 10.3390/metabo14010026] [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: 11/17/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
Overweight and obesity are frequent symptoms in patients with major depressive disorder (MDD) and abnormal lipid metabolism (ALM). There are no studies on the rate, risk factors, and underlying mechanisms of overweight/obesity in Chinese patients with MDD with comorbid ALM. The purpose of this study was to examine the rate of overweight/obesity and the associated risk factors among Chinese patients with MDD first-episode and drug-naïve (FEDN) with comorbid ALM. This study was a cross-sectional research work. A total of 1718 patients were enrolled. Their clinical and laboratory data were obtained. All participants were assessed with the 17-item Hamilton Depression Rating Scale (HAMD), the Hamilton Anxiety Rating Scale (HAMA), and the Positive and Negative Syndrome Scale (PANSS) positive subscale. The plasma total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triacylglycerols (TG), blood glucose concentrations, thyroid peroxidase antibody (A-TPO), thyoglubulin antibody (A-TG), thyroid-stimulating hormone (TSH), free thyoxine (FT4) and free triiodothyronine (FT3), and blood glucose concentrations were measured. ALM was identified as elevations in the plasma lipid values in this study. Of all the included subjects, the rate of ALM was 81.1%. The rate of obesity and overweight was 3.94% and 57.21%, respectively. Logistic regression analysis showed that TSH was the independent risk factor for overweight or obesity in MDD patients (adjusted OR = 1.158, 95%CI = 1.081-1.24, p < 0.001). The risk of developing overweight or obesity in MDD with ALM with comorbid TSH abnormalities was 2.176 times higher than those without TSH abnormalities (p < 0.001). Further linear regression showed TSH level (B = 0.1, t = 3.376, p = 0.001) and systolic blood pressure (B = 0.015, t = 2.351, p = 0.019) were risk factors for a higher body mass index (BMI). Our results demonstrate that being overweight is very frequent among patients with FEDN MDD with comorbid ALM but not obesity. TSH was the risk factor for overweight and obesity in MDD patients with comorbid ALM.
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Affiliation(s)
- Xiao Huang
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China;
| | - Yuan Sun
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China;
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 101408, China
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Rhee SJ, Min S, Hong M, Lee H, Lee HS, Kang DH, Ahn YM. The association between insulin resistance and depressive symptoms - A national representative cross-sectional study. J Psychosom Res 2023; 175:111502. [PMID: 37812941 DOI: 10.1016/j.jpsychores.2023.111502] [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: 08/12/2023] [Revised: 09/24/2023] [Accepted: 09/24/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE Increasing evidence suggests a positive association between insulin resistance (IR) and depression. However, whether sex-or body mass index-specific differences exist remains controversial, and only few studies have analyzed specific symptom domains. Thus, the present study aimed to analyze the association between IR and depressive symptom domains and to clarify the effects of sex and body mass index. METHODS The study sample comprised 4007 participants, aged 19-79, from the Korea National Health and Nutrition Examination Study 2020. Participants completed health interviews and examinations, providing data on circulating insulin and glucose levels, the Patient Health Questionnaire-9 (PHQ-9), and related covariates. IR was calculated using the homeostasis model assessment of insulin resistance. Associations between IR and PHQ-9 were analyzed using negative binomial regression with adjustments for the complex survey design. RESULTS The association between log-transformed IR and PHQ-9 total scores was statistically significant (incidence rate ratio [IRR] = 1.17, 95% confidence interval [CI] = 1.07-1.29, p = 0.001). Only body mass index specific differences were statistically significant, as the association was only significant in those without obesity (IRR = 1.21, 95% CI = 1.06-1.38, p = 0.005). IR was associated with cognitive/affective (IRR = 1.23, 95% CI = 1.08-1.41, p = 0.002) and somatic (IRR = 1.14, 95% CI = 1.04-1.25, p = 0.005) depressive symptom domains. Sensitivity analyses revealed similar results. CONCLUSIONS IR was positively associated with cognitive/affective and somatic depressive symptoms in non-obese individuals.
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Affiliation(s)
- Sang Jin Rhee
- Biomedical Research Institute, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea
| | - Sooyeon Min
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea
| | - Minseok Hong
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea
| | - Hyunju Lee
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea
| | - Han-Sung Lee
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea
| | - Dae Hun Kang
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, 103, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea.
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Kemp JVA, Kumar V, Saleem A, Hashman G, Hussain M, Taylor VH. Examining Associations Between Women's Mental Health and Obesity. Psychiatr Clin North Am 2023; 46:539-549. [PMID: 37500249 DOI: 10.1016/j.psc.2023.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Obesity is a common comorbidity associated with mental illness. It is important to understand the many ways weight gain and obesity can impact the cause and course of mental illness in women, with a special focus on vulnerable life stages. Women seem disproportionally impacted by the weight gain side effects of medications, and issues such as weight gain are more likely to impact symptoms of mental illness, impacting self-esteem. This article summarizes the existing literature on the associations between women's mental health and obesity. Understanding this association will lead to better health outcomes.
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Affiliation(s)
- Jennifer V A Kemp
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada; Matheson Centre for Mental Health Research & Education, University of Calgary, Foothills Campus, 3280 Hospital Drive Northwest, 1D-57, Calgary, Alberta T2N 4Z6, Canada
| | - Vivek Kumar
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada; Matheson Centre for Mental Health Research & Education, University of Calgary, Foothills Campus, 3280 Hospital Drive Northwest, 1D-57, Calgary, Alberta T2N 4Z6, Canada
| | - April Saleem
- Department of Pathology and Molecular Medicine, Gastrointestinal Disease Research Unit, Queen's University, 76 Stuart Street, Sheth Lab (Floor 3), Kingston, Ontario K7L 2V7, Canada
| | - Gabrielle Hashman
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada; Matheson Centre for Mental Health Research & Education, University of Calgary, Foothills Campus, 3280 Hospital Drive Northwest, 1D-57, Calgary, Alberta T2N 4Z6, Canada; Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Mashael Hussain
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada; Matheson Centre for Mental Health Research & Education, University of Calgary, Foothills Campus, 3280 Hospital Drive Northwest, 1D-57, Calgary, Alberta T2N 4Z6, Canada
| | - Valerie H Taylor
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada.
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Leal ACG, Lopes LJ, Rezende-Alves K, Bressan J, Pimenta AM, Hermsdorff HHM. Ultra-processed food consumption is positively associated with the incidence of depression in Brazilian adults (CUME project). J Affect Disord 2023; 328:58-63. [PMID: 36791971 DOI: 10.1016/j.jad.2023.01.120] [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: 05/05/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE To evaluate the association between the consumption of ultra-processed food and the incidence of depression in Brazilian adults. METHODS This longitudinal study included 2572 participants (M = 936 and F = 1636, mean age of 36.1 years) from the Cohort of Universities of Minas Gerais - CUME Project, Brazil. Ultra-processed food (UPF) consumption (in % of daily energy intake, DEI), as defined by the NOVA food classification system, was assessed at baseline using a validated semi-quantitative 144-item food frequency questionnaire. Participants were classified as incident cases of depression if they reported a medical diagnosis of depression in at least one of the follow-up questionnaires. Crude and adjusted cox regression models were used to assess the relationship between UPF consumption and the incidence of depression. RESULTS After a mean of follow-up of 2,96 years, a total of 246 incident cases of depression were identified. The mean consumption of UPF was 44 g/d or 24 % of DEI. Participants in the highest quartile of UPF consumption (31 to 72 % of DEI) had a higher risk of developing depression (HR = 1.82 95 % CI = 1.15-2.88) than those in the lowest quartile (0 to 16 % of DEI) after adjusting for potential confounders. CONCLUSION Higher UPF consumption is a risk factor of depression incidence in Brazilian adults with high education level.
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Affiliation(s)
| | | | - Katiusse Rezende-Alves
- Department of Medicine and Nursing, Universidade Federal de Viçosa (UFV), Viçosa, MG, Brazil.
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, MG, Brazil.
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Yang B, Yang J, Wong MMH, Rana J, Yang Q, Chan V, Khan MS, Yang A, Lo K. Trends in elevated waist-to-height ratio and waist circumference in U.S. adults and their associations with cardiometabolic diseases and cancer, 1999-2018. Front Nutr 2023; 10:1124468. [PMID: 37113294 PMCID: PMC10126508 DOI: 10.3389/fnut.2023.1124468] [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: 12/15/2022] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction Although waist-to-height ratio (WHtR) has established association with cardiometabolic disease, the trend of changes in elevated WHtR among general population have not been examined adequately. Methods This study examined the prevalence of elevated WHtR and waist circumference (WC) and their trends over time using Joinpoint regression models among adults who participated in the United States National Health and Nutrition Examination Survey (U.S. NHANES) 1999-2018. We performed weighted logistic regression to identify the association between central obesity subtypes and the prevalence of comorbidities, including diabetes, chronic kidney disease, hypertension, cardiovascular disease, and cancer. Results The prevalence of elevated WHtR has increased from 74.8% in 1999-2000 to 82.7% in 2017-2018 while elevated WC also increased from 46.9% in 1999-2000 to 60.3% in 2017-2018. Men, older adults, former smokers, and people with lower education levels were more likely to have elevated WHtR. A total of 25.5% of American adults had normal WC but elevated WHtR, and they had a significantly higher chance of suffering from diabetes (odds ratio [OR] = 2.06 [1.66, 2.55]), hypertension (OR = 1.75 [1.58, 1.93]) and CVD (OR = 1.32 [1.11, 1.57]). Discussion In conclusion, the burden of elevated WHtR and WC have been increasing among U.S. adults throughout the years, and the changes have been more significant across most subgroups. It is also notable that approximately a quarter of the population had normal WC but elevated WHtR, which had increased likelihood of having cardiometabolic diseases, especially diabetes. Future clinical practices should pay more attention to this subgroup of the population with overlooked health risks.
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Affiliation(s)
- Bo Yang
- Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI, United States
| | - Jingli Yang
- College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, China
| | - Martin Ming-him Wong
- School of Professional and Continuing Education, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Juwel Rana
- Department of Epidemiology, Biostatistics and Occupational Health, School of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh
| | - Qinghua Yang
- Department of Nephrology, Peking University International Hospital, Beijing, China
| | - Vicky Chan
- Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Moyukh Shabon Khan
- Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Aimin Yang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- *Correspondence: Aimin Yang,
| | - Kenneth Lo
- Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Kenneth Lo,
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10
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The Related Metabolic Diseases and Treatments of Obesity. Healthcare (Basel) 2022; 10:healthcare10091616. [PMID: 36141228 PMCID: PMC9498506 DOI: 10.3390/healthcare10091616] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
Obesity is a chronic disease characterized by the abnormal or excessive accumulation of body fat, affecting more than 1 billion people worldwide. Obesity is commonly associated with other metabolic disorders, such as type 2 diabetes, non-alcoholic fatty liver disease, cardiovascular diseases, chronic kidney disease, and cancers. Factors such as a sedentary lifestyle, overnutrition, socioeconomic status, and other environmental and genetic conditions can cause obesity. Many molecules and signaling pathways are involved in the pathogenesis of obesity, such as nuclear factor (NF)-κB, Toll-like receptors (TLRs), adhesion molecules, G protein-coupled receptors (GPCRs), programmed cell death 1 (PD-1)/programmed death-ligand 1 (PD-L1), and sirtuin 1 (SIRT1). Commonly used strategies of obesity management and treatment include exercise and dietary change or restriction for the early stage of obesity, bariatric surgery for server obesity, and Food and Drug Administration (FDA)-approved medicines such as semaglutide and liraglutide that can be used as monotherapy or as a synergistic treatment. In addition, psychological management, especially for patients with obesity and distress, is a good option. Gut microbiota plays an important role in obesity and its comorbidities, and gut microbial reprogramming by fecal microbiota transplantation (FMT), probiotics, prebiotics, or synbiotics shows promising potential in obesity and metabolic syndrome. Many clinical trials are ongoing to evaluate the therapeutic effects of different treatments. Currently, prevention and early treatment of obesity are the best options to prevent its progression to many comorbidities.
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11
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Wang Z, Cheng Y, Li Y, Han J, Yuan Z, Li Q, Zhong F, Wu Y, Fan X, Bo T, Gao L. The Relationship Between Obesity and Depression Is Partly Dependent on Metabolic Health Status: A Nationwide Inpatient Sample Database Study. Front Endocrinol (Lausanne) 2022; 13:880230. [PMID: 35692399 PMCID: PMC9174461 DOI: 10.3389/fendo.2022.880230] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/04/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Some studies have demonstrated a bidirectional association between obesity and depression, whereas others have not. This discordance might be due to the metabolic health status. We aimed to determine whether the relationship between obesity and depression is dependent on metabolic health status. METHODS In total, 9,022,089 participants were enrolled and classified as one of four obesity phenotypes: metabolically healthy nonobesity (MHNO), metabolically unhealthy nonobesity (MUNO), metabolically healthy obesity (MHO), and metabolically unhealthy obesity (MUO). We then divided the population into eight phenotypes based on obesity and the number of metabolic risk factors. Furthermore, the associations of eight phenotypes, based on obesity and specific metabolic risk factors, with depression were assessed. RESULT Among all participants, a higher risk of depression was observed for MUNO, MHO and MUO than for MHNO. The risk was highest for MUO (OR = 1.442; 95% CI = 1.432, 1.451). However, the association between MHO and depression was different for men and women (OR = 0.941, men; OR = 1.132, women). The risk of depression increased as the number of metabolic risk factors increased. Dyslipidemia was the strongest metabolic risk factor. These relationships were consistent among patients ≥ 45 years of age. CONCLUSIONS The increased risk of obesity-related depression appears to partly depend on metabolic health status. The results highlight the importance of a favorable metabolic status, and even nonobese populations should be screened for metabolic disorders.
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Affiliation(s)
- Zhixiang Wang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
| | - Yiping Cheng
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yuan Li
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
| | - Junming Han
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
| | - Zhongshang Yuan
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Qihang Li
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fang Zhong
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yafei Wu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
| | - Xiude Fan
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
- *Correspondence: Xiude Fan, ; Tao Bo, ; Ling Gao,
| | - Tao Bo
- Central Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- *Correspondence: Xiude Fan, ; Tao Bo, ; Ling Gao,
| | - Ling Gao
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, China
- Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Jinan, China
- Central Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- *Correspondence: Xiude Fan, ; Tao Bo, ; Ling Gao,
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