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Kontoangelos K, Raptis A, Lambadiari V, Economou M, Tsiori S, Katsi V, Papageorgiou C, Martinaki S, Dimitriadis G, Papageorgiou C. Burnout Related to Diabetes Mellitus: A Critical Analysis. Clin Pract Epidemiol Ment Health 2022; 18:e174501792209010. [PMID: 37274843 PMCID: PMC10156041 DOI: 10.2174/17450179-v18-e2209010] [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: 12/24/2021] [Revised: 06/09/2022] [Accepted: 06/29/2022] [Indexed: 06/07/2023]
Abstract
Background Diabetes burnout is a condition when a patient with diabetes feels tired from his/her disease and neglects it for a certain period or continuously. Objective Diabetes burnout is frequent, and there is extended literature about psychosocial stress and its negative effects on health. Methods A search for relevant studies was conducted using PubMed, Google Scholar and ResearchGate. A systematic review was conducted on the relevant articles after critical appraisal. Only publications in English were selected. The objective of this study was to evaluate the association between burnout syndrome and diabetes mellitus. Results This article mainly focused on studies that evaluated the presence of burnout and diabetes mellitus effects. Diabetes can influence psychological health equally with somatic strength. Relatives can also express depression, guilt, fright, worry, rage, and burnout. Psychosocial job stress and extended working hours are linked with a higher possibility of myocardial infarction, diabetes mellitus, and hypertension. Conclusion Diabetes burnout is a combination of emotions and practices, ranging from tiredness to indifference, linked with a distressing sense of hopelessness. Revealing this health condition is necessary so that preventive measures can be taken.
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Affiliation(s)
- Konstantinos Kontoangelos
- 1 Department of Psychiatry, Eginition Hospital, Medical School National & Kapodistrian University of Athens, Athens, Greece
- University Mental Health Neurosciences and Precision Medicine Research Institute “Costas Stefanis”, Athens, Greece
| | - Athanasios Raptis
- 2 Department of Internal Medicine-Propaedeutic-Research Institute and Diabetes Center, Athens University Medical School, Attikon University Hospital, Athens, Greece
| | - Vaia Lambadiari
- 2 Department of Internal Medicine-Propaedeutic-Research Institute and Diabetes Center, Athens University Medical School, Attikon University Hospital, Athens, Greece
| | - Marina Economou
- 1 Department of Psychiatry, Eginition Hospital, Medical School National & Kapodistrian University of Athens, Athens, Greece
- University Mental Health Neurosciences and Precision Medicine Research Institute “Costas Stefanis”, Athens, Greece
| | - Sofia Tsiori
- 1 Department of Psychiatry, Eginition Hospital, Medical School National & Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki Katsi
- 1 Department of Cardiology, “Hippokration” Hospital, Medical School National & Kapodistrian University of Athens, Athens, Greece
| | - Christos Papageorgiou
- University Mental Health Neurosciences and Precision Medicine Research Institute “Costas Stefanis”, Athens, Greece
| | - Sofia Martinaki
- 1 Department of Psychiatry, Eginition Hospital, Medical School National & Kapodistrian University of Athens, Athens, Greece
| | - George Dimitriadis
- National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Charalabos Papageorgiou
- University Mental Health Neurosciences and Precision Medicine Research Institute “Costas Stefanis”, Athens, Greece
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2
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Bou Khalil R, Risch N, Sleilaty G, Richa S, Seneque M, Lefebvre P, Sultan A, Avignon A, Maimoun L, Renard E, Courtet P, Guillaume S. Neutrophil-to-lymphocyte ratio (NLR) variations in relationship with childhood maltreatment in patients with anorexia nervosa: a retrospective cohort study. Eat Weight Disord 2022; 27:2201-2212. [PMID: 35128621 DOI: 10.1007/s40519-022-01372-z] [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: 09/18/2021] [Accepted: 01/20/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Anorexia nervosa (AN) is a serious mental illness. It is frequently accompanied by a history of childhood maltreatment (CM) that may constitute a specific ecophenotype in patients with eating disorders necessitating special assessment and management. This retrospective study tested whether in patients with AN, CM-related chronic stress may manifest through low-grade inflammation reflected by an increase in white blood cell ratios (neutrophil-to-lymphocyte ratio, NLR, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio). METHODS Participants (N = 206) were enrolled at an eating disorder daycare unit in Montpellier, France, from March 2013 and January 2020. CM was assessed using the childhood trauma questionnaire (CTQ). The Eating Disorder Examination Questionnaire (EDE-Q) and the MINI were used to assess AN severity and the other clinical characteristics, respectively. RESULTS NLR was higher in patients with AN and history of CM (p = 0.029) and in patients with AN and history of emotional abuse (p = 0.021), compared with patients with AN without history of CM. In multivariate analysis, emotional abuse (β = 0.17; p = 0.027) contributed significantly to NLR variability. CONCLUSION In patients with AN, NLR is a low-grade inflammation marker that is influenced by various sociodemographic, clinical and biological factors. It is more directly affected by some CM types, especially emotional abuse, than by the presence/absence of CM history. Future studies should focus on mediators between CM and increased inflammation, such as interoceptive awareness, emotional dysregulation, food addiction, and stress sensitization. LEVEL OF EVIDENCE III. Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- R Bou Khalil
- Department of Psychiatry, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut, Lebanon. .,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.
| | - N Risch
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295, Montpellier, France
| | - G Sleilaty
- Clinical Research Center and Department of Cardiac and Thoracic Surgery, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut, Lebanon
| | - S Richa
- Department of Psychiatry, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut, Lebanon
| | - M Seneque
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295, Montpellier, France
| | - P Lefebvre
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, University of Montpellier, Montpellier, France
| | - A Sultan
- University of Montpellier, PhyMedExp, INSERM, CNRS UMR, CHRU Montpellier, Montpellier, France
| | - A Avignon
- Desbrest Institute of Epidemiology and Public Health, Univ Montpellier, INSERM, CHU, Montpellier, France
| | - L Maimoun
- University of Montpellier, PhyMedExp, INSERM, CNRS UMR, CHRU Montpellier, Montpellier, France.,Département de Médecine Nucléaire, Hôpital Lapeyronie, CHU Montpellier, Montpellier, France
| | - E Renard
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Endocrinology, Diabetes, Nutrition, CHU Montpellier, Montpellier, France
| | - P Courtet
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295, Montpellier, France
| | - S Guillaume
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295, Montpellier, France
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3
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Bublitz MH, Freeburg T, Sharp M, Salameh M, Bourjeily G. Childhood adversity, prenatal depression, and maternal inflammation across pregnancy. Obstet Med 2022; 15:25-30. [PMID: 35444718 PMCID: PMC9014541 DOI: 10.1177/1753495x211011910] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/04/2021] [Accepted: 03/25/2021] [Indexed: 01/04/2023] Open
Abstract
Background To examine whether change in neutrophil-lymphocyte ratio, a marker of systemic inflammation, differs by childhood adversity and prenatal depression. Methods Prenatal complete blood count data were used to calculate neutrophil-lymphocyte ratio in first and third trimesters. The Adverse Childhood Experiences scale measured childhood adversity, and the Patient Health Questionnaire-9 measured depression. This is a secondary analysis of a study of predictors of risk for sleep-disordered breathing. Results Participants were 98 pregnant women, mean age 30 years (SD = 5), mean body mass index of 35 kg/m2 (SD = 7), 61% identified as white, and 28% identified as Hispanic. Women who reported childhood sexual abuse history displayed greater increase in neutrophil-lymphocyte ratio over pregnancy relative to women without childhood sexual abuse. Change in neutrophil-lymphocyte ratio across pregnancy did not differ by prenatal depression. Conclusion Experiences of sexual abuse in childhood may impact markers of systemic inflammation in pregnancy.
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Affiliation(s)
- Margaret H Bublitz
- Department of Psychiatry and Human Behavior, The Warren Alpert
Medical School of Brown University, Providence, RI, USA,Department of Medicine, The Warren Alpert Medical School of
Brown University, Providence, RI, USA,Women’s Medicine Collaborative, The Miriam Hospital, Providence,
RI, USA,Margaret H Bublitz Department of Psychiatry
and Human Behavior, The Warren Alpert Medical School of Brown University, 146
West River Street, Providence, RI 02904, USA.
| | - Taylor Freeburg
- Department of Medicine, The Warren Alpert Medical School of
Brown University, Providence, RI, USA
| | - Meghan Sharp
- Department of Psychiatry and Human Behavior, The Warren Alpert
Medical School of Brown University, Providence, RI, USA,Women’s Medicine Collaborative, The Miriam Hospital, Providence,
RI, USA
| | - Myriam Salameh
- Women’s Medicine Collaborative, The Miriam Hospital, Providence,
RI, USA
| | - Ghada Bourjeily
- Department of Medicine, The Warren Alpert Medical School of
Brown University, Providence, RI, USA,Women’s Medicine Collaborative, The Miriam Hospital, Providence,
RI, USA
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4
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Verheyen VJ, Remy S, Govarts E, Colles A, Rodriguez Martin L, Koppen G, Voorspoels S, Bruckers L, Bijnens EM, Vos S, Morrens B, Coertjens D, De Decker A, Franken C, Den Hond E, Nelen V, Covaci A, Loots I, De Henauw S, Van Larebeke N, Teughels C, Nawrot TS, Schoeters G. Urinary Polycyclic Aromatic Hydrocarbon Metabolites Are Associated with Biomarkers of Chronic Endocrine Stress, Oxidative Stress, and Inflammation in Adolescents: FLEHS-4 (2016-2020). TOXICS 2021; 9:toxics9100245. [PMID: 34678941 PMCID: PMC8537433 DOI: 10.3390/toxics9100245] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 01/06/2023]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants of public health concern. Multiple biological mechanisms have been hypothesized to contribute to PAHs-associated adverse health effects. Little is known about the impact of PAHs on endocrine stress and inflammation in adolescence. We examined 393 Flemish adolescents (14-15 years) cross-sectionally, measured urinary concentrations of hydroxylated naphthalene, fluorene, phenanthrene and pyrene metabolites, and calculated the sum of all measured metabolites. We determined hair cortisol concentration (HCC) as endocrine stress biomarker, leucocyte counts and neutrophil-lymphocyte ratio (NLR) in peripheral blood as inflammatory biomarkers, and urinary 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) concentration as oxidative stress biomarker. Exposure-response associations were analyzed by multiple regression, adjusted for a priori selected covariates. A doubling of 1-hydroxypyrene concentration was associated with a factor of 1.13 (95% CI: 1.03, 1.24) increase in HCC and a factor of 1.07 (95% CI: 1.02, 1.13) increase in 8-oxodG. Doublings of 2- and 3-hydroxyphenanthrene concentrations were associated with a factor of 1.08 (95% CI: 1.02, 1.14) and 1.06 (95% CI: 1.00, 1.12) increase in 8-oxodG, respectively. Doubling of 2-hydroxyphenanthrene and of the sum of 2- and 3-hydroxyfluorene was associated with, respectively, a factor of 1.08 (95% CI: 1.02, 1.14) and 1.06 (95% CI: 1.01, 1.13) increase in NLR. Our results indicate the glucocorticoid pathway as a potential target for PAH exposure in adolescents and suggest oxidative stress, endocrine stress, and inflammation in adolescence as underlying mechanisms and early markers for PAH-related adverse health effects.
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Affiliation(s)
- Veerle J. Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
- Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
- Correspondence:
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Ann Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Laura Rodriguez Martin
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Gudrun Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Stefan Voorspoels
- VITO GOAL, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium;
| | - Liesbeth Bruckers
- I-BioStat, Data Science Institute, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium;
| | - Esmée M. Bijnens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; (E.M.B.); (S.V.); (T.S.N.)
| | - Stijn Vos
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; (E.M.B.); (S.V.); (T.S.N.)
| | - Bert Morrens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000 Antwerp, Belgium; (B.M.); (D.C.); (I.L.)
| | - Dries Coertjens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000 Antwerp, Belgium; (B.M.); (D.C.); (I.L.)
| | - Annelies De Decker
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000 Antwerp, Belgium; (A.D.D.); (C.F.); (E.D.H.); (V.N.)
| | - Carmen Franken
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000 Antwerp, Belgium; (A.D.D.); (C.F.); (E.D.H.); (V.N.)
| | - Elly Den Hond
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000 Antwerp, Belgium; (A.D.D.); (C.F.); (E.D.H.); (V.N.)
| | - Vera Nelen
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000 Antwerp, Belgium; (A.D.D.); (C.F.); (E.D.H.); (V.N.)
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium;
| | - Ilse Loots
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000 Antwerp, Belgium; (B.M.); (D.C.); (I.L.)
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium;
| | - Nicolas Van Larebeke
- Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, 1050 Brussels, Belgium;
- Department of Radiotherapy and Experimental Cancerology, Ghent University, B-9000 Ghent, Belgium
| | - Caroline Teughels
- Flemish Planning Bureau for the Environment and Spatial Development, Koning Albert II laan 20, bus 8, 1000 Brussels, Belgium;
| | - Tim S. Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; (E.M.B.); (S.V.); (T.S.N.)
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
- Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
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5
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Verheyen VJ, Remy S, Bijnens EM, Colles A, Govarts E, Martin LR, Koppen G, Bruckers L, Nielsen F, Vos S, Morrens B, Coertjens D, De Decker A, Franken C, Den Hond E, Nelen V, Covaci A, Loots I, De Henauw S, van Larebeke N, Teughels C, Nawrot TS, Schoeters G. Long-term residential exposure to air pollution is associated with hair cortisol concentration and differential leucocyte count in Flemish adolescent boys. ENVIRONMENTAL RESEARCH 2021; 201:111595. [PMID: 34186082 DOI: 10.1016/j.envres.2021.111595] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Exposure to air pollution and traffic noise are associated with adverse health outcomes in adolescents. Chronic endocrine stress and systemic inflammation have been hypothesized to underlie the adverse health effects. Simultaneous assessment of inflammation and chronic endocrine stress in epidemiological studies is lacking. The aim of the study was to investigate biomarkers of chronic endocrine stress and inflammation in relation to long-term residential exposure to air pollution and traffic noise in adolescents. METHODS In Flemish adolescents (14-15 years), we determined hair cortisol concentration (HCC) as a chronic stress biomarker in 3-cm scalp-near hair sections (n = 395), and leucocyte and leucocyte subtype counts (neutrophils, monocytes, lymphocytes) as inflammatory biomarkers in peripheral blood (n = 385). Daily particulate matter (PM2.5, PM10), nitrogen dioxide (NO2) and black carbon (BC) concentrations were modelled at the residential address and averaged over 3-month and 1-year periods prior to sampling. Residential traffic noise level was estimated and classified in 5 dB intervals. Sex-specific associations between residential exposures and effect biomarkers were studied using linear regression models, adjusted for a priori selected covariates. RESULTS In boys, HCC increased with a factor 1.30 (95% CI: 1.10, 1.54) for an increase in 1-year mean NO2 from the 25th to 75th percentile (p75/p25), after adjustment for age, BMI, personal and neighborhood socioeconomic status. The corresponding estimate for PM10 was 1.24 (95% CI: 1.02, 1.51). Total leucocyte count in boys, adjusted for the aforementioned covariates and recent health complaints, was positively associated with PM2.5, PM10, NO2 and BC. In particular, the neutrophil count increased with a factor 1.11 (95% CI: 1.03, 1.19) for a (p75/p25)-factor increase in 1-year mean BC, corresponding estimates for PM2.5, PM10 and NO2 were 1.10 (95% CI: 1.01, 1.19), 1.10 (95% CI: 1.01, 1.20) and 1.08 (95% CI: 1.00, 1.16). Lymphocyte count increased with a factor 1.05 (95% CI: 1.01, 1.10) for a (p75/p25)-factor increase in 1-year mean NO2. Similar results were observed for 3-month mean exposures. Results were robust to adjustment for recent air pollution exposure. In girls, air pollutants were not associated with HCC or differential leucocyte count. Residential traffic noise level was not associated with HCC or leucocyte counts in boys nor girls. CONCLUSIONS Long-term residential exposure to air pollutants was positively associated with chronic endocrine stress and inflammation in adolescent boys, not in girls. This study may contribute to a better understanding of the early pathophysiological changes that may underlie adverse health effects of air pollution exposure in adolescents.
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Affiliation(s)
- Veerle J Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - Esmée M Bijnens
- Centre for Environmental Sciences, Hasselt University, Agoralaan building D, 3590, Diepenbeek, Belgium
| | - Ann Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - Laura Rodriguez Martin
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - Gudrun Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - Liesbeth Bruckers
- I-BioStat, Data Science Institute, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Flemming Nielsen
- Institute of Public Health, Department of Environmental Medicine, University of Southern Denmark, J.B. Winsløws Vej 17A, 5000, Odense, Denmark
| | - Stijn Vos
- Centre for Environmental Sciences, Hasselt University, Agoralaan building D, 3590, Diepenbeek, Belgium
| | - Bert Morrens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000, Antwerp, Belgium
| | - Dries Coertjens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000, Antwerp, Belgium
| | - Annelies De Decker
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Carmen Franken
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Elly Den Hond
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Vera Nelen
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Ilse Loots
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000, Antwerp, Belgium
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - Nicolas van Larebeke
- Analytical, Environmental and Geo- Chemistry, Vrije Universiteit Brussel, Brussels, Belgium; Department of Radiotherapy and Experimental Cancerology, Ghent University, Ghent, Belgium
| | - Caroline Teughels
- Flemish Planning Bureau for the Environment and Spatial Development, Koning Albert II laan 20, bus 8, 1000, Brussels, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan building D, 3590, Diepenbeek, Belgium
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
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6
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Ajdacic-Gross V, Ajdacic L, Xu Y, Müller M, Rodgers S, Wyss C, Olbrich S, Buadze A, Seifritz E, Wagner EYN, Radovanovic D, von Wyl V, Steinemann N, Landolt MA, Castelao E, Strippoli MPF, Gholamrezaee MM, Glaus J, Vandeleur C, Preisig M, von Känel R. Backtracing persistent biomarker shifts to the age of onset: A novel procedure applied to men’s and women’s white blood cell counts in post-traumatic stress disorder. Biomark Neuropsychiatry 2021. [DOI: 10.1016/j.bionps.2021.100030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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7
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Early postoperative pain after laparoscopic donor nephrectomy predicts 30-day postoperative infectious complications: a pooled analysis of randomized controlled trials. Pain 2021; 161:1565-1570. [PMID: 32107359 DOI: 10.1097/j.pain.0000000000001842] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Our research group recently published a positive association between early postoperative pain and 30-day postoperative complications in a broad surgical population. To investigate whether heterogeneity of the population and surgical procedures influenced these results, we explored this association in a homogenous surgical population. A secondary analysis of the LEOPARD-2 (clinicaltrials.gov NCT02146417) and RELAX-1 study (NCT02838134) in laparoscopic donor nephrectomy patients (n = 160) was performed. Pain scores on the postanesthesia care unit and postoperative day (POD) 1 and 2 were compared between patients with infectious, noninfectious, and no complications 30 days after surgery. Patients who developed infectious complications had significantly higher pain scores on POD1 and 2 (6.7 ± 2.1 and 6.4 ± 2.8) than patients without complications (4.9 ± 2.2 and 4.1 ± 1.9), respectively (P = 0.006 and P = 0.000). Unacceptable pain (numeric rating scale [NRS] ≥ 6) on POD1 was reported by 72% of patients who developed infectious complications, compared to 38% with noninfectious complications and 30% without complications (P = 0.018). This difference was still present on POD2 at 67% with infectious complications, 21% with noninfectious, and 40% without complications (P = 0.000). Multiple regression analysis identified unacceptable pain (numeric rating scale ≥6) on POD2 as a significant predictor for 30-day infectious complications (odds ratio 6.09, P = 0.001). Results confirm the association between early postoperative pain and 30-day infectious complications in a separate, homogenous surgical population. Further clinical trials should focus on finetuning of postoperative analgesia to elucidate the effects on the endocrine and immune response, preserve immune homeostasis, and prevent postoperative infectious complications.
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8
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Kracker Imthon A, Antônio Caldart C, do Rosário MC, Fontenelle LF, Constantino Miguel E, Arzeno Ferrão Y. Stressful Life Events and the Clinical Expression of Obsessive-Compulsive Disorder (OCD): An Exploratory Study. J Clin Med 2020; 9:E3371. [PMID: 33096706 PMCID: PMC7590000 DOI: 10.3390/jcm9103371] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In obsessive-compulsive disorder (OCD), symptom content and severity appear to fluctuate over the course of the life cycle in accordance with stressful life events. The objective of this paper was to compare OCD patients with and without reported stressful life events (SLEs) in terms of the sociodemographics of patients and the clinical characteristics of OCD. METHODS This was a cross-sectional study involving 1001 patients with OCD. Data concerning SLEs were collected via the Yale OCD Natural History Questionnaire, while for OCD symptoms, the Dimensional Yale-Brown Obsessive-Compulsive Scale was used. RESULTS Of the 1001 OCD patients, 605 (60.5%) reported experiencing at least one SLE in their lifetime. Self-declared nonwhite skin color (odds ratio (OR) = 1.51), the presence of a sensory phenomenon (OR = 1.47), and comorbidity with post-traumatic stress disorder (PTSD) (OR = 2.38) were some of the logistic regression variables related to the reported SLEs with relevant statistical significance and risk (i.e., OR) values. CONCLUSIONS Our results indicate that SLEs may make Brazilian OCD patients vulnerable to the onset or exacerbation of obsessive-compulsive symptoms. The positive association of the occurrence of SLEs and sensory phenomena in this population could corroborate that environmental influences impact the neurobiology associated with OCD, and likely with other psychiatric disorders as well.
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Affiliation(s)
- André Kracker Imthon
- Psychiatric Service, President Vargas Hospital, Porto Alegre 90035-074, Brazil; (C.A.C.); (Y.A.F.)
- Department of Internal Medicine-Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
- The Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders, São Paulo 05403-903, Brazil; (M.C.d.R.); (L.F.F.); (E.C.M.)
| | - César Antônio Caldart
- Psychiatric Service, President Vargas Hospital, Porto Alegre 90035-074, Brazil; (C.A.C.); (Y.A.F.)
- Department of Internal Medicine-Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
- The Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders, São Paulo 05403-903, Brazil; (M.C.d.R.); (L.F.F.); (E.C.M.)
| | - Maria Conceição do Rosário
- The Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders, São Paulo 05403-903, Brazil; (M.C.d.R.); (L.F.F.); (E.C.M.)
- Child and Adolescent Psychiatry Unit (UPIA) at the Department of Psychiatry, Federal University of São Paulo, São Paulo 04017-030, Brazil
| | - Leonardo F. Fontenelle
- The Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders, São Paulo 05403-903, Brazil; (M.C.d.R.); (L.F.F.); (E.C.M.)
- Turner Institute for Brain and Mental Health, Monash University, Clayton VIC 3800, Australia
- D’Or Institute for Research and Education (IDOR) and Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro, Rio de Janeiro 22290-140, Brazil
| | - Euripedes Constantino Miguel
- The Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders, São Paulo 05403-903, Brazil; (M.C.d.R.); (L.F.F.); (E.C.M.)
- Department of Psychiatry, São Paulo University Medical School, São Paulo 05403-903, Brazil
| | - Ygor Arzeno Ferrão
- Psychiatric Service, President Vargas Hospital, Porto Alegre 90035-074, Brazil; (C.A.C.); (Y.A.F.)
- Department of Internal Medicine-Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
- The Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders, São Paulo 05403-903, Brazil; (M.C.d.R.); (L.F.F.); (E.C.M.)
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Chawla A, Paraoan V, Rabiu R, Clark T, Powell S, Grammatopoulos D, Armitage C, Penedo A, Havard A, Metcalfe A, Barlow T, Khatri C. Determining the stress biomarker profile in patients undergoing total knee replacement and the relationship with outcome at 12 months. Knee 2019; 26:1379-1385. [PMID: 31575511 DOI: 10.1016/j.knee.2019.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/06/2019] [Accepted: 08/26/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Total knee replacement (TKR) is the commonest joint arthroplasty procedure worldwide. Despite excellent outcomes, some studies have reported dissatisfaction in up to 20% of patients. There is evidence of an association between the biochemical stress response to surgery and outcomes. The objective of this study is to describe the stress biomarker profile for TKR, and correlate this with patient outcomes. METHODS A prospective cohort study of 50 patients undergoing primary TKR was conducted. Serum IL-6, TNF-α, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were measured immediately pre- and post-operatively, and on Days 1 and 3. Follow-up questionnaires including the Oxford Knee Score (OKS) and EuroQol five dimensions (EQ-5D) were completed at 12-months. Univariate analysis was completed using a linear regression model (p < 0.05). RESULTS Serum IL-6, NLR, and PLR all increased to Day 1 post-operatively, and decreased by Day 3. TNF-α values increased across all time points. Statistical analysis found a significant negative correlation (r = -0.414; p = 0.005) between pre-operative IL-6 and 12-month OKS. There was a significant positive correlation between pre-operative NLR and 12 month OKS (r = 0.272; p = 0.039) and 12 month EQ5D (r = 0.268; p = 0.043). CONCLUSION This is the first study to describe the biochemical stress response to TKR. The results raise the potential for a pre-operative risk stratification tool for patients based on IL-6 and NLR measurements. Further research should be conducted to explore the underlying mechanisms involved, and investigate interventions to reduce pre-operative physiological stress with a view to improving post-operative outcomes.
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Affiliation(s)
- Amit Chawla
- Clinical Trials Unit, University of Warwick Medical School, Coventry, UK.
| | - Vlad Paraoan
- Clinical Trials Unit, University of Warwick Medical School, Coventry, UK
| | - Rasheed Rabiu
- Clinical Trials Unit, University of Warwick Medical School, Coventry, UK
| | - Tamsyn Clark
- Clinical Trials Unit, University of Warwick Medical School, Coventry, UK
| | - Sam Powell
- University of Warwick Medical School, Coventry, UK
| | - Dimitris Grammatopoulos
- Division of Translational and Experimental Medicine, Warwick Medical School, UK; Institute of Precision Diagnostics and Translational Medicine, Department of Pathology, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Charlotte Armitage
- Clinical Biochemistry, Department of Pathology, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Ana Penedo
- Clinical Biochemistry, Department of Pathology, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Alwyn Havard
- Alwyn Havard and Associates, Animal & Avian Bio Sciences, Broadway, UK
| | - Andrew Metcalfe
- Clinical Trials Unit, University of Warwick Medical School, Coventry, UK
| | - Tim Barlow
- Clinical Trials Unit, University of Warwick Medical School, Coventry, UK
| | - Chetan Khatri
- Clinical Trials Unit, University of Warwick Medical School, Coventry, UK
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Cadegiani FA, Kater CE. Novel causes and consequences of overtraining syndrome: the EROS-DISRUPTORS study. BMC Sports Sci Med Rehabil 2019; 11:21. [PMID: 31548891 PMCID: PMC6751688 DOI: 10.1186/s13102-019-0132-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 08/22/2019] [Indexed: 12/22/2022]
Abstract
Background Hormonal physiology in athletes, dysfunctional paths leading to overtraining syndrome (OTS), and clinical and biochemical behaviors that are independently modified by the presence of OTS remain unclear. Although multiple markers of OTS have recently been identified, the independent influence of OTS on hormones and metabolism have not been assessed. Hence, the objective of the present study was to uncover the previously unrecognized independent predictors of OTS and understand how OTS independently modifies the behaviors of clinical and biochemical parameters. Methods In a total of 39 athletes (OTS-affected athletes (OTS) = 14 and healthy athletes (ATL) = 25), we performed two clusters of statistical analyses using the full data of the Endocrine and Metabolic Responses on Overtraining Syndrome (EROS) study, in a total of 117 markers. We first used logistic regression to analyze five modifiable parameters (carbohydrate, protein, and overall caloric intake, sleep quality, and concurrent cognitive effort) as potential additional independent risk factors for OTS, and OTS as the outcome. We then used multivariate linear regression to analyze OTS as the independent variable and 38 dependent variables. Training patterns were found to be similar between OTS and ATL, and therefore excessive training was not a risk, and consequently not a predictor, for OTS. Results Each of the three dietary patterns (daily carbohydrate, daily protein, and daily overall calorie intake) were found to be the independent triggers of OTS, while sleeping, social, and training characteristics depended on other factors to induce OTS. Once triggered, OTS independently induced multiple changes, including reductions of cortisol, late growth hormone and adrenocorticotropic hormone responses to stimulations, testosterone-to-estradiol ratio, neutrophils, neutrophil-to-lymphocyte ratio, vigor levels, hydration status, and muscle mass, while increase of tension levels and visceral fat. Conclusions OTS can be independently triggered by eating patterns, regardless of training patterns, while the occurrence of OTS reduced late hormonal responses and the testosterone-to-estradiol ratio, worsened mood, and affected the immunology panel. These novel findings may explain underperformance, which is the key characteristic of OTS.
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Affiliation(s)
- Flavio A Cadegiani
- Adrenal and Hypertension Unit, Division of Endocrinology and Metabolism, Department of Medicine, Federal University of São Paulo (Unifesp/EPM), Rua Pedro de Toledo 781 - 13th floor, São Paulo, SP 04039-032 Brazil
| | - Claudio E Kater
- Adrenal and Hypertension Unit, Division of Endocrinology and Metabolism, Department of Medicine, Federal University of São Paulo (Unifesp/EPM), Rua Pedro de Toledo 781 - 13th floor, São Paulo, SP 04039-032 Brazil
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Stress and inflammation - The need to address the gap in the transition between acute and chronic stress effects. Psychoneuroendocrinology 2019; 105:164-171. [PMID: 30826163 DOI: 10.1016/j.psyneuen.2019.02.021] [Citation(s) in RCA: 158] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 02/13/2019] [Accepted: 02/19/2019] [Indexed: 12/19/2022]
Abstract
Stress responses help us navigate our environment and respond appropriately to threats. Stress systems communicate threats to the entire organism, and as such, also stimulate inflammatory mechanisms. This modulation might serve protective functions in the short term, but sustained low-grade inflammation has severe long-term health consequences. While we have reached a reasonable level of understanding of acute, as well as chronic stress effects on inflammatory mechanisms, there is a significant gap in our understanding of the transitional phase between acute and chronic stress. The purpose of this review is to first summarize current knowledge of our understanding of acute stress effects on inflammation, as well as of chronic stress effects on inflammation, and to then analyze the state of knowledge about the transitional phase between acute and chronic stress. Research discussed here shows that we are beginning to understand the early phase of repeated acute stress, but lack information on longer term exposure to repeated acute stress experiences. More research is needed to bridge this important gap und our conceptualization and understanding of the stress and health relationship.
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Mazgelytė E, Karčiauskaitė D, Linkevičiūtė A, Mažeikienė A, Burokienė N, Matuzevičienė R, Radzevičius M, Janiulionienė A, Jakaitienė A, Dindienė L, Kučinskienė ZA. Association of Hair Cortisol Concentration with Prevalence of Major Cardiovascular Risk Factors and Allostatic Load. Med Sci Monit 2019; 25:3573-3582. [PMID: 31086129 PMCID: PMC6530440 DOI: 10.12659/msm.913532] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The high prevalence of cardiovascular diseases cannot be explained completely by conventional risk factors such as older age, smoking, diabetes mellitus, hypertension, obesity, and dyslipidemia. Results of recent studies indicate that chronic stress may be an independent risk factor for cardiovascular morbidity and mortality. Thus, the aim of our study was to investigate the associations between the hair cortisol concentration (HCC), which is considered as a potential biomarker of long-term psychosocial stress, and traditional cardiovascular risk factors, including smoking, dyslipidemia, hypertension, and obesity. Material/Methods Fasting blood samples and anthropometric and lifestyle data were collected from 163 apparently healthy men. HCC was determined using high-performance liquid chromatography. Allostatic load (AL) index, defined as an integrated score of multiple interacting systems involved in the adaptation to adverse physical or psychosocial situations, was also calculated. Results We found that many prevalent cardiovascular risk factors, including hypertension, smoking, higher than recommended waist circumference (WC), and low-density lipoprotein cholesterol (LDL-C) median values, are associated with higher HCC. Hair cortisol level was also positively associated with the manifestation of individual cardiovascular risk factors such as higher-than-recommended total cholesterol, LDL-C, non-high-density lipoprotein cholesterol, body mass index, and WC median values. Moreover, a significant positive relationship between HCC and AL index was observed. Conclusions The results of this study suggest that increased prevalence of traditional cardiovascular risk factors is associated with higher HCC. Also, both HCC and AL index might be appropriate markers for the evaluation of chronic stress level.
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Affiliation(s)
- Eglė Mazgelytė
- Department of Physiology, Biochemistry, Microbiology, and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Dovilė Karčiauskaitė
- Department of Physiology, Biochemistry, Microbiology, and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Aušra Linkevičiūtė
- Department of Physiology, Biochemistry, Microbiology, and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Asta Mažeikienė
- Department of Physiology, Biochemistry, Microbiology, and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Neringa Burokienė
- Clinics of Internal Diseases, Family Medicine and Oncology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Rėda Matuzevičienė
- Department of Physiology, Biochemistry, Microbiology, and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Mantas Radzevičius
- Department of Physiology, Biochemistry, Microbiology, and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Aušra Janiulionienė
- Centre of Laboratory Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Audronė Jakaitienė
- Department of Human and Medical Genetics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Lina Dindienė
- Faculty of Mathematics and Natural Sciences, Kaunas University of Technology, Kaunas, Lithuania
| | - Zita Aušrelė Kučinskienė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Vilnius University, Vilnius, Lithuania
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The year of immunopsychiatry: A special issue that foresaw the future. Psychoneuroendocrinology 2019; 103:49-51. [PMID: 30640037 DOI: 10.1016/j.psyneuen.2019.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/03/2019] [Indexed: 12/12/2022]
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Abstract
OBJECTIVE Previous research indicates a link between burnout symptoms and reduced vagally mediated heart rate variability (HRV); however, the directionality of this relationship is still largely unknown. The objective of the present study was to examine the longitudinal relationship between HRV and burnout symptoms for 1 year, with a special focus on the emotional exhaustion (EE) burnout subdimension, which remains inadequately distinguished from overlapping with depressive symptoms. METHODS Here we present HRV and behavioral data from 167 individuals (mean [SD] age = 43.43 [11.78] years; 30.5% male) who attended two biomarker samplings (T1 and T2) of the Dresden Burnout Study approximately 12 months apart. RESULTS In hierarchical linear regression analyses, T1 HRV significantly inversely predicted T2 overall burnout symptoms (β = -.16; p = .03) and EE (β = -.23; p = .02), adjusting for age, sex, body mass index, adverse health behaviors, and depressive symptoms. Importantly, only high EE at T1 (β = -.22; p = .04), and not the T1 Maslach Burnout Inventor total score, predicted reductions in HRV from T1 to T2. CONCLUSIONS We report for the first time longitudinal evidence that HRV is associated with changes in burnout symptoms, independently of depressive symptoms. Results suggest vagal dysfunction being predictive and specific for burnout symptoms, making HRV a promising starting point for the explanation of biophysiological mechanisms underlying burnout symptoms and cardiovascular diseases. The finding of only EE at T1 being predictive for changes in HRV underscores the importance of exhaustion for modulations in autonomic regulation.
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