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Huang P, Yan L, Li Z, Zhao S, Feng Y, Zeng J, Chen L, Huang A, Chen Y, Lei S, Huang X, Deng Y, Xie D, Guan H, Peng W, Yu L, Chen B. Potential shared gene signatures and molecular mechanisms between atherosclerosis and depression: Evidence from transcriptome data. Comput Biol Med 2023; 152:106450. [PMID: 36565484 DOI: 10.1016/j.compbiomed.2022.106450] [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: 10/18/2022] [Revised: 12/09/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Atherosclerosis and depression contribute to each other; however, mechanisms linking them at the genetic level remain unexplored. This study aimed to identify shared gene signatures and related pathways between these comorbidities. METHODS Atherosclerosis-related datasets were downloaded from the Gene Expression Omnibus database. Differential and weighted gene co-expression network analyses were employed to identify atherosclerosis-related genes. Depression-related genes were downloaded from the DisGeNET database, and the overlaps between atherosclerosis-related genes and depression-related genes were characterized as crosstalk genes. The functional enrichment analysis and protein-protein interaction network were performed in these gene sets. Subsequently, the Boruta algorithm and Recursive Feature Elimination algorithm were performed to identify feature-selection genes. A support vector machine was constructed to measure the accuracy of calculations, and two external validation sets were included to verify the results. RESULTS Based on two atherosclerosis-related datasets (GSE28829 and GSE43292), 165 genes were determined as atherosclerosis-related genes. Meanwhile, 1478 depression-related genes were obtained. After intersecting, 24 crosstalk genes were identified, and two pathways, "lipid and atherosclerosis" and "tryptophan metabolism," were revealed as mutual pathways according to the enrichment analysis results. Through the protein-protein interaction network, Molecular Complex Detection plugin, and cytoHubba plugin, PTPRC and MMP9 were identified as the hub gene. Moreover, SLC22A3, CASP1, AMPD3, and PIK3CG were recognized as feature-selection genes. Based on two external validation sets, CASP1 and MMP9 were finally determined as the critical crosstalk genes. CONCLUSIONS "Lipid and atherosclerosis" and "tryptophan metabolism" were possibly the pathways of atherosclerosis secondary to depression and depression due to atherosclerosis, respectively. CASP1 and MMP9 were revealed as the most pivotal candidates linking atherosclerosis and depression by mediating these two pathways. Further experimentation is needed to confirm these conclusions.
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Affiliation(s)
- Peiying Huang
- The Second Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Li Yan
- Department of Neurosurgery of Shenyang Second Hospital of Traditional Chinese Medicine, Shenyang, China
| | - Zhishang Li
- Emergency Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Shuai Zhao
- Emergency Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Yuchao Feng
- Guangdong Provincial Key Laboratory of Research on Emergency in Traditional Chinese Medicine, Clinical Research Team of Prevention and Treatment of Cardiac Emergencies with Traditional Chinese Medicine, Guangzhou, China
| | - Jing Zeng
- Emergency Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Li Chen
- Emergency Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Afang Huang
- Departments of Laboratory Medicine of Foshan Forth People's Hospital, Foshan, China
| | - Yan Chen
- Emergency Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Sisi Lei
- The Second Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaoyan Huang
- Emergency Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Yi Deng
- Emergency Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Dan Xie
- The Second Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hansu Guan
- The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weihang Peng
- The Second Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liyuan Yu
- The Second Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Bojun Chen
- The Second Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China; Emergency Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China; Guangdong Provincial Key Laboratory of Research on Emergency in Traditional Chinese Medicine, Clinical Research Team of Prevention and Treatment of Cardiac Emergencies with Traditional Chinese Medicine, Guangzhou, China.
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Fang T, Zhang Q, Wang Z, Liu JP. Bidirectional association between depression and diabetic nephropathy by meta-analysis. PLoS One 2022; 17:e0278489. [PMID: 36538528 PMCID: PMC9767359 DOI: 10.1371/journal.pone.0278489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 11/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Studies suggested that the association between depression and diabetic nephropathy may be bi-directional, but this hypothesis remains investigating. In this meta-analysis, the bi-directional relationship between depression and diabetic nephropathy was investigated. METHODS A search for the publications on depression and diabetic nephropathy in the databases of PubMed, Web of science, and Embase from the earliest available to August 2022 was conducted. Two sets of pooled risk estimates were calculated using random effects models: diabetic nephropathy predicting depression and depression predicting diabetic nephropathy. Cross-sectional studies were assessed using Agency for Healthcare Research and Quality (AHRQ), cohort and case-control studies were assessed using Newcastle-Ottawa Scale (NOS). RESULT Of the 974,121 patients in 30 clinical studies, 24 studies met eligibility for diabetic nephropathy predicting onset of depression, representing 28,438 incident cases. The other 6 studies met criteria for depression predicting onset of diabetic nephropathy, representing 945,683 incident cases. The pooled odds ratio (OR) of diabetic nephropathy predicting depression was 1.46 (95% CI 1.27-1.67). The OR of depression predicting diabetic nephropathy was 1.22 (95% CI 1.13-1.31). CONCLUSION This meta-analysis shows that the relationship between depression and diabetic nephropathy may be bidirectional. Diabetic nephropathy may be a predictor of depression, and depression may also be an indicator of diabetic nephropathy. The mechanisms underlying the bidirectional relationship need to be further investigated and interventions of the comorbidity of depression and diabetic nephropathy need be studied in clinical practice.
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Affiliation(s)
- Tingting Fang
- Institute of Ageing Research, Hangzhou Normal University, School of Basic Medicine, Hangzhou, Zhejiang Province, China
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
- * E-mail: (TF); (JPL)
| | - Qiuling Zhang
- Department of Endocrinology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Zhiguo Wang
- Institute of Ageing Research, Hangzhou Normal University, School of Basic Medicine, Hangzhou, Zhejiang Province, China
| | - Jun-Ping Liu
- Institute of Ageing Research, Hangzhou Normal University, School of Basic Medicine, Hangzhou, Zhejiang Province, China
- Monash University Department of Immunology and Pathology, Central Clinical School, Faculty of Medicine, Prahran, Victoria, Australia
- Hudson Institute of Medical Research, Clayton, Victoria, Australia
- * E-mail: (TF); (JPL)
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Tong L, Pu L, Guo X, Sun M, Guo F, Zhao S, Gao W, Jin L. Multimorbidity study with different levels of depression status. J Affect Disord 2021; 292:30-35. [PMID: 34091380 DOI: 10.1016/j.jad.2021.05.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Depression is one of the leading causes of disability burden and frequently co-occurs with multiple chronic diseases, but limited research has yet evaluated the correlation between multimorbidity and depression status by sex and age. METHODS 29303 adults from 2005-2016 National Health and Nutrition Examination Survey were involved in the study. The validated Patient Health Questionnaire (PHQ-9) was used to assess depression status. The linear trend of the prevalence of multimorbidity was tested by logistic regressions, which was visualized by the weighted network. Gamma coefficient (γ) was used to evaluate the correlation between multimorbidity and depression status. RESULTS The prevalence of multimorbidity in participants with no depression, mild depression, moderate depression and severe depression was 52.1%, 63.0%, 68.4% and 76.1%, respectively (p for trend < 0.001). In network analysis, the absolute network density increased with the levels of depression status (from 4.54 to 15.04). Positive correlation was identified between multimorbidity and depression status (γ=0.21, p<0.001), and the correlation was different by sex and age, where it was stronger in women than men (females: γ=0.23, males: γ=0.16), and stronger in the young and the middle-age (young: γ=0.30, middle-age: γ=0.29, old: γ=0.22). LIMITATIONS This is a cross-sectional study and thus we cannot draw firm conclusions on causal correlations. CONCLUSIONS Positive correlation between multimorbidity and depression status was identified, where the number of multimorbidity increased with the levels of depression status, especially in females, the young and the middle-age.
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Affiliation(s)
- Li Tong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin, 130021, China.
| | - Liyuan Pu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin, 130021, China.
| | - Xuecan Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin, 130021, China.
| | - Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin, 130021, China.
| | - Feng Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin, 130021, China.
| | - Saisai Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin, 130021, China.
| | - Wenhui Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin, 130021, China.
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin, 130021, China.
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Jin EH, Han K, Lee DH, Shin CM, Lim JH, Yoon H, Kim N. Increased Risk of Major Depressive Disorder After Cholecystectomy: A Nationwide Population-Based Cohort Study in Korea. Clin Transl Gastroenterol 2021; 12:e00339. [PMID: 33929976 PMCID: PMC8059997 DOI: 10.14309/ctg.0000000000000339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 03/05/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION This study investigated the risk of depression in Korean adults who underwent cholecystectomy and appeared for subsequent long-term follow-ups. A national population-based data set was used for analysis. METHODS All patients (n = 111,934) aged 40 years and older who underwent cholecystectomy between 2010 and 2015 and a control population (n = 223,868), matched for age and sex, were identified from the database of the Korean National Health Insurance Corporation. The hazard ratio (HR) and 95% confidence interval (CI) of depression were estimated after cholecystectomy, and a Cox regression analysis was performed. RESULTS The incidence of depression in the cholecystectomy group was 27.3 per 1,000 person-years and that in the control group was 20.3 per 1,000 person-years. Patients who underwent cholecystectomy showed an increased risk of major depressive disorder (MDD) with an adjusted HR (aHR) of 1.34 (95% CI: 1.31-1.37, P < 0.001). The mean follow-up period after a 1-year lag was 3.67 ± 1.79 years. In the subgroup analysis, the risk of developing MDD after cholecystectomy was relatively high in patients aged 40-49 years (aHR 1.51, 95% CI: 1.44-1.58) and in participants without diabetes mellitus (aHR: 1.36, 95% CI: 1.33-1.39), hypertension (aHR: 1.38, 95% CI: 1.34-1.42), or dyslipidemia (aHR: 1.35, 95% CI: 1.32-1.38). DISCUSSION Compared with the control population, patients who underwent cholecystectomy exhibited an increased incidence of MDD. Thus, physicians should implement an enhanced program of MDD screening for at least several years after cholecystectomy.
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Affiliation(s)
- Eun Hyo Jin
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea;
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Dong Ho Lee
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggido, South Korea.
| | - Cheol Min Shin
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggido, South Korea.
| | - Joo Hyun Lim
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea;
| | - Hyuk Yoon
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggido, South Korea.
| | - Nayoung Kim
- Department of Internal Medicine and Seoul National University Bundang Hospital, Seongnam, Gyeonggido, South Korea.
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Gnawali A, Patel V, Cuello-Ramírez A, Al Kaabi AS, Noor A, Rashid MY, Henin S, Mostafa JA. Why are Women With Polycystic Ovary Syndrome at Increased Risk of Depression? Exploring the Etiological Maze. Cureus 2021; 13:e13489. [PMID: 33777576 PMCID: PMC7990040 DOI: 10.7759/cureus.13489] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a complex and common multisystemic disorder. Women with PCOS have up to eight times higher prevalence of depression than control groups. This paper aims to explore the underlying risk factors for developing depression in this high-risk group. Studies indicate an interplay of multiple mechanisms that place women with PCOS at an increased risk for depression. The pathophysiology thought to play a role includes disturbances in the endocrine axes and changes to the metabolic pathway. The risk of depression is independently linked to insulin resistance and obesity in this population. However, rates of depression were still higher than control groups when accounting for these variables, demonstrating that they are not the only mechanism causing depression. The clinical manifestations of hyperandrogenism and menstrual abnormalities may compound negative views and lower self-esteem and negatively impact mood. Many of these women also struggle with infertility, and due to the added external pressures like societal beliefs and culture, they may be further negatively impacted and worsen their depressive symptoms. The prevalence of depression in women with PCOS is high; thus, this paper highlights the essential understanding of the underlying mechanisms at play. This is to better aid in addressing the fundamental cause of depression in this high-risk group effectively.
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Affiliation(s)
- Anupa Gnawali
- Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Viral Patel
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | | | - Anoud S Al Kaabi
- Neonatology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Asfa Noor
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohammed Y Rashid
- General Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Shereen Henin
- Internal Medicine, Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jihan A Mostafa
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Lee JW, Park SH. Association between depression and nonalcoholic fatty liver disease: Contributions of insulin resistance and inflammation. J Affect Disord 2021; 278:259-263. [PMID: 32977263 DOI: 10.1016/j.jad.2020.09.073] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/21/2020] [Accepted: 09/11/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND It is unclear whether depression is linked to nonalcoholic fatty liver disease (NAFLD). The purpose of this study was to examine the association between depression and NAFLD and whether the association is partly explained by insulin resistance or inflammation. METHODS Subjects consisted of 4,688 adults who participated in the 2016 Korea National Health and Nutrition Examination Survey. Depression was defined by Patient Health Questionnaire-9 score ≥ 10 or a previous diagnosis of depression. NAFLD was defined by hepatic steatosis index >36. Insulin resistance was assessed by triglycerides and glucose (TyG) index. Inflammation was measured with C-reactive protein (CRP). RESULTS Depression had a significant association with TyG index (p = 0.005), but not with CRP. Depression was a significant predictor of NAFLD (OR = 1.63; 95% CI, 1.26-2.10; p < 0.001). Adjustment for sociodemographic features and waist circumference did not substantially affect the results. Further adjustment for comorbidities reduced the estimate for depression by 23% (OR = 1.56; 95% CI, 1.18-2.06; p = 0.002). Inclusion of CRP in a fully adjusted model did not affect the results. Addition of the TyG index decreased the estimate for depression by 28% (OR = 1.39; 95% CI, 0.88-2.19; p = 0.161), and the resulting estimate became no longer significant. The TyG index remained the independent predictor of outcome. LIMITATIONS The absence of a structured diagnostic interview for depression and histological diagnosis of NAFLD. CONCLUSIONS These data support an association of depression with NAFLD. Insulin resistance seems to play a major role in modulating the association between depression and NAFLD risk.
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Affiliation(s)
- Ju Won Lee
- Department of medicine, Graduate school, Inje University College of Medicine, Busan, Korea
| | - Seung Ha Park
- Department of Internal Medicine, Inje University Haeundae Paik-Hospital, Inje University College of Medicine, #1435, Jwa-dong, Haeundae-gu, Busan, 612-030, Korea.
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Ottesen NM, Meluken I, Frikke-Schmidt R, Plomgaard P, Scheike T, Fernandes BS, Berk M, Poulsen HE, Kessing LV, Miskowiak K, Vinberg M. Are remitted affective disorders and familial risk of affective disorders associated with metabolic syndrome, inflammation and oxidative stress? - a monozygotic twin study. Psychol Med 2020; 50:1736-1745. [PMID: 31482770 DOI: 10.1017/s003329171900182x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) is associated with reduced life expectancy in patients with affective disorders, however, whether MetS also plays a role before the onset of affective disorder is unknown. We aimed to investigate whether MetS, inflammatory markers or oxidative stress act as risk factors for affective disorders, and whether MetS is associated with increased inflammation and oxidative stress. METHODS We conducted a high-risk study including 204 monozygotic (MZ) twins with unipolar or bipolar disorder in remission or partial remission (affected), their unaffected co-twins (high-risk) and twins with no personal or family history of affective disorder (low-risk). Metabolic Syndrome was ascertained according to the International Diabetes Federation (IDF) criteria. Inflammatory markers and markers of oxidative stress were analyzed from fasting blood and urine samples, respectively. RESULTS The affected and the high-risk group had a significantly higher prevalence of MetS compared to the low-risk group (20% v. 15% v. 2.5%, p = 0.0006), even after adjusting for sex, age, smoking and alcohol consumption. No differences in inflammatory and oxidative markers were seen between the three groups. Further, MetS was associated with alterations in inflammatory markers, and oxidative stress was modestly correlated with inflammation. CONCLUSION Metabolic syndrome is associated with low-grade inflammation and may act as a risk factor and a trait marker for affective disorders. If confirmed in longitudinal studies, this suggests the importance of early intervention and preventive approaches targeted towards unhealthy lifestyle factors that may contribute to later psychopathology.
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Affiliation(s)
- Ninja Meinhard Ottesen
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Iselin Meluken
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Ruth Frikke-Schmidt
- Department of Clinical Biochemistry Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Plomgaard
- Department of Clinical Biochemistry Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Scheike
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Brisa S Fernandes
- Centre for Addiction and Mental Health (CAMH) and Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, Australia
- Orygen, the National Centre of Excellence in Youth Mental Health, the Florey Institute for Neuroscience and Mental Health, and the Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Henrik Enghusen Poulsen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Pharmacology, Bispebjerg Frederiksberg Hospital, Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Kamilla Miskowiak
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Maj Vinberg
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
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Singh MK, Leslie SM, Packer MM, Zaiko YV, Phillips OR, Weisman EF, Wall DM, Jo B, Rasgon N. Brain and behavioral correlates of insulin resistance in youth with depression and obesity. Horm Behav 2019; 108:73-83. [PMID: 29596854 PMCID: PMC6173667 DOI: 10.1016/j.yhbeh.2018.03.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 03/23/2018] [Accepted: 03/24/2018] [Indexed: 01/10/2023]
Abstract
Depression, together with insulin resistance, is increasingly prevalent among youth. These conditions have traditionally been compartmentalized, but recent evidence suggests that a shared brain motivational network underlies their co-occurrence. We posit that, in the context of depressive symptoms, insulin resistance is associated with aberrant structure and functional connectivity in the Anterior Cingulate Cortex (ACC) and hippocampus. This motivational neural circuit underlies dysfunctional behavioral responses and increased sensitivity to rewarding aspects of ingesting high calorie food that lead to disinhibition of eating even when satiated. To investigate this shared mechanism, we evaluated a sample of forty-two depressed and overweight (BMI > 85th%) youth aged 9 to 17. Using ACC and hippocampus structural and seed-based regions of interest, we investigated associations between insulin resistance, depression, structure (ACC thickness, and ACC and hippocampal area), and resting-state functional connectivity (RSFC). We predicted that aberrant associations among these neural and behavioral characteristics would be stronger in insulin resistant compared to insulin sensitive youth. We found that youth with greater insulin resistance had higher levels of anhedonia and more food seeking behaviors, reduced hippocampal and ACC volumes, and greater levels of ACC and hippocampal dysconnectivity to fronto-limbic reward networks at rest. For youth with high levels of insulin resistance, thinner ACC and smaller hippocampal volumes were associated with more severe depressive symptoms, whereas the opposite was true for youth with low levels of insulin resistance. The ACC-hippocampal motivational network that subserves depression and insulin resistance separately, may represent a critical neural interaction that link these syndromes together.
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Affiliation(s)
- Manpreet K Singh
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States.
| | - Sara M Leslie
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Mary Melissa Packer
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Yevgeniya V Zaiko
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Owen R Phillips
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Elizabeth F Weisman
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Danielle M Wall
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Booil Jo
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
| | - Natalie Rasgon
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States
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Akinlade KS, Rahamon SK, Lasebikan VO. Beta-cell Function and Metabolic Clearance Rate of Glucose in Patients with Major Mental Health Disorders on Antipsychotic Drug Treatment. J Natl Med Assoc 2018; 110:504-511. [PMID: 30129504 DOI: 10.1016/j.jnma.2018.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 07/10/2017] [Accepted: 01/01/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Insulin resistance and metabolic alteration continue to be essential features of major mental health disorders (MMHD) with poorly understood and multifaceted mechanisms. This study was carried out to provide information on insulin resistance, beta-cell function, metabolic clearance rate of glucose and their possible interplay with duration of antipsychotic use in patients with major mental health disorders. METHODOLOGY Plasma levels of glucose and insulin were determined in 124 patients with MMHD after an overnight fast and at 30 and 120 min of standard Oral Glucose Tolerance Test. Thereafter, indices of insulin resistance, beta-cell function and estimated metabolic clearance rate of glucose (eMCR) were calculated appropriately. Statistical analysis was done using ANOVA, Kruskal Wallis, independent Student's t-test and Mann-Whitney U. P-values less than 0.05 were considered as statistically significant. RESULTS Metabolic factors (fasting and postprandial glucose and insulin), indices of insulin sensitivity and β-cell function were not significantly different when patients with schizophrenia, bipolar and depression were compared with one another. Postprandial insulin level at 30 min (30 min PPI), estimated First and Second Phases of Insulin Release (eFPIR, eSPIR) were significantly lower in patients on atypical antipsychotic drugs [18.15 (3.57-40.35) μIU/ml), 617.63 (320.06-911.31) pmol/l, 180.30 (114.82-249.39) pmol/l] compared with patients on typical antipsychotic drugs [27.48 (13.33-47.68) μIU/ml, 767.69 (530.58-1198.35) pmol/l, 209.89 (154.01-310.97) pmol/l]. Furthermore, the mean waist circumference and body mass index were significantly higher in patients who have been on anti-psychotic drug for more than 10 years compared with patients with less than 5 years history of anti-psychotic use. eMCR of glucose progressively declined with increasing duration of antipsychotic use and it was significantly lower in patients who have been on antipsychotic drugs for more than 10 years [8.09 (5.90-9.44) ml.kg-1.min-1] compared with patients who have been on the drugs for less than 5 years [9.03 (7.47-10.04) ml.kg-1.min-1]. CONCLUSION Patients on atypical antipsychotics seem to have insulin secretion phases consistent with β-cell dysfunction. Also, chronicity of antipsychotic treatment predisposes patients with major mental health disorders to central adiposity and low metabolic clearance rate of glucose, a forerunner of glucose intolerance.
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Stephen DSS, Abraham A. High-fat simple carbohydrate (HFSC) diet impairs hypothalamic and corpus striatal serotonergic metabolic pathway in metabolic syndrome (MetS) induced C57BL/6J mice. Nutr Neurosci 2017; 22:51-62. [DOI: 10.1080/1028415x.2017.1354511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- DSouza Serena Stephen
- Father George Albuquerque Pai Cell and Molecular Biology Laboratory, Department of Postgraduate Studies and Research in Biotechnology, St Aloysius (Autonomous) College, Mangaluru 575003, Karnataka, India
- 125-B, Protein Engineering Laboratory, Department of Chemical Engineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India
| | - Asha Abraham
- Father George Albuquerque Pai Cell and Molecular Biology Laboratory, Department of Postgraduate Studies and Research in Biotechnology, St Aloysius (Autonomous) College, Mangaluru 575003, Karnataka, India
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Selenium deficiency-induced thioredoxin suppression and thioredoxin knock down disbalanced insulin responsiveness in chicken cardiomyocytes through PI3K/Akt pathway inhibition. Cell Signal 2017; 38:192-200. [PMID: 28734787 DOI: 10.1016/j.cellsig.2017.07.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 06/26/2017] [Accepted: 07/16/2017] [Indexed: 01/15/2023]
Abstract
Thioredoxin (Txn) system is the most crucial antioxidant defense mechanism in cell consisting of Txn, thioredoxin reductase (TR) and Nicotinamide Adenine Dinucleotide Phosphate (NADPH). Perturbations in Txn system may compromise cell survival through oxidative stress induction. Metabolic activity of insulin plays important roles in fulfilling the stable and persistent demands of heart through glucose metabolism. However, the roles of Txn and Txn system in insulin modulated cardiac energy metabolism have been less reported. Therefore, to investigate the role of Txn in myocardial metabolism, we developed a Se-deficient chicken model (0.033mg/kg) for in-vivo and Txn knock down cardiomyocytes culture model (siRNA) for in-vitro studies. Quantitative real time PCR and western blotting was performed. Se deficiency suppressed Txn and TR in cardiac tissues. Significant increases in ROS (P<0.05) levels signify the onset of oxidative stress and in both models. Se deficiency-induced Txn suppression model and Txn knock down cardiomyocytes models significantly decreased (P<0.05), the mRNA and protein levels of insulin-like growth factors (IGF1, IGF2), IGF-binding proteins (IGFBP2, IGFBP4), insulin receptor (IR), insulin receptor substrates (IRS1, IRS2), and glucose transporters (GLUT1, GLUT3, GLUT8), however, IGFBP3 expression increased in Txn knock down cardiomyocytes. In addition, in contrast to their respective controls, Se deficiency-induced Txn depleted tissues and Txn deleted cardiomyocytes showed suppression in mRNA and protein levels of PI3K, AKT, P-PI3K, and repression in FOX, P-FOX JNK genes. Combing the in vitro and in vivo experiments, we demonstrate that Txn gene suppression can cause dysfunction of insulin-modulated cardiac energy metabolism and increase insulin resistance through PI3K-Akt pathway inhibition. Herein, we conclude that inactivation of Txn system can alter cellular insulin response through IRS/PI3K/Akt pathway repression and JNK and FOX expression. These findings point out that Txn system can redox regulate the insulin dependent glucose metabolism in heart and is essential for cell vitality. Moreover, the increased expression of IGFBP3 indicates that it can be a potential negative modulator of metabolic activity of insulin in Txn deficient cells.
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Olguner Eker Ö, Özsoy S, Eker B, Doğan H. Metabolic Effects of Antidepressant Treatment. Noro Psikiyatr Ars 2017; 54:49-56. [PMID: 28566959 DOI: 10.5152/npa.2016.12373] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 09/29/2015] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION This study aimed to investigate body measurements, glucose-insulin metabolism, and lipid profile in patients with anxiety and depressive symptoms and also the effects of antidepressant drugs on these metabolic parameters. METHODS The study included 40 outpatients and 32 healthy controls. The patients received antidepressant treatment (sertraline, escitalopram, fluoxetine, and venlafaxine) for 8 weeks. Body measurements were performed, and lipid, fasting blood glucose, and insulin levels were measured before and after treatment in patients and once in healthy controls. Insulin resistance was evaluated using the homeostasis model assessment (HOMA) index. RESULTS Body mass index was higher in patients than in healthy controls, and there was no change in patients after treatment. In patients, high-density lipoprotein (HDL) cholesterol levels increased owing to the antidepressant treatment. Insulin level and HOMA index had a tendency to decrease with the treatment in patients and were similar to those of healthy controls before the treatment; however, they became lower than those of healthy controls after the treatment. There was an increase in waist circumference and total and HDL cholesterol levels, whereas there was a decrease in fasting blood glucose levels with treatment in patients using escitalopram. There was no change in body measurements and biochemical and hormone values in patients using fluoxetine, sertraline, and venlafaxine. There was an increase in weight, body mass index, and waist circumference after treatment in patients with depression; however, there was no change in patients with anxiety. CONCLUSION In patients with psychiatric disorders having anxiety and depressive symptoms, metabolic changes independent of drugs and the metabolic effects of drugs are present.
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Affiliation(s)
- Özlem Olguner Eker
- Department of Psychiatry, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Saliha Özsoy
- Department of Psychiatry, Erciyes University School of Medicine, Kayseri, Turkey
| | - Baki Eker
- Department of Internal Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Hatice Doğan
- Department of Child and Adolescent Psychiatry, Kayseri Training and Research Hospital, Kayseri, Turkey
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Liu Y, Zhou Q, Zhao Y, Wang Y, Wang Y, Wang J, Xu J, Xue C. Enrichment, Distribution of Vanadium-Containing Protein in Vanadium-Enriched Sea Cucumber Apostichopus japonicus and the Ameliorative Effect on Insulin Resistance. Biol Trace Elem Res 2016; 171:167-75. [PMID: 26419760 DOI: 10.1007/s12011-015-0517-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 09/22/2015] [Indexed: 12/25/2022]
Abstract
Sea cucumbers are a potential source of natural organic vanadium that may improve insulin resistance. In this work, vanadium was accumulated rapidly in blood, body wall, and intestine by sea cucumber Apostichopus japonicus. Furthermore, water-soluble vanadium-containing proteins, the main form of the organic vanadium, were tentatively accumulated and isolated by a bioaccumulation experiment. It was also designed to evaluate the beneficial effect of vanadium-containing proteins (VCPs) from sea cucumber rich in vanadium on the development of hyperglycemia and insulin resistance in C57BL/6J mice fed with a high-fat high-sucrose diet (HFSD). HFSD mice treated with VCPs significantly decreased fasting blood glucose, serum insulin, and HOMA-IR values as compared to HFSD mice, respectively. Serum adiponectin, resistin, TNF-α, and leptin levels in insulin-resistant mice were dramatically reduced by a VCP supplement. These results show an ameliorative effect on insulin resistance by treatment with VCPs. Such compound seems to be a valuable therapy to achieve and/or maintain glycemic control and therapeutic agents in the treatment arsenal for insulin resistance and type 2 diabetes.
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Affiliation(s)
- Yanjun Liu
- College of Food Science and Engineering, Ocean University of China, 5 Yushan Road, 266003, Qingdao, Shandong Province, China
| | - Qingxin Zhou
- College of Food Science and Engineering, Ocean University of China, 5 Yushan Road, 266003, Qingdao, Shandong Province, China
| | - Yanlei Zhao
- College of Food Science and Engineering, Ocean University of China, 5 Yushan Road, 266003, Qingdao, Shandong Province, China
| | - Yiming Wang
- College of Food Science and Engineering, Ocean University of China, 5 Yushan Road, 266003, Qingdao, Shandong Province, China
| | - Yuming Wang
- College of Food Science and Engineering, Ocean University of China, 5 Yushan Road, 266003, Qingdao, Shandong Province, China
| | - Jingfeng Wang
- College of Food Science and Engineering, Ocean University of China, 5 Yushan Road, 266003, Qingdao, Shandong Province, China
| | - Jie Xu
- College of Food Science and Engineering, Ocean University of China, 5 Yushan Road, 266003, Qingdao, Shandong Province, China
| | - Changhu Xue
- College of Food Science and Engineering, Ocean University of China, 5 Yushan Road, 266003, Qingdao, Shandong Province, China.
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Lee JG, Choi JH, Kim SY, Kim KS, Joo SJ. Psychiatric Characteristics of the Cardiac Outpatients with Chest Pain. Korean Circ J 2016; 46:169-78. [PMID: 27014347 PMCID: PMC4805561 DOI: 10.4070/kcj.2016.46.2.169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 05/11/2015] [Accepted: 08/10/2015] [Indexed: 12/05/2022] Open
Abstract
Background and Objectives A cardiologist's evaluation of psychiatric symptoms in patients with chest pain is rare. This study aimed to determine the psychiatric characteristics of patients with and without coronary artery disease (CAD) and explore their relationship with the intensity of chest pain. Subjects and Methods Out of 139 consecutive patients referred to the cardiology outpatient department, 31 with atypical chest pain (heartburn, acid regurgitation, dyspnea, and palpitation) were excluded and 108 were enrolled for the present study. The enrolled patients underwent complete numerical rating scale of chest pain and the symptom checklist for minor psychiatric disorders at the time of first outpatient visit. The non-CAD group consisted of patients with a normal stress test, coronary computed tomography angiogram, or coronary angiogram, and the CAD group included those with an abnormal coronary angiogram. Results Nineteen patients (17.6%) were diagnosed with CAD. No differences in the psychiatric characteristics were observed between the groups. "Feeling tense", "self-reproach", and "trouble falling asleep" were more frequently observed in the non-CAD (p=0.007; p=0.046; p=0.044) group. In a multiple linear regression analysis with a stepwise selection, somatization without chest pain in the non-CAD group and hypochondriasis in the CAD group were linearly associated with the intensity of chest pain (β=0.108, R2=0.092, p=0.004; β= -0.525, R2=0.290, p=0.010). Conclusion No differences in psychiatric characteristics were observed between the groups. The intensity of chest pain was linearly associated with somatization without chest pain in the non-CAD group and inversely linearly associated with hypochondriasis in the CAD group.
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Affiliation(s)
- Jea-Geun Lee
- Division of Cardiology, Department of Internal Medicine, School of Medicine, Jeju National University, Jeju, Korea
| | - Joon Hyouk Choi
- Division of Cardiology, Department of Internal Medicine, School of Medicine, Jeju National University, Jeju, Korea
| | - Song-Yi Kim
- Division of Cardiology, Department of Internal Medicine, School of Medicine, Jeju National University, Jeju, Korea
| | - Ki-Seok Kim
- Division of Cardiology, Department of Internal Medicine, School of Medicine, Jeju National University, Jeju, Korea
| | - Seung-Jae Joo
- Division of Cardiology, Department of Internal Medicine, School of Medicine, Jeju National University, Jeju, Korea
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Khawaja IS, Kazaglis L, Hashmi A, Khurshid KA, Eiken C, Hurwitz TD. Obstructive Sleep Apnea and Depression: A Review. Psychiatr Ann 2016. [DOI: 10.3928/00485713-20160125-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Dankel SJ, Loenneke JP, Loprinzi PD. Mild Depressive Symptoms Among Americans in Relation to Physical Activity, Current Overweight/Obesity, and Self-Reported History of Overweight/Obesity. Int J Behav Med 2016; 23:553-60. [DOI: 10.1007/s12529-016-9541-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Exploring the Link between the Components of Metabolic Syndrome and the Risk of Depression. BIOMED RESEARCH INTERNATIONAL 2016; 2015:586251. [PMID: 26770976 PMCID: PMC4685082 DOI: 10.1155/2015/586251] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 11/15/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) has been reported with an increased risk of depression. MetS was also associated with insulin resistance. This study aimed to evaluate whether MetS components might contribute to depression in participants with insulin resistance (IR) or not. METHODS This study included 3,331 participants ≥18 years in the NHANES 2009-2010. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). MetS components were measured using blood chemistry and body measurements. IR was identified using the homeostasis model assessment method. RESULTS Predicted PHQ-9 scores significantly increased as the number of MetS components increased in patients with IR. The adjusted β coefficients of the predicted PHQ-9 score with 2, 4, and 5 MetS components were 1.803, 2.081, and 3.048, respectively (P for trend < 0.05). Low HDL-C levels were significantly associated with higher predicted total PHQ-9 scores in fully adjusted models in the IR group (P < 0.05). CONCLUSION The results indicated that the presence of a greater number of components of MetS was significantly associated with higher predicted total PHQ-9 scores in participants with IR. Among the components of MetS, the most apparent association was observed between low HDL and higher predicted total PHQ-9 scores.
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Chan MK, Cooper JD, Bot M, Steiner J, Penninx BWJH, Bahn S. Identification of an Immune-Neuroendocrine Biomarker Panel for Detection of Depression: A Joint Effects Statistical Approach. Neuroendocrinology 2016; 103:693-710. [PMID: 26580065 DOI: 10.1159/000442208] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 11/05/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Less than half of depression patients are correctly diagnosed within the primary care setting. Previous proteomic studies have identified numerous immune and neuroendocrine changes in patients. However, few studies have considered the joint effects of biological molecules and their diagnostic potential. Our aim was to develop and validate a diagnostic serum biomarker panel identified through joint effects analysis of multiplex immunoassay profiling data from 1,007 clinical samples. METHODS In stage 1, we conducted a meta-analysis of two independent cohorts of 78 first-/recent-onset drug-naive/drug-free depression patients and 156 controls and applied the 10-fold cross-validation with least absolute shrinkage and selection operator regression to identify an optimal diagnostic prediction model (biomarker panel). In stage 2, we tested the discriminatory performance of this biomarker panel using the naturalistic Netherlands Study of Depression and Anxiety (NESDA) cohort of 468 depression patients and 305 controls. RESULTS An optimal panel of 33 immune-neuroendocrine biomarkers and gender was selected in the meta-analysis. Testing this biomarker-gender panel using the NESDA cohort resulted in a moderate to good performance to differentiate patients from controls (0.69 < AUC < 0.86), particularly the first-episode patients free of chronic non-psychiatric diseases or medications and following incorporation of sociodemographic covariates (0.76 < AUC < 0.92). CONCLUSION Despite the need for additional validation studies, we demonstrated that a blood-based biomarker-sociodemographic panel can detect depression in naturalistic healthcare settings with good discriminatory power. Further refinements of blood biomarker panels aiding in the diagnosis of depression may provide a cost-effective means to increase accuracy of clinical diagnosis within the primary care setting.
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Affiliation(s)
- Man K Chan
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
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Ribeiro RP, Marziale MHP, Martins JT, Ribeiro PHV, Robazzi MLDCC, Dalmas JC. Prevalence of Metabolic Syndrome among nursing personnel and its association with occupational stress, anxiety and depression. Rev Lat Am Enfermagem 2015; 23:435-40. [PMID: 26155007 PMCID: PMC4547066 DOI: 10.1590/0104-1169.0383.2573] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 03/04/2015] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE: to identify the prevalence of Metabolic Syndrome among nursing personnel, and its
association with occupational stress, anxiety and depression. METHOD: a descriptive correlational study undertaken with 226 nursing personnel from a
teaching hospital. Data collection was undertaken through application of the Job
Stress Scale, the Hospital Anxiety and Depression Scale and a sociodemographic
questionnaire, with variables of Metabolic Syndrome. Univariate analyses and
Chi-squared and Pearson tests were used for correlation between the variables,
with a level of significance of 5%. RESULTS: 86 (38.1%) workers presented Metabolic Syndrome, of whom 183 (81.1%) were female,
and 43 (19.9%) male, aged between 23 and 66 years old. In relation to anxiety and
depression, 154 (68.1%) presented anxiety, with 48 (31.2%) also presenting
Metabolic Syndrome; 185 (81.8%) presented depression, of whom 62 (33.5%) also had
Metabolic Syndrome. It was ascertained that 61 (27.0%) workers presented stress
and that of these, 14 (22.9%) presented Metabolic Syndrome. CONCLUSION: a correlation was observed between the variables of anxiety and Metabolic
Syndrome and stress and Metabolic Syndrome, there being no correlation between the
variables of depression and Metabolic Syndrome.
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Affiliation(s)
| | | | | | | | | | - José Carlos Dalmas
- Departamento de Enfermagem, Universidade Estadual de Londrina, Londrina, PR, BR
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Greenwood EA, Pasch LA, Shinkai K, Cedars MI, Huddleston HG. Putative role for insulin resistance in depression risk in polycystic ovary syndrome. Fertil Steril 2015; 104:707-14.e1. [PMID: 26054555 DOI: 10.1016/j.fertnstert.2015.05.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/12/2015] [Accepted: 05/12/2015] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To evaluate whether insulin resistance is associated with depression risk in women with polycystic ovary syndrome (PCOS), independent of other factors, including body mass index (BMI). DESIGN Cross-sectional. SETTING Tertiary university center. PATIENT(S) A total of 301 women, aged 14-52 years, with PCOS by Rotterdam criteria, consecutively examined between 2006 and 2013. INTERVENTION(S) Complete history and physical examinations, including endovaginal ultrasounds, dermatologic assessments, completion of Beck Depression Inventory Fast Screen (BDI-FS), and serum testing. MAIN OUTCOME MEASURE(S) Scores >4 on BDI-FS indicated a positive screen for depression. Scores were further subdivided into mild (5-8), moderate (9-12), and severe (>12) depression risk. Insulin resistance was assessed using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). RESULT(S) A total of 131 women (44%) were at risk for depression, determined by positive BDI-FS screening. These patients had higher BMI (32.3 vs. 28.5), and elevated insulin resistance, assessed by HOMA-IR (5.2 vs. 2.6), compared with patients with negative depression screening. In a stratified analysis by BMI category, obese women with positive depression screens had elevated HOMA-IR, compared with obese women with normal BDI-FS scores (7.4 vs. 4.1). In a multivariate logistic regression analysis, HOMA-IR was independently related to the odds of depression risk after controlling for age, ethnicity, BMI, and exercise (odds ratio: 1.07). CONCLUSION(S) Depression is common in PCOS. After controlling for confounders in multivariate regression analyses, we found HOMA-IR to be significantly associated with depression risk. Our data suggest a complex interplay among insulin resistance, obesity, and depression in PCOS, warranting additional investigation. Mental health assessment is indicated in comprehensive care of patients with PCOS.
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Affiliation(s)
- Eleni A Greenwood
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California.
| | - Lauri A Pasch
- Department of Psychiatry, University of California San Francisco, San Francisco, California
| | - Kanade Shinkai
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Marcelle I Cedars
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California
| | - Heather G Huddleston
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California
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Tsai MC, Chen CH, Lee HC, Lin HC, Lee CZ. Increased Risk of Depressive Disorder following Cholecystectomy for Gallstones. PLoS One 2015; 10:e0129962. [PMID: 26053886 PMCID: PMC4460135 DOI: 10.1371/journal.pone.0129962] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/13/2015] [Indexed: 02/06/2023] Open
Abstract
Background Prior studies indicate a possible association between depression and cholecystectomy, but no study has compared the risk of post-operative depressive disorders (DD) after cholecystectomy. This retrospective follow-up study aimed to examine the relationship between cholecystectomy and the risk of DD in patients with gallstones in a population-based database. Methods Using ambulatory care data from the Longitudinal Health Insurance Database 2000, 6755 patients who received a first-time principal diagnosis of gallstones at the emergency room (ER) were identified. Among them, 1197 underwent cholecystectomy. Each patient was then individually followed-up for two years to identify those who were later diagnosed with DD. Cox proportional hazards regressions were performed to estimate the risk of developing DD between patients with gallstone who did and those who did not undergo cholecystectomy. Results Of 6755 patients with gallstones, 173 (2.56%) were diagnosed with DD during the two-year follow-up. Among patients who did and those who did not undergo cholecystectomy, 3.51% and 2.36% later developed depressive disorder, respectively. After adjusting for the patient’s sex, age and geographic location, the hazard ratio (HR) of DD within two years of gallstone diagnosis was 1.43 (95% CI, 1.02–2.04) for patients who underwent cholecystectomy compared to those who did not. Females, but not males, had a higher the adjusted HR of DD (1.61; 95% CI, 1.08–2.41) for patients who underwent cholecystectomy compared to those who did not. Conclusions There is an association between cholecystectomy and subsequent risk of DD among females, but not in males.
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Affiliation(s)
- Ming-Chieh Tsai
- Division of Gastroenterology, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Chao-Hung Chen
- Department of Cosmetic Applications and Management, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
- Department of Thoracic Surgery, MacKay Memorial Hospital, Taipei, Taiwan
| | - Hsin-Chien Lee
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Herng-Ching Lin
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Cha-Ze Lee
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- * E-mail:
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Shah SC, Kornak J, Khalili M. Depression is not associated with peripheral insulin resistance in patients with chronic hepatitis C infection. J Viral Hepat 2015; 22:272-80. [PMID: 25196736 PMCID: PMC4386832 DOI: 10.1111/jvh.12306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Depression is common in individuals infected with hepatitis C virus (HCV), and both depression and HCV infection are independently associated with insulin resistance (IR). To evaluate the relationship between depression and IR, among other factors, in an HCV-infected cohort. In this cross-sectional analysis, seventy-four non-type 2 diabetic, noncirrhotic, HCV-infected patients underwent comprehensive clinical, histologic and metabolic evaluation. IR was assessed directly with an insulin suppression test by measuring steady-state plasma glucose (SSPG) levels during continuous infusions of octreotide, glucose and insulin. Logistic regression modelling was used to evaluate predictors associated with depression. Thirty-nine (53%) patients were depressed, and 21 (54%) depressed patients were on at least one antidepressant. A higher estimated proportion of depressed patients were Caucasian (51% vs 20%, P = 0.005), unemployed (69% vs 49%, P = 0.07), heavier smokers (18 pack-years vs 13 pack-years, P = 0.07), on substance abuse therapy (16% vs 3%, P = 0.06) and had lower HDL levels (1.2 mmol/L vs 1.4 mmol/L, P = 0.01). The mean SSPG levels in depressed and nondepressed patients were 7.3 and 8.3 mmol/L (P = 0.45), respectively. In multipredictor adjusted analysis, only Caucasian race (OR 4.19, 95% CI 1.42-12.35, P = 0.009) and lower HDL (OR 0.95, 95% CI 0.89-0.99, P = 0.046) were associated with depression. In conclusion, although prevalent, depression was not associated with peripheral IR in this HCV-infected cohort. Attention to other modifiable factors associated with depression in the HCV-infected population is warranted.
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Affiliation(s)
- S. C. Shah
- Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA
| | - J. Kornak
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - M. Khalili
- Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA,Liver Center, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA
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Kontoangelos K, Papageorgiou CC, Raptis AE, Tsiotra P, Lambadiari V, Papadimitriou GN, Rabavilas AD, Dimitriadis G, Raptis SA. Homocysteine, cortisol, diabetes mellitus, and psychopathology. J Diabetes Res 2015; 2015:354923. [PMID: 25722989 PMCID: PMC4333328 DOI: 10.1155/2015/354923] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 01/10/2015] [Accepted: 01/13/2015] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE This study investigates the association of homocysteine and cortisol with psychological factors in type 2 diabetic patients. METHOD Homocysteine, cortisol, and psychological variables were analyzed from 131 diabetic patients. Psychological factors were assessed with the Eysenck Personality Questionnaire (EPQ), Hostility and Direction of Hostility Questionnaire (HDHQ), the Symptom Checklist 90-R (SCL 90-R), the Zung Self-Rating Depression Scale (ZDRS), and the Maudsley O-C Inventory Questionnaire (MOCI). Blood samples were taken by measuring homocysteine and cortisol in both subgroups during the initial phase of the study (T0). One year later (T1), the uncontrolled diabetic patients were reevaluated with the use of the same psychometric instruments and with an identical blood analysis. RESULTS The relation of psychoticism and homocysteine is positive among controlled diabetic patients (P value = 0.006 < 0.05) and negative among uncontrolled ones (P value = 0.137). Higher values of cortisol correspond to lower scores on extraversion subscale (r(p) = -0.223, P value = 0.010). Controlled diabetic patients showed a statistically significant negative relationship between homocysteine and the act-out hostility subscale (r(sp) = -0.247, P = 0.023). There is a statistically significant relationship between homocysteine and somatization (r(sp) = -0.220, P = 0.043). CONCLUSIONS These findings support the notion that homocysteine and cortisol are related to trait and state psychological factors in patients with diabetes mellitus type 2.
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Affiliation(s)
- K. Kontoangelos
- 1st Department of Psychiatry, Athens University Medical School, Eginition Hospital, 11528 Athens, Greece
- University Mental Health Research Institute, 11527 Athens, Greece
| | - C. C. Papageorgiou
- 1st Department of Psychiatry, Athens University Medical School, Eginition Hospital, 11528 Athens, Greece
- University Mental Health Research Institute, 11527 Athens, Greece
| | - A. E. Raptis
- 2nd Department of Internal Medicine, Research Institute and Diabetes Center, Athens University Medical School, Attikon University Hospital, 12462 Athens, Greece
| | - P. Tsiotra
- Hellenic National Center for Research, Prevention and Treatment of Diabetes Mellitus and Its Complications (HNDC), 10675 Athens, Greece
| | - V. Lambadiari
- 2nd Department of Internal Medicine, Research Institute and Diabetes Center, Athens University Medical School, Attikon University Hospital, 12462 Athens, Greece
| | - G. N. Papadimitriou
- 1st Department of Psychiatry, Athens University Medical School, Eginition Hospital, 11528 Athens, Greece
| | - A. D. Rabavilas
- University Mental Health Research Institute, 11527 Athens, Greece
| | - G. Dimitriadis
- 2nd Department of Internal Medicine, Research Institute and Diabetes Center, Athens University Medical School, Attikon University Hospital, 12462 Athens, Greece
| | - S. A. Raptis
- 2nd Department of Internal Medicine, Research Institute and Diabetes Center, Athens University Medical School, Attikon University Hospital, 12462 Athens, Greece
- Hellenic National Center for Research, Prevention and Treatment of Diabetes Mellitus and Its Complications (HNDC), 10675 Athens, Greece
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Ismail B, Aboul-Fotouh S, Mansour AA, Shehata HH, Salman MI, Ibrahim EA, Hassan OA, Abdel-tawab AM. Behavioural, metabolic, and endothelial effects of the TNF-α suppressor thalidomide on rats subjected to chronic mild stress and fed an atherogenic diet. Can J Physiol Pharmacol 2014; 92:375-85. [DOI: 10.1139/cjpp-2013-0446] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
There is accumulating evidence suggesting that depression is a risk factor for cardiovascular diseases. This study aimed to examine the hypothesis that the proinflammatory cytokine TNF-α would partially explain the link between depression and atherosclerotic endothelial changes. Rats were distributed among 6 groups: (i) control group; (ii) group subjected to chronic mild stress (CMS); (iii) group fed a cholesterol–cholic acid–thiouracil (CCT diet); and (iv) CMS group fed the CCT diet and treated with the vehicle for 8 weeks. The last 2 groups were subjected to CMS–CCT and received thalidomide (THAL) or imipramine (IMIP). Rats were assessed behaviorally (sucrose preference, open field, and forced-swimming tests). TNF-α protein was assessed from the serum, aorta, and liver. Aortic TNF-α gene expression (assessed using RT–PCR), serum lipid profile, and insulin levels were measured. Endothelial function was assessed in isolated aortic rings. The THAL and IMIP groups showed ameliorated CMS–CCT-related behavioral changes. CMS–CCT-induced metabolic and endothelial dysfunctions were improved in the THAL group but were worsened in the IMIP group. RT–PCR showed a significant reduction of aortic TNF-α mRNA expression in the THAL and IMIP treatment groups. These data paralleled the findings for aortic immunohistochemistry. The THAL group, but not the IMIP group, showed improved CMS–CCT-induced changes in the vascular reactivity of the aortic rings. Thus, TNF-α provides a target link between depression, metabolic syndrome, and endothelial dysfunction. This could open a new therapeutic approach to address the comorbidities of depression.
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Affiliation(s)
- Basma Ismail
- Department of Pharmacology, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt
- Cardiac PET Centre, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
| | - Sawsan Aboul-Fotouh
- Department of Pharmacology, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt
- Clinical Pharmacology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Amal A. Mansour
- Department of Medical Biochemistry, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt
| | - Hanan H. Shehata
- Department of Medical Biochemistry, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt
| | - Manal I. Salman
- Department of Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eman A. Ibrahim
- Department of Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Olfat A. Hassan
- Department of Pharmacology, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt
| | - Ahmed M. Abdel-tawab
- Department of Pharmacology, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt
- Clinical Pharmacology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Abstract
Diabetes Mellitus is a common metabolic disorder presenting increased amounts of serum glucose and will cover 5.4% of population by year 2025. Accordingly, this review was performed to gather and discuss the stand points on diagnosis, pathophysiology, non-pharmacological therapy and drug management of diabetes this disorder as described in medieval Persian medicine. To this, reports on diabetes were collected and analyzed from selected medical and pharmaceutical textbooks of Traditional Persian Medicine. A search on databases as Pubmed, Sciencedirect, Scopus and Google scholar was also performed to reconfirm the Anti diabetic activities of reported herbs. The term, Ziabites, was used to describe what is now spoken as diabetes. It was reported that Ziabites, is highly associated with kidney function. Etiologically, Ziabites was characterized as kidney hot or cold dystemperament as well as diffusion of fluid from other organs such as liver and intestines into the kidneys. This disorder was categorized into main types as hot (Ziabites-e-har) and cold (Ziabites-e-barid) as well as sweet urine (Bole-e-shirin). Most medieval cite signs of Ziabites were remarked as unusual and excessive thirst, frequent urination and polydipsia. On the management, life style modification and observing the essential rules of prevention in Persian medicine as well as herbal therapy and special simple manipulations were recommended. Current investigation was done to clarify the knowledge of medieval scientists on diabetes and related interventions. Reported remedies which are based on centuries of experience might be of beneficial for- further studies to the management of diabetes.
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Affiliation(s)
- Mohammad M. Zarshenas
- Medicinal Plants Processing Research Center, Shiraz, Iran
- Essence of Parsiyan Wisdom Institute, Traditional Medicine and Medicinal Plant Incubator, Shiraz, Iran
- Research Office for the History of Persian Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedigheh Khademian
- Department of Traditional Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmoodreza Moein
- Department of Pharmacognosy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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Population impact of depression either as a risk factor or consequence of type 2 diabetes in adults: a meta-analysis of longitudinal studies. Asian J Psychiatr 2013; 6:460-72. [PMID: 24309855 DOI: 10.1016/j.ajp.2013.09.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 09/09/2013] [Accepted: 09/15/2013] [Indexed: 11/21/2022]
Abstract
This meta-analysis examined the reciprocal relationship between depression and diabetes mellitus type 2 (T2DM) by conducting a bias adjusted meta-analysis of longitudinal studies using relative and absolute risk estimates. Specifically, the data were reconstructed to compute relative risk (RR), risk difference (RD), and the number needed to be exposed for one additional person to be harmed (NNEH) or benefited (NNEB). The 25 studies selected for review generated 29 datasets of which 15 examined endpoint A (depression as a risk factor for T2DM), and 14 examined endpoint B (T2DM as a risk factor for depression). For both endpoints, there was a small relative risk increase (for both the RR and hazard ratio (HR)) though with significant heterogeneity between studies. This however translated to a non-significant NNEH of 87 (NNEB 161 to ∞ to NNEH 35) and NNEH of 233 (NNEB 28 to ∞ to NNEH 23) for studies examining endpoint A and endpoint B respectively. This study suggests that the magnitude of the relative risk increase for depression as a risk factor or consequence of T2DM is small without significant impact on absolute risk indices. While these risks may be considered in terms of individual patient management, they are unlikely to have an impact on a population perspective.
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Gezginç K, Sahingöz M, Uguz F, Yazıcı F. Is depression associated with glucose tolerance abnormality in pregnant women? A cross-sectonal study. Arch Psychiatr Nurs 2013; 27:219-22. [PMID: 24070989 DOI: 10.1016/j.apnu.2013.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 06/19/2013] [Accepted: 06/20/2013] [Indexed: 11/28/2022]
Abstract
This study aims to examine the association between glucose tolerance abnormality and depression and anxiety in pregnant women. One hundred and sixty-seven women with gestational ages ranging from 24 to 28 weeks were screened with the 50 g oral glucose challenge test. All participants were assessed with the Beck Depression Inventory and the Beck Anxiety Inventory. The rate of depression was higher in women with abnormal glucose results (44.3%) than in women with normal glucose results (21.7%). Similarly, depressed women had higher glucose levels than non-depressed women. Findings suggest that depression and anxiety may be associated with glucose tolerance abnormality in pregnant women.
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Affiliation(s)
- Kazim Gezginç
- Department of Obstetrics and Gynecology, University of Necmettin Erbakan, Meram Faculty of Medicine, Konya, Turkey.
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Mason JS, Kenna HA, Rasgon NL. Insulin resistance in major depressive disorder and the effects of psychotropic medications. ACTA ACUST UNITED AC 2012. [DOI: 10.2217/cpr.12.46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jacobs GE, Hulskotte EGJ, van Gerven JMA, Zuurman L, de Kam ML, Elassaiss-Schaap J, Ruigt G, van Pelt J, Peeters BWMM, Peeters PAM, Burggraaf J. Desmopressin as a pharmacological tool in vasopressinergic hypothalamus-pituitary-adrenal axis modulation: neuroendocrine, cardiovascular and coagulatory effects. J Psychopharmacol 2011; 25:353-60. [PMID: 20142306 DOI: 10.1177/0269881109358203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Arginine-vasopressin (AVP) is a physiological co-activator of the hypothalamus-pituitary-adrenal (HPA) axis, together with corticotrophin releasing hormone (CRH). A synthetic analogue of AVP, desmopressin (dDAVP), is often used as a pharmacological tool to assess co-activation in health and disease. The relation between dDAVP's neuroendocrine, cardiovascular, pro-coagulatory, anti-diuretic and non-specific stress effects has not been studied. A randomized, double-blind, placebo-controlled, three-way crossover study was performed in 12 healthy male and female volunteers (6 : 6). dDAVP was administered intravenously as a 10 μg bolus (over 1 min) or a 30 μg incremental infusion (over 60 min). Neuroendocrine, cardiovascular, pro-coagulatory, anti-diuretic effects and adverse events (AEs) were recorded, and autonomic nervous system (ANS) activation evaluated. The incremental infusion reached 1.8-fold higher dDAVP concentrations than the bolus. Neuroendocrine effects were similar for the 10 μg dDAVP bolus and the 30 μg incremental infusion, while cardiovascular and coagulatory effects were greater with the 30 µg dose. Osmolality and ANS activity remained uninfluenced. AEs corresponded to dDAVP's side-effect profile. In conclusion, the neuroendocrine effects of a 10 μg dDAVP bolus administered over 1 min are similar to those of a 30 μg incremental infusion administered over one hour, despite higher dDAVP concentrations after the infusion. Cardiovascular and coagulatory effects showed clear dose-related responses. A 10 μg dDAVP bolus is considered a safe vasopressinergic function test at which no confounding effects of systemic or autonomic stress were seen.
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Affiliation(s)
- G E Jacobs
- Centre for Human Drug Research, Leiden, The Netherlands
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Qiuhua Shen, Bergquist-Beringer S, Sousa VD. Major depressive disorder and insulin resistance in nondiabetic young adults in the United States: the National Health and Nutrition Examination Survey, 1999-2002. Biol Res Nurs 2010; 13:175-81. [PMID: 21044969 DOI: 10.1177/1099800410384501] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The association between depression and insulin resistance has been evaluated in previous studies with conflicting results. This study aimed to explore the relationship between major depressive disorder (MDD) and insulin resistance among nondiabetic young adult men and women in the United States. METHOD Analyses of cross-sectional data from the National Health and Nutrition Examination Survey (NHANES), 1999-2002, were conducted. The nationally representative sample consisted of 279 men and 358 women aged 20-39 years. MDD was determined by the WHO Composite International Diagnostic Interview (CIDI). Insulin resistance was measured by the homeostasis model assessment for insulin resistance. RESULTS Of 637 subjects, 16 men and 18 women had MDD (weighted percentage = 6.6%, SE = 1.2). Using logistic regression, no significant association was found between MDD and insulin resistance among the nondiabetic young adults in bivariate analysis (β = -0.01, OR = 0.99, 95% CI = [0.38, 2.57], p = .98). A significant interaction effect between gender and MDD was observed. For men, MDD was negatively associated with insulin resistance after adjusting for age, race/ethnicity, waist circumference, smoking status, systolic blood pressure and triglyceride level (β = -2.12, OR = 0.12, 95% CI = [0.02, 0.62], p = .01). No significant association between MDD and insulin resistance among women was found (β = 0.61, OR = 1.84, 95% CI = [0.47, 7.14], p = .38). CONCLUSIONS Overall findings suggest there is no significant association between MDD and insulin resistance among nondiabetic young adults aged 20-39 years. However, gender differences in this relationship were noted.
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Affiliation(s)
- Qiuhua Shen
- School of Nursing, University of Kansas Medical Center, Kansas City, KS, USA.
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Koponen H, Jokelainen J, Keinänen-Kiukaanniemi S, Vanhala M. Depressive symptoms and 10-year risk for cardiovascular morbidity and mortality. World J Biol Psychiatry 2010; 11:834-9. [PMID: 20632843 DOI: 10.3109/15622975.2010.486842] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Depression is associated with increased physical morbidity and overall mortality. As less is known about how much depression increases the 10-year risk for fatal and nonfatal cardiovascular (CV) events, we evaluated the cross-sectional risk with two well-characterized risk functions measuring CV mortality and total CV event risk. METHODS The prevalence of increased depressive symptoms was measured with the Beck Depression Inventory (BDI), and the SCORE and Framingham risk functions were calculated in a middle-aged population-based sample (N=923). For metabolic syndrome (MetS), the modified National Cholesterol Education Program-Adult Treatment Panel III criteria were employed. RESULTS Depressive symptoms were associated with increased CV mortality and morbidity risk in men: OR for SCORE 2.9; 95%CI 1.4-5.7 and OR for Framingham function 2.2 (95%CI 1.1-4.2). In women, the corresponding figures were 1.4 (95%CI 0.3-6.9) and 1.3 (95%CI 0.7-2.6). The BDI scores showed significant correlations with SCORE (r=0.18 for men, P < 0.001; and r=0.14 for women, P=0.002), and Framingham function (for men r=0.16, P < 0.001; and for women r=0.13, P=0.005). CONCLUSIONS Our results suggest that screening and effective treatment of depression are important in the primary and secondary prevention of cardiovascular events, especially in males.
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Affiliation(s)
- Hannu Koponen
- Department of Psychiatry, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
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McIntyre RS, Park KY, Law CWY, Sultan F, Adams A, Lourenco MT, Lo AKS, Soczynska JK, Woldeyohannes H, Alsuwaidan M, Yoon J, Kennedy SH. The association between conventional antidepressants and the metabolic syndrome: a review of the evidence and clinical implications. CNS Drugs 2010; 24:741-53. [PMID: 20806987 DOI: 10.2165/11533280-000000000-00000] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Major depressive disorder is a prevalent recurrent medical syndrome associated with inter-episodic dysfunction. The metabolic syndrome is comprised of several established risk factors for cardiovascular disease (i.e. abdominal obesity, dyslipidaemia, dysglycaemia and hypertension). The criterion items of the metabolic syndrome collectively represent a multi-dimensional risk factor for cardiovascular disease and type 2 diabetes mellitus. Extant evidence indicates that both major depressive disorder and the metabolic syndrome, albeit distinct, often co-occur and are possibly subserved by overlapping pathophysiology and causative mechanisms. Conventional antidepressants exert variable effects on constituent elements of the metabolic syndrome, inviting the need for careful consideration prior to treatment selection and sequencing. Initiating and maintaining antidepressant therapy should include routine surveillance for clinical and/or biochemical evidence suggestive of the metabolic syndrome.
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Affiliation(s)
- Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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Paz-Filho G, Licinio J, Wong ML. Pathophysiological basis of cardiovascular disease and depression: a chicken-and-egg dilemma. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2010; 32:181-91. [PMID: 20658057 PMCID: PMC4259495 DOI: 10.1590/s1516-44462010000200015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Accepted: 03/10/2010] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To describe the pathophysiological basis linking cardiovascular disease (CVD) and depression; to discuss the causal relationship between them, and to review the effects of antidepressant treatment on cardiovascular disease. METHOD A review of the literature based on the PubMed database. DISCUSSION Depression and cardiovascular disease are both highly prevalent. Several studies have shown that the two are closely related. They share common pathophysiological etiologies or co-morbidities, such as alterations in the hypothalamic-pituitary axis, cardiac rhythm disturbances, and hemorheologic, inflammatory and serotoninergic changes. Furthermore, antidepressant treatment is associated with worse cardiac outcomes (in case of tricyclics), which are not observed with selective serotonin reuptake inhibitors. CONCLUSION Although there is a strong association between depression and cardiovascular disease, it is still unclear whether depression is actually a causal factor for CVD, or is a mere consequence, or whether both conditions share a common pathophysiological etiology. Nevertheless, both conditions must be treated concomitantly. Drugs other than tricyclics must be used, when needed, to treat the underlying depression and not as mere prophylactic of cardiac outcomes.
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Affiliation(s)
- Gilberto Paz-Filho
- The John Curtin School of Medical Research, Australian National University, Canberra, Australia
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Pearson S, Schmidt M, Patton G, Dwyer T, Blizzard L, Otahal P, Venn A. Depression and insulin resistance: cross-sectional associations in young adults. Diabetes Care 2010; 33:1128-33. [PMID: 20185745 PMCID: PMC2858189 DOI: 10.2337/dc09-1940] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine the association between depressive disorder and insulin resistance in a sample of young adults using the Composite International Diagnostic Interview to ascertain depression status. RESEARCH DESIGN AND METHODS Cross-sectional data were collected from 1,732 participants aged between 26 and 36 years. Insulin resistance was derived from blood chemistry measures of fasting insulin and glucose using the homeostasis model assessment method. Those identified with mild, moderate, or severe depression were classified as having depressive disorder. RESULTS The 12-month prevalence of depressive disorder was 5.4% among men and 11.7% among women. In unadjusted models mean insulin resistance was 17.2% (95% CI 0.7-36.0%, P = 0.04) higher in men and 11.4% (1.5-22.0%, P = 0.02) higher in women with depressive disorder. After adjustment for behavioral and dietary factors, the increased level of insulin resistance associated with depressive disorder was 13.2% (-3.1 to 32.3%, P = 0.12) in men and 6.1% (-4.1 to 17.4%, P = 0.25) in women. Waist circumference was identified as a mediator in the relationship between depression and insulin resistance, reducing the beta coefficient in the fully adjusted models in men by 38% and in women by 42%. CONCLUSIONS A positive association was found between depressive disorder and insulin resistance in this population-based sample of young adult men and women. The association seemed to be mediated partially by waist circumference.
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Affiliation(s)
- Sue Pearson
- Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia.
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Wagner J, Allen NA, Swalley LM, Melkus GD, Whittemore R. Depression, depression treatment, and insulin sensitivity in adults at risk for type 2 diabetes. Diabetes Res Clin Pract 2009; 86:96-103. [PMID: 19720419 PMCID: PMC2760653 DOI: 10.1016/j.diabres.2009.06.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Revised: 06/15/2009] [Accepted: 06/22/2009] [Indexed: 01/09/2023]
Abstract
AIMS To compare insulin sensitivity (Si) in adults at risk for type 2 diabetes (T2DM) who were categorized as non-depressed, treated for depression and untreated depression after controlling for physical activity (PA). METHODS Baseline data was analyzed from individuals enrolled in a diabetes prevention program (n=56). Si was calculated using the whole-body insulin sensitivity method. The Centers for Epidemiologic Studies Depression Scale (CESD) was used to assess depressive symptoms and depressed cases were identified using a cutoff of >or=16. Depression treatment was identified using a self-report form validated by medical chart review. The PA subscale of the Health Promoting Lifestyle Profile was used to determine PA levels. RESULTS One third of participants had elevated depressive symptoms; 19% were taking antidepressant medication. Mean Si was 3.1 (+/-1.9). In ANOVA, depressed individuals showed significantly lower Si (M=1.8+/-0.9) than non-depressed individuals (M=3.4+/-1.8). However, individuals taking antidepressant medications had Si similar to non-depressed individuals (M=3.7+/-2.3: p=.63). In ANCOVA this association remained after controlling for PA. CONCLUSIONS These data suggest that in adults at high risk for T2DM, depression treatment may improve insulin resistance observed in depression. Healthcare practitioners are encouraged to screen, treat, or refer their patients with depression for treatment.
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Serotonin 5-HT(2A) Receptor Function as a Contributing Factor to Both Neuropsychiatric and Cardiovascular Diseases. Cardiovasc Psychiatry Neurol 2009; 2009:475108. [PMID: 20029624 PMCID: PMC2790184 DOI: 10.1155/2009/475108] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Revised: 08/07/2009] [Accepted: 08/14/2009] [Indexed: 12/19/2022] Open
Abstract
There are high levels of comorbidity between neuropsychiatric and cardiovascular disorders. A key molecule central to both cognitive and cardiovascular function is the molecule serotonin. In the brain, serotonin modulates neuronal activity and is actively involved in mediating many cognitive functions and behaviors. In the periphery, serotonin is involved in vasoconstriction, inflammation, and cell growth, among other processes. It is hypothesized that one component of the serotonin system, the 5-HT(2A) receptor, is a common and contributing factor underlying aspects of the comorbidity between neuropsychiatric and cardiovascular disorders. Within the brain this receptor participates in processes such as cognition and working memory, been implicated in effective disorders such as schizophrenia, and mediate the primary effects of hallucinogenic drugs. In the periphery, 5-HT(2A) receptors have been linked to vasoconstriction and hypertension, and to inflammatory processes that can lead to atherosclerosis.
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Chronobiology, excessive daytime sleepiness and depression: Is there a link? Sleep Med 2009; 10:505-14. [DOI: 10.1016/j.sleep.2008.05.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 04/30/2008] [Accepted: 05/02/2008] [Indexed: 11/18/2022]
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Vanhala M, Jokelainen J, Keinänen-Kiukaanniemi S, Kumpusalo E, Koponen H. Depressive symptoms predispose females to metabolic syndrome: a 7-year follow-up study. Acta Psychiatr Scand 2009; 119:137-42. [PMID: 19016666 DOI: 10.1111/j.1600-0447.2008.01283.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the risk for developing metabolic syndrome when having depressive symptoms. METHOD The prevalence of depressive symptoms and metabolic syndrome at baseline, and after a 7-year follow-up as measured with Beck depression inventory (BDI), and using the modified National Cholesterol Education Program--Adult Treatment Panel III criteria for metabolic syndrome (MetS) were studied in a middle-aged population-based sample (n = 1294). RESULTS The logistic regression analysis showed a 2.5-fold risk (95% CI: 1.2-5.2) for the females with depressive symptoms (BDI >or=10) at baseline to have MetS at the end of the follow-up. The risk was highest in the subgroup with more melancholic symptoms evaluated with a summary score of the melancholic items in BDI (OR 6.81, 95% CI: 2.09-22.20). In men, there was no risk difference. CONCLUSION The higher risks for MetS in females with depressive symptoms at baseline suggest that depression may be an important predisposing factor for the development of MetS.
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Affiliation(s)
- M Vanhala
- Unit of Family Practice, Central Hospital of Middle Finland, Jyväskylä, Finland
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41
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Sowden GL, Huffman JC. The impact of mental illness on cardiac outcomes: A review for the cardiologist. Int J Cardiol 2009; 132:30-7. [DOI: 10.1016/j.ijcard.2008.10.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2008] [Accepted: 10/01/2008] [Indexed: 11/28/2022]
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Insulin resistance and depressive symptoms in middle-aged and elderly Chinese: findings from the Nutrition and Health of Aging Population in China Study. J Affect Disord 2008; 109:75-82. [PMID: 18063093 DOI: 10.1016/j.jad.2007.11.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2007] [Revised: 11/06/2007] [Accepted: 11/06/2007] [Indexed: 11/23/2022]
Abstract
BACKGROUND Depression is associated with an increased risk of incident diabetes, and insulin resistance is thought to be the underlying link between them. Nevertheless, only a few studies have explored the association between insulin resistance and depression with contradictory results, and none have been conducted in Chinese populations. METHODS We aimed to determine the association between insulin resistance and depressive symptoms among middle-aged and elderly Chinese using data from the Nutrition and Health of Aging Population in China Study, a population-based cross-sectional study conducted in 2005 in China. Participants included 3285 community residents aged 50-70 years. Depressive symptoms were defined as a Center for Epidemiological Studies of Depression Scale (CES-D) score of 16 or higher. Insulin resistance was calculated using the updated homeostasis model assessment (HOMA2-IR) methods. RESULTS Value of HOMA2-IR was significantly higher in participants with depressive symptoms (0.284 vs. 0.261, P=0.008), even after adjustment for various confounding factors in the regression model (0.311 vs. 0.291, P=0.026). Logistical regression analyses showed that participants with depressive symptoms had a higher risk of having insulin resistance (defined as in the top quartile of HOMA2-IR values, odds ratio=1.54, 95% confidence intervals=1.17-2.04). LIMITATIONS Due to the cross-sectional study design, causal relation remains unknown. CONCLUSIONS The present study found positive associations between depressive symptoms and insulin resistance among Chinese populations. Further prospective studies are needed to validate the results and find the temporal and causal relation between them.
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Brewer JK. Behavioral genetics of the depression/cancer correlation: a look at the Ras oncogene family and the 'cerebral diabetes paradigm'. J Mol Neurosci 2008; 35:307-22. [PMID: 18563304 DOI: 10.1007/s12031-008-9078-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2008] [Accepted: 03/31/2008] [Indexed: 11/26/2022]
Abstract
This study investigates the causes of the observed linkage between depression and later onset of cancer. The prevailing view is that cancer in depressed patients results from a weakened immune system. However, molecular biologists have recognized that dysregulation of the ras proto-oncogene results in impaired serotonin and dopamine synthesis manifesting as major depression. A qualitative review of the literature showed that (1) studies using the Minnesota Multiphasic Personality Inventory showed a greater correlation between depression and later cancer onset than those employing other measures and (2) the more related the cancer type was to the Ras oncogene family, the greater the correlation between depression and later cancer onset. These results support the hypothesis that the ras proto-oncogene plays a role in the etiology of depression and could be the common denominator in long-observed depression/cancer linkages. Previous depression/cancer linkage studies are confounded in that they failed to analyze cancer type and accurately diagnose depression.
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Affiliation(s)
- Janet K Brewer
- Department of Medicine, Division of Neurosciences, Section of Neuropsychology, University of Illinois-Carle Clinic, 602 West University Avenue, Urbana, IL 61801, USA.
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Narita K, Murata T, Hamada T, Takahashi T, Kosaka H, Sudo S, Mizukami K, Yoshida H, Wada Y. Adiponectin multimer distribution, not absolute amount of plasma, correlates with depression severity in healthy elderly subjects. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:124-7. [PMID: 17761380 DOI: 10.1016/j.pnpbp.2007.07.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2007] [Revised: 07/28/2007] [Accepted: 07/28/2007] [Indexed: 11/27/2022]
Abstract
Adiponectin is an adipocyte-specific secretory protein that circulates in serum as three oligomeric complexes known as the high, medium and low molecular weight form (HMW, MMW and LMW). HMW adiponectin has been suggested to be a better predictor of metabolic variables, and it was recently reported that the ratio of HMW to total adiponectin or to LMW, not the absolute amount of plasma adiponectin, might be crucial in determining insulin sensitivity. Insulin resistance (IR) is considered to be a primary component of vascular risk factors. Although the association of depression with atherosclerotic vascular diseases has been well documented, the contribution of IR to the evolution and progression of depression-associated vascular morbidity and mortality remains unknown. The current preliminary study showed that the ratio of HMW to total adiponectin or to LMW, not the absolute amount of plasma adiponectin, was negatively associated with depression severity in healthy elderly subjects without metabolic syndrome. This pilot study supports a promising role of adiponectin multimer distribution for clarifying the pathophysiological mechanism by which depression is associated with increased risk for IR, leading to cardiovascular disease, metabolic syndrome or type 2 diabetes.
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Affiliation(s)
- Kosuke Narita
- Department of Neuropsychiatry, University of Fukui, Eiheiji-cho, Fukui 910-1193, Japan
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Are the available experimental models of type 2 diabetes appropriate for a gender perspective? Pharmacol Res 2007; 57:6-18. [PMID: 18221886 DOI: 10.1016/j.phrs.2007.11.007] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Revised: 11/20/2007] [Accepted: 11/21/2007] [Indexed: 01/01/2023]
Abstract
Several experimental models have so far been developed to improve our knowledge of the pathogenetic mechanisms of type 2 diabetes mellitus (T2D), to determine the possible pharmacological targets of this disease and to better evaluate diabetes-associated complications, e.g. the cardiovascular disease. In particular, the study of T2D gained the attention of several groups working with different animal species: rodents, cats or pigs, as well as other non-human primate species. Each of these species provided useful and different clues. However, T2D has to be considered as a gender-associated disease: sex differences play in fact a key role in the onset as well as in the progression of the disease and a higher mortality for cardiovascular diseases is detected in diabetic women with respect to men. The results obtained from all the available animal models appear to only partially address this issue so that the search for more precise information in this respect appears to be mandatory. In this review we summarize these concepts and literature in the field and propose a reappraisal of the various animal models for a study of T2D that would take into consideration a gender perspective.
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Insulin resistance and depressive symptoms in young adult males: findings from Finnish military conscripts. Psychosom Med 2007; 69:723-8. [PMID: 17942838 DOI: 10.1097/psy.0b013e318157ad2e] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate whether the association between insulin resistance (IR) and depressive symptoms is present already in young adult males. The association between IR and depression has been poorly studied, although the existence of a connection of Type II diabetes with depression is well established. We previously demonstrated at epidemiological level in two groups of men aged 31 years and 61 to 63 years that IR is linked with depressive symptoms. METHODS In a cross-sectional study, involving 1054 healthy Finnish male military conscripts of about 19 years of age, IR was defined through homeostasis model assessment (HOMA-IR). The severity of the depressive symptoms was evaluated through a Finnish modification of the 13-item Beck Depression Inventory (R-BDI). Moderate-to-severe depressive symptoms were said to be present, if the R-BDI score was > or = 8, and mild depressive symptoms were present if the R-BDI score was 5 to 7. RESULTS After adjusting for confounders, moderate-to-severe depressive symptoms increased the risk for IR, as defined by the highest decile of the HOMA-IR, up to 2.8-fold (odds ratio = 2.8; 1.2-6.5). Mild depressive symptoms were not significantly associated with IR. CONCLUSIONS In young adult males, co-occurring strictly defined IR seems to be positively associated with current moderate-to-severe depressive symptoms.
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Lustman PJ, Williams MM, Sayuk GS, Nix BD, Clouse RE. Factors influencing glycemic control in type 2 diabetes during acute- and maintenance-phase treatment of major depressive disorder with bupropion. Diabetes Care 2007; 30:459-66. [PMID: 17327305 DOI: 10.2337/dc06-1769] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Depression management in both short- and longer-term treatment studies has been associated with improvement in glycemic control. We used bupropion hydrochloride (Wellbutrin XL) to determine whether this improvement could be attributed to changes in anthropometrics or diabetes self-care. RESEARCH DESIGN AND METHODS Ninety-three patients with type 2 diabetes and major depressive disorder (MDD) received bupropion hydrochloride in a two-phase, open-label treatment trial. Those who completed the acute phase (10 weeks; n = 75) and whose depression remitted (n = 63) continued bupropion at the remission dose and were followed in the maintenance phase (24 weeks) until attrition (n = 8) or relapse of MDD (n = 0). Self-report scales were used to measure depression symptom severity and diabetes self-care behaviors. Body composition and glycemic control were determined using dual-energy X-ray absorptiometry and serial determinations of A1C. RESULTS BMI, total fat mass, and A1C decreased and composite diabetes self-care improved over the acute phase (-0.5 kg/m2, -0.7 kg, -0.5%, and +0.4, respectively, P < 0.01 for each), effects that persisted through the maintenance phase for BMI, A1C, and self-care (P < or = 0.01 for each). Reductions in BMI (B = 0.30, P = 0.01) and depression severity (B = 0.04, P = 0.046) independently predicted lower A1C after acute-phase treatment, whereas only reduction in depression severity (B = 0.08, P = 0.001) predicted A1C over the maintenance interval. CONCLUSIONS In the short term, improvement in glycemic control during bupropion treatment is predicted independently by improvements in mood and body composition. Longer-term improvements in glycemic control are predicted primarily by sustained improvement in mood via mechanisms independent of anthropometric and self-care modifications.
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Affiliation(s)
- Patrick J Lustman
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8134, St. Louis, MO 63110, USA.
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Timonen M, Rajala U, Jokelainen J, Keinänen-Kiukaanniemi S, Meyer-Rochow VB, Räsänen P. Depressive symptoms and insulin resistance in young adult males: results from the Northern Finland 1966 birth cohort. Mol Psychiatry 2006; 11:929-33. [PMID: 16702975 DOI: 10.1038/sj.mp.4001838] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The association between insulin resistance (IR) and depression is a subject of growing research interest, especially as previous population-based studies have presented conflicting findings. The present study extends our understanding about the putative impact of the severity of depressive symptoms on this association and it provides further epidemiological evidence in support of earlier findings, suggesting that the association between IR and depression is present already in young adult males. To determine the impact of the severity of depressive symptoms on the putative association between IR and depression in young adult males, we were given access to the Northern Finland 1966 Birth Cohort database. During the 31-year follow-up survey of this genetically homogeneous birth cohort, IR was assessed by 'Qualitative Insulin Sensitivity Check Index' (QUICKI), and severity of depressive symptoms by 'Hopkins' Symptom Checklist-25' (HSCL-25). This study involved 2,609 male cohort members with complete variable information. In men, the means of the QUICKI-values decreased (i.e., IR increased) in line with the increased severity of depressive symptoms as assessed by HSCL-25 subgroups (analysis of covariance P-value for trend, P=0.003). In multivariate generalized logistic regression analyses, after adjusting for confounders, IR was positively associated with current severe depressive symptoms, the odds ratio (OR) being over threefold (adjusted OR 3.15, 95% confidence interval 1.48-6.68) and the value of OR increased in parallel with a tighter definition of IR (P-value for trend=0.007). The results indicate that in young males, a positive association exists specifically with severe depressive symptoms.
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Affiliation(s)
- M Timonen
- Department of Public Health Science and General Practice, University of Oulu, Oulu, Finland
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Abstract
OBJECTIVE Nonalcoholic steatohepatitis (NASH) is a morbid liver disease with limited treatment. Depression and anxiety have been associated recently with insulin resistance and inflammatory states, factors that are relevant to the development of NASH. We hypothesized that depression and anxiety would be more prevalent in NASH patients and predict more severe histological findings on liver biopsy. METHODS Histories of major depressive disorder (MDD) and generalized anxiety disorder (GAD) were determined using a structured interview and DSM-IV criteria in 36 NASH subjects and 36 matched controls without liver disease who had undergone cholecystectomy. Histological changes on liver biopsy in NASH subjects were age-adjusted and compared in subjects with and without psychiatric disorders. A multivariate model incorporating other potential risk factors for NASH (female sex, body mass index, waist-to-hip ratio, and presence of diabetes) was used to determine independent effects of MDD and GAD on severity of histological findings. RESULTS NASH subjects had significantly increased lifetime rates of MDD (odds ratio [OR], 3.8; 95% confidence interval [CI], 1.4-10.2; p = .018) and GAD (OR 5.0, 95% CI, 1.7-14.9; p = .005). The onset of psychiatric illness preceded diagnosis of liver disease by 18 to 20 years. Each psychiatric disorder was associated with more severe histological features (p < .05 for each), the effect of GAD on fibrosis stage persisting in the multivariate model. CONCLUSIONS MDD and GAD are overrepresented in NASH subjects and are associated with more advanced liver histological abnormalities. Additional investigation will be required to determine if depression and anxiety affect the development or progression of NASH and serve as modifiable risk factors.
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Affiliation(s)
- Jill E Elwing
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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Gans ROB. The metabolic syndrome, depression, and cardiovascular disease: interrelated conditions that share pathophysiologic mechanisms. Med Clin North Am 2006; 90:573-91. [PMID: 16843763 DOI: 10.1016/j.mcna.2006.05.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This article introduces the metabolic syndrome as a clinical phenotype with consequences for diagnosis and treatment that go beyond the different clinical specialties involved. A life-course approach is suggested as a means of understanding the complex interrelations between the metabolic syndrome, depression, and cardiovascular disease. Pathophysiologic mechanisms that these conditions share are discussed in detail. These considerations provide arguments for a more integrative approach to patients in general that surpass the current disease-centered services such as endocrinology, psychiatry, and cardiology.
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Affiliation(s)
- Rijk O B Gans
- University Medical Center Groningen, Hanzeplein 1 9700 RB, Groningen, The Netherlands.
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