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Ko J, Park H, Park S, Kim DH, Cho J. Increased risk of developing cerebro-cardiovascular diseases in police officers: a nationwide retrospective cohort study. Clin Hypertens 2024; 30:18. [PMID: 38946000 PMCID: PMC11215820 DOI: 10.1186/s40885-024-00277-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/22/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Police officers face an increased risk of developing cerebro-cardiovascular diseases (CVD). However, current literature lacks population-based cohort studies specifically focusing on this association. This study aimed to investigate the association between police officers and the risk of developing CVD compared with education officers, while accounting for socioeconomic and demographic factors. METHODS We used the Korean National Health Insurance Service data spanning from 2009 to 2020. In this population-based retrospective matched cohort study, we identified age, sex, and calendar years of job-enrollment-matched education officers for each police officer. This study evaluated the CVD occurrence, including acute myocardial infarction, ischemic stroke, and hemorrhagic stroke. Using multivariable Cox regression analysis, we determined the risk of developing CVD, expressed as a hazard ratio (HR) and 95% confidence interval (CI). RESULTS Among 104,134 police officers and 104,134 education officers, 4,391(42.2%) cases and 3,631(34.9%) cases of CVD occurred, respectively. The mean ± standard deviation age was 38.4 ± 9.4 years in police officers and 38.6 ± 9.5 years in education officers. The proportion of men was 84.8 % in both groups. Police officers were significantly associated with a higher risk of developing CVD compared with education officers, with an adjusted HR of 1.15 (95% CI, 1.09-1.22). In addition, police officers had significantly higher risks for acute myocardial infarction (adjusted HR, 1.16; 95% CI, 1.06-1.26) and ischemic stroke (adjusted HR, 1.17; 95% CI, 1.09-1.25). CONCLUSIONS The findings of our study highlight a significant increase in the risk of developing CVD among police officers, particularly among those aged 45 years and older and those with uncontrolled blood pressure compared to their education officer counterparts. Future cohort studies are required to confirm this association.
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Affiliation(s)
- Juyeon Ko
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyunji Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sungha Park
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dae-Hee Kim
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jaelim Cho
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Institute of Human Complexity and Systems Science, Yonsei University, Incheon, Republic of Korea.
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Dumiaty Y, Underwood BM, Phy-Lim J, Chee MJ. Neurocircuitry underlying the actions of glucagon-like peptide 1 and peptide YY 3-36 in the suppression of food, drug-seeking, and anxiogenesis. Neuropeptides 2024; 105:102427. [PMID: 38579490 DOI: 10.1016/j.npep.2024.102427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/07/2024]
Abstract
Obesity is a critical health condition worldwide that increases the risks of comorbid chronic diseases, but it can be managed with weight loss. However, conventional interventions relying on diet and exercise are inadequate for achieving and maintaining weight loss, thus there is significant market interest for pharmaceutical anti-obesity agents. For decades, receptor agonists for the gut peptide glucagon-like peptide 1 (GLP-1) featured prominently in anti-obesity medications by suppressing appetite and food reward to elicit rapid weight loss. As the neurocircuitry underlying food motivation overlaps with that for drugs of abuse, GLP-1 receptor agonism has also been shown to decrease substance use and relapse, thus its therapeutic potential may extend beyond weight management to treat addictions. However, as prolonged use of anti-obesity drugs may increase the risk of mood-related disorders like anxiety and depression, and individuals taking GLP-1-based medication commonly report feeling demotivated, the long-term safety of such drugs is an ongoing concern. Interestingly, current research now focuses on dual agonist approaches that include GLP-1 receptor agonism to enable synergistic effects on weight loss or associated functions. GLP-1 is secreted from the same intestinal cells as the anorectic gut peptide, Peptide YY3-36 (PYY3-36), thus this review assessed the therapeutic potential and underlying neural circuits targeted by PYY3-36 when administered independently or in combination with GLP-1 to curb the appetite for food or drugs of abuse like opiates, alcohol, and nicotine. Additionally, we also reviewed animal and human studies to assess the impact, if any, for GLP-1 and/or PYY3-36 on mood-related behaviors in relation to anxiety and depression. As dual agonists targeting GLP-1 and PYY3-36 may produce synergistic effects, they can be effective at lower doses and offer an alternative approach for therapeutic benefits while mitigating undesirable side effects.
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Affiliation(s)
- Yasmina Dumiaty
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada.
| | - Brett M Underwood
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada.
| | - Jenny Phy-Lim
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada.
| | - Melissa J Chee
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada.
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3
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Stefanovics EA, Grilo CM, Potenza MN, Pietrzak RH. Obesity in Latinx and White U.S. military veterans: Mental health, psychosocial burden, non-suicidal self-injury and suicidal behavior. Psychiatry Res 2024; 335:115844. [PMID: 38484606 DOI: 10.1016/j.psychres.2024.115844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/02/2024] [Accepted: 03/07/2024] [Indexed: 04/14/2024]
Abstract
Obesity disproportionately affects Latinx communities and is linked to an increased risk of mental health problems. Military veterans are more likely to develop mental health problems, but the role of Latinx ethnicity in moderating the association between obesity and these problems is unclear. To address this gap, this study examined psychiatric and psychosocial correlates of obesity in a nationally representative sample of Latinx and White U.S. military veterans. Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed 3524 Latinx and White veterans. Analyses revealed that Latinx ethnicity moderated associations between obesity and several measures. Specifically, among veterans with obesity, Latinx veterans had higher rates of major depression, generalized anxiety, post-traumatic stress disorders, drug use disorders, non-suicidal self-injury, and higher levels of childhood trauma, loneliness, and hostility relative to White veterans. These findings underscore the importance of culturally sensitive prevention and treatment efforts to help mitigate symptoms of internalizing disorders, drug use disorder, loneliness, and hostility, and to cultivate psychosocial resources such as resilience and coping self-efficacy among Latinx veterans with obesity.
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Affiliation(s)
- Elina A Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center (MIRECC), West Haven, CT, USA; U.S. Department of Veterans Affairs National Center on Homelessness Among Veterans, Tampa, FL, USA.
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Yale Child Study Center, Yale University, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA; Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
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Barve A, Thomas Tobin CS. Cross-sectional evaluation of the multidimensional indicators of psychosocial functioning and its sociodemographic correlates among Indian adults: WHO SAGE Study (2007-2010). PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003102. [PMID: 38662761 PMCID: PMC11045086 DOI: 10.1371/journal.pgph.0003102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 03/24/2024] [Indexed: 04/28/2024]
Abstract
This study examined the relationship between sociodemographic characteristics and psychosocial functioning (PF) among Indian adults. Data (N = 11,230) for this study came from the World Health Organization's SAGE (Longitudinal Study of Global Aging and Adult Health) Wave 1 2007-2010. First, multivariable regression analyses (logistic or linear regression depending on the outcome variable) were run to evaluate whether PF indicators varied by gender after controlling other sociodemographic characteristics. Next, the relationship between sociodemographic characteristics and PF indicators was examined using ordinary least square regression (OLS) models and logistic regression models, separately for men and women. Specifically, the PF indicators, including social indicators of interpersonal relationship difficulty, social connectedness, and personal indicators of sleep, affect, perceived quality of life, and cognition were each regressed on sociodemographic factors. All analyses in the study were cross-sectional in nature and conducted using STATA version 15.1. Overall, the study found significant sociodemographic differences in PF among Indian adults that also varied by gender. As such, social and/or economic disadvantage was associated with poorer PF. However, the results demonstrated that socioeconomic patterns in PF were much more nuanced among women than among men. This study adds to previous research on PF in India and provides new insights into how sociodemographic characteristics shape it. A major research implication of this finding is that inconsistent with assumptions of previous research, an increase in SES is not always linked to proportionate increases in PF among women. The study also makes a compelling case for separately examining multiple non-clinical outcomes of psychosocial health.
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Affiliation(s)
- Apurva Barve
- Department of Community Health Sciences, University of California, Los Angeles, Los Angeles, California, United State of America
| | - Courney S. Thomas Tobin
- Department of Community Health Sciences, University of California, Los Angeles, Los Angeles, California, United State of America
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Yang J, Chen Y, Tian Y, Li X, Yu Q, Huang C, Chen Z, Ning M, Li S, He J, Du J, Huang B, Li Y. Risk factors and consequences of mental health problems in nurses: A scoping review of cohort studies. Int J Ment Health Nurs 2024. [PMID: 38622945 DOI: 10.1111/inm.13337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/02/2024] [Accepted: 04/07/2024] [Indexed: 04/17/2024]
Abstract
Mental health problems in nurses are prevalent and impairing. To date, no literature has comprehensively synthesised cohort evidence on mental health among nurses. This scoping review aimed to synthesise the existing literature on the risk factors and consequences of mental health problems in nurses. A systematic search was conducted on PubMed, EMBASE, Epistemonikos database, Web of Science, CINAHL, and PsycINFO from inception to March 2023. We identified 171 cohort studies from 16 countries, mostly (95.3%) from high-income economies. This review indicated that nurses worldwide encountered significant mental health challenges, including depression, cognitive impairment, anxiety, trauma/post-traumatic stress disorder, burnout, sleep disorder, and other negative mental health problems. These problems were closely related to various modifiable risk factors such as nurses' behaviours and lifestyles, social support, workplace bullying and violence, shift work, job demands, and job resources. Moreover, nurses' mental health problems have negative effects on their physical health, behaviour and lifestyle, occupation and organisation, and intrapersonal factors. These findings provided an enhanced understanding of mental health complexities among nurses, and shed light on policy enactment to alleviate the negative impact of mental health problems on nurses. Addressing mental health among nurses should be a top priority.
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Affiliation(s)
- Jiaxin Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- School of Computer Science and Engineering, Central South University, Changsha, Hunan, China
| | - Yamin Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Central South University, Xiangya Nursing School, Changsha, Hunan, China
| | - Yusheng Tian
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xuting Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qiang Yu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Neurosurgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chongmei Huang
- School of Nursing at Ningxia Medical University, Yinchuan, Ning Xia, China
| | - Zengyu Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Central South University, Xiangya Nursing School, Changsha, Hunan, China
| | - Meng Ning
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Central South University, Xiangya Nursing School, Changsha, Hunan, China
| | - Sini Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiaqing He
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Du
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bingqing Huang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Kim EY, Lee YB, Lee GN, Han K, Jeong SM. Associations between body weight change and incidence of major depressive disorder in patients with type 2 diabetes mellitus: a nationwide longitudinal follow-up cohort study of 1.1 million. Psychol Med 2024:1-9. [PMID: 38469866 DOI: 10.1017/s0033291724000515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
BACKGROUND Comorbid depression substantially affects the management of glycemia and diabetes-related complications among patients with type 2 diabetes mellitus. In this study, we sought to determine the association between weight change over 4 years and depression risk among patients with type 2 diabetes mellitus. METHODS This population-based retrospective cohort study from the National Health Insurance Services of Korea included 1 111 345 patients with type 2 diabetes who were divided into groups according to body weight change over 4 years. Body weight changes were compared with the preceding 4-year period (2005-2008). Depression was defined according to the International Classification of Diseases 10th revision code for depression (F32 and F33) on one or more inpatient or outpatient claims. RESULTS During a median follow-up of 7.4 years, 244 081 cases of depression were identified. We observed a U-shaped association between body weight change and depression risk with a higher risk among both groups of weight loss (hazard ratio (HR) 1.17, 95% CI 1.15-1.19 for ⩾ -10%; HR 1.07, 95% CI 1.06-1.08 for -10 to -5%) and weight gain (HR 1.06, 95% CI 1.04-1.08 for ⩾10%; HR 1.02, 95% CI 1.01-1.04 for 5-10%) compared with the stable weight group (-5 to 5%). CONCLUSIONS A U-shaped association between body weight change and depression risk was observed in this large nationwide cohort study. Our study suggests that patients with type 2 diabetes and weight change, either gain or loss, could be considered a high-risk group for depression.
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Affiliation(s)
- Eun Young Kim
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Mental Health Center, Seoul National University Health Care Center, Seoul, Republic of Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Gyu-Na Lee
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Su-Min Jeong
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Family Medicine, Seoul National University Health Service Center, Seoul, Republic of Korea
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Prevalence and short-term change in symptoms of anxiety and depression following bariatric surgery: a prospective cohort study. BMJ Open 2024; 14:e071231. [PMID: 38171620 PMCID: PMC10773381 DOI: 10.1136/bmjopen-2022-071231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 11/23/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES Bariatric surgery is an effective treatment for severe obesity that leads to significant physical health improvements. Few studies have prospectively described the short-term impact of surgery on mental health using standardised case-finding measures for anxiety or depressive disorders. This study describes the prevalence and short-term course of these conditions following surgery. DESIGN Prospective observational cohort study. SETTING 12 National Health Service centres in England. PARTICIPANTS Participants studied took part in the By-Band-Sleeve study, a multicentre randomised controlled trial evaluating the surgical management of severe obesity. We included participants who had undergone surgery (gastric bypass, gastric band or sleeve gastrectomy) within 6 months of randomisation. PRIMARY AND SECONDARY OUTCOME MEASURES Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) at baseline and 12 months post-randomisation. Sociodemographic variables collected at prerandomisation included body mass index, age, sex, ethnicity, marital status, tobacco use, employment status and income band. RESULTS In our sample of 758 participants, 94.5% (n 716) and 93.9% (n 712) had completed baseline anxiety (HADS-A) and depression (HADS-D) subscales. At pre-randomisation 46.1% (n 330/716, 95% CI 42.4% to 49.7%) met clinical case criteria for anxiety and 48.2% (n 343/712, 95% CI 44.5% to 51.8%) for depression. Among participants returning completed 12 months post-randomisation questionnaires (HADS-A n 503/716, HADS-D n 498/712), there was a significant reduction in the proportion of clinical cases with anxiety (-9.5%, 95% CI -14.3% to -4.8% p<0.001) and depression (-22.3%, 95% CI -27.0% to -17.6% p<0.001). CONCLUSIONS Almost half of people undergoing bariatric surgery had underlying anxiety or depressive symptoms. In the short term, these symptoms appear to substantially improve. Future work must identify whether these effects are sustained beyond the first post-randomisation year. TRIAL REGISTRATION NUMBER NCT02841527 and ISRCTN00786323.
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Hathaway CA, Townsend MK, Conejo-Garcia JR, Fridley BL, Moran Segura C, Nguyen JV, Armaiz-Pena GN, Sasamoto N, Saeed-Vafa D, Terry KL, Kubzansky LD, Tworoger SS. The relationship of lifetime history of depression on the ovarian tumor immune microenvironment. Brain Behav Immun 2023; 114:52-60. [PMID: 37557966 PMCID: PMC10592154 DOI: 10.1016/j.bbi.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Depression is associated with a higher ovarian cancer risk. Prior work suggests that depression can lead to systemic immune suppression, which could potentially alter the anti-tumor immune response. METHODS We evaluated the association of pre-diagnosis depression with features of the anti-tumor immune response, including T and B cells and immunoglobulins, among women with ovarian tumor tissue collected in three studies, the Nurses' Health Study (NHS; n = 237), NHSII (n = 137) and New England Case-Control Study (NECC; n = 215). Women reporting depressive symptoms above a clinically relevant cut-point, antidepressant use, or physician diagnosis of depression at any time prior to diagnosis of ovarian cancer were considered to have pre-diagnosis depression. Multiplex immunofluorescence was performed on tumor tissue microarrays to measure immune cell infiltration. In pooled analyses, we estimated odds ratios (OR) and 95% confidence intervals (CI) for the positivity of tumor immune cells using a beta-binomial model comparing those with and without depression. We used Bonferroni corrections to adjust for multiple comparisons. RESULTS We observed no statistically significant association between depression status and any immune markers at the Bonferroni corrected p-value of 0.0045; however, several immune markers were significant at a nominal p-value of 0.05. Specifically, there were increased odds of having recently activated cytotoxic (CD3+CD8+CD69+) and exhausted-like T cells (CD3+Lag3+) in tumors of women with vs. without depression (OR = 1.36, 95 %CI = 1.09-1.69 and OR = 1.24, 95 %CI = 1.01-1.53, respectively). Associations were comparable when considering high grade serous tumors only (comparable ORs = 1.33, 95 %CI = 1.05-1.69 and OR = 1.25, 95 %CI = 0.99-1.58, respectively). There were decreased odds of having tumor infiltrating plasma cells (CD138+) in women with vs. without depression (OR = 0.54, 95 %CI = 0.33-0.90), which was similar among high grade serous carcinomas, although not statistically significant. Depression was also related to decreased odds of having naïve and memory B cells (CD20+: OR = 0.54, 95 %CI = 0.30-0.98) and increased odds of IgG (OR = 1.22, 95 %CI = 0.97-1.53) in high grade serous carcinomas. CONCLUSION Our results provide suggestive evidence that depression may influence ovarian cancer outcomes through changes in the tumor immune microenvironment, including increasing T cell activation and exhaustion and reducing antibody-producing B cells. Further studies with clinical measures of depression and larger samples are needed to confirm these results.
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Affiliation(s)
| | - Mary K Townsend
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Brooke L Fridley
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Carlos Moran Segura
- Advanced Analytical and Digital Laboratory, Moffitt Cancer Center, Tampa, FL, USA
| | - Jonathan V Nguyen
- Advanced Analytical and Digital Laboratory, Moffitt Cancer Center, Tampa, FL, USA
| | - Guillermo N Armaiz-Pena
- Department of Basic Sciences, Division of Pharmacology, School of Medicine, Ponce Health Sciences University, Ponce, PR, USA
| | - Naoko Sasamoto
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Daryoush Saeed-Vafa
- Advanced Analytical and Digital Laboratory, Moffitt Cancer Center, Tampa, FL, USA; Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, FL, USA
| | - Kathryn L Terry
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA.
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Karageorgiou V, Casanova F, O'Loughlin J, Green H, McKinley TJ, Bowden J, Tyrrell J. Body mass index and inflammation in depression and treatment-resistant depression: a Mendelian randomisation study. BMC Med 2023; 21:355. [PMID: 37710313 PMCID: PMC10502981 DOI: 10.1186/s12916-023-03001-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 07/24/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) has a significant impact on global burden of disease. Complications in clinical management can occur when response to pharmacological modalities is considered inadequate and symptoms persist (treatment-resistant depression (TRD)). We aim to investigate inflammation, proxied by C-reactive protein (CRP) levels, and body mass index (BMI) as putative causal risk factors for depression and subsequent treatment resistance, leveraging genetic information to avoid confounding via Mendelian randomisation (MR). METHODS We used the European UK Biobank subcohort ([Formula: see text]), the mental health questionnaire (MHQ) and clinical records. For treatment resistance, a previously curated phenotype based on general practitioner (GP) records and prescription data was employed. We applied univariable and multivariable MR models to genetically predict the exposures and assess their causal contribution to a range of depression outcomes. We used a range of univariable, multivariable and mediation MR models techniques to address our research question with maximum rigour. In addition, we developed a novel statistical procedure to apply pleiotropy-robust multivariable MR to one sample data and employed a Bayesian bootstrap procedure to accurately quantify estimate uncertainty in mediation analysis which outperforms standard approaches in sparse binary outcomes. Given the flexibility of the one-sample design, we evaluated age and sex as moderators of the effects. RESULTS In univariable MR models, genetically predicted BMI was positively associated with depression outcomes, including MDD ([Formula: see text] ([Formula: see text] CI): 0.133(0.072, 0.205)) and TRD (0.347(0.002, 0.682)), with a larger magnitude in females and with age acting as a moderator of the effect of BMI on severity of depression (0.22(0.050, 0.389)). Multivariable MR analyses suggested an independent causal effect of BMI on TRD not through CRP (0.395(0.004, 0.732)). Our mediation analyses suggested that the effect of CRP on severity of depression was partly mediated by BMI. Individuals with TRD ([Formula: see text]) observationally had higher CRP and BMI compared with individuals with MDD alone and healthy controls. DISCUSSION Our work supports the assertion that BMI exerts a causal effect on a range of clinical and questionnaire-based depression phenotypes, with the effect being stronger in females and in younger individuals. We show that this effect is independent of inflammation proxied by CRP levels as the effects of CRP do not persist when jointly estimated with BMI. This is consistent with previous evidence suggesting that overweight contributed to depression even in the absence of any metabolic consequences. It appears that BMI exerts an effect on TRD that persists when we account for BMI influencing MDD.
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Affiliation(s)
| | | | | | - Harry Green
- College of Medicine & Health, University of Exeter, Exeter, UK
| | | | - Jack Bowden
- College of Medicine & Health, University of Exeter, Exeter, UK
- Genetics Department, Novo Nordisk Research Centre Oxford, Oxford, UK
| | - Jessica Tyrrell
- College of Medicine & Health, University of Exeter, Exeter, UK
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Wang T, Dai B, Shi H, Li H, Fan K, Zhang D, Zhou Y. Weight change across adulthood in relation to the risk of depression. Front Psychol 2023; 14:1108093. [PMID: 37621933 PMCID: PMC10446764 DOI: 10.3389/fpsyg.2023.1108093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 07/27/2023] [Indexed: 08/26/2023] Open
Abstract
Background Studies examining weight change patterns and depression are scarce and report inconsistent findings. This study-aimed to elucidate the association between weight change patterns and the risk of depression in a large, representative sample of US adults. Methods Data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 was analyzed. Five weight change groups were categorized: stable normal, weight loss, weight gain, maximum overweight, and stable obesity. Depression was ascertained using the validated Patient Health Questionnaire (PHQ-9) and depression was defined as PHQ score ≥ 10. Results A total of 17,556 participants were included. Compared with participants who maintained normal weight, stable obesity participants had increased risks of depression across adulthood from age 25 years to 10 years before the survey (OR = 1.61, 95% CI =1.23 to 2.11), in the 10 years period before the survey (OR = 2.15, 95% CI =1.71 to 2.70), and from age 25 years to survey (OR = 1.88, 95% CI =1.44 to 2.44). Weight gain was associated with an increased risk of depression from age 25 years to 10 years before the survey (OR = 1.71, 95% CI = 1.41 to 2.04), in the 10 years period before the survey (OR = 1.73, 95% CI = 1.35 to 2.21), and for the period from age 25 years to survey (OR = 1.83, 95% CI = 1.49 to 2.24). In the stratified analyses, we found statistically significant interactions with sex. Conclusion Our study suggested that stable obesity and weight gain across adulthood were associated with increased risks of depression.
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Affiliation(s)
- Tao Wang
- School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, China
- Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China
| | - Bingqin Dai
- Shandong Provincial Center for Disease Control and Prevention, Jinan, China
| | - Huanchen Shi
- School of Basic Medicine, Qingdao University, Qingdao, China
| | - Huawei Li
- School of Nursing, Qingdao University, Qingdao, China
| | - Kexin Fan
- School of Nursing, Qingdao University, Qingdao, China
| | - Dongfeng Zhang
- School of Public Health, Qingdao University, Qingdao, China
| | - Yunping Zhou
- School of Nursing, Qingdao University, Qingdao, China
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11
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Sobolewska-Nowak J, Wachowska K, Nowak A, Orzechowska A, Szulc A, Płaza O, Gałecki P. Exploring the Heart-Mind Connection: Unraveling the Shared Pathways between Depression and Cardiovascular Diseases. Biomedicines 2023; 11:1903. [PMID: 37509542 PMCID: PMC10377477 DOI: 10.3390/biomedicines11071903] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/11/2023] [Accepted: 06/15/2023] [Indexed: 07/30/2023] Open
Abstract
Civilization diseases are defined as non-communicable diseases that affect a large part of the population. Examples of such diseases are depression and cardiovascular disease. Importantly, the World Health Organization warns against an increase in both of these. This narrative review aims to summarize the available information on measurable risk factors for CVD and depression based on the existing literature. The paper reviews the epidemiology and main risk factors for the coexistence of depression and cardiovascular disease. The authors emphasize that there is evidence of a link between depression and cardiovascular disease. Here, we highlight common risk factors for depression and cardiovascular disease, including obesity, diabetes, and physical inactivity, as well as the importance of the prevention and treatment of CVD in preventing depression and other mental disorders. Conversely, effective treatment of CVD can also help prevent depression and improve mental health outcomes. It seems advisable to introduce screening tests for depression in patients treated for cardiac reasons. Importantly, in patients treated for mood disorders, it is worth controlling CVD risk factors, for example, by checking blood pressure and pulse during routine visits. It is also worth paying attention to the mental condition of patients with CVD. This study underlines the importance of interdisciplinary co-operation.
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Affiliation(s)
| | - Katarzyna Wachowska
- Department of Adult Psychiatry, Medical Univeristy of Lodz, 90-419 Lodz, Poland
| | - Artur Nowak
- Department of Immunopathology, Medical Univeristy of Lodz, 90-419 Lodz, Poland
| | - Agata Orzechowska
- Department of Adult Psychiatry, Medical Univeristy of Lodz, 90-419 Lodz, Poland
| | - Agata Szulc
- Psychiatric Clinic of the Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Olga Płaza
- Psychiatric Clinic of the Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Piotr Gałecki
- Department of Adult Psychiatry, Medical Univeristy of Lodz, 90-419 Lodz, Poland
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12
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Ye M, Kahana E, Deimling G, Perzynski A, Stange K. Beyond the treatment: The role of race, sex, and education in health trajectories between cancer survivors and noncancer older adults. J Geriatr Oncol 2023; 14:101532. [PMID: 37229884 PMCID: PMC10330899 DOI: 10.1016/j.jgo.2023.101532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/21/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION The number of older, long-term cancer survivors is increasing. However, little is known about how cancer and aging affect the health trajectories of older adults differently. In addition, the impact of race, sex, and education on the processes of aging and the cancer experience needs further investigation. The current study aims to address this knowledge gap by combining two National Cancer Institute (NIC)-funded longitudinal studies conducted in Cleveland from 1998 to 2010. MATERIALS AND METHODS The unique cross-sequential design facilitates a comparison between the health changes in long-term (five years +) older cancer survivors (breast, prostate, and colorectal cancer) and demographically matched older adults without a history of cancer in the same geographic area within the same period. The study also captured comprehensive information on how socioeconomic status interacts with cancer and aging over time. General linear models were employed in the data analysis. RESULTS The findings showed that early cancer experience did not affect long-term cancer survivors' health status in later life. Conversely, comorbidities, being an African American, being female, and having education less than a college degree significantly decreased the health trajectory in later life for all older adults. Moreover, compared to other groups, older African American cancer survivors reported a dramatic decrease in self-reported health after controlling for other conditions. DISCUSSION Study findings can inform public policy and social services to offer comprehensive treatment plans and help individuals overcome their diseases and lead longer and healthier lives.
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Affiliation(s)
- Minzhi Ye
- Kent State University The School of Lifespan Development and Educational Science, 111E, Nixson Hall, 1225 Theatre Drive, Kent, OH 44243, USA.
| | - Eva Kahana
- Case Western Reserve University Department of Sociology, Rm 226, Mather Memorial Building, 11220 Bellflower Rd, Cleveland, OH 44106, USA
| | - Gary Deimling
- Case Western Reserve University Department of Sociology, Rm 226, Mather Memorial Building, 11220 Bellflower Rd, Cleveland, OH 44106, USA
| | - Adam Perzynski
- The MetroHealth System Population Health Research Institute, 2500 Metrohealth Dr., Rammelkamp, Bldg., 2nd Floor, Cleveland, OH 44109, USA
| | - Kurt Stange
- Case Western Reserve University Center for Community Health Integration, School of Medicine 10900 Euclid Ave. Cleveland, OH 44106, USA
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13
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Leutner M, Dervic E, Bellach L, Klimek P, Thurner S, Kautzky A. Obesity as pleiotropic risk state for metabolic and mental health throughout life. Transl Psychiatry 2023; 13:175. [PMID: 37248222 DOI: 10.1038/s41398-023-02447-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 04/12/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Obesity, a highly prevalent disorder and central diagnosis of the metabolic syndrome, is linked to mental health by clinical observations and biological pathways. Patients with a diagnosis of obesity may show long-lasting increases in risk for receiving psychiatric co-diagnoses. Austrian national registry data of inpatient services from 1997 to 2014 were analyzed to detect associations between a hospital diagnosis of obesity (ICD-10: E66) and disorders grouped by level-3 ICD-10 codes. Data were stratified by age decades and associations between each pair of diagnoses were computed with the Cochran-Mantel-Haenszel method, providing odds ratios (OR) and p values corrected for multiple testing. Further, directions of the associations were assessed by calculating time-order-ratios. Receiving a diagnosis of obesity significantly increased the odds for a large spectrum of psychiatric disorders across all age groups, including depression, psychosis-spectrum, anxiety, eating and personality disorders (all pcorr < 0.01, all OR > 1.5). For all co-diagnoses except for psychosis-spectrum, obesity was significantly more often the diagnosis received first. Further, significant sex differences were found for most disorders, with women showing increased risk for all disorders except schizophrenia and nicotine addiction. In addition to the well-recognized role in promoting disorders related to the metabolic syndrome and severe cardiometabolic sequalae, obesity commonly precedes severe mental health disorders. Risk is most pronounced in young age groups and particularly increased in female patients. Consequently, thorough screening for mental health problems in patients with obesity is urgently called for to allow prevention and facilitate adequate treatment.
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Affiliation(s)
- Michael Leutner
- Department of Internal Medicine III, Clinical Division of Endocrinology and Metabolism, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Elma Dervic
- Section for Science of Complex Systems, CeMSIIS, Medical University of Vienna, Spitalgasse 23, A-1090, Vienna, Austria
- Complexity Science Hub Vienna, Josefstaedter Straße 39, 1080, Vienna, Austria
| | - Luise Bellach
- Department of Internal Medicine III, Clinical Division of Endocrinology and Metabolism, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Peter Klimek
- Section for Science of Complex Systems, CeMSIIS, Medical University of Vienna, Spitalgasse 23, A-1090, Vienna, Austria
- Complexity Science Hub Vienna, Josefstaedter Straße 39, 1080, Vienna, Austria
| | - Stefan Thurner
- Section for Science of Complex Systems, CeMSIIS, Medical University of Vienna, Spitalgasse 23, A-1090, Vienna, Austria
- Complexity Science Hub Vienna, Josefstaedter Straße 39, 1080, Vienna, Austria
| | - Alexander Kautzky
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
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14
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Zhao H, Shi H, Ren Z, He M, Cui L, Wang S, Zhao J, Li W, Wei Y, Zhang W, Chen Z, Liu H, Zhang X. Longitudinal relationship between body mass index and depressive symptoms among Chinese adults: The moderating roles of lifestyle factors and age. J Psychosom Res 2023; 170:111380. [PMID: 37244071 DOI: 10.1016/j.jpsychores.2023.111380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE This study aims to verify the moderating roles of lifestyle factors and age between body mass index (BMI), BMI trajectory and depressive symptoms of Chinese adults through a prospective design. METHODS The participants who are 18 years old and above from the China Family Panel Studies (CFPS) were included in the 2016 baseline and 2018 follow-up research. BMI was calculated according to self-report weight (kilogram) and height (centimeter). Depressive symptoms were evaluated via the Center for Epidemiologic Studies Depression (CESD-20) scale. Inverse probability-of-censoring weighted estimation (IPCW) was used to check whether selection bias existed. Modified Poisson regression was performed to calculate prevalence and risk ratios as well as 95% confidence intervals. RESULTS After adjustment, it was found that the positive associations of persistent underweight (RR = 1.154, P < 0.001) and normal weight → underweight (RR = 1.143, P < 0.001) with 2018 depressive symptoms were significant among middle-aged people, while the negative association of persistent overweight/obesity (RR = 0.972, P < 0.001) was significant in young adults. Notably, smoking moderated the relationship between baseline BMI and subsequent depressive symptoms (interaction P = 0.028). Also, exercise regularly and exercise duration weekly moderated the relationships of baseline BMI (interaction P = 0.004 and 0.015) and trajectories of BMI (interaction P = 0.008 and 0.011) with depressive symptoms among Chinese adults, respectively. CONCLUSION Weight management strategies for underweight and normal weight → underweight adults should pay attention to the role of exercise in maintaining normal weight and improving depressive symptoms.
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Affiliation(s)
- Hanfang Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hong Shi
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Li Cui
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shixun Wang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Jieyu Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Wenjun Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
| | - Yachen Wei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
| | - Wenjing Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
| | - Ziqiang Chen
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
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15
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Fang YY, Lee JI, Wu NY, Chang CI, Huang MC, Lee CY, Huang JY, Lee GGC, Chen CS. Effect of a novel telehealth device for dietary cognitive behavioral intervention in overweight or obesity care. Sci Rep 2023; 13:6441. [PMID: 37081127 PMCID: PMC10116097 DOI: 10.1038/s41598-023-33238-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/10/2023] [Indexed: 04/22/2023] Open
Abstract
Obesity has become a major public health issue which relate to numerous physical problems and highly comorbid with depression and anxiety. Recently, some studies of technology-based interventions for weight reduction emerged to overcome the barriers from time, cost and distance. Mood component and eating behavior related to obesity are less discussed so far with technology-based intervention though. This pilot study was aimed to investigate the effect of telehealth assisted intervention on weight reduction, mood status, and eating behavior change under a smartphone application (app) with novel 3D food picture recognition and incorporated with cognitive behavioral training programs. Adult aged 30-60 years old with overweight were recruited and randomly assigned to control-first group and intervention-first group. In period 1, control-first group had regular life and intervention-first group underwent app intervention; in period 2, two groups went crossover. Body composition and psychological/behavioral questionnaires were collected at baseline, end of period 1, and end of period 2. Nonparametric statistics was performed for data analyzing. A total of 20 participants were enrolled. In control-first group, there were statistically significant reduction in body weight (- 0.55 kg, p = 0.02) and change of body weight percentage (- 0.6%, p = 0.02) after App use. In intervention-first group, the fat percentage decreased by 0.4% after App use in period 1, and increased by 0.05% in period 2. The integrated crossover data revealed that subjects of App group had significant improvements in mindful eating behavior. This pilot study showed the effectiveness in using CogniNU app for weight control and eating behavior. The difference of short-term and long-term effectiveness of technology-based weight control intervention deserves more investigation in the future.Clinical Trial Registration: ISRCTN16082909.
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Affiliation(s)
- Yi-Ya Fang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jia-In Lee
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Nai-Yuan Wu
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Chiao-I Chang
- Department of Public Health and Environmental Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Meng-Chuan Huang
- Division of Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Ying Lee
- Division of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jui-Yen Huang
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Gwo Giun Chris Lee
- Department of Electrical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Cheng-Sheng Chen
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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16
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Association between adiposity and emergent depressive symptoms in a 10-years prospective cohort of older adults: The EpiFloripa Aging study. J Affect Disord 2023; 330:198-205. [PMID: 36907463 DOI: 10.1016/j.jad.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND The association between obesity and depressive symptoms has been described in the literature, but there is a scarcity of longitudinal data. This study aimed to verify the association between body mass index (BMI) and waist circumference and the incidence of depressive symptoms over a 10-year follow-up in a cohort of older adults. METHODS Data from the first (2009-2010), second (2013-2014), and third (2017-2019) waves of the EpiFloripa Aging Cohort Study were used. Depressive symptoms were assessed by the 15-item Geriatric Depression Scale (GDS-15) and classified in significant depressive symptoms for those with ≥6 points. The Generalized Estimating Equations model was used to estimate the longitudinal association between BMI and waist circumference and depressive symptoms across a 10-year follow-up. RESULTS The incidence of depressive symptoms (N = 580) was 9.9 %. The relationship between BMI and the incidence of depressive symptoms in older adults followed a U-shaped curve. Older adults with obesity had an incidence relative ratio of 76 % (IRR = 1.24, p = 0.035) for increasing the score of depressive symptoms after 10 years, compared to those with overweight. The higher category of waist circumference (Male: ≥102; Female: ≥88 cm) was associated with depressive symptoms (IRR = 1.09, p = 0.033), only in a non-adjusted analysis. LIMITATIONS Relatively high follow-up dropout rate; Few individuals in the underweight BMI category; BMI must be considered with caution because it does not measure only fat mass. CONCLUSIONS Obesity was associated with the incidence of depressive symptoms when compared with overweight in older adults.
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17
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Chrzastek Z, Guligowska A, Sobczuk P, Kostka T. Dietary factors, risk of developing depression, and severity of its symptoms in older adults-A narrative review of current knowledge. Nutrition 2023; 106:111892. [PMID: 36436336 DOI: 10.1016/j.nut.2022.111892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 10/10/2022] [Accepted: 10/19/2022] [Indexed: 11/27/2022]
Abstract
Depression is one of the most common diseases in the older population. Difficulties in recognizing its etiology and recurrence make depression a major challenge for health care professionals. The risk of developing depression is influenced by many factors, including lifestyle and diet. Research studies have shown a relationship between the consumption of specific macro- and microelements and depression. However, so far, no nutritional recommendations on how to reduce the risk of the disease and its relapses in older adults have been developed. This review outlines research results of conducted studies and focuses on both basic and potentially promising elements of diet, such as proteins, carbohydrates, fats, dietary fiber, vitamins (D, E, C, and B), and microelements such as magnesium, zinc, selenium, or iron.
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Affiliation(s)
- Zuzanna Chrzastek
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland.
| | - Agnieszka Guligowska
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Piotr Sobczuk
- Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, Lodz, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
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18
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Management of Obesity and Obesity-Related Disorders: From Stem Cells and Epigenetics to Its Treatment. Int J Mol Sci 2023; 24:ijms24032310. [PMID: 36768633 PMCID: PMC9916844 DOI: 10.3390/ijms24032310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/17/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
Obesity is a complex worldwide disease, characterized by an abnormal or excessive fat accumulation. The onset of this pathology is generally linked to a complex network of interactions among genetic and environmental factors, aging, lifestyle, and diets. During adipogenesis, several regulatory mechanisms and transcription factors are involved. As fat cells grow, adipose tissue becomes increasingly large and dysfunctional, losing its endocrine function, secreting pro-inflammatory cytokines, and recruiting infiltrating macrophages. This long-term low-grade systemic inflammation results in insulin resistance in peripheral tissues. In this review we describe the main mechanisms involved in adipogenesis, from a physiological condition to obesity. Current therapeutic strategies for the management of obesity and the related metabolic syndrome are also reported.
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19
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Rashmi R, Srivastava S, Muhammad T, Kumar M, Paul R. Indigenous population and major depressive disorder in later life: a study based on the data from Longitudinal Ageing Study in India. BMC Public Health 2022; 22:2258. [PMID: 36463131 PMCID: PMC9719225 DOI: 10.1186/s12889-022-14745-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Existing evidence suggests that the indigenous older population who live with their families and friends might experience lesser depressive symptoms due to better emotional support and well-being. The present study aimed to investigate the differentials in the prevalence of the major depressive disorder among tribal and non-tribal older populations in India and to explore the contribution of socio-demographic, health-related, and household factors in such disparities. METHODS A cross-sectional study was conducted using data from the Longitudinal Aging Study in India (2017-18). The analytical sample included 30,637 older adults, among whom 5,025 and 25,612 belonged to the Scheduled Tribe (ST) and non-Scheduled Tribe (non-ST) social groups, respectively. Major depressive disorder assessed by the Composite International Diagnostic Interview short-form (CIDI-SF) scale was the outcome variable. Descriptive statistics, bivariate and multivariable regression and, decomposition analyses were conducted. RESULTS About 4.8% and 8.9% of older adults from the ST and non-ST social groups had major depression. For both tribal and non-tribal groups, older adults who were unmarried, dissatisfied with living arrangements, and those who faced lifetime discrimination were at increased risk of major depression. Findings from differences due to characteristics (E) revealed that if the regional differences were minimized, it would decrease the ST-non-ST gap in major depression by about 19.6%. Similarly, equal self-rated health status and chronic conditions among ST and non-ST groups would decrease the gap in major depression by almost 9.6% and 7.9%, respectively. Additionally, an equal status of Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL) among older adults would decrease the gap in major depression by about 3.8% and 3% respectively. Also, findings from differences due to coefficients (C) revealed that if older adults from the ST group had the same status of ADL as of older adults from the non-ST group, it would decrease the gap in major depression by about 11.8%. CONCLUSION The findings revealed a greater prevalence of major depression in older adults belonging to the non-ST group than the ST group. For both tribal and non-tribal groups, older adults who were unmarried, dissatisfied with living arrangements, and those who faced lifetime discrimination were at increased risk of major depression and these factors along with health-related variables contributed to significant ST-non-ST gap in depression, advantageous to tribal population; suggesting further research on the coping mechanisms of mental illnesses among indigenous population in India.
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Affiliation(s)
- Rashmi Rashmi
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
| | - Shobhit Srivastava
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
| | - T. Muhammad
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
| | - Manish Kumar
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
| | - Ronak Paul
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
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Lawn RB, Murchland AR, Kim Y, Chibnik LB, Tworoger SS, Rimm EB, Sumner JA, Roberts AL, Nishimi KM, Ratanatharathorn AD, Jha SC, Koenen KC, Kubzansky LD. Trauma, psychological distress and markers of systemic inflammation among US women: A longitudinal study. Psychoneuroendocrinology 2022; 145:105915. [PMID: 36115323 PMCID: PMC10448736 DOI: 10.1016/j.psyneuen.2022.105915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Prior evidence links posttraumatic stress disorder (PTSD) and depression, separately, with chronic inflammation. However, whether effects are similar across each independently or potentiated when both are present is understudied. We evaluated combined measures of PTSD and depression in relation to inflammatory biomarker concentrations. METHODS Data are from women (n's ranging 628-2797) in the Nurses' Health Study II. Trauma exposure, PTSD, and depression symptoms were ascertained using validated questionnaires. We examined (a) a continuous combined psychological distress score summing symptoms for PTSD and depression, and (b) a categorical cross-classified measure of trauma/PTSD symptoms/depressed mood status (reference group: no trauma or depressed mood). Three inflammatory biomarkers (C-reactive protein [CRP], interleukin-6 [IL-6], tumor necrosis factor alpha receptor 2 [TNFR2]) were assayed from at least one of two blood samples collected 10-16 years apart. We examined associations of our exposures with levels of each biomarker concentration (log-transformed and batch-corrected) as available across the two time points (cross-sectional analyses; CRP, IL-6 and TNFR2) and with rate of change in biomarkers across time (longitudinal analyses; CRP and IL-6) using separate linear mixed effects models. RESULTS In sociodemographic-adjusted models accounting for trauma exposure, a one standard deviation increase in the continuous combined psychological distress score was associated with 10.2% (95% confidence interval (CI): 5.2-15.4%) higher CRP and 1.5% (95% CI: 0.5-2.5%) higher TNFR2 concentrations cross-sectionally. For the categorical exposure, women with trauma/PTSD symptoms/ depressed mood versus those with no trauma or depressed mood had 29.5% (95% CI: 13.3-47.9%) higher CRP and 13.1% (95% CI: 5.1-21.7%) higher IL-6 cross-sectionally. In longitudinal analysis, trauma/PTSD symptoms/depressed mood was associated with increasing CRP levels over time. CONCLUSIONS High psychological distress levels with trauma exposure is associated with elevated inflammation and is a potential biologic pathway by which distress can impact development of inflammatory-related chronic diseases, such as cardiovascular disease. Considering multiple forms of distress in relation to these pathways may provide greater insight into who is at risk for biologic dysregulation and later susceptibility to chronic diseases.
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Affiliation(s)
- Rebecca B Lawn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Audrey R Murchland
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Yongjoo Kim
- College of Korean Medicine, Sangji University, Wonju, Republic of Korea
| | - Lori B Chibnik
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Eric B Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jennifer A Sumner
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Andrea L Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kristen M Nishimi
- Mental Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA; Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Andrew D Ratanatharathorn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Shaili C Jha
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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21
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Muacevic A, Adler JR, Weldeslase TA, Akinyemi I, Akinwumi B, Oladunjoye AO, Ogundare T, Bezold M. Association Between Obesity and Self-Reported Depression Among Female University Students in the United States. Cureus 2022; 14:e31386. [PMID: 36514672 PMCID: PMC9741992 DOI: 10.7759/cureus.31386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
AIM To determine the relationship between obesity and depression among female undergraduate students at Western Illinois University (WIU), Macomb, Illinois. METHODS A cross-sectional study using self-reported questionnaires were conducted between August 15, 2019, and December 15, 2019. A cohort of 434 female undergraduate students was retrieved from the study. We determined the association between self-reported diagnosis of depression within the last year and body mass index (BMI) among female students. RESULTS The prevalence of depression among female undergraduates at WIU was 33.2%. Obese and overweight female undergraduate students had a higher likelihood of being diagnosed with depression than students with normal BMI (reference), overweight (OR= 1.91; 95% CI 1.11-3.31), obese (OR= 2.20; 95% CI 1.30-3.80). Latino and black students were less likely to report depression than white students, Latino (OR=0.37 95% CI 0.15-0.92), and Black (OR= 0.40; 95% CI 0.18-0.86). There was also a positive association between chronic back pain and development of the diagnosis of depression, (OR=2.26; 95% CI 1.45-3.52). CONCLUSION Depression among female undergraduate students is very common in the USA. Obese and overweight female students are more likely to be depressed than students with normal BMI. There is a need for urgent public health interventions to reduce the obesity rate among university students.
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22
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Cao B, Xu J, Li R, Teopiz KM, McIntyre RS, Chen H. Interventions targeting comorbid depression and overweight/obesity: A systematic review. J Affect Disord 2022; 314:222-232. [PMID: 35878825 DOI: 10.1016/j.jad.2022.07.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/18/2022] [Accepted: 07/17/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Overweight/obesity and depression are highly co-occurring conditions with shared pathophysiology as well as social and economic determinants. To our knowledge, this is the first systematic review aims to comprehensively synthesize extant literature with a focus on the effectiveness of interventions targeting obesity and depression comorbidity. METHODS We searched databases including MEDLINE, ProQuest Central, Web of Science, PsycINFO, Cochrane Library, from inception of the databases until Nov 12, 2021. Articles were included if they reported on the effects of pharmacological, psychological or dietary interventions on comorbid depression and overweight/obesity as their primary or secondary outcome. RESULTS Of the 5480 identified records, 19 eligible researches comprising 15 RCTs and 4 uncontrolled longitudinal studies for 3408 participants with comorbid depression and overweight/obesity. The available literature is not sufficient to inform evidence-based treatments targeting obesity and comorbid depression contemporaneously. Notwithstanding, the combination of CBT and lifestyle intervention show efficacy targeting obesity and comorbid depression as do some nutritional supplements, antidepressants and anti-diabetic agents. LIMITATIONS The high heterogeneity of various interventions in the included studies may cause a lack of comparability between different studies. CONCLUSIONS Concurrent management of depression and overweight/obesity is suggested by available data. There is a pressing need for studies that evaluate the effectiveness in real world samples of persons experiencing multiple co-occurring chronic diseases including but not limited to depression and overweight/obesity.
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Affiliation(s)
- Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China; National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing 400715, PR China.
| | - Jiatong Xu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China
| | - Ruonan Li
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China
| | - Kayla M Teopiz
- Mood Disorders Psychopharmacology Unit, University of Toronto, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University of Toronto, Canada; Canadian Rapid Treatment Center of Excellence, Mississauga, Canada
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China; National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing 400715, PR China.
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23
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Whipp AM, Heinonen-Guzejev M, Pietiläinen KH, van Kamp I, Kaprio J. Branched-chain amino acids linked to depression in young adults. Front Neurosci 2022; 16:935858. [PMID: 36248643 PMCID: PMC9561956 DOI: 10.3389/fnins.2022.935858] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Depression is a heterogeneous mental health problem affecting millions worldwide, but a majority of individuals with depression do not experience relief from initial treatments. Therefore, we need to improve our understanding of the biology of depression. Metabolomic approaches, especially untargeted ones, can suggest new hypotheses for further exploring biological mechanisms. Using the FinnTwin12 cohort, a longitudinal Finnish population-based twin cohort, with data collected in adolescence and young adulthood including 725 blood plasma samples, we investigated associations between depression and 11 low–molecular weight metabolites (amino acids and ketone bodies). In linear regression models with the metabolite (measured at age 22) as the dependent variable and depression ratings (measured at age 12, 14, 17, or 22 from multiple raters) as independent variables [adjusted first for age, sex, body mass index (BMI), and additional covariates (later)], we initially identified a significant negative association of valine with depression. Upon further analyses, valine remained significantly negatively associated with depression cross-sectionally and over time [meta-analysis beta = −13.86, 95% CI (−18.48 to −9.25)]. Analyses of the other branched-chain amino acids showed a significant negative association of leucine with depression [meta-analysis beta = −9.24, 95% CI (−14.53 to −3.95)], while no association was observed between isoleucine and depression [meta-analysis beta = −0.95, 95% CI (−6.00 to 4.11)]. These exploratory epidemiologic findings support further investigations into the role of branched-chain amino acids in depression.
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Affiliation(s)
- Alyce M. Whipp
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
- *Correspondence: Alyce M. Whipp,
| | | | - Kirsi H. Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Abdominal Center, Obesity Center, Endocrinology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Irene van Kamp
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
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Li Y, Li L, Liu J. The impact of health insurance on self-protection of Chinese rural residents. Front Public Health 2022; 10:874619. [PMID: 36187632 PMCID: PMC9523309 DOI: 10.3389/fpubh.2022.874619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 08/29/2022] [Indexed: 01/21/2023] Open
Abstract
Purpose Health insurance lowers the price of medical services, which reduces the insured's demand for self-protection (such as, live a healthy lifestyle or invest in disease prevention) that could help reduce the probability of getting sick, then ex ante moral hazard happens. The purpose of this study is to examine the impact and its heterogeneity of health insurance on the self-protection of Chinese rural residents. Method This study firstly builds a theoretical model of health insurance and self-protection. Then, based on the data from the 2004 to 2015 China Health and Nutrition Survey (CHNS), we adopt ordinary least squares model (OLS), probit model, and instrumental variable (IV) method to empirically investigate the impact of health insurance on Chinese rural residents' self-protection. Results After addressing the endogeneity problem, the study finds that participating in health insurance exerts a significant negative impact on the demand for self-protection. Specifically, health insurance participation not only increases residents' tendency toward drinking liquor by 3.4%, and that of having general obesity by 3.7%, but also reduces residents' preventive medical expenditure (PME) by 1.057%, increasing Body Mass Index (BMI) by 0.784 kg/m2. Further analysis shows that there is heterogeneity between groups, as health insurance participation reduces PME of people who are female, younger, and high-educated, and increases the tendency toward drinking liquor of people who are younger and low-educated. Conclusions To reduce the impact of ex ante moral hazard induced by health insurance, our findings suggest that it is necessary to improve the disease prevention function of health insurance and introduce a risk adjustment mechanism into the premium or co-payment design of health insurance.
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Affiliation(s)
- Yao Li
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Lei Li
- School of Economics, Zhongnan University of Economics and Law, Wuhan, China,*Correspondence: Lei Li
| | - Junxia Liu
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
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25
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FOND G, FERNANDES S, LUCAS G, Greenberg N, BOYER L. Depression in healthcare workers: results from the nationwide AMADEUS survey. Int J Nurs Stud 2022; 135:104328. [PMID: 35952535 PMCID: PMC9359895 DOI: 10.1016/j.ijnurstu.2022.104328] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 10/31/2022]
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26
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Mental Stress and Cardiovascular Health-Part I. J Clin Med 2022; 11:jcm11123353. [PMID: 35743423 PMCID: PMC9225328 DOI: 10.3390/jcm11123353] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/05/2022] [Accepted: 06/09/2022] [Indexed: 12/30/2022] Open
Abstract
Epidemiological studies have shown that a substantial proportion of acute coronary events occur in individuals who lack the traditional high-risk cardiovascular (CV) profile. Mental stress is an emerging risk and prognostic factor for coronary artery disease and stroke, independently of conventional risk factors. It is associated with an increased rate of CV events. Acute mental stress may develop as a result of anger, fear, or job strain, as well as consequence of earthquakes or hurricanes. Chronic stress may develop as a result of long-term or repetitive stress exposure, such as job-related stress, low socioeconomic status, financial problems, depression, and type A and type D personality. While the response to acute mental stress may result in acute coronary events, the relationship of chronic stress with increased risk of coronary artery disease (CAD) is mainly due to acceleration of atherosclerosis. Emotionally stressful stimuli are processed by a network of cortical and subcortical brain regions, including the prefrontal cortex, insula, amygdala, hypothalamus, and hippocampus. This system is involved in the interpretation of relevance of environmental stimuli, according to individual’s memory, past experience, and current context. The brain transduces the cognitive process of emotional stimuli into hemodynamic, neuroendocrine, and immune changes, called fight or flight response, through the autonomic nervous system and the hypothalamic–pituitary–adrenal axis. These changes may induce transient myocardial ischemia, defined as mental stress-induced myocardial ischemia (MSIMI) in patients with and without significant coronary obstruction. The clinical consequences may be angina, myocardial infarction, arrhythmias, and left ventricular dysfunction. Although MSIMI is associated with a substantial increase in CV mortality, it is usually underestimated because it arises without pain in most cases. MSIMI occurs at lower levels of cardiac work than exercise-induced ischemia, suggesting that the impairment of myocardial blood flow is mainly due to paradoxical coronary vasoconstriction and microvascular dysfunction.
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27
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Chua MWJ. An Old Ally to Address the 'Triple Threat'. Am J Med 2022; 135:678-679. [PMID: 34808101 DOI: 10.1016/j.amjmed.2021.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 11/01/2022]
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28
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PPARγ Dysfunction in the Medial Prefrontal Cortex Mediates High-Fat Diet-Induced Depression. Mol Neurobiol 2022; 59:4030-4043. [DOI: 10.1007/s12035-022-02806-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/16/2022] [Indexed: 11/25/2022]
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Martín-Peláez S, Serra-Majem L, Cano-Ibáñez N, Martínez-González MÁ, Salas-Salvadó J, Corella D, Lassale C, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Fernández-Aranda F, Bueno-Cavanillas A, Tur JA, Martín V, Pintó X, Delgado-Rodríguez M, Matía P, Vidal J, Vázquez C, Daimiel L, Ros E, Toledo E, Nishi SK, Sorli JV, Malcampo M, Zulet MÁ, Moreno-Rodríguez A, Cueto-Galán R, Vivancos-Aparicio D, Colom A, García-Ríos A, Casas R, Bernal-López MR, Santos-Lozano JM, Vázquez Z, Gómez-Martínez C, Ortega-Azorín C, del Val JL, Abete I, Goikoetxea-Bahon A, Pascual E, Becerra-Tomás N, Chillarón JJ, Sánchez-Villegas A. Contribution of cardio-vascular risk factors to depressive status in the PREDIMED-PLUS Trial. A cross-sectional and a 2-year longitudinal study. PLoS One 2022; 17:e0265079. [PMID: 35417452 PMCID: PMC9007355 DOI: 10.1371/journal.pone.0265079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/13/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cardio-vascular disease and depression are thought to be closely related, due to shared risk factors. The aim of the study was to determine the association between cardio-vascular risk (CVR) factors and depressive status in a population (55-75 years) with metabolic syndrome (MetS) from the PREDIMED-Plus trial. METHODS AND FINDINGS Participants were classified into three groups of CVR according to the Framingham-based REGICOR function: (1) low (LR), (2) medium (MR) or (3) high/very high (HR). The Beck Depression Inventory-II (BDI-II) was used to assess depressive symptoms at baseline and after 2 years. The association between CVR and depressive status at baseline (n = 6545), and their changes after 2 years (n = 4566) were evaluated through multivariable regression models (logistic and linear models). HR women showed higher odds of depressive status than LR [OR (95% CI) = 1.78 (1.26, 2.50)]. MR and HR participants with total cholesterol <160 mg/mL showed higher odds of depression than LR [OR (95% CI) = 1.77 (1.13, 2.77) and 2.83 (1.25, 6.42) respectively)] but those with total cholesterol ≥280 mg/mL showed lower odds of depression than LR [OR (95% CI) = 0.26 (0.07, 0.98) and 0.23 (0.05, 0.95), respectively]. All participants decreased their BDI-II score after 2 years, being the decrease smaller in MR and HR diabetic compared to LR [adjusted mean±SE = -0.52±0.20, -0.41±0.27 and -1.25±0.31 respectively). MR and HR participants with total cholesterol between 240-279 mg/mL showed greater decreases in the BDI-II score compared to LR (adjusted mean±SE = -0.83±0.37, -0.77±0.64 and 0.97±0.52 respectively). CONCLUSIONS Improving cardiovascular health could prevent the onset of depression in the elderly. Diabetes and total cholesterol in individuals at high CVR, may play a specific role in the precise response. International Standard Randomized Controlled Trial (ISRCTN89898870).
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Affiliation(s)
- Sandra Martín-Peláez
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- * E-mail:
| | - Lluis Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Miguel Ángel Martínez-González
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarre, Pamplona, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Jordi Salas-Salvadó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Reus, Spain
- University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Camille Lassale
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
| | - Jose Alfredo Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain
- Precision Nutrition Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Ángel M. Alonso-Gómez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Nursing, School of Health Sciences. University of Malaga- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Jesús Vioque
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH. Alicante, Spain
| | - Dora Romaguera
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - José López-Miranda
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
| | - Ramón Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Internal Medicine, Institut dÌnvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Francisco J. Tinahones
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, Málaga, Spain
| | - José Lapetra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Fernando Fernández-Aranda
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Josep A. Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Vicente Martín
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Xavier Pintó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Miguel Delgado-Rodríguez
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Center for Advanced Studies in Olive Grove and Olive Oils, University of Jaén, Jaén, Spain
| | - Pilar Matía
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Josep Vidal
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Institut dÌnvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Clotilde Vázquez
- Department of Endocrinology and Nutrition, Hospital Fundación Jiménez-Díaz, Instituto de Investigaciones Biomédicas IISFJD. University Autónoma, Madrid, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Emili Ros
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigació Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain
| | - Estefanía Toledo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarre, Pamplona, Spain
| | - Stephanie K. Nishi
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Reus, Spain
- University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Jose V. Sorli
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Mireia Malcampo
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
| | - M. Ángeles Zulet
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain
| | - Anaí Moreno-Rodríguez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Raquel Cueto-Galán
- Department of Nursing, School of Health Sciences. University of Malaga- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | | | - Antoni Colom
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Antonio García-Ríos
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
| | - Rosa Casas
- Department of Internal Medicine, Institut dÌnvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - M Rosa Bernal-López
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, Málaga, Spain
| | - Jose Manuel Santos-Lozano
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Zenaida Vázquez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarre, Pamplona, Spain
| | - Carlos Gómez-Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Reus, Spain
- University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | | | - Jose Luís del Val
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
| | - Itziar Abete
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain
| | - Amaia Goikoetxea-Bahon
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Elena Pascual
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarre, Pamplona, Spain
| | - Nerea Becerra-Tomás
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Reus, Spain
- University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Juan J. Chillarón
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
| | - Almudena Sánchez-Villegas
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Institute for Innovation & Sustainable Development in Food Chain. Universidad Pública de Navarra (UPNA), IdisNA, Pamplona, Spain
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OUP accepted manuscript. Nutr Rev 2022; 80:2178-2197. [DOI: 10.1093/nutrit/nuac025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Akkaya Demir S, Akder RN, Meseri R. Is it chicken or the egg: Obesity, anxiety and depression in hospital workers. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2021. [DOI: 10.3233/mnm-211567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Healthcare workers are susceptible to obesity, anxiety and depression. OBJECTIVE: To determine the prevalence and association of obesity, anxiety and depression symptoms in individuals working in a hospital. METHODS: In this cross-sectional study all of the employees of a hospital were invited to participate (n = 150). Anxiety (via Beck Anxiety Scale) and depression symptoms (via Beck Depression Scale) and obesity were dependent and independent variables. Obesity was determined both with body mass index (BMI) and abdominal obesity (Waist circumference-WC). Data were collected with face-to-face interviews and anthropometric measurements were done. Data were analyzed using SPSS version 25.0 with student t-test, chi-square and correlation tests. Significance was set at a p-value < 0.05. RESULTS: Among the participants who agreed to participate (n = 131, 64.1% females), 35.1% were obese and 50.4% were abdominally obese. The 35.9% had moderate-severe anxiety symptoms, 19.1% had moderate-severe depression symptoms. Both BMI and WC had positive, moderate and significant correlation with anxiety and depression scores. After adjusting for socio-demographic variables obesity (both with BMI and WC) was an independent factor for anxiety and depression symptom presence, whereas after adjusted for these variables anxiety and depression symptom presence was an independent factor for obesity and abdominal obesity (p = 0.001 for all). CONCLUSIONS: There is a correlation between anxiety, depression and obesity. In addition to nutrition interventions in combating obesity, services that will improve mental health should be provided together as teamwork.
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Affiliation(s)
| | - Rana Nagihan Akder
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ege University, Izmir, Turkey
| | - Reci Meseri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ege University, Izmir, Turkey
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Yoosuf S, Gupta G, Bhargava R, Kumar N, Ranjan P, Pandey RM, Pandey S, Vikram NK. Magnitude of psychiatric comorbidity in patients with obesity in Northern Indian population. Diabetes Metab Syndr 2021; 15:102270. [PMID: 34509138 DOI: 10.1016/j.dsx.2021.102270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS To determine the prevalence of different psychiatric comorbidities in patients with obesity and study their relationship with the degrees of obesity. METHODS This cross-sectional study included 151 patients with a BMI≥25 kg/m2. Subjects with diagnosed psychiatric illness, type 2 diabetes mellitus, coronary artery disease or any neurological illness were excluded. Prevalence of psychiatric comorbidities was assessed by MINI screening tool for all major axis 1 disorders including anxiety, eating and mood disorders. The WHOQOL-BREF was used for assessment of well-being, in the four domains, physical, psychological, social and environmental. RESULTS Females constituted 68.6% of the study population. Lifetime diagnosis of any psychiatric illness was present in 24%, higher in females than males [31% vs 9%, p = 0.003]. The WHOQOL-BREF average scores of psychological, physical and environmental domains were significantly lower (p < 0.001) in patients diagnosed with depression as compared to those without. The WHOQOL-BREF average score of only the physical domain were significantly lower in individuals with BMI ≥30 kg/m2 as compared to those with BMI <30 kg/m2. CONCLUSIONS The burden of undiagnosed psychiatric comorbidity in patients with obesity decreases the quality of life. There is need to screen for psychiatric comorbidities for effective management of obesity.
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Affiliation(s)
| | | | | | - Nand Kumar
- Departments of Psychiatry and NDDTC, India
| | | | - Ravindra M Pandey
- Departments of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Shivam Pandey
- Departments of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
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Abstract
After participating in this activity, learners should be better able to:• Identify risk factors for late-life depression• Evaluate strategies to prevent late-life depression ABSTRACT: Late-life depression (LLD) is one of the major sources of morbidity and mortality in the world. Because LLD is related to increased public health burden, excess health care costs and utilization, reduced quality of life, and increased mortality, prevention is a priority. Older adults differ from younger adults with respect to key features, such as their chronicity and lifetime burden of depression and their constellation of comorbidities and risk factors. LLD likely arises from a complex interplay of risk factors, including medical, physiologic, psychosocial, behavioral, and environmental factors. Thus, a comprehensive understanding of LLD risk factors is necessary to inform prevention strategies. In this narrative literature review, we address both the risk architecture of LLD and several potential strategies for prevention. Our description of LLD risk factors and prevention approaches is informed by the framework developed by the National Academy of Medicine (formerly, Institute of Medicine), which includes indicated, selective, and universal approaches to prevention.
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Salinero-Fort MA, Gómez-Campelo P, Cárdenas-Valladolid J, San Andrés-Rebollo FJ, de Miguel-Yanes JM, de Burgos-Lunar C. Effect of depression on mortality in type 2 diabetes mellitus after 8 years of follow-up. The DIADEMA study. Diabetes Res Clin Pract 2021; 176:108863. [PMID: 33992707 DOI: 10.1016/j.diabres.2021.108863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 04/18/2021] [Accepted: 05/11/2021] [Indexed: 11/28/2022]
Abstract
AIM To assess the effect of depression on all-cause mortality in patients with type 2 diabetes mellitus (T2DM) followed up during 8 years in primary care in Spain. METHODS Depression was diagnosed according to MINI 5.0.0 questionnaire, physician-diagnosis or following antidepressant therapy for at least two months in 3923 people with T2DM. We analyzed mortality-rates/10,000 person-years. We compared survival according to baseline depression with Kaplan-Meier estimates and the log-rank test. We performed Cox proportional hazard model analyses. RESULTS Baseline depression was diagnosed in 22.1% of participants. Mortality was higher in patients with depression (31.9% vs. 26.9%; p = 0.003), who had a significantly poorer survival (median survival = 7.4 vs. 7.8 years, respectively; Log Rank = 15.83; p < 0.001). Depression showed an adjusted mortality hazard ratio (HR) = 1.40 (95%CI:1.20-1.65; p < 0.001). The strongest predictive factors were: age >75 years (HR = 6.04; 95%CI:4.62-7.91; p < 0.001), insulin use (HR = 2.37; 95%CI:1.86-3.00; p < 0.001), lower limb amputation (HR = 1.99; 95%CI:1.28-3.11; p = 0.002), heart failure (HR = 1.94; 95%CI:1.63-2.30; p < 0.001), and male gender (HR = 1.90; 95%CI:1.59-2.27). CONCLUSION In a Spanish cohort of older T2DM patients, depression was associated with a higher mortality risk. More efforts are needed to minimize the influence of depression on mortality in people with T2DM and to implement measures that allow its early diagnosis and effective treatment.
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Affiliation(s)
- M A Salinero-Fort
- Subdirección General de Investigación Sanitaria, Consejería de Sanidad de Madrid, Spain; Fundación de Investigación e Innovación Biosanitaria de Atención Primaria, Madrid, Spain; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain; Grupo de Investigación en Envejecimiento y Fragilidad, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain.
| | - P Gómez-Campelo
- Grupo de Investigación en Envejecimiento y Fragilidad, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain; Fundación de Investigación Biomédica del Hospital Universitario La Paz, Madrid, Spain
| | - J Cárdenas-Valladolid
- Fundación de Investigación e Innovación Biosanitaria de Atención Primaria, Madrid, Spain; Grupo de Investigación en Envejecimiento y Fragilidad, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain; Dirección Técnica de Sistemas de Información Sanitaria, Gerencia Asistencial de Atención Primaria, Madrid, Spain
| | - F J San Andrés-Rebollo
- Fundación de Investigación e Innovación Biosanitaria de Atención Primaria, Madrid, Spain; Centro de Salud Las Calesas, Gerencia Asistencial de Atención Primaria, Madrid, Spain
| | - J M de Miguel-Yanes
- Instituto de Investigación Sanitaria del Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - C de Burgos-Lunar
- Fundación de Investigación e Innovación Biosanitaria de Atención Primaria, Madrid, Spain; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain; Grupo de Investigación en Envejecimiento y Fragilidad, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain; Hospital Universitario Clínico de San Carlos, Madrid, Spain
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Comparison of High-Intensity Training Versus Moderate-Intensity Continuous Training on Cardiorespiratory Fitness and Body Fat Percentage in Persons With Overweight or Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Phys Act Health 2021; 18:610-623. [PMID: 33837165 DOI: 10.1123/jpah.2020-0335] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND High-intensity training is comprised of sprint interval training (SIT) and high-intensity interval training (HIIT). This study compared high-intensity training with moderate-intensity continuous training (MICT) on cardiorespiratory fitness (CRF) and body fat percentage for overweight or obese persons. METHODS A systematic search of randomized controlled trials using the health science databases occurred up to April, 2020. Twenty-six studies were included for complete analysis. A total of 784 participations were analyzed. The unstandardized mean difference for each outcome measurement was extracted from the studies and pooled with the random effects model. RESULTS MICT was significantly better at improving CRF compared with SIT (mean difference = -0.92; 95% confidence interval, -1.63 to -0.21; P = .01; I2 = 10%). Furthermore, there was no significant difference between MICT versus HIIT on CRF (mean difference = -0.52; 95% confidence interval, -1.18 to 0.13; P = .12; I2 = 23%). There was no significant difference in body fat percentage between MICT versus HIIT and MICT versus SIT. CONCLUSIONS MICT was significantly better at improving CRF than SIT in overweight or obese persons.
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Stefan N, Birkenfeld AL, Schulze MB. Global pandemics interconnected - obesity, impaired metabolic health and COVID-19. Nat Rev Endocrinol 2021; 17:135-149. [PMID: 33479538 DOI: 10.1038/s41574-020-00462-1] [Citation(s) in RCA: 267] [Impact Index Per Article: 89.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2020] [Indexed: 02/07/2023]
Abstract
Obesity and impaired metabolic health are established risk factors for the non-communicable diseases (NCDs) type 2 diabetes mellitus, cardiovascular disease, neurodegenerative diseases, cancer and nonalcoholic fatty liver disease, otherwise known as metabolic associated fatty liver disease (MAFLD). With the worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), obesity and impaired metabolic health also emerged as important determinants of severe coronavirus disease 2019 (COVID-19). Furthermore, novel findings indicate that specifically visceral obesity and characteristics of impaired metabolic health such as hyperglycaemia, hypertension and subclinical inflammation are associated with a high risk of severe COVID-19. In this Review, we highlight how obesity and impaired metabolic health increase complications and mortality in COVID-19. We also summarize the consequences of SARS-CoV-2 infection for organ function and risk of NCDs. In addition, we discuss data indicating that the COVID-19 pandemic could have serious consequences for the obesity epidemic. As obesity and impaired metabolic health are both accelerators and consequences of severe COVID-19, and might adversely influence the efficacy of COVID-19 vaccines, we propose strategies for the prevention and treatment of obesity and impaired metabolic health on a clinical and population level, particularly while the COVID-19 pandemic is present.
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Affiliation(s)
- Norbert Stefan
- Institute of Diabetes Research and Metabolic Diseases (IDM), the Helmholtz Center, Munich, Germany.
- Department of Internal Medicine IV, Division of Endocrinology, Diabetology and Nephrology, University Hospital of Tübingen, Tübingen, Germany.
- German Center for Diabetes Research (DZD), Neuherberg, Germany.
| | - Andreas L Birkenfeld
- Institute of Diabetes Research and Metabolic Diseases (IDM), the Helmholtz Center, Munich, Germany
- Department of Internal Medicine IV, Division of Endocrinology, Diabetology and Nephrology, University Hospital of Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Department of Diabetes, School of Life Course Science, King's College London, London, UK
| | - Matthias B Schulze
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
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Depression is associated with increased adiposity in a 4-year follow-up: results from the ELSA-Brasil. J Affect Disord 2021; 282:179-186. [PMID: 33418365 DOI: 10.1016/j.jad.2020.12.091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/30/2020] [Accepted: 12/22/2020] [Indexed: 11/21/2022]
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Yusufov M, Kopeski LM, Silverman AL, Björgvinsson T. Associations of Body Weight and Waist Circumference with Psychopathology, Substance Use, and Well-Being in an Adult Transdiagnostic Sample. J Affect Disord 2021; 281:279-288. [PMID: 33341010 DOI: 10.1016/j.jad.2020.12.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 11/10/2020] [Accepted: 12/05/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Prior studies have established inconsistent associations between body weight and mental health. However, most work has relied on body mass index (BMI) and examination of a single mental health variable. The present study examined associations of BMI and waist circumference with multiple mental health variables in a transdiagnostic psychiatric sample. METHODS Nursing staff measured waist circumference and calculated the BMI of 742 adults (54.6% female, 45.4% male) presenting for psychiatric treatment. Participants completed the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), Behavior and Symptom Identification Scale (BASIS-24), and Mental Health Continuum-Short Form (MHC-SF) as part of standard clinical monitoring. Suicide risk was assessed using the clinician-administered Mini International Neuropsychiatric Interview (M.I.N.I.). For curve fit estimation regression models, we entered BMI and waist circumference as independent variables separately; we entered seven dependent variables separately: 1) depression, 2) anxiety, 3) substance use, 4) self-harm, 5) interpersonal functioning, 6) well-being, and 7) suicide risk. RESULTS Increased BMI was associated with decreased well-being and increased depression. Increased waist circumference was associated with worse interpersonal functioning. Non-linear (quadratic) associations were observed between weight and depression, substance use, self-harm, and suicide. LIMITATIONS Most of the sample was White and only 2.6% was in the underweight category, limiting broad applicability of findings. Cross-sectional design precludes causal attributions. CONCLUSIONS Given associations between well-being, depression, interpersonal functioning, substance use, self-harm, and suicide with weight, findings may be used to inform mental health treatment, particularly by tailoring interventions to high-risk weight categories (underweight, obese) in psychiatric populations.
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Affiliation(s)
- Miryam Yusufov
- Dana-Farber Cancer Institute, Department of Psychosocial Oncology & Palliative Care, 450 Brookline Avenue, Boston, MA 02215; McLean Hospital, Behavioral Health Partial Program, 115 Mill Street, Belmont, MA 02478; Harvard Medical School, Department of Psychiatry, Boston, MA 02115.
| | - Lynne M Kopeski
- McLean Hospital, Behavioral Health Partial Program, 115 Mill Street, Belmont, MA 02478
| | | | - Thröstur Björgvinsson
- McLean Hospital, Behavioral Health Partial Program, 115 Mill Street, Belmont, MA 02478; Harvard Medical School, Department of Psychiatry, Boston, MA 02115
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Pistis G, Milaneschi Y, Vandeleur CL, Lasserre AM, Penninx BW, Lamers F, Boomsma DI, Hottenga JJ, Marques-Vidal P, Vollenweider P, Waeber G, Aubry JM, Preisig M, Kutalik Z. Obesity and atypical depression symptoms: findings from Mendelian randomization in two European cohorts. Transl Psychiatry 2021; 11:96. [PMID: 33542229 PMCID: PMC7862438 DOI: 10.1038/s41398-021-01236-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/12/2021] [Accepted: 01/15/2021] [Indexed: 02/08/2023] Open
Abstract
Studies considering the causal role of body mass index (BMI) for the predisposition of major depressive disorder (MDD) based on a Mendelian Randomization (MR) approach have shown contradictory results. These inconsistent findings may be attributable to the heterogeneity of MDD; in fact, several studies have documented associations between BMI and mainly the atypical subtype of MDD. Using a MR approach, we investigated the potential causal role of obesity in both the atypical subtype and its five specific symptoms assessed according to the Statistical Manual of Mental Disorders (DSM), in two large European cohorts, CoLaus|PsyCoLaus (n = 3350, 1461 cases and 1889 controls) and NESDA|NTR (n = 4139, 1182 cases and 2957 controls). We first tested general obesity measured by BMI and then the body fat distribution measured by waist-to-hip ratio (WHR). Results suggested that BMI is potentially causally related to the symptom increase in appetite, for which inverse variance weighted, simple median and weighted median MR regression estimated slopes were 0.68 (SE = 0.23, p = 0.004), 0.77 (SE = 0.37, p = 0.036), and 1.11 (SE = 0.39, p = 0.004). No causal effect of BMI or WHR was found on the risk of the atypical subtype or for any of the other atypical symptoms. Our findings show that higher obesity is likely causal for the specific symptom of increase in appetite in depressed participants and reiterate the need to study depression at the granular level of its symptoms to further elucidate potential causal relationships and gain additional insight into its biological underpinnings.
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Affiliation(s)
- Giorgio Pistis
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Yuri Milaneschi
- grid.420193.d0000 0004 0546 0540Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Vrije Universiteit Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - Caroline L. Vandeleur
- grid.8515.90000 0001 0423 4662Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Aurélie M. Lasserre
- grid.8515.90000 0001 0423 4662Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Brenda W.J.H. Penninx
- grid.420193.d0000 0004 0546 0540Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Vrije Universiteit Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - Femke Lamers
- grid.420193.d0000 0004 0546 0540Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Vrije Universiteit Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - Dorret I. Boomsma
- grid.12380.380000 0004 1754 9227Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Jouke-Jan Hottenga
- grid.12380.380000 0004 1754 9227Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Pedro Marques-Vidal
- grid.8515.90000 0001 0423 4662Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Peter Vollenweider
- grid.8515.90000 0001 0423 4662Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Gérard Waeber
- grid.8515.90000 0001 0423 4662Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean-Michel Aubry
- grid.150338.c0000 0001 0721 9812Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland
| | - Martin Preisig
- grid.8515.90000 0001 0423 4662Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Zoltán Kutalik
- grid.9851.50000 0001 2165 4204Institute of Primary Care and Public Health (Unisante), University of Lausanne, Lausanne, Switzerland ,grid.419765.80000 0001 2223 3006Swiss Institute of Bioinformatics, Lausanne, Switzerland
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McGlennon TW, Buchwald JN, Pories WJ, Yu F, Roberts A, Ahnfeldt EP, Menon R, Buchwald H. Part 2: Bypassing TBI-Metabolic Surgery and the Link Between Obesity and Traumatic Brain Injury-A Review. Obes Surg 2021; 31:26-35. [PMID: 33405185 DOI: 10.1007/s11695-020-05142-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/30/2020] [Accepted: 11/30/2020] [Indexed: 01/22/2023]
Abstract
Obesity is a common outcome of traumatic brain injury (TBI) that exacerbates principal TBI symptom domains identified as common areas of post-TBI long-term dysfunction. Obesity is also associated with increased risk of later-life dementia and Alzheimer's disease. Patients with obesity and chronic TBI may be more vulnerable to long-term mental abnormalities. This review explores the question of whether weight loss induced by bariatric surgery could delay or perhaps even reverse the progression of mental deterioration. Bariatric surgery, with its induction of weight loss, remission of type 2 diabetes, and other expressions of the metabolic syndrome, improves metabolic efficiency, leads to reversal of brain lesions seen on imaging studies, and improves function. These observations suggest that metabolic/bariatric surgery may be the most effective therapy for TBI.
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Affiliation(s)
- T W McGlennon
- Statistics Division, McGlennon MotiMetrics, Maiden Rock, WI, USA
| | - J N Buchwald
- Division of Scientific Research Writing, Medwrite, Maiden Rock, WI, USA
| | - Walter J Pories
- Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Fang Yu
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | | | - Eric P Ahnfeldt
- Uniformed Services University of the Health Sciences, Bethesda, MA, USA
| | - Rukmini Menon
- Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Henry Buchwald
- University of Minnesota Medical School, Minneapolis, MN, USA.
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Moh MC, Low S, Ng TP, Ang SF, Ang K, Sum CF, Subramaniam T, Lim SC. Association between depressive symptoms and pulse wave velocity is mediated by increased adiposity in older adults with type 2 diabetes. J Psychiatry Neurosci 2021; 46:E176-E183. [PMID: 33464781 PMCID: PMC7955836 DOI: 10.1503/jpn.200080] [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] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Studies investigating the association between depression and aortic stiffness in older patients with type 2 diabetes are lacking. We postulated an association between depressive symptoms and aortic stiffness, and this relationship may be mediated by increased adiposity. METHODS We analyzed participants with type 2 diabetes aged 55 years or older (n = 958). We measured aortic stiffness using carotid-femoral pulse wave velocity (cut-off ≥ 12 m/s) using the tonometry method. We defined depressive symptoms as a score of greater than 5 on the Geriatric Depression Scale-15 (GDS-15). Adiposity indices we assessed were body mass index, waist circumference, waistto-height ratio, visceral fat area and fat mass. RESULTS Among the participants, 27.2% had aortic stiffness, of whom 6.5% had depressive symptoms. Score on the GDS-15 was correlated with pulse wave velocity, and both variables were correlated with the adiposity markers we analyzed (all p < 0.05). Depressive symptoms were associated with pulse wave velocity (B = 1.79, 95% confidence interval [CI] 0.83-2.75) or aortic stiffness (risk ratio 1.60, 95% CI 1.10-2.33) in the unadjusted model. The association persisted after controlling for demographics, duration of diabetes, glycated hemoglobin, comorbidities and medications. Further adjustment for visceral fat area and fat mass in separate models reduced the association between depressive symptoms and pulse wave velocity or aortic stiffness. Mediation models revealed that the mediation proportions of fat mass and visceral fat area on the association between depressive symptoms and pulse wave velocity were 11.8% and 9.7%, respectively. A preliminary analysis of longitudinal data (n = 184) showed similar findings. LIMITATIONS Causality cannot be inferred from the associations we observed. CONCLUSION Depressive symptoms are associated with elevated pulse wave velocity in older people with type 2 diabetes, and this relationship may be partially mediated by increased adiposity.
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Affiliation(s)
- Mei Chung Moh
- From the Clinical Research Unit, Khoo Teck Puat Hospital, Singapore (Moh, Low, S. Ang, K. Ang, Subramaniam, Lim); the Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore (Low, Sum, Subramaniam, Lim); the Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (Ng); and the Saw Swee Hock School of Public Health, National University Hospital, Singapore (Lim)
| | - Serena Low
- From the Clinical Research Unit, Khoo Teck Puat Hospital, Singapore (Moh, Low, S. Ang, K. Ang, Subramaniam, Lim); the Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore (Low, Sum, Subramaniam, Lim); the Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (Ng); and the Saw Swee Hock School of Public Health, National University Hospital, Singapore (Lim)
| | - Tze Pin Ng
- From the Clinical Research Unit, Khoo Teck Puat Hospital, Singapore (Moh, Low, S. Ang, K. Ang, Subramaniam, Lim); the Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore (Low, Sum, Subramaniam, Lim); the Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (Ng); and the Saw Swee Hock School of Public Health, National University Hospital, Singapore (Lim)
| | - Su Fen Ang
- From the Clinical Research Unit, Khoo Teck Puat Hospital, Singapore (Moh, Low, S. Ang, K. Ang, Subramaniam, Lim); the Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore (Low, Sum, Subramaniam, Lim); the Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (Ng); and the Saw Swee Hock School of Public Health, National University Hospital, Singapore (Lim)
| | - Keven Ang
- From the Clinical Research Unit, Khoo Teck Puat Hospital, Singapore (Moh, Low, S. Ang, K. Ang, Subramaniam, Lim); the Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore (Low, Sum, Subramaniam, Lim); the Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (Ng); and the Saw Swee Hock School of Public Health, National University Hospital, Singapore (Lim)
| | - Chee Fang Sum
- From the Clinical Research Unit, Khoo Teck Puat Hospital, Singapore (Moh, Low, S. Ang, K. Ang, Subramaniam, Lim); the Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore (Low, Sum, Subramaniam, Lim); the Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (Ng); and the Saw Swee Hock School of Public Health, National University Hospital, Singapore (Lim)
| | - Tavintharan Subramaniam
- From the Clinical Research Unit, Khoo Teck Puat Hospital, Singapore (Moh, Low, S. Ang, K. Ang, Subramaniam, Lim); the Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore (Low, Sum, Subramaniam, Lim); the Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (Ng); and the Saw Swee Hock School of Public Health, National University Hospital, Singapore (Lim)
| | - Su Chi Lim
- From the Clinical Research Unit, Khoo Teck Puat Hospital, Singapore (Moh, Low, S. Ang, K. Ang, Subramaniam, Lim); the Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore (Low, Sum, Subramaniam, Lim); the Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (Ng); and the Saw Swee Hock School of Public Health, National University Hospital, Singapore (Lim)
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Moriarity DP, Horn SR, Kautz MM, Haslbeck JMB, Alloy LB. How handling extreme C-reactive protein (CRP) values and regularization influences CRP and depression criteria associations in network analyses. Brain Behav Immun 2021; 91:393-403. [PMID: 33342465 PMCID: PMC7753060 DOI: 10.1016/j.bbi.2020.10.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/10/2020] [Accepted: 10/20/2020] [Indexed: 12/11/2022] Open
Abstract
Increasingly, it has been recognized that analysis at the symptom, rather than diagnostic, level will drive progress in the field of immunopsychiatry. Network analysis offers a useful tool in this pursuit with the ability to identify associations between immune markers and individual symptoms, independent of all other variables modeled. However, investigation into how methodological decisions (i.e., including vs. excluding participants with C-reactive protein (CRP) >10 mg/L, regularized vs. nonregularized networks) influence results is necessary to establish best practices for the use of network analysis in immunopsychiatry. In a sample of 3,464 adult participants from the 2015-2016 National Health and Nutrition Examination Survey dataset, this study found consistent support for associations between CRP and fatigue and changes in appetite and some support for additional CRP-criterion associations. Methodologically, results consistently demonstrated that including individuals with CRP >10 mg/L and estimating nonregularized networks provided better estimates of these associations. Thus, we recommend considering the use of nonregularized networks in immunopsychiatry and inclusion of cases with CRP values >10 mg/L when testing the association between CRP and depression criteria, unless contraindicated by the research question being tested. Additionally, results most consistently suggest that CRP is uniquely related to fatigue and changes in appetite, supporting their inclusion in an immunometabolic phenotype of depression. Finally, these associations suggest that fatigue and changes in appetite might be particularly receptive to anti-inflammatory treatments. However, future research with more nuanced measures is necessary to parse out whether appetite increases or decreases drive this association. Further, longitudinal research is an important next step to test how these relationships manifest over time.
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Affiliation(s)
- Daniel P Moriarity
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA 19122, United States.
| | - Sarah R Horn
- Department of Psychology, University of Oregon, 1227 University St, Eugene, OR 97403, United States
| | - Marin M Kautz
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA 19122, United States
| | | | - Lauren B Alloy
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA 19122, United States
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Roberts AL, Kubzansky LD, Chibnik LB, Rimm EB, Koenen KC. Association of Posttraumatic Stress and Depressive Symptoms With Mortality in Women. JAMA Netw Open 2020; 3:e2027935. [PMID: 33275156 PMCID: PMC7718604 DOI: 10.1001/jamanetworkopen.2020.27935] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/08/2020] [Indexed: 01/26/2023] Open
Abstract
Importance Consistent evidence has found associations between posttraumatic stress disorder (PTSD) and increased risk of chronic disease and greater prevalence of health risk factors. However, the association between PTSD and all-cause mortality has not been thoroughly investigated in civilians. Objective To investigate the association between PTSD symptoms, with or without comorbid depressive symptoms, and risk of death. Design, Setting, and Participants This prospective cohort study was conducted using data on female US nurses in the Nurses' Health Study II followed up from 2008 to 2017. Women who responded to a 2008 questionnaire querying PTSD and depressive symptoms were included. Data were analyzed from September 2018 to November 2020. Exposures Symptoms of PTSD, measured using the short screening scale for Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) PTSD, and depression symptoms, measured using the Center for Epidemiologic Studies Depression Scale-10 in 2008. Main Outcomes and Measures All-cause mortality was determined via National Death Index, US Postal Service, or report of participant's family. The hypothesis being tested was formulated after data collection. Trauma exposure and PTSD symptoms were jointly coded as no trauma exposure (reference), trauma and no PTSD symptoms, 1 to 3 PTSD symptoms (subclinical), 4 to 5 PTSD symptoms (moderate), and 6 to 7 PTSD symptoms (high). Results Among 51 602 women (50 137 [97.2%] White individuals), the mean (range) age was 53.3 (43-64) years at study baseline in 2008. PTSD and probable depression were comorbid; of 4019 women with high PTSD symptoms, 2093 women (52.1%) had probable depression, while of 10 105 women with no trauma exposure, 1215 women (12.0%) had probable depression. Women with high PTSD symptoms and probable depression were at nearly 4-fold greater risk of death compared with women with no trauma exposure and no depression (hazard ratio [HR], 3.80; 95% CI, 2.65-5.45; P < .001). After adjustment for health factors, women with these conditions had a more than 3-fold increased risk (HR, 3.11; 95% CI, 2.16-4.47, P < .001). Women with subclinical PTSD symptoms without probable depression had increased risk of death compared with women with no trauma exposure and no depression (HR, 1.43; 95% CI, 1.06-1.93; P = .02). Among 7565 women with PTSD symptoms and probable depression, 109 deaths (1.4%) occurred for which we obtained cause of death information, compared with 124 such deaths (0.6% ) among 22 215 women with no depression or PTSD symptoms. Women with PTSD symptoms and probable depression, compared with women with no PTSD or depression, had higher rates of death from cardiovascular disease (17 women [0.22%] vs 11 women [0.05%]; P < .001), diabetes (4 women [0.05%] vs 0 women; P < .001), unintentional injury (7 women [0.09%] vs 7 women [0.03%]; P = .03), suicide (9 women [0.12%] vs 1 woman [<0.01%]; P < .001), and other causes of death (14 women [0.19%] vs 17 women [0.08%]; P = .01). Conclusions and Relevance These findings suggest that at midlife, women with high PTSD symptoms and co-occurring probable depression are at increased risk of death compared with women without these disorders. Treatment of PTSD and depression in women with symptoms of both disorders and efforts to improve their health behaviors may reduce their increased risk of mortality.
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Affiliation(s)
| | | | - Lori B. Chibnik
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Eric B. Rimm
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Czernichow S, Beeker N, Rives‐Lange C, Guerot E, Diehl J, Katsahian S, Hulot J, Poghosyan T, Carette C, Jannot A. Obesity Doubles Mortality in Patients Hospitalized for Severe Acute Respiratory Syndrome Coronavirus 2 in Paris Hospitals, France: A Cohort Study on 5,795 Patients. Obesity (Silver Spring) 2020; 28:2282-2289. [PMID: 32815621 PMCID: PMC7461006 DOI: 10.1002/oby.23014] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/07/2020] [Accepted: 08/11/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Preliminary data from different cohorts of small sample size or with short follow-up indicate poorer prognosis in people with obesity compared with other patients. This study aims to precisely describe the strength of association between obesity in patients hospitalized with coronavirus disease 2019 (COVID-19) and mortality and to clarify the risk according to usual cardiometabolic risk factors in a large cohort. METHODS This is a prospective cohort study including 5,795 patients aged 18 to 79 years hospitalized from February 1 to April 30, 2020, in the Paris area, with confirmed infection by severe acute respiratory syndrome coronavirus 2. Adjusted regression models were used to estimate the odds ratios (ORs) and 95% CIs for the mortality rate at 30 days across BMI classes, without and with imputation for missing BMI values. RESULTS Eight hundred ninety-one deaths had occurred at 30 days. Mortality was significantly raised in people with obesity, with the following ORs for BMI of 30 to 35 kg/m2 , 35 to 40 kg/m2 , and >40 kg/m2 : 1.89 (95% CI: 1.45-2.47), 2.79 (95% CI: 1.95-3.97), and 2.55 (95% CI: 1.62-3.95), respectively (18.5-25 kg/m2 was used as the reference class). This increase holds for all age classes. CONCLUSIONS Obesity doubles mortality in patients hospitalized with COVID-19.
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Affiliation(s)
- Sébastien Czernichow
- Université de ParisParisFrance
- Department of NutritionSpecialized Obesity CenterHôpital Européen Georges PompidouAssistance Publique–Hôpitaux de ParisParisFrance
- Epidemiology and Biostatistics Sorbonne Paris City CenterUMR1153Institut National de la Santé et de la Recherche MédicaleParisFrance
| | - Nathanael Beeker
- Université de ParisParisFrance
- Clinical Research UnitHôpital CochinAssistance Publique–Hôpitaux de ParisParisFrance
| | - Claire Rives‐Lange
- Université de ParisParisFrance
- Department of NutritionSpecialized Obesity CenterHôpital Européen Georges PompidouAssistance Publique–Hôpitaux de ParisParisFrance
- Epidemiology and Biostatistics Sorbonne Paris City CenterUMR1153Institut National de la Santé et de la Recherche MédicaleParisFrance
| | - Emmanuel Guerot
- Université de ParisParisFrance
- Department of Intensive Care MedicineHôpital Européen Georges PompidouAssistance Publique–Hôpitaux de ParisParisFrance
| | - Jean‐Luc Diehl
- Université de ParisParisFrance
- Department of Intensive Care MedicineHôpital Européen Georges PompidouAssistance Publique–Hôpitaux de ParisParisFrance
| | - Sandrine Katsahian
- Université de ParisParisFrance
- Department of Medical Informatics, Biostatistics, and Public HealthHôpital Européen Georges PompidouAssistance Publique–Hôpitaux de ParisParisFrance
- Department of Information Sciences to Support Personalized MedicineCentre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de ParisParisFrance
| | - Jean‐Sébastien Hulot
- Université de ParisParisFrance
- Clinical Investigation Center 1418Hôpital Européen Georges PompidouAssistance Publique–Hôpitaux de ParisParisFrance
- Cardiovascular, Renal, Transplants, and Neurovascular Medical University DepartmentHôpital Européen Georges PompidouAssistance Publique–Hôpitaux de ParisParisFrance
| | - Tigran Poghosyan
- Université de ParisParisFrance
- Department of Digestive, Oncological, and Bariatric SurgeryHôpital Européen Georges PompidouAssistance Publique–Hôpitaux de ParisParisFrance
| | - Claire Carette
- Université de ParisParisFrance
- Department of NutritionSpecialized Obesity CenterHôpital Européen Georges PompidouAssistance Publique–Hôpitaux de ParisParisFrance
- Clinical Investigation Center 1418Hôpital Européen Georges PompidouAssistance Publique–Hôpitaux de ParisParisFrance
| | - Anne‐Sophie Jannot
- Université de ParisParisFrance
- Department of Medical Informatics, Biostatistics, and Public HealthHôpital Européen Georges PompidouAssistance Publique–Hôpitaux de ParisParisFrance
- Department of Information Sciences to Support Personalized MedicineCentre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de ParisParisFrance
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Chepulis L, Morison B, Lao C, Keenan R, Paul R, Lawrenson R. The prevalence of mental health medication use in a cohort of New Zealand patients with diabetes. Prim Care Diabetes 2020; 14:703-708. [PMID: 32723664 DOI: 10.1016/j.pcd.2020.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 06/08/2020] [Accepted: 07/16/2020] [Indexed: 11/18/2022]
Abstract
AIMS Diabetes is associated with depression, anxiety and psychosis via complex bidirectional relationships that are affected by factors such as the type of diabetes and socioeconomic status. The aim of the study was to estimate the prevalence of mental health conditions in patients with diabetes in a New Zealand primary care population using proxy medication dispensing data. METHODS Primary care data (July 1 2016 - June 30, 2018) was collected from the Patient Management System of 15 different general practices, and was linked via National Health Index number to clinical records at the Waikato District Health Board and the New Zealand Ministry of Health Pharmaceutical database. RESULTS A total of 3978 patients with diabetes were identified from an enrolled patient population of 74,250. Of these, 18.0% of patients with diabetes were dispensed an antidepressant, anxiolytic, or antipsychotic. These medications were prescribed more in New Zealand Europeans (20.9% versus 13.9% in Māori), women, type 2 diabetes, those on insulin, and those with a higher BMI (all P<0.001). CONCLUSIONS Approximately one fifth of patients with diabetes in primary care have mental health disorders. Appropriate management requires concomitant treatment of both the diabetes and the mental health disorder to improve patient outcomes.
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Affiliation(s)
- Lynne Chepulis
- Waikato Medical Research Centre, University of Waikato, Hamilton, New Zealand.
| | - Brittany Morison
- Waikato Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - Chunhuan Lao
- Waikato Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - Rawiri Keenan
- Waikato Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - Ryan Paul
- Waikato Medical Research Centre, University of Waikato, Hamilton, New Zealand; Waikato Regional Diabetes Service, Waikato District Health Board, Hamilton, New Zealand
| | - Ross Lawrenson
- Waikato Medical Research Centre, University of Waikato, Hamilton, New Zealand; Waikato Regional Diabetes Service, Waikato District Health Board, Hamilton, New Zealand
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Personality Functioning in Obesity and Binge Eating Disorder: Combining a Psychodynamic and Trait Perspective. J Psychiatr Pract 2020; 26:472-484. [PMID: 33275384 DOI: 10.1097/pra.0000000000000513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE There is preliminary evidence for an association between personality traits and binge eating disorder (BED) in obese patients. In addition, recent studies have shown impaired psychodynamic personality functioning in BED. However, these results are partly inconsistent. The goal of this study was to explore and evaluate personality traits and personality functioning in obese patients with BED or subthreshold BED. Moreover, we aimed to explore the additional value of combined assessment of personality traits and personality functioning. METHODS Treatment-seeking obese female patients with BED (n=129) or subthreshold BED (n=91) were compared with obese (n=107) and nonobese (n=90) female community controls in terms of personality traits (using the Temperament and Character Inventory) and personality functioning (using the Developmental Profile Inventory) in univariate and multivariate analyses. RESULTS Harm Avoidance was higher and Self-Directedness was lower in obese patients with BED or subthreshold BED compared with obese and nonobese community controls. In addition, obese patients with BED or subthreshold BED presented more maladaptive and less adaptive personality functioning than controls. Although univariate analyses did not find significant differences in personality traits or personality functioning between obese patients with BED and those with subthreshold BED, when both personality traits and personality functioning were combined in multivariate analysis (data from both the Temperament and Character Inventory and Developmental Profile Inventory), obese patients with BED showed greater vulnerabilities in personality traits and functioning than obese patients with subthreshold BED. CONCLUSIONS Obese patients with BED or subthreshold BED had specific impairments in personality traits and personality functioning. Combined assessment indicated that patients with BED had the most vulnerable personality profile of the 4 groups. The results support the added value of assessment of both personality traits and psychodynamic personality functioning, in line with the alternative Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) model for personality disorders.
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Dragano NRV, Fernø J, Diéguez C, López M, Milbank E. Reprint of: Recent Updates on Obesity Treatments: Available Drugs and Future Directions. Neuroscience 2020; 447:191-215. [PMID: 33046217 DOI: 10.1016/j.neuroscience.2020.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In the last thirty years, obesity has reached epidemic proportions and is now regarded as a major health issue in contemporary society trending to serious economic and social burdens. The latest projections of the World Health Organization are alarming. By 2030, nearly 60% of the worldwide population could be either obese or overweight, highlighting the needs to find innovative treatments. Currently, bariatric surgery is the most effective way to efficiently lower body mass. Although great improvements in terms of recovery and patient care were made in these surgical procedures, bariatric surgery remains an option for extreme forms of obesity and seems unable to tackle obesity pandemic expansion. Throughout the last century, numerous pharmacological strategies targeting either peripheral or central components of the energy balance regulatory system were designed to reduce body mass, some of them reaching sufficient levels of efficiency and safety. Nevertheless, obesity drug therapy remains quite limited on its effectiveness to actually overcome the obesogenic environment. Thus, innovative unimolecular polypharmacology strategies, able to simultaneously target multiple actors involved in the obesity initiation and expansion, were developed during the last ten years opening a new promising avenue in the pharmacological management of obesity. In this review, we first describe the clinical features of obesity-associated conditions and then focus on the outcomes of currently approved drug therapies for obesity as well as new ones expecting to reach the clinic in the near future.
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Affiliation(s)
- Nathalia R V Dragano
- NeurObesity Group, Department of Physiology, CiMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela 15782, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 15706, Spain.
| | - Johan Fernø
- Hormone Laboratory, Haukeland University Hospital, N-5021 Bergen, Norway
| | - Carlos Diéguez
- NeurObesity Group, Department of Physiology, CiMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela 15782, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 15706, Spain
| | - Miguel López
- NeurObesity Group, Department of Physiology, CiMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela 15782, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 15706, Spain
| | - Edward Milbank
- NeurObesity Group, Department of Physiology, CiMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela 15782, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 15706, Spain.
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Braga SP, Delanogare E, Machado AE, Prediger RD, Moreira ELG. Switching from high-fat feeding (HFD) to regular diet improves metabolic and behavioral impairments in middle-aged female mice. Behav Brain Res 2020; 398:112969. [PMID: 33075395 DOI: 10.1016/j.bbr.2020.112969] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/18/2020] [Accepted: 10/10/2020] [Indexed: 12/30/2022]
Abstract
Obesity represents a risk factor for metabolic syndrome and cardiovascular and psychiatric disorders. Excessive caloric intake, particularly in dietary fats, is an environmental factor that contributes to obesity development. Thus, the observation that switching from long-standing dietary obesity to standard diet (SD) can ameliorate the high-fat diet-induced metabolic, memory, and emotionality-related impairments are particularly important. Herein we investigated whether switching from the high-fat diet (HFD) to SD could improve the metabolic and behavioral impairments observed in middle-aged females C57Bl/6 mice. During twelve weeks, the animals received a high-fat diet (61 % fat) or SD diet. After 12-weeks, the HFD group's diet was switched to SD for an additional four weeks. It was observed a progressive deleterious effect of HFD in metabolic and behavioral parameters in mice. After four weeks of HFD-feeding, the animals showed glucose intolerance and increased locomotor activity. A subsequent increase in the body mass gain, hyperglycemia, and depressive-like behavior was observed after eight weeks, and memory impairments after twelve weeks. After replacing the HFD to SD, it was observed an improvement of metabolic (loss of body mass, normal plasma glucose levels, and glucose tolerance) and behavioral (absence of memory and emotional alterations) parameters. These results demonstrate the temporal development of metabolic and behavioral impairments following HFD in middle-age female mice and provide new evidence that these alterations can be improved by switching back the diet to SD.
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Affiliation(s)
- Sara Pereira Braga
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, SC, Brazil
| | - Eslen Delanogare
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, SC, Brazil
| | - Adriano Emanuel Machado
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, SC, Brazil
| | - Rui Daniel Prediger
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, SC, Brazil; Departamento de Farmacologia, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, SC, Brazil
| | - Eduardo Luiz Gasnhar Moreira
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, SC, Brazil; Programa de Pós-Graduação em Neurociências, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, SC, Brazil; Departamento de Ciências Fisiológicas, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, SC, Brazil.
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Hwang AC, Lee WJ, Peng LN, Liu LK, Lin MH, Loh CH, Chen LK. Unfavorable body composition and quality of life among community-dwelling middle-aged and older adults: What really matters? Maturitas 2020; 140:34-40. [DOI: 10.1016/j.maturitas.2020.05.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/19/2020] [Accepted: 05/29/2020] [Indexed: 12/25/2022]
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50
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Okereke OI, Reynolds CF, Mischoulon D, Chang G, Vyas CM, Cook NR, Weinberg A, Bubes V, Copeland T, Friedenberg G, Lee IM, Buring JE, Manson JE. Effect of Long-term Vitamin D3 Supplementation vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores: A Randomized Clinical Trial. JAMA 2020; 324:471-480. [PMID: 32749491 PMCID: PMC7403921 DOI: 10.1001/jama.2020.10224] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
IMPORTANCE Low levels of 25-hydroxyvitamin D have been associated with higher risk for depression later in life, but there have been few long-term, high-dose large-scale trials. OBJECTIVE To test the effects of vitamin D3 supplementation on late-life depression risk and mood scores. DESIGN, SETTING, AND PARTICIPANTS There were 18 353 men and women aged 50 years or older in the VITAL-DEP (Vitamin D and Omega-3 Trial-Depression Endpoint Prevention) ancillary study to VITAL, a randomized clinical trial of cardiovascular disease and cancer prevention among 25 871 adults in the US. There were 16 657 at risk for incident depression (ie, no depression history) and 1696 at risk for recurrent depression (ie, depression history but no treatment for depression within the past 2 years). Randomization occurred from November 2011 through March 2014; randomized treatment ended on December 31, 2017, and this was the final date of follow-up. INTERVENTION Randomized assignment in a 2 × 2 factorial design to vitamin D3 (2000 IU/d of cholecalciferol) and fish oil or placebo; 9181 were randomized to vitamin D3 and 9172 were randomized to matching placebo. MAIN OUTCOMES AND MEASURES The primary outcomes were the risk of depression or clinically relevant depressive symptoms (total of incident and recurrent cases) and the mean difference in mood scores (8-item Patient Health Questionnaire depression scale [PHQ-8]; score range, 0 points [least symptoms] to 24 points [most symptoms]; the minimal clinically important difference for change in scores was 0.5 points). RESULTS Among the 18 353 randomized participants (mean age, 67.5 [SD, 7.1] years; 49.2% women), the median treatment duration was 5.3 years and 90.5% completed the trial (93.5% among those alive at the end of the trial). Risk of depression or clinically relevant depressive symptoms was not significantly different between the vitamin D3 group (609 depression or clinically relevant depressive symptom events; 12.9/1000 person-years) and the placebo group (625 depression or clinically relevant depressive symptom events; 13.3/1000 person-years) (hazard ratio, 0.97 [95% CI, 0.87 to 1.09]; P = .62); there were no significant differences between groups in depression incidence or recurrence. No significant differences were observed between treatment groups for change in mood scores over time; mean change in PHQ-8 score was not significantly different from zero (mean difference for change in mood scores, 0.01 points [95% CI, -0.04 to 0.05 points]). CONCLUSIONS AND RELEVANCE Among adults aged 50 years or older without clinically relevant depressive symptoms at baseline, treatment with vitamin D3 compared with placebo did not result in a statistically significant difference in the incidence and recurrence of depression or clinically relevant depressive symptoms or for change in mood scores over a median follow-up of 5.3 years. These findings do not support the use of vitamin D3 in adults to prevent depression. TRIAL REGISTRATION ClinicalTrials.gov Identifiers: NCT01169259 and NCT01696435.
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Affiliation(s)
- Olivia I. Okereke
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Charles F. Reynolds
- Department of Psychiatry, UPMC and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - David Mischoulon
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Grace Chang
- Department of Psychiatry, VA Boston Healthcare System, Brockton, Massachusetts
| | - Chirag M. Vyas
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Nancy R. Cook
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Alison Weinberg
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Vadim Bubes
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Trisha Copeland
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Georgina Friedenberg
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - I-Min Lee
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Julie E. Buring
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - JoAnn E. Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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