1
|
Van Dyne A, Wu TC, Adamowicz DH, Lee EE, Tu XM, Eyler LT. Longitudinal relationships between BMI and hs-CRP among people with schizophrenia. Schizophr Res 2024; 271:337-344. [PMID: 39089101 DOI: 10.1016/j.schres.2024.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 08/03/2024]
Abstract
In people with schizophrenia (PwS), inflammation and metabolic issues significantly increase morbidity and mortality. However, our ability to understand inflammatory-metabolic mechanisms in this population has been limited to cross-sectional studies. This study involved 169 PwS and 156 non-psychiatric comparisons (NCs), aged 25-65, observed between 2012 and 2022 with 0 to 5 follow-ups post-baseline. High-sensitivity C-reactive protein (hs-CRP), a marker of inflammation, was measured via a particle-enhanced immuno-turbidimetric assay. Body mass index (BMI) was used as a proxy for metabolic function. The measurement intervals for hs-CRP and BMI ranged between 6 and 48 months. Linear mixed models (LMM) results revealed that at all time points, PwS has a higher hs-CRP (t (316) = 4.73, p < .001) and BMI (t (315) = 4.13, p < .001) than NCs; however, for BMI, this difference decreased over time (t (524) = -5.15, p < .001). To study interrelationships between hs-CRP and BMI, continuous time structural equational modeling (CTSEM) was used, accounting for uneven measurement intervals. CTSEM results showed that both hs-CRP predicted future BMI (Est. = 12.91, 95 % CI [7.70; 17.88]) and BMI predicted future hs-CRP (Est. = 1.54, 95 % CI [1.00; 2.04]), indicating a bidirectional relationship between inflammation and metabolic function. Notably, the influence of hs-CRP on future BMI was more robust than the other lagged relationship (p = .015), especially in PwS (Est. = 2.43, 95 % CI [0.39; 0.97]). Our study highlights the important role of inflammation in metabolic function and offers insights into potential interventions targeting inflammation in PwS.
Collapse
Affiliation(s)
- Angelina Van Dyne
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States of America.
| | - Tsung-Chin Wu
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
| | - David H Adamowicz
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States of America
| | - Ellen E Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States of America; VA San Diego Healthcare System, La Jolla, CA, United States of America
| | - Xin M Tu
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States of America; VA San Diego Healthcare System, La Jolla, CA, United States of America
| |
Collapse
|
2
|
Osmari DG, Garcez A, Dias-da-Costa JS, Olinto MTA. Association between obesity and common mental disorders in women: a population-based study in Southern Brazil. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1577-1585. [PMID: 37410161 DOI: 10.1007/s00127-023-02530-z] [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: 09/18/2022] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE The study aimed to investigate the relationship between obesity and common mental disorders (CMD) among women. METHODS This is a cross-sectional population-based study with a representative sample of 981 adult women (20-60 years of age) living in the urban area of the municipality of São Leopoldo, RS, Brazil, in 2015. The presence of CMD was assessed using the Self-Reporting Questionnaire (SRQ-20 ≥ 8). Obesity was defined by body mass index (BMI ≥ 30.0 kg/m2). Prevalence ratios (PRs) for the association between obesity and CMD were measured by Poisson regression with robust variance, including their respective 95% confidence intervals (CIs). RESULTS The mean age of the sample was 40.3 years (standard deviation = 11.4 years). The prevalence of CMD was 33.7% (95% CI 30.8-36.7), while obesity was 31.2% (95% CI 28.3-34.1). The occurrence of CMD was higher in women with low levels of education and belonging to lower economic class, as well as smokers and those who were insufficiently active. Obesity was more prevalent in older women (50-60 years old) with less schooling, who did not consume alcohol, and those who were insufficiently active. After adjusting for potential confounding factors, women with obesity were 22% more likely to have CMD when compared to those without obesity (PR = 1.22; 95% CI 1.02-1.45; p = 0.030). CONCLUSIONS This study demonstrated a significant association between obesity and the presence of CMD among women. Additionally, the prevalence of obesity and CMD were high in this population group.
Collapse
Affiliation(s)
- Débie Garlet Osmari
- Post-Graduate Program in Collective Health, University of Vale do Rio dos Sinos, UNISINOS, São Leopoldo, RS, Brazil
| | - Anderson Garcez
- Post-Graduate Program in Nutrition Sciences, Federal University of Health Science of Porto Alegre, UFCSPA, Porto Alegre, RS, Brazil
| | - Juvenal Soares Dias-da-Costa
- Post-Graduate Program in Collective Health, University of Vale do Rio dos Sinos, UNISINOS, São Leopoldo, RS, Brazil
| | - Maria Teresa Anselmo Olinto
- Post-Graduate Program in Food, Nutrition and Health, Federal University of Rio Grande do Sul, UFRGS, R. Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, CEP 90035-002, Brazil.
- Post-Graduate Program in Medical Sciences: Endocrinology, Federal University of Rio Grande do Sul State, UFRGS, Porto Alegre, RS, Brazil.
| |
Collapse
|
3
|
Bonin S, Harnois-Leblanc S, Béland M, Simoneau G, Mathieu MÈ, Barnett TA, Sabiston CM, Henderson M. The association between depressive symptoms and overweight or obesity in prepubertal children: Findings from the QUALITY cohort. J Affect Disord 2024; 367:486-495. [PMID: 39187203 DOI: 10.1016/j.jad.2024.08.138] [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: 12/13/2023] [Revised: 07/31/2024] [Accepted: 08/23/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Youth obesity and depression are public health concerns. Although meta-analyses suggest a positive association between those conditions in adults and adolescents, evidence remains unclear in prepubertal children. We examined the bidirectional associations between levels of depressive symptoms and weight status in 8-10-year-old children with a parental history of obesity, over two years, and whether they differ by sex. METHODS Data were drawn from the QUebec Adipose and Lifestyle InvesTigation in Youth Cohort Study's baseline and first follow-up evaluations (n = 558). Depressive symptoms were assessed using the 12-item Center for Epidemiological Studies Depression scale and weight status using body mass index z-scores based on World Health Organization standards. Linear and logistic regression models were used to test the directionality and magnitude of the associations, adjusting for age, sex, physical activity, screen time, parental education, alcohol and cigarette use, and baseline outcome measure. RESULTS Children with higher levels of depressive symptoms at baseline were not more likely to have overweight/obesity at follow-up (odds ratio [95 % Coefficient Interval] = 0.95[0.88;1.02]). Baseline overweight/obesity was not associated with subsequent higher levels of depressive symptoms (beta coefficient [95 % Coefficient Interval] = 0.20 [-0.47;0.87]). No sex differences emerged. LIMITATIONS Selection bias may have occurred due to loss at follow-up (10 % attrition) and exclusion of 6 participants taking mood disorder medication. CONCLUSIONS Unlike in adults and adolescents, no association between weight status and depressive symptoms was observed in childhood over two years. Underlying mechanisms linking both conditions later in life may not apply as early as prepubertal childhood.
Collapse
Affiliation(s)
- Sarah Bonin
- Research center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Canada
| | - Soren Harnois-Leblanc
- Research center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Canada; Department of Preventive and Social Medicine, School of Public Health, Université de Montréal, Montréal, Canada; Research center of Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - Mélanie Béland
- Research center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Canada; Department of Epidemiology, INRS-Armand-Frappier, Laval, Canada
| | - Gabrielle Simoneau
- Research center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Canada
| | - Marie-Ève Mathieu
- Research center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Canada; School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montréal, Canada
| | - Tracie A Barnett
- Research center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Canada; Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Canada
| | - Mélanie Henderson
- Research center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Canada; Department of Preventive and Social Medicine, School of Public Health, Université de Montréal, Montréal, Canada; Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montréal, Canada.
| |
Collapse
|
4
|
Zagaria A, Fiori V, Vacca M, Lombardo C, Pariante CM, Ballesio A. Inflammation as a mediator between adverse childhood experiences and adult depression: A meta-analytic structural equation model. J Affect Disord 2024; 357:85-96. [PMID: 38677656 DOI: 10.1016/j.jad.2024.04.072] [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: 02/09/2024] [Revised: 04/05/2024] [Accepted: 04/21/2024] [Indexed: 04/29/2024]
Abstract
Exposure to adverse childhood experiences (ACEs) confers a higher risk of developing depression in adulthood, yet the mediation of inflammation remains under debate. To test this model, we conducted a systematic review and two-stage structural equation modelling meta-analysis of studies reporting correlations between ACEs before age 18, inflammatory markers and depression severity in adulthood. Scopus, Pubmed, Medline, PsycInfo, and CINAHL were searched up to 2 October 2023. Twenty-two studies reporting data on C-reactive protein (CRP, n = 12,935), interleukin-6 (IL-6, n = 4108), tumour necrosis factor-α (TNF-α, n = 2256) and composite measures of inflammation (n = 1674) were included. Unadjusted models revealed that CRP (β = 0.003, 95 % LBCI 0.0002 to 0.0068), IL-6 (β = 0.003, 95 % LBCI 0.001 to 0.006), and composite inflammation (β = 0.009, 95 % LBCI 0.004 to 0.018) significantly mediated the association between ACEs and adult depression. The mediation effects no longer survived after adjusting for BMI; however, a serial mediation model revealed that BMI and IL-6 sequentially mediated the association between ACEs and depression (β = 0.002, 95 % LBCI 0.0005 to 0.0046), accounting for 14.59 % and 9.94 % of the variance of IL-6 and depressive symptoms, respectively. Due to the cross-sectional nature of assessment of inflammation and depression findings should be approached with caution; however, results suggest that complex interactions of psychoneuroimmunological and metabolic factors underlie the association between ACEs and adulthood depression.
Collapse
Affiliation(s)
- Andrea Zagaria
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Valeria Fiori
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Mariacarolina Vacca
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Caterina Lombardo
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrea Ballesio
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
| |
Collapse
|
5
|
Zhang Y, Munshi S, Burrows K, Kuplicki R, Figueroa-Hall LK, Aupperle RL, Khalsa SS, Teague TK, Taki Y, Paulus MP, Savitz J, Zheng H. Leptin's Inverse Association With Brain Morphology and Depressive Symptoms: A Discovery and Confirmatory Study Across 2 Independent Samples. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:714-725. [PMID: 38631553 DOI: 10.1016/j.bpsc.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Major depressive disorder has a complex, bidirectional relationship with metabolic dysfunction, but the neural correlates of this association are not well understood. METHODS In this cross-sectional investigation, we used a 2-step discovery and confirmatory strategy utilizing 2 independent samples (sample 1: 288 participants, sample 2: 196 participants) to examine the association between circulating indicators of metabolic health (leptin and adiponectin) and brain structures in individuals with major depressive disorder. RESULTS We found a replicable inverse correlation between leptin levels and cortical surface area within essential brain areas responsible for emotion regulation, such as the left posterior cingulate cortex, right pars orbitalis, right superior temporal gyrus, and right insula (standardized beta coefficient range: -0.27 to -0.49, puncorrected < .05). Notably, this relationship was independent of C-reactive protein levels. We also identified a significant interaction effect of leptin levels and diagnosis on the cortical surface area of the right superior temporal gyrus (standardized beta coefficient = 0.26 in sample 1, standardized beta coefficient = 0.30 in sample 2, puncorrected < .05). We also observed a positive correlation between leptin levels and atypical depressive symptoms in both major depressive disorder groups (r = 0.14 in sample 1, r = 0.29 in sample 2, puncorrected < .05). CONCLUSIONS The inverse association between leptin and cortical surface area in brain regions that are important for emotion processing and leptin's association with atypical depressive symptoms support the hypothesis that metabolic processes may be related to emotion regulation. However, the molecular mechanisms through which leptin may exert these effects should be explored further.
Collapse
Affiliation(s)
- Ye Zhang
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
| | | | | | | | - Leandra K Figueroa-Hall
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Oxley College of Health Sciences, The University of Tulsa, Tulsa, Oklahoma
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Oxley College of Health Sciences, The University of Tulsa, Tulsa, Oklahoma
| | | | - T Kent Teague
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma; Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma; Department of Pharmaceutical Sciences, University of Oklahoma College of Pharmacy, Tulsa, Oklahoma
| | - Yasuyuki Taki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan; Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Japan; Smart-Aging Research Center, Tohoku University, Sendai, Japan
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Oxley College of Health Sciences, The University of Tulsa, Tulsa, Oklahoma
| | - Jonathan Savitz
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Oxley College of Health Sciences, The University of Tulsa, Tulsa, Oklahoma
| | - Haixia Zheng
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Oxley College of Health Sciences, The University of Tulsa, Tulsa, Oklahoma
| |
Collapse
|
6
|
Tassone VK, Wu M, Meshkat S, Duffy SF, Baig S, Jung H, Lou W, Bhat V. The association between depressive symptoms and high-sensitivity C-reactive protein: Is body mass index a moderator? Brain Behav Immun Health 2024; 38:100773. [PMID: 38698915 PMCID: PMC11063595 DOI: 10.1016/j.bbih.2024.100773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 05/05/2024] Open
Abstract
Objective Depression and obesity are highly comorbid conditions with shared biological mechanisms. It remains unclear how depressive symptoms and body mass index (BMI) interact in relation to inflammation. This cross-sectional study investigated the independent associations of depressive symptoms and BMI with high sensitivity C-reactive protein (hs-CRP), as well as the moderating role of BMI on the depressive symptoms-hs-CRP association. Methods Participants (n = 8827) from the 2015-2018 National Health and Nutrition Examination Surveys were aged ≥20 with a BMI ≥18.5 kg/m2, completed the Depression Screener, and had hs-CRP data. Multivariable linear regression was used to analyze hs-CRP in relation to depressive symptoms and BMI. An interaction term was included to examine whether the depressive symptoms-hs-CRP relationship differs depending on BMI. Results There was a slight, albeit non-significant, increase in hs-CRP levels with each one-point increase in depressive symptoms (aCoef.Estm. = 0.01, 95% CI = -0.05, 0.06, p = 0.754). Participants with overweight (aCoef.Estm. = 1.07, 95% CI = 0.61, 1.53, p < 0.001) or obese (aCoef.Estm. = 3.51, 95% CI = 3.04, 3.98, p < 0.001) BMIs had higher mean hs-CRP levels than those with a healthy BMI. There were no significant interactions between depressive symptoms and overweight (aCoef.Estm. = 0.04, 95% CI = -0.04, 0.13, p = 0.278) or obese (aCoef.Estm. = 0.11, 95% CI = -0.01, 0.22, p = 0.066) BMI indicating a lack of difference in the depressive symptoms-hs-CRP association across participants in the healthy versus overweight and obese ranges. Conclusions This study suggests that BMI might not act as a moderator in the association between depressive symptoms and hs-CRP. Results should be replicated in larger samples. Further research is warranted to understand underlying mechanisms.
Collapse
Affiliation(s)
- Vanessa K. Tassone
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, M5B 1M4, Canada
| | - Michelle Wu
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, M5B 1M4, Canada
| | - Shakila Meshkat
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, M5B 1M4, Canada
| | - Sophie F. Duffy
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, M5B 1M4, Canada
| | - Smia Baig
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, M5B 1M4, Canada
| | - Hyejung Jung
- Department of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada
| | - Wendy Lou
- Department of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada
| | - Venkat Bhat
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, M5B 1M4, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, M5S 1A8, Canada
- Mental Health and Addictions Services, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 1R8, Canada
| |
Collapse
|
7
|
Zhang G, Wang S, Ma P, Li S, Sun X, Zhao Y, Pan J. Increased regional body fat is associated with depressive symptoms: a cross-sectional analysis of NHANES data obtained during 2011-2018. BMC Psychiatry 2024; 24:336. [PMID: 38702637 PMCID: PMC11067210 DOI: 10.1186/s12888-024-05782-4] [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: 10/04/2023] [Accepted: 04/22/2024] [Indexed: 05/06/2024] Open
Abstract
AIMS The findings from previous epidemiological studies of the association between regional body fat and depressive symptoms have been unclear. We aimed to determine the association between the body fat in different regions and depressive symptoms based on data from the National Health and Nutrition Examination Survey (NHANES). METHODS This study included 3393 participants aged ≥ 20 years from the NHANES performed during 2011-2018. Depressive symptoms were assessed using the Patient Health Questionnaire-9. The fat mass (FM) was measured in different regions using dual-energy X-ray absorptiometry to determine the total FM, trunk FM, arm FM, and leg FM. The FM index (FMI) was obtained by dividing the FM in kilograms by the square of the body height in meters. Weighted data were calculated in accordance with analytical guidelines. Linear logistic regression models were used to quantify the association between regional FMI and depressive symptoms. Univariate and stratified analyses were also performed. RESULTS The participants in this study comprised 2066 males and 1327 females. There were 404 (11.91%) participants with depressive symptoms, who were aged 40.89 ± 11.74 years and had a body mass index of 30.07 ± 7.82 kg/m². A significant association was found between total FMI and depressive symptoms. In the fully adjusted multivariate regression model, a higher total FMI (odds ratio = 2.18, 95% confidence interval [CI] = 1.08-4.39) was related to a higher risk of depressive symptoms, while increased total FMI (β = 1.55, 95% CI = 0.65-2.44, p = 0.001), trunk FMI (β = 0.57, 95% CI = 0.04-1.10, p = 0.036), and arm FMI (β = 0.96, 95% CI = 0.33-1.59, p = 0.004) were significantly associated with PHQ-9 (Patient Health Questionnaire-9) scores, whereas the leg FMI was not (p = 0.102). The weighted association between total FMI and depressive symptoms did not differ significantly between most of the subpopulations (all p values for interaction > 0.05). The risk of having depression was higher in individuals who were non-Hispanic Whites, smokers, drinkers, obese, and had diabetes and thyroid problems (p < 0.05). CONCLUSION These findings suggest that the population with a higher regional FMI is more likely to have depressive symptoms, especially in those who also have an increased total FMI. The association is more pronounced in individuals who are smokers, drinkers, obese, and have diabetes and thyroid problems.
Collapse
Affiliation(s)
- GuiMei Zhang
- Department of Psychiatry, Sleep Medicine Centre, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, 510632, P.R. China
| | - Sisi Wang
- Department of Psychiatry, Sleep Medicine Centre, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, 510632, P.R. China
| | - Ping Ma
- Department of Psychiatry, Sleep Medicine Centre, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, 510632, P.R. China
| | - Shuna Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510632, China
| | - Xizhe Sun
- Department of Psychiatry, Sleep Medicine Centre, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, 510632, P.R. China
| | - Yang Zhao
- Department of Psychiatry, Sleep Medicine Centre, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, 510632, P.R. China
| | - Jiyang Pan
- Department of Psychiatry, Sleep Medicine Centre, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, 510632, P.R. China.
| |
Collapse
|
8
|
Suneson K, Söderberg Veibäck G, Lindahl J, Tjernberg J, Ståhl D, Ventorp S, Ängeby F, Lundblad K, Wolkowitz OM, Lindqvist D. Omega-3 fatty acids for inflamed depression - A match/mismatch study. Brain Behav Immun 2024; 118:192-201. [PMID: 38432599 DOI: 10.1016/j.bbi.2024.02.029] [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: 09/30/2023] [Revised: 01/31/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024] Open
Abstract
Despite decades of research on the pathophysiology of depression, the development of new therapeutic interventions has been slow, and no biomarkers of treatment response have been clinically implemented. Several lines of evidence suggest that the clinical and biological heterogeneity among patients with major depressive disorder (MDD) has hampered progress in this field. MDD with low-grade inflammation - "inflamed depression" - is a subtype of depression that may be associated with a superior antidepressant treatment response to anti-inflammatory compounds. Omega-3 fatty acid eicosapentaenoic acid (EPA) has anti-inflammatory properties, and preliminary data suggest that it may be particularly efficacious in inflamed depression. In this study we tested the hypothesis that add-on EPA has greater antidepressant efficacy in MDD patients with high baseline high-sensitivity C-reactive protein (hs-CRP) compared to MDD patients with low hs-CRP. All subjects received 2.2 g EPA, 400 mg docosahexaenoic acid and 800 mg of other fatty acids daily for 8 weeks, added to stable ongoing antidepressant treatment. The primary outcome was change in the 17-item Hamilton Depression Rating Scale (HAMD-17). Patients and raters were blind to baseline hs-CRP status. In an intention-to-treat analysis including all subjects with at least one post baseline visit (n = 101), ahs-CRPcut-off of ≥1 mg/L, but not ≥3 mg/L, was associated with a greater improvement in HAMD-17 total score. In addition to a general antidepressant effect among patients with hs-CRP ≥ 1 mg/L, adjuvant EPA treatment improved symptoms putatively related to inflamed depression such as fatigue and sleep difficulties. This adds to the mounting evidence that delineation of MDD subgroups based on inflammation may be clinically relevant to predict treatment response to anti-inflammatory interventions.
Collapse
Affiliation(s)
- Klara Suneson
- Unit for Biological and Precision Psychiatry, Department of Clinical Sciences Lund, Lund University; Department of Adult Psychiatry, Office for Psychiatry, Habilitation and Technical Aids, Malmö, Sweden
| | - Gustav Söderberg Veibäck
- Unit for Biological and Precision Psychiatry, Department of Clinical Sciences Lund, Lund University; Department of Gastroenterology and Nutrition, Department of Clinical Sciences, Skåne University Hospital, Malmö, Sweden
| | - Jesper Lindahl
- Unit for Biological and Precision Psychiatry, Department of Clinical Sciences Lund, Lund University; Department of Adult Psychiatry, Office for Psychiatry, Habilitation and Technical Aids, Lund, Sweden
| | - Johanna Tjernberg
- Unit for Biological and Precision Psychiatry, Department of Clinical Sciences Lund, Lund University; Psychiatry Research Skåne, Office for Psychiatry, Habilitation and Technical Aids, Lund, Sweden
| | - Darya Ståhl
- Unit for Biological and Precision Psychiatry, Department of Clinical Sciences Lund, Lund University
| | - Simon Ventorp
- Unit for Biological and Precision Psychiatry, Department of Clinical Sciences Lund, Lund University
| | - Filip Ängeby
- Unit for Biological and Precision Psychiatry, Department of Clinical Sciences Lund, Lund University; Department of Adult Psychiatry, Office for Psychiatry, Habilitation and Technical Aids, Lund, Sweden
| | - Karl Lundblad
- Department of Adult Psychiatry, Office for Psychiatry, Habilitation and Technical Aids, Lund, Sweden; Office for Psychiatry, Norra Stockholm Psykiatri, Region Stockholm, Sweden
| | - Owen M Wolkowitz
- Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Daniel Lindqvist
- Unit for Biological and Precision Psychiatry, Department of Clinical Sciences Lund, Lund University; Psychiatry Research Skåne, Office for Psychiatry, Habilitation and Technical Aids, Lund, Sweden.
| |
Collapse
|
9
|
Mascarenhas C, Sousa ACA, Rato L. Effects of Pharmaceutical Substances with Obesogenic Activity on Male Reproductive Health. Int J Mol Sci 2024; 25:2324. [PMID: 38397000 PMCID: PMC10889417 DOI: 10.3390/ijms25042324] [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: 12/30/2023] [Revised: 01/28/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
Obesogens have been identified as a significant factor associated with increasing obesity rates, particularly in developed countries. Substances with obesogenic traits are prevalent in consumer products, including certain pharmaceuticals. Specific classes of pharmaceuticals have been recognized for their ability to induce weight gain, often accompanied by hormonal alterations that can adversely impact male fertility. Indeed, research has supplied evidence underscoring the crucial role of obesogens and therapeutic agents in the normal functioning of the male reproductive system. Notably, sperm count and various semen parameters have been closely linked to a range of environmental and nutritional factors, including chemicals and pharmacological agents exhibiting obesogenic properties. This review aimed to explore studies focused on analyzing male fertility parameters, delving into the intricacies of sperm quality, and elucidating the direct and adverse effects that pharmacological agents may have on these aspects.
Collapse
Affiliation(s)
- Caio Mascarenhas
- School of Health, Polytechnic Institute of Guarda, 6300-035 Guarda, Portugal;
| | - Ana C. A. Sousa
- Department of Biology, School of Science and Technology, University of Évora, 7006-554 Évora, Portugal;
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-671 Évora, Portugal
| | - Luís Rato
- School of Health, Polytechnic Institute of Guarda, 6300-035 Guarda, Portugal;
- CICS-UBI—Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal
| |
Collapse
|
10
|
Meshkat S, Liu Y, Jung H, Tassone VK, Pang H, Janssen-Aguilar R, Lou W, Bhat V. Temporal associations of BMI and glucose parameters with depressive symptoms among US adults. Psychiatry Res 2024; 332:115709. [PMID: 38211470 DOI: 10.1016/j.psychres.2023.115709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/20/2023] [Accepted: 12/30/2023] [Indexed: 01/13/2024]
Abstract
As the prevalence of obesity, diabetes, and depression increases, it is important to examine how their associations are changing overtime. We investigated the temporal trends in the association between depressive symptoms, body mass index (BMI) and glucose profile parameters using data from 2005 to 2018 National Health and Nutrition Examination Survey. Depressive symptoms were assessed using the Patient Health Questionnaire. A total of 32,653 participants were included. Risk of depressive symptoms increased with higher BMI (aOR = 1.586, 95 % CI [1.364, 1.843]), insulin (aOR = 1.327, 95 % CI [1.159, 1.519]), HbA1c (aOR = 1.330, 95 % CI [1.116, 1.585]), or fasting glucose (aOR = 1.565, 95 % CI [1.247, 1.964]) levels compared to those with low levels. Sex differences were found, as overweight males had lower odds of depressive symptoms compared to healthy males, while overweight and obese females had higher odds compared to healthy females. High BMI and glucose parameters were consistently associated with higher depressive symptoms prevalence over time. Temporal variations were observed in the depressive symptoms-BMI and depressive symptoms-HbA1c associations, particularly at the 2007-2008 cycle. This study provides analytic insights into population level trends concerning physical and mental health problems.
Collapse
Affiliation(s)
- Shakila Meshkat
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Yuqing Liu
- Department of Biostatistics, University of Toronto, Toronto, Ontario, Canada
| | - Hyejung Jung
- Department of Biostatistics, University of Toronto, Toronto, Ontario, Canada
| | - Vanessa K Tassone
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Hilary Pang
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - Wendy Lou
- Department of Biostatistics, University of Toronto, Toronto, Ontario, Canada
| | - Venkat Bhat
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Mental Health and Addictions Services, St. Michael's Hospital, Toronto, Ontario, Canada.
| |
Collapse
|
11
|
McLaughlin AP, Lambert E, Milton R, Mariani N, Kose M, Nikkheslat N, Patsalos O, Ferraro L, Chamseddine G, Panagiotopoulos S, Chang A, Ramar S, Patel A, Rubino F, Mondelli V. Peripheral inflammation associated with depression and reduced weight loss: a longitudinal study of bariatric patients. Psychol Med 2024; 54:601-610. [PMID: 37652080 DOI: 10.1017/s0033291723002283] [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] [Indexed: 09/02/2023]
Abstract
BACKGROUND Research implicates inflammation in the vicious cycle between depression and obesity, yet few longitudinal studies exist. The rapid weight loss induced by bariatric surgery is known to improve depressive symptoms dramatically, but preoperative depression diagnosis may also increase the risk for poor weight loss. Therefore, we investigated longitudinal associations between depression and inflammatory markers and their effect on weight loss and clinical outcomes in bariatric patients. METHODS This longitudinal observational study of 85 patients with obesity undergoing bariatric surgery included 41 cases with depression and 44 controls. Before and 6 months after surgery, we assessed depression by clinical interview and measured serum high-sensitivity C-reactive protein (hsCRP) and inflammatory cytokines, including interleukin (IL)-6 and IL-10. RESULTS Before surgery, depression diagnosis was associated with significantly higher serum hsCRP, IL-6, and IL-6/10 ratio levels after controlling for confounders. Six months after surgery, patients with pre-existing depression still had significantly higher inflammation despite demonstrating similar weight loss to controls. Hierarchical regression showed higher baseline hsCRP levels predicted poorer weight loss (β = -0.28, p = 0.01) but had no effect on depression severity at follow-up (β = -0.02, p = 0.9). Instead, more severe baseline depressive symptoms and childhood emotional abuse predicted greater depression severity after surgery (β = 0.81, p < 0.001; and β = 0.31, p = 0.001, respectively). CONCLUSIONS Depression was significantly associated with higher inflammation beyond the effect of obesity and other confounders. Higher inflammation at baseline predicted poorer weight loss 6 months after surgery, regardless of depression diagnosis. Increased inflammation, rather than depression, may drive poor weight loss outcomes among bariatric patients.
Collapse
Affiliation(s)
- Anna P McLaughlin
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, and King's College London, London, UK
| | - Ellen Lambert
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, and King's College London, London, UK
| | - Rebecca Milton
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Nicole Mariani
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Melisa Kose
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Naghmeh Nikkheslat
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Olivia Patsalos
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, and King's College London, London, UK
| | - Luca Ferraro
- ASST Santi Paolo e Carlo, Azienda Socio Sanitaria Territorale Santi Paolo e Carlo, Milan, Italy
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Ghassan Chamseddine
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Spyros Panagiotopoulos
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Avril Chang
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Sasindran Ramar
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Ameet Patel
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Francesco Rubino
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, and King's College London, London, UK
| |
Collapse
|
12
|
Liu Y, Lin H, Zhang H, Zhang X, Yin S. Correlation analysis between physical activity and depressive tendencies among occupational groups: an isotemporal substitution approach. BMC Public Health 2023; 23:2241. [PMID: 37964346 PMCID: PMC10644550 DOI: 10.1186/s12889-023-17134-0] [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: 02/01/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023] Open
Abstract
OBJECTIVES Sedentary behaviour (SB) and physical activity (PA) have been shown to be associated with depression. However, behaviours, such as PA, occupy a portion of an individual's 24-h day. Thus, an increase in time for one behaviour takes away time from another. Previous evidence suggests that it would be more appropriate to shift the focus to the importance of reallocating time spent in sedentary behaviour to time spent in physical activity. The aim of this study was to analyse the mutual replacement effect of different health behaviours on depressive tendencies by isotemporal substitution modelling (ISM) under the objective condition of considering a limited 24-h day. Second, we aimed to further explore the potential association between excessive or insufficient sleep duration and depressive symptoms. METHODS A total of 10656 employees from 79 companies in four provinces of China participated in this survey. The Center for Epidemiological Studies Depression Scale (CES-D) was used to measure workers' depressive tendencies. The duration of various types of physical activity was self-reported by workers based on the International Physical Activity Questionnaire (IPAQ). ISM was used to assess the associations of time spent in different activities on displacement of equivalent time spent on other activities with depression risk. RESULTS A total of 10656 participants (89.5% of the sample) were included in the analysis. The ISM found that a 30-min unit of SB replaced with walking (OR, 95% CI: 0.83, 0.77-0.88), sleep (≤ 8 h) (OR, 95% CI: 0.77, 0.74-0.79), moderate physical activity (MPA) (OR, 95% CI: 0.87, 0.81-0.93) and vigorous physical activity (VPA) (OR, 95% CI: 0.91, 0.84-0.99) was significantly and negatively associated with the risk of depressive tendencies. When sleep duration was less than 8 h, each additional half hour of sleep time was significantly associated with a lower risk of depressive tendencies, and this association was no longer significant after 8 h. CONCLUSION Prolonged SB is common in the current workplace in China. Replacing an average of 30 min per day of SB with VPA and MPA, even walking is associated with less depression among workers. In addition, insufficient daily sleep is also an important risk factor for workers' depressive tendencies. These findings provide valuable evidence to promote mental health among occupational groups and support the development of healthy workplaces.
Collapse
Affiliation(s)
- Yihua Liu
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Haoxiang Lin
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Hao Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Xiaoyue Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Shengli Yin
- DeZhou Center for Disease Control and Prevention, Dezhou, China.
| |
Collapse
|
13
|
Zhang L, Yin J, Sun H, Yang J, Liu Y. Association between atherogenic coefficient and depression in US adults: a cross-sectional study with data from National Health and Nutrition Examination Survey 2005-2018. BMJ Open 2023; 13:e074001. [PMID: 37899167 PMCID: PMC10619029 DOI: 10.1136/bmjopen-2023-074001] [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: 03/24/2023] [Accepted: 10/11/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVE The pathogenesis of depression is related to immune inflammatory response. Atherogenic coefficient (AC) is an important indicator of lipid abnormalities, which can lead to immune inflammatory responses. However, no study has investigated the relationship between AC and depression in adult Americans. Therefore, we investigated this relationship. DESIGN This study used a cross-sectional design. SETTING The National Health and Nutrition Examination Survey (2005-2018) data were used for this study. PARTICIPANTS A total of 32 502 participants aged 20 years or older who had complete information for AC and depression were included in this study. PRIMARY AND SECONDARY OUTCOME MEASURES Depressive symptoms were assessed using the nine-item version of the Patient Health Questionnaire (PHQ-9), with a cut-off point of 9/10 indicating likely depression cases. Weighted logistic regression analyses and the smooth curve fittings were performed to explore the association between AC and depression. RESULTS After adjusting for potential confounders, a single unit increase in AC was associated with a 3% increase in the prevalence of depression (HR=1.03, 95% CI=1.00 to 1.06, p=0.039). The relationship between AC and depression was more obvious in females. CONCLUSIONS The AC is positively associated with depression.
Collapse
Affiliation(s)
- Lu Zhang
- The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jiahui Yin
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Haiyang Sun
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jiguo Yang
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Shandong, China
| | - Yuanxiang Liu
- Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| |
Collapse
|
14
|
Werneck AO, Owen N, Araujo RHO, Silva DR, Hallgren M. Mentally-passive sedentary behavior and incident depression: Mediation by inflammatory markers. J Affect Disord 2023; 339:847-853. [PMID: 37467803 DOI: 10.1016/j.jad.2023.07.053] [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: 03/21/2023] [Revised: 07/03/2023] [Accepted: 07/08/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Sedentary behavior (SB; time spent sitting, as distinct from lack of exercise or physical activity) is associated with depression, yet little is known about the relationship between different types of SB (e.g., mentally-passive versus mentally-active) with depression and potential biological mediators of these associations. METHODS We used cohort data from the 1958 National Child Development Study (n = 4607; 50.4 % women), conducted in UK, employing the 44 y and 46 y waves as baseline, and the 50 y and 55 y waves as follow-up. Participants reported time spent in TV viewing and watching videos (mentally-passive SB); and, time sitting while doing light activities such as deskwork or driving a car during worktime (mentally-active SB). Depression diagnosis was self-reported during the initial and follow-up waves. Waist circumference, C-reactive protein, and glycated hemoglobin were examined as potential mediators. RESULTS Mentally-passive SB was associated with incident depression (HR: 1.43; 95%CI: 1.19; 1.71), while there was no association for mentally-active SB. Waist circumference (coefficient: -0.03; 95%CI: -0.05; -0.01; 9.2 %) and C-reactive protein (coefficient: -0.03; 95%CI: -0.04; -0.01; 8.3 %), but not glycated hemoglobin, partly mediated the association for mentally-passive SB. CONCLUSIONS In the relationship of mentally-passive SB with incident depression, the mediating contributions of waist circumference and C-reactive protein point to possible inflammatory-related mechanisms.
Collapse
Affiliation(s)
- André O Werneck
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), Brazil
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria, Australia; Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Raphael H O Araujo
- Graduation Program in Health Sciences, Londrina State University (UEL), Londrina, Brazil
| | - Danilo R Silva
- Department of Physical Education, Federal University of Sergipe (UFS), São Cristóvão, Brazil; Department of Sports and Computer Science, Universidad Pablo de Olavide (UPO), Seville, Spain; Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile
| | - Mats Hallgren
- Epidemiology of Psychiatric Conditions, Substance use and Social Environment (EPiCSS), Department of Global Public Health, Karolinska Institutet, Stockholm 171 77, Sweden.
| |
Collapse
|
15
|
Sominsky L, O'Hely M, Drummond K, Cao S, Collier F, Dhar P, Loughman A, Dawson S, Tang ML, Mansell T, Saffery R, Burgner D, Ponsonby AL, Vuillermin P. Pre-pregnancy obesity is associated with greater systemic inflammation and increased risk of antenatal depression. Brain Behav Immun 2023; 113:189-202. [PMID: 37437818 DOI: 10.1016/j.bbi.2023.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Pre-pregnancy obesity is an emerging risk factor for perinatal depression. However, the underlying mechanisms remain unclear. We investigated the association between pre-pregnancy body mass index (BMI) and perinatal depressive symptoms in a large population-based pre-birth cohort, the Barwon Infant Study. We also assessed whether the levels of circulating inflammatory markers during pregnancy mediated this relationship. METHODS Depressive symptoms were assessed in 883 women using the Edinburgh Postnatal Depression Scale (EPDS) and psychological stress using the Perceived Stress Scale (PSS) at 28 weeks gestation and 4 weeks postpartum. Glycoprotein acetyls (GlycA), high-sensitivity C-reactive protein (hsCRP) and cytokines were assessed at 28 weeks gestation. We performed regression analyses, adjusted for potential confounders, and investigated mediation using nested counterfactual models. RESULTS The estimated effect of pre-pregnancy obesity (BMI ≥ 30 kg/m2) on antenatal EPDS scores was 1.05 points per kg/m2 increase in BMI (95% CI: 0.20, 1.90; p = 0.02). GlycA, hsCRP, interleukin (IL) -1ra and IL-6 were higher in women with obesity, compared to healthy weight women, while eotaxin and IL-4 were lower. Higher GlycA was associated with higher EPDS and PSS scores and partially mediated the association between pre-pregnancy obesity and EPDS/PSS scores in unadjusted models, but this association attenuated upon adjustment for socioeconomic adversity. IL-6 and eotaxin were negatively associated with EPDS/PSS scores, however there was no evidence for mediation. CONCLUSIONS Pre-pregnancy obesity increases the risk of antenatal depressive symptoms and is also associated with systemic inflammation during pregnancy. While discrete inflammatory markers are associated with antenatal depressive symptoms and perceived stress, their role in mediating the effects of pre-pregnancy obesity on antenatal depression requires further investigation.
Collapse
Affiliation(s)
- Luba Sominsky
- Barwon Health, Geelong, Victoria, Australia; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia.
| | - Martin O'Hely
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Katherine Drummond
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Sifan Cao
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Fiona Collier
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Poshmaal Dhar
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Amy Loughman
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Samantha Dawson
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Mimi Lk Tang
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Toby Mansell
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Anne-Louise Ponsonby
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Peter Vuillermin
- Barwon Health, Geelong, Victoria, Australia; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
| |
Collapse
|
16
|
Wu SK, Chen WJ, Chang JPC, Guu TW, Hsin MC, Huang CK, Mischoulon D, Capuron L, Su KP. Personalized Medicine of Omega-3 Fatty Acids in Depression Treatment in Obese and Metabolically Dysregulated Patients. J Pers Med 2023; 13:1003. [PMID: 37373992 DOI: 10.3390/jpm13061003] [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: 05/21/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
The co-occurrence of depression and obesity has become a significant public health concern worldwide. Recent studies have shown that metabolic dysfunction, which is commonly observed in obese individuals and is characterized by inflammation, insulin resistance, leptin resistance, and hypertension, is a critical risk factor for depression. This dysfunction may induce structural and functional changes in the brain, ultimately contributing to depression's development. Given that obesity and depression mutually increase each other's risk of development by 50-60%, there is a need for effective interventions that address both conditions. The comorbidity of depression with obesity and metabolic dysregulation is thought to be related to chronic low-grade inflammation, characterized by increased circulating levels of pro-inflammatory cytokines and C-reactive protein (CRP). As pharmacotherapy fails in at least 30-40% of cases to adequately treat major depressive disorder, a nutritional approach is emerging as a promising alternative. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are a promising dietary intervention that can reduce inflammatory biomarkers, particularly in patients with high levels of inflammation, including pregnant women with gestational diabetes, patients with type 2 diabetes mellitus, and overweight individuals with major depressive disorder. Further efforts directed at implementing these strategies in clinical practice could contribute to improved outcomes in patients with depression, comorbid obesity, and/or metabolic dysregulation.
Collapse
Grants
- MOST 109-2320-B-038-057-MY3, 110-2321-B-006-004, 110-2811-B-039-507, 110-2320-B-039-048-MY2,110-2320-B-039-047-MY3, 110-2813-C-039-327-B, 110-2314-B-039-029-MY3, 111-2321-B-006-008, and NSTC 111-2314-B-039-041-MY3 Ministry of Science and Technology, Taiwan
- ANHRF 109-31, 109-40, 110-13, 110-26, 110-44, 110-45, 111-27, 111-28, 111-47, 111-48, and 111-52 An-Nan Hospital, China Medical University, Tainan, Taiwan
- CMRC-CMA-2 Ministry of Education (MOE), Taiwan
- CMU 110-AWARD-02, 110-N-17, 1110-SR-73 China Medical University, Taichung, Taiwan
- DMR-106-101, 106-227, 109-102, 109-244, 110-124, 111-245, 112-097, 112-086, 112-109, 112-232 and DMR-HHC-109-11, HHC-109-12, HHC-110-10, and HHC-111-8 China Medical University Hospital, Taichung, Taiwan
Collapse
Affiliation(s)
- Suet-Kei Wu
- Graduate Institute of Nutrition, China Medical University, Taichung 404, Taiwan
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan
| | - Wei-Jen Chen
- An-Nan Hospital, China Medical University, Tainan 709, Taiwan
| | - Jane Pei-Chen Chang
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan
- Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
- College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Ta-Wei Guu
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan
- Division of Psychiatry, Department of Internal Medicine, China Medical University Beigang Hospital, Yunlin 651, Taiwan
| | - Ming-Che Hsin
- Body Science & Metabolic Disorders International Medical Centre (BMIMC), China Medical University & Hospital, Taichung 404, Taiwan
| | - Chih-Kun Huang
- Body Science & Metabolic Disorders International Medical Centre (BMIMC), China Medical University & Hospital, Taichung 404, Taiwan
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Lucile Capuron
- NutriNeuro, University of Bordeaux, INRAE, Bordeaux INP, UMR 1286, F-33076 Bordeaux, France
| | - Kuan-Pin Su
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan
- An-Nan Hospital, China Medical University, Tainan 709, Taiwan
- Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
- College of Medicine, China Medical University, Taichung 404, Taiwan
| |
Collapse
|
17
|
Suneson K, Grudet C, Ventorp F, Malm J, Asp M, Westrin Å, Lindqvist D. An inflamed subtype of difficult-to-treat depression. Prog Neuropsychopharmacol Biol Psychiatry 2023; 125:110763. [PMID: 37037323 DOI: 10.1016/j.pnpbp.2023.110763] [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: 10/18/2022] [Revised: 04/03/2023] [Accepted: 04/06/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Chronic low-grade inflammation may play a role in the pathophysiology of depression, at least in a subset of patients. High-sensitivity C-reactive protein (hs-CRP) has been used to define an inflamed subgroup of depression with specific clinical characteristics and symptoms. In this study we investigated biochemical and clinical characteristics in patients with difficult-to-treat depression with and without chronic low-grade inflammation. METHOD We assayed plasma levels of interferon-gamma, tumor necrosis factor-alpha, Interleukin (IL)-10, IL-6, IL-8, and vitamin D in a clinically well-characterized sample of patients with difficult-to-treat depression (n = 263) and healthy controls (n = 46). Serum hs-CRP levels were available in the patient group and were used to define "inflamed depression" (hs-CRP > 3 mg/L). Based on previous studies correlating specific depressive symptoms to inflammatory markers, we calculated a composite score of inflammatory depressive symptoms (Infl-Dep score). A principal component analysis (PCA) was performed to identify patterns of variance in cytokines and vitamin D among patients. RESULTS Mean levels of IL-6 and IL-8 were significantly higher in depressed patients compared to controls, also after adjusting for sex, smoking, BMI, and age. None of the other inflammatory markers differed significantly between depressed patients and controls. Two components were extracted using PCA; one showed general cytokine elevations and one represented a pattern where IL-6 and IL-8 were inversely related to vitamin D (IL6-IL8-VitD component). The inflamed subgroup (hs-CRP > 3, n = 51) exhibited significantly higher BMI, higher Infl-Dep scores and higher IL6-IL8-VitD component scores than uninflamed patients (hs-CRP ≤ 3, n = 212). There were no significant differences in overall depression severity or suicidality between the inflamed and uninflamed groups. CONCLUSION Our results support the hypothesis of an inflamed subgroup of depression as a meaningful construct. This subgroup may have certain biological and clinical characteristics and more studies are needed to determine potential clinical implications.
Collapse
Affiliation(s)
- Klara Suneson
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden; Office for Psychiatry and Habilitation, Psychiatric Clinic Helsingborg, Region Skåne, 252 23 Helsingborg, Sweden
| | - Cécile Grudet
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden
| | - Filip Ventorp
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden; Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, 221 85 Lund, Sweden
| | - Johan Malm
- Department of Translational Medicine, Lund University, Skåne University Hospital, 205 02, Malmö, Sweden
| | - Marie Asp
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden; Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, 221 85 Lund, Sweden
| | - Åsa Westrin
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden; Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Region Skåne, 221 85 Lund, Sweden
| | - Daniel Lindqvist
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden; Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Region Skåne, 221 85 Lund, Sweden.
| |
Collapse
|
18
|
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.
Collapse
|
19
|
Chu K, Cadar D, Iob E, Frank P. Excess body weight and specific types of depressive symptoms: Is there a mediating role of systemic low-grade inflammation? Brain Behav Immun 2023; 108:233-244. [PMID: 36462595 PMCID: PMC10567582 DOI: 10.1016/j.bbi.2022.11.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Obesity is associated with an increased risk of depression. Systemic low-grade inflammation, a plausible consequence of obesity, has also been linked to depression. However, the potential mediating effects of systemic low-grade inflammation on the association between excess body weight and specific symptom domains of depression remain uncertain. This study examined whether systemic low-grade inflammation mediated the associations of excess body weight (overweight and obesity) with subsequent overall, cognitive-affective, and somatic depressive symptoms. DESIGN This study used a prospective cohort design. METHODS The final analytical sample included 4,942 adults aged ≥50 years drawn from the English Longitudinal Study of Ageing (ELSA). Body mass index (BMI) and covariates were ascertained at baseline (wave 4, 2008/09). Continuous BMI scores were divided into four categories: 'normal weight' (18.5 ≤ BMI <25 kg/m2); 'overweight' (25 ≤ BMI <30 kg/m2); 'obesity' (BMI ≥30 kg/m2); in addition to 'excess body weight' ('overweight' and 'obesity' combined). Covariates included sociodemographic variables, behavioural factors, and chronic physical conditions. Serum concentrations of CRP were measured at wave 6 (2012/13). Depressive symptoms were assessed at baseline and ten years later (wave 9, 2018/19), using the 8-item Centre for Epidemiological Studies Depression (CES-D) Scale. Two symptom domains were constructed, distinguishing between cognitive-affective (depressed mood, loneliness, sadness, enjoyment in life, and happiness) and somatic (sleep problems, low energy levels, and fatigue) symptoms. Mediation analyses were performed to examine whether CRP statistically mediated the associations between BMI categories and depressive symptoms. RESULTS In multivariable-adjusted analyses, excess body weight was associated with elevated somatic (OR = 1.231, 95% CI: 1.029, 1.473), but not cognitive-affective or overall depressive symptoms at follow-up. Higher CRP was associated with elevated somatic (OR = 1.156, 95% CI: 1.061, 1.259), but not cognitive-affective or overall depressive symptoms. CRP acted as a partial mediator (14.92%) of the association between excess body weight and elevated somatic, but not cognitive-affective, or overall depressive symptoms. CONCLUSION Systemic low-grade inflammation may partially explain the association of excess body weight with somatic depressive symptoms, but not the associations with cognitive-affective or overall depressive symptoms.
Collapse
Affiliation(s)
- Keqin Chu
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Dorina Cadar
- Department of Behavioural Science and Health, University College London, London, UK; Brighton and Sussex Medical School, Brighton, East Sussex, UK.
| | - Eleonora Iob
- Social, Genetic & Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Philipp Frank
- Department of Behavioural Science and Health, University College London, London, UK.
| |
Collapse
|
20
|
Varma M, Kaur A, Bhandari R, Kumar A, Kuhad A. Major depressive disorder (mdd): emerging immune targets at preclinical level. Expert Opin Ther Targets 2023; 27:479-501. [PMID: 37334668 DOI: 10.1080/14728222.2023.2225216] [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: 01/04/2023] [Accepted: 06/11/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Major depressive disorder is a mental health disorder that is characterized by a persistently low mood and loss of interest. MDD is affecting over 3.8% of the global population as a major health problem. Its etiology is complex, and involves the interaction between a number of factors, including genetic predisposition and the presence of environmental stresses. AREAS COVERED The role of the immune and inflammatory systems in depression has been gaining interest, with evidence suggesting the potential involvement of pro-inflammatory molecules like TNF, interleukins, prostaglandins, and other cytokines, among others, has been put forth. Along with this, the potential of agents, from NSAIDs to antibiotics, are being evaluated in therapy for depression. The current review will discuss emerging immune targets at the preclinical level. EXPERT OPINION With increasing evidence to show that immune and inflammatory mediators are implicated in MDD, increasing research toward their potential as drug targets is encouraged. At the same time, agents acting on these mediators and possessing anti-inflammatory potential are also being evaluated as future therapeutic options for MDD, and increasing focus toward non-conventional drugs which can act through these mechanisms is important as regards the future prospects of the use of anti-inflammatory agents in depression.
Collapse
Affiliation(s)
- Manasi Varma
- UGC-Centre of Advanced Study, University Institute of Pharmaceutical Sciences, Chandigarh, India
| | - Arshpreet Kaur
- UGC-Centre of Advanced Study, University Institute of Pharmaceutical Sciences, Chandigarh, India
| | - Ranjana Bhandari
- UGC-Centre of Advanced Study, University Institute of Pharmaceutical Sciences, Chandigarh, India
| | - Ashwani Kumar
- UGC-Centre of Advanced Study, University Institute of Pharmaceutical Sciences, Chandigarh, India
| | - Anurag Kuhad
- UGC-Centre of Advanced Study, University Institute of Pharmaceutical Sciences, Chandigarh, India
| |
Collapse
|
21
|
Yoo A, Lee S. Neuronal growth regulator 1 may modulate interleukin-6 signaling in adipocytes. Front Mol Biosci 2023; 10:1148521. [PMID: 37187893 PMCID: PMC10175572 DOI: 10.3389/fmolb.2023.1148521] [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: 01/20/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023] Open
Abstract
Interleukin-6 (IL-6) is a pleiotropic cytokine that plays both anti- and pro-inflammatory roles. Due to the restricted expression of membrane IL-6 receptor (IL-6R), most pro-inflammatory functions of IL-6 are attributed to its association with soluble IL-6R (sIL-6R). Neuronal growth regulator 1 (NEGR1) is a brain-enriched membrane protein that has recently been recognized as a risk factor for many human diseases including obesity, depression, and autism. In the present study, we report that the expression levels of IL-6 and IL-6R, as well as the phosphorylation of signal transducer and activator of transcription (STAT) 3, were significantly elevated in white adipose tissues of Negr1 knockout mice. Elevated levels of circulating IL-6 and sIL-6R have also been observed in Negr1 -/- mice. Furthermore, NEGR1 interacted with IL-6R, which was supported by subcellular fractionation and an in situ proximity ligation assay. Importantly, NEGR1 expression attenuated the phosphorylation of STAT3 by sIL-6R, suggesting that NEGR1 negatively regulates IL-6 trans-signaling. Taken together, we propose that NEGR1 may play a regulatory role in IL-6 signaling by interacting with IL-6R, which may contribute to a molecular link underlying obesity, inflammation, and the depression cycle.
Collapse
|
22
|
Christensen SM, Varney C, Gupta V, Wenz L, Bays HE. Stress, psychiatric disease, and obesity: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 4:100041. [PMID: 37990662 PMCID: PMC10662113 DOI: 10.1016/j.obpill.2022.100041] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 10/30/2022] [Indexed: 11/23/2023]
Abstract
Background Previous Obesity Medicine Association (OMA) Clinical Practice Statements (CPS) included topics such as behavior modification, motivational interviewing, and eating disorders, as well as the effect of concomitant medications on weight gain/reduction (i.e., including psychiatric medications). This OMA CPS provides clinicians a more focused overview of stress and psychiatric disease as they relate to obesity. Methods The scientific support for this CPS is based upon published citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership. Results Topics in this CPS include the relationship between psychological stress and obesity, including both acute and chronic stress. Additionally, this CPS describes the neurobiological pathways regarding stress and addiction-like eating behavior and explores the relationship between psychiatric disease and obesity, with an overview of psychiatric medications and their potential effects on weight gain and weight reduction. Conclusions This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on stress and psychiatric disease is one of a series of OMA CPSs designed to assist clinicians in the care of patients with the disease of obesity. Knowledge of stress, addiction-like eating behavior, psychiatric disease, and effects of psychiatric medications on body weight may improve the care obesity medicine clinicians provide to their patients with obesity.
Collapse
Affiliation(s)
- Sandra M. Christensen
- Integrative Medical Weight Management, 2611 NE 125th St., Suite 100B, Seattle, WA, 98125, USA
| | - Catherine Varney
- University of Virginia School of Medicine, Department of Family Medicine, University of Virginia Bariatric Surgery, PO BOX 800729, Charlottesville, VA, 22908, USA
| | - Vivek Gupta
- 510 N Prospect Suite 301, Redondo Beach, California, 90277, USA
| | - Lori Wenz
- St. Mary's Bariatric and Metabolic Surgery Clinic, 2440 N 11th St, Grand Junction, CO, 81501, USA
- Comprehensive Weight Management, Cayucos, CA, USA
| | - Harold Edward Bays
- Louisville Metabolic and Atherosclerosis Research Center, University of Louisville School of Medicine, 3288 Illinois Avenue, Louisville, KY, 40213, USA
| |
Collapse
|
23
|
Karshikoff B, Lekander M, Lasselin J. Editorial: Vulnerability and protective factors for inflammation-associated somatoform and mental disorders. Brain Behav Immun 2022; 106:227-230. [PMID: 36055543 DOI: 10.1016/j.bbi.2022.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Bianka Karshikoff
- Department of Social Sciences, University of Stavanger, Stavanger, Norway; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mats Lekander
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Health, ME Neuroradiologi, Karolinska Universitetssjukhuset, Stockholm, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Julie Lasselin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Health, ME Neuroradiologi, Karolinska Universitetssjukhuset, Stockholm, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden
| |
Collapse
|
24
|
Cowdery SP, Bjerkeset O, Sund ER, Mohebbi M, Pasco JA, Berk M, Williams LJ. Depressive symptomology and cancer incidence in men and women: Longitudinal evidence from the HUNT study. J Affect Disord 2022; 316:1-9. [PMID: 35934219 DOI: 10.1016/j.jad.2022.08.002] [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: 02/28/2022] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Depressive symptoms and mood disorders are associated with a host of physical conditions. However, it is inconclusive whether depressive symptoms are also associated with cancer onset. The aim of this study was to investigate whether depressive symptoms are associated with cancer incidence in a large population-based sample of men and women. METHODS This study examined data from waves two (HUNT 2, 1995-97) and three (HUNT 3, 2006-08) of the Trøndelag Health Study (HUNT). Depressive symptoms were ascertained using the Hospital Anxiety and Depression Scale (HADS-D ≥ 8), cancer onset was identified via linkage with the Cancer Registry of Norway, death records by the national Cause of Death Register (CDR), and information on lifestyle and demographic factors was self-reported. Cox-proportional hazard regression models were used to test associations. Unadjusted, age-adjusted and multivariable best models accounting for smoking, education, marital status and current employment are presented. RESULTS Men and women (n = 61,985; 46.0 % men) were followed from baseline over a period of 778,802 person-years. During the 20-year study period, there were 6856 (11.1 %) individuals with incident cancers and 12,480 (20.1 %) deaths (n = 2498 attributed to cancer). For men with depressive symptoms, 505 (15.3 %) developed incident cancer during the follow-up period, whereas among those without depressive symptoms, 3164 (12.5 %) developed incident cancer. Following adjustment for age, depressive symptomology was not significantly associated with risk of overall cancer onset, nor among prostate, colon or melanoma subtypes. Depressive symptoms were associated with an increased risk of bronchus and lung cancer both before (HR 1.90, 95 % CI 1.43-2.50, p ≤0.001) and after adjustment for age (HR 1.38, 95 % CI 1.04-1.80, p = 0.025). However, further adjustment for additional possible confounders explained this association. For women with depressive symptoms, 384 (11.2 %) developed incident cancer during the follow-up period, whereas among those with no depressive symptomology, 2803 (9.3 %) developed incident cancer. After accounting for age, depressive symptomology was not associated with risk of overall cancer onset, nor among breast, colon, lung and bronchus, or melanoma subtypes. Additional analyses evaluating relationship of depression symptom severity and cancer onset did not alter findings for men or women. LIMITATIONS This report is limited by the post-hoc study design and subsequent non-randomised nature. Future prospective studies are required. CONCLUSION These results suggest that depressive symptoms are not associated with an increased risk of overall or site-specific cancer onset in these men and women. Given the increased co-occurrence of other medical conditions such as cardiovascular disease, diabetes, stroke and musculoskeletal disorders in people with depression, the role of clinically diagnosed depression and other psychiatric disorders in association with cancer onset necessitates further consideration.
Collapse
Affiliation(s)
- Stephanie P Cowdery
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia.
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway; Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Erik R Sund
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway; Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway; Levanger Hospital, Trøndelag Hospital Trust, Levanger, Norway.
| | | | - Julie A Pasco
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia; Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia; University Hospital Geelong, Barwon Health, Geelong, Australia.
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia; University Hospital Geelong, Barwon Health, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
| | - Lana J Williams
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia.
| |
Collapse
|
25
|
Severe psychiatric disorders and general medical comorbidities: inflammation-related mechanisms and therapeutic opportunities. Clin Sci (Lond) 2022; 136:1257-1280. [PMID: 36062418 DOI: 10.1042/cs20211106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/16/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022]
Abstract
Individuals with severe psychiatric disorders, such as mood disorders and schizophrenia, are at increased risk of developing other medical conditions, especially cardiovascular and metabolic diseases. These medical conditions are underdiagnosed and undertreated in these patients contributing to their increased morbidity and mortality. The basis for this increased comorbidity is not well understood, possibly reflecting shared risks factors (e.g. lifestyle risk factors), shared biological mechanisms and/or reciprocal interactions. Among overlapping pathophysiological mechanisms, inflammation and related factors, such as dysbiosis and insulin resistance, stand out. Besides underlying the association between psychiatric disorders and cardiometabolic diseases, these mechanisms provide several potential therapeutic targets.
Collapse
|
26
|
De Giorgi R, Quinton AMG, Waters S, Cowen PJ, Harmer CJ. An experimental medicine study of the effects of simvastatin on emotional processing, reward learning, verbal memory, and inflammation in healthy volunteers. Psychopharmacology (Berl) 2022; 239:2635-2645. [PMID: 35511258 PMCID: PMC9069418 DOI: 10.1007/s00213-022-06156-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/22/2022] [Indexed: 11/26/2022]
Abstract
RATIONALE Clinical studies suggest that the highly lipophilic, anti-inflammatory molecule, simvastatin, might be an ideal candidate for drug repurposing in the treatment of depression. The neuropsychological effects of simvastatin are not known, but their ascertainment would have significant translational value about simvastatin's influence on mood and cognition. OBJECTIVES We aimed to investigate the effects of simvastatin on a battery of psychological tests and inflammatory markers in healthy volunteers. METHODS Fifty-three healthy subjects were randomly assigned to 7 days of either simvastatin (N = 27) or sucrose-based placebo (N = 26) given in a double-blind fashion. Then, participants were administered questionnaires measuring subjective rates of mood and anxiety, and a battery of tasks assessing emotional processing, reward learning, and verbal memory. Blood samples for C-reactive protein were also collected. RESULTS Compared to placebo, participants on simvastatin showed a higher number of positively valenced intrusions in the emotional recall task (F1,51 = 4.99, p = 0.03), but also an increase in anxiety scores (F1,51 = 5.37, p = 0.02). An exploratory analysis of the females' subgroup (N = 27) showed lower number of misclassifications as sad facial expression in the simvastatin arm (F1,25 = 6.60, p = 0.02). No further statistically significant changes could be observed on any of the other outcomes measured. CONCLUSIONS We found limited evidence that 7-day simvastatin use in healthy volunteer induces a positive emotional bias while also being associated with an increase in anxiety, potentially reflecting the early effects of antidepressants in clinical practice. Such effect might be more evident in female subjects. Different drug dosages, treatment lengths, and sample selection need consideration in further experimental medicine and clinical studies. TRIAL REGISTRATION Clinicaltrials.gov: NCT04652089.
Collapse
Affiliation(s)
- Riccardo De Giorgi
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, Oxfordshire, UK.
- Oxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, Oxfordshire, UK.
| | - Alice M G Quinton
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, Oxfordshire, UK
| | - Shona Waters
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, Oxfordshire, UK
| | - Philip J Cowen
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, Oxfordshire, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, Oxfordshire, UK
| | - Catherine J Harmer
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, Oxfordshire, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, Oxfordshire, UK
| |
Collapse
|
27
|
Fernández-Rodríguez R, Martínez-Vizcaíno V, Mesas AE, Notario-Pacheco B, Medrano M, Heilbronn LK. Does intermittent fasting impact mental disorders? A systematic review with meta-analysis. Crit Rev Food Sci Nutr 2022; 63:11169-11184. [PMID: 35713641 DOI: 10.1080/10408398.2022.2088687] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Accumulating evidence supports the benefits of intermittent fasting (IF) as a dietary strategy for cardiometabolic health and weight control. However, little is known about the potential implications of IF on mental disorders. The aim of this review was to synthesize evidence regarding the effects of IF on mental disorders (depression, anxiety, and mood state) in the general population. We conducted a systematic search in five databases from inception to January 2022. Randomized and nonrandomized clinical trials (RCTs/nonRCTs) were included. A random effects method was used to pool standardized mean differences (SMDs) and 95% CIs. A total of 14 studies involving 562 individuals were included, of which 8 were RCTs and 6 were nonRCTs. IF showed a moderate and positive effect on depression scores when compared to control groups (SMD: 0.41; 95%CI: 0.05 to 0.76; I2=45%; n = 4). Conversely, within-group analyses did not show any significant effect of IF on anxiety (SMD: 0.10; 95%CI: -0.09 to 0.30; I2=0%; n = 5) or mood state (SMD: 0.14; 95%CI: -0.09 to 0.37; I2=59%; n = 7). IF modalities did not negatively impact mental disorders in the general population. In fact, IF showed a positive influence on diminishing depression scores, and did not modify anxiety or mood.
Collapse
Affiliation(s)
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla La-Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Arthur E Mesas
- Health and Social Research Center, Universidad de Castilla La-Mancha, Cuenca, Spain
- Health Science Centre, Universidade Estadual de Londrina, Londrina, Brazil
| | | | - María Medrano
- Health and Social Research Center, Universidad de Castilla La-Mancha, Cuenca, Spain
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Pamplona, Spain
| | - Leonie K Heilbronn
- Adelaide Medical School, Faculty of Health and Medical Sciences, Adelaide, Australia
| |
Collapse
|
28
|
Rahimian R, Belliveau C, Chen R, Mechawar N. Microglial Inflammatory-Metabolic Pathways and Their Potential Therapeutic Implication in Major Depressive Disorder. Front Psychiatry 2022; 13:871997. [PMID: 35782423 PMCID: PMC9245023 DOI: 10.3389/fpsyt.2022.871997] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/23/2022] [Indexed: 12/19/2022] Open
Abstract
Increasing evidence supports the notion that neuroinflammation plays a critical role in the etiology of major depressive disorder (MDD), at least in a subset of patients. By virtue of their capacity to transform into reactive states in response to inflammatory insults, microglia, the brain's resident immune cells, play a pivotal role in the induction of neuroinflammation. Experimental studies have demonstrated the ability of microglia to recognize pathogens or damaged cells, leading to the activation of a cytotoxic response that exacerbates damage to brain cells. However, microglia display a wide range of responses to injury and may also promote resolution stages of inflammation and tissue regeneration. MDD has been associated with chronic priming of microglia. Recent studies suggest that altered microglial morphology and function, caused either by intense inflammatory activation or by senescence, may contribute to depression and associated impairments in neuroplasticity. In this context, modifying microglia phenotype by tuning inflammatory pathways might have important translational relevance to harness neuroinflammation in MDD. Interestingly, it was recently shown that different microglial phenotypes are associated with distinct metabolic pathways and analysis of the underlying molecular mechanisms points to an instrumental role for energy metabolism in shaping microglial functions. Here, we review various canonical pro-inflammatory, anti-inflammatory and metabolic pathways in microglia that may provide new therapeutic opportunities to control neuroinflammation in brain disorders, with a strong focus on MDD.
Collapse
Affiliation(s)
- Reza Rahimian
- Douglas Mental Health University Institute, McGill Group for Suicide Studies, Verdun, QC, Canada
| | - Claudia Belliveau
- Douglas Mental Health University Institute, McGill Group for Suicide Studies, Verdun, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Rebecca Chen
- Douglas Mental Health University Institute, McGill Group for Suicide Studies, Verdun, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Naguib Mechawar
- Douglas Mental Health University Institute, McGill Group for Suicide Studies, Verdun, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| |
Collapse
|
29
|
Seal SV, Henry M, Pajot C, Holuka C, Bailbé D, Movassat J, Darnaudéry M, Turner JD. A Holistic View of the Goto-Kakizaki Rat Immune System: Decreased Circulating Immune Markers in Non- Obese Type 2 Diabetes. Front Immunol 2022; 13:896179. [PMID: 35677049 PMCID: PMC9168276 DOI: 10.3389/fimmu.2022.896179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/25/2022] [Indexed: 11/22/2022] Open
Abstract
Type-2 diabetes is a complex disorder that is now considered to have an immune component, with functional impairments in many immune cell types. Type-2 diabetes is often accompanied by comorbid obesity, which is associated with low grade inflammation. However,the immune status in Type-2 diabetes independent of obesity remains unclear. Goto-Kakizaki rats are a non-obese Type-2 diabetes model. The limited evidence available suggests that Goto-Kakizaki rats have a pro-inflammatory immune profile in pancreatic islets. Here we present a detailed overview of the adult Goto-Kakizaki rat immune system. Three converging lines of evidence: fewer pro-inflammatory cells, lower levels of circulating pro-inflammatory cytokines, and a clear downregulation of pro-inflammatory signalling in liver, muscle and adipose tissues indicate a limited pro-inflammatory baseline immune profile outside the pancreas. As Type-2 diabetes is frequently associated with obesity and adipocyte-released inflammatory mediators, the pro-inflammatory milieu seems not due to Type-2 diabetes per se; although this overall reduction of immune markers suggests marked immune dysfunction in Goto-Kakizaki rats.
Collapse
Affiliation(s)
- Snehaa V Seal
- Department of Infection and Immunity, Luxembourg Institute of Health (LIH), Esch-sur-Alzette, Luxembourg.,Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Mathilde Henry
- Institut National de Recherche Pour l'agriculture, l'alimentation et l'environnement (INRAE), Bordeaux Institut National Polytechnique (INP), NutriNeuro, Unité Mixte de Recherche (UMR) 1286, University of Bordeaux, Bordeaux, France
| | - Clémentine Pajot
- Institut National de Recherche Pour l'agriculture, l'alimentation et l'environnement (INRAE), Bordeaux Institut National Polytechnique (INP), NutriNeuro, Unité Mixte de Recherche (UMR) 1286, University of Bordeaux, Bordeaux, France
| | - Cyrielle Holuka
- Department of Infection and Immunity, Luxembourg Institute of Health (LIH), Esch-sur-Alzette, Luxembourg.,Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Danielle Bailbé
- Université de Paris, Laboratoire B2PE (Biologie et Pathologie du Pancréas Endocrine), Unité BFA (Biologie Fonctionnelle et Adaptative), Centre National de la Recherche Scientifique -Unité Mixte de Recherche (CNRS UMR) 8251, Paris, France
| | - Jamileh Movassat
- Université de Paris, Laboratoire B2PE (Biologie et Pathologie du Pancréas Endocrine), Unité BFA (Biologie Fonctionnelle et Adaptative), Centre National de la Recherche Scientifique -Unité Mixte de Recherche (CNRS UMR) 8251, Paris, France
| | - Muriel Darnaudéry
- Institut National de Recherche Pour l'agriculture, l'alimentation et l'environnement (INRAE), Bordeaux Institut National Polytechnique (INP), NutriNeuro, Unité Mixte de Recherche (UMR) 1286, University of Bordeaux, Bordeaux, France
| | - Jonathan D Turner
- Department of Infection and Immunity, Luxembourg Institute of Health (LIH), Esch-sur-Alzette, Luxembourg
| |
Collapse
|
30
|
Perna L, Trares K, Perneczky R, Tato M, Stocker H, Möllers T, Holleczek B, Schöttker B, Brenner H. Risk of Late-Onset Depression and Cognitive Decline: Results From Inflammatory Proteome Analyses in a Prospective Population-Based Cohort Study. Am J Geriatr Psychiatry 2022; 30:689-700. [PMID: 34961662 DOI: 10.1016/j.jagp.2021.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Research suggests that inflammation is linked to both late-onset depression (LOD) and cognitive decline, and that LOD might have biological underpinnings differentiating it from recurrent depression. Evidence from inflammatory proteome analyses in large prospective cohorts is scarce. The aim of this study was to assess whether and which inflammation-related biomarkers are associated with LOD, recurrent depression, and cognitive decline due to vascular pathology (vascular dementia). DESIGN Ongoing population-based cohort study of older adults followed for up to 17 years with regard to clinical diagnosis of various age-related diseases (ESTHER study, n = 9,940). SETTING Longitudinal cohort started in 2000-2002 in a community setting in Saarland, a southwestern German state. PARTICIPANTS Subgroup of randomly selected participants of the ESTHER study (n = 1,665). MEASUREMENTS Inflammatory biomarkers were measured with the Olink Target 96 in baseline samples. RESULTS Out of 78 biomarkers interleukin 10 (IL-10) and C-C chemokine ligand 4 (CCL4) were associated with significantly increased risk of LOD after multiple testing correction. Hazard ratios (95-confidence interval) per 1 standard deviation increase were 1.37 (1.15-1.63) for IL-10 and 1.34 (1.13-1.59) for CCL4. None of the inflammatory markers was associated with recurrent depression. The dose-response analysis showed a similar monotonic risk increase for LOD and vascular dementia with increasing IL-10 levels. CONCLUSION These results suggest that inflammatory markers are involved in the etiology of LOD, but not of recurrent depression and that LOD and vascular dementia might share common inflammatory etiology with respect to IL-10.
Collapse
Affiliation(s)
- Laura Perna
- Department of Translational Research in Psychiatry (LP), Max Planck Institute of Psychiatry, Munich, Germany; Division of Mental Health of Older Adults (LP, RP, MT), Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany; Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Kira Trares
- Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research (NAR) (KT, HS, TM, BS, HB), Heidelberg University, Heidelberg, Germany; Medical Faculty (KT, HS), Heidelberg University, Heidelberg, Germany
| | - Robert Perneczky
- Division of Mental Health of Older Adults (LP, RP, MT), Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany; Ageing Epidemiology (AGE) Research Unit (RP), School of Public Health, Imperial College London, UK; German Center for Neurodegenerative Diseases (DZNE) (RP), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy) (RP), Munich, Germany
| | - Maia Tato
- Division of Mental Health of Older Adults (LP, RP, MT), Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - Hannah Stocker
- Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research (NAR) (KT, HS, TM, BS, HB), Heidelberg University, Heidelberg, Germany; Medical Faculty (KT, HS), Heidelberg University, Heidelberg, Germany
| | - Tobias Möllers
- Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research (NAR) (KT, HS, TM, BS, HB), Heidelberg University, Heidelberg, Germany
| | - Bernd Holleczek
- Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany; Saarland Cancer Registry (BH), Saarbrücken, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research (NAR) (KT, HS, TM, BS, HB), Heidelberg University, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research (NAR) (KT, HS, TM, BS, HB), Heidelberg University, Heidelberg, Germany
| |
Collapse
|
31
|
Dos Santos Guilherme M, Tsoutsouli T, Chongtham MC, Winter J, Gerber S, Müller MB, Endres K. Selective targeting of chronic social stress-induced activated neurons identifies neurogenesis-related genes to be associated with resilience in female mice. Psychoneuroendocrinology 2022; 139:105700. [PMID: 35220090 DOI: 10.1016/j.psyneuen.2022.105700] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/17/2022] [Accepted: 02/17/2022] [Indexed: 11/16/2022]
Abstract
Prolonged social stress is a major cause for depression in humans and is associated with a wide range of subsequent pathophysiological changes such as elevated blood pressure. A routinely used model for investigating this kind of stress in mice is the chronic social defeat paradigm where a smaller intruder is exposed to an aggressive inhabitant of a home cage. This model is restricted to males and includes a high proportion of physical stress that might e.g., interfere with immunological aspects of the stress. The prevalence of depression in humans is even higher in women than in men. Therefore, expanding models to female individuals is desirable. We here tested the social instability model as a tool for administering chronic social stress to female C57BL/6J mice and analyzed short-term as well as long-lasting effects. Animals were housed in groups of four and were shuffled two times a week, resulting in a permanent re-structuration of their social hierarchy. While directly after the stress exposure, serum corticosterone was elevated, increased body weight and fat deposits were observed in stressed mice even one year after discontinuation of the stress. At the behavioral level, animals could be stratified into resilient and susceptible animals directly post-stress, but those subgroups were not distinguishable any more in the long-term analysis. To identify molecular contributors to resilience in the here presented social instability induced stress model, Arc-activity dependent trapping of neurons was conducted in Arc-creERT2/sun1sfGFP mice. RNA samples derived from activated nuclei from the ventral hippocampus, a brain region involved in stress-regulation during attacks or explorative behavior of mice, were subjected to a neurogenesis pathway array. While several genes were differentially regulated by stress, in particular, artemin, a neurotrophic factor was upregulated in resilient versus susceptible individuals.
Collapse
Affiliation(s)
- Malena Dos Santos Guilherme
- Department of Psychiatry and Psychotherapy, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Theodora Tsoutsouli
- Department of Psychiatry and Psychotherapy, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Monika Chanu Chongtham
- Institute for Human Genetics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany; Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Jennifer Winter
- Institute for Human Genetics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany; Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Susanne Gerber
- Institute for Human Genetics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marianne B Müller
- Department of Psychiatry and Psychotherapy, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany; Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Kristina Endres
- Department of Psychiatry and Psychotherapy, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany.
| |
Collapse
|
32
|
Brydges CR, Bhattacharyya S, Dehkordi SM, Milaneschi Y, Penninx B, Jansen R, Kristal BS, Han X, Arnold M, Kastenmüller G, Bekhbat M, Mayberg HS, Craighead WE, Rush AJ, Fiehn O, Dunlop BW, Kaddurah-Daouk R. Metabolomic and inflammatory signatures of symptom dimensions in major depression. Brain Behav Immun 2022; 102:42-52. [PMID: 35131442 PMCID: PMC9241382 DOI: 10.1016/j.bbi.2022.02.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/25/2022] [Accepted: 02/01/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a highly heterogenous disease, both in terms of clinical profiles and pathobiological alterations. Recently, immunometabolic dysregulations were shown to be correlated with atypical, energy-related symptoms but less so with the Melancholic or Anxious distress symptom dimensions of depression in The Netherlands Study of Depression and Anxiety (NESDA) study. In this study, we aimed to replicate these immunometabolic associations and to characterize the metabolomic correlates of each of the three MDD dimensions. METHODS Using three clinical rating scales, Melancholic, and Anxious distress, and Immunometabolic (IMD) dimensions were characterized in 158 patients who participated in the Predictors of Remission to Individual and Combined Treatments (PReDICT) study and from whom plasma and serum samples were available. The NESDA-defined inflammatory index, a composite measure of interleukin-6 and C-reactive protein, was measured from pre-treatment plasma samples and a metabolomic profile was defined using serum samples analyzed on three metabolomics platforms targeting fatty acids and complex lipids, amino acids, acylcarnitines, and gut microbiome-derived metabolites among other metabolites of central metabolism. RESULTS The IMD clinical dimension and the inflammatory index were positively correlated (r = 0.19, p = 0.019) after controlling for age, sex, and body mass index, whereas the Melancholic and Anxious distress dimensions were not, replicating the previous NESDA findings. The three symptom dimensions had distinct metabolomic signatures using both univariate and set enrichment statistics. IMD severity correlated mainly with gut-derived metabolites and a few acylcarnitines and long chain saturated free fatty acids. Melancholia severity was significantly correlated with several phosphatidylcholines, primarily the ether-linked variety, lysophosphatidylcholines, as well as several amino acids. Anxious distress severity correlated with several medium and long chain free fatty acids, both saturated and polyunsaturated ones, sphingomyelins, as well as several amino acids and bile acids. CONCLUSION The IMD dimension of depression appears reliably associated with markers of inflammation. Metabolomics provides powerful tools to inform about depression heterogeneity and molecular mechanisms related to clinical dimensions in MDD, which include a link to gut microbiome and lipids implicated in membrane structure and function.
Collapse
Affiliation(s)
| | - Sudeepa Bhattacharyya
- Arkansas Biosciences Institute, Department of Biological Sciences, Arkansas State University, AR, USA
| | | | - Yuri Milaneschi
- Amsterdam UMC / GGZ inGeest Research & Innovation, Amsterdam, Netherlands
| | - Brenda Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Netherlands
| | - Rick Jansen
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Netherlands; Department of Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Bruce S Kristal
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Xianlin Han
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Matthias Arnold
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Institute of Computational Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Gabi Kastenmüller
- Institute of Computational Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Mandakh Bekhbat
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Helen S Mayberg
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Psychology, Emory University, Atlanta, GA, USA
| | - A John Rush
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Psychiatry, Health Sciences Center, Texas Tech University, Permian Basin, TX, USA; Duke-National University of Singapore, Singapore
| | - Oliver Fiehn
- West Coast Metabolomics Center, University of California, Davis, USA
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Rima Kaddurah-Daouk
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Medicine, Duke University, Durham, NC, USA; Duke Institute of Brain Sciences, Duke University, Durham, NC, USA.
| |
Collapse
|
33
|
Eriksson MD, Eriksson JG, Korhonen P, Salonen MK, Mikkola TM, Kajantie E, Wasenius NS, von Bonsdorff M, Kautiainen H, Laine MK. Non-melancholic depressive symptoms are associated with above average fat mass index in the Helsinki birth cohort study. Sci Rep 2022; 12:6987. [PMID: 35484274 PMCID: PMC9051115 DOI: 10.1038/s41598-022-10592-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
There is an existing link between two of the most common diseases, obesity and depression. These are both of great public health concern, but little is known about the relationships between the subtypes of these conditions. We hypothesized that non-melancholic depressive symptoms have a stronger relationship with both body composition (lean mass and fat mass) and dysfunctional glucose metabolism than melancholic depression. For this cross-sectional study 1510 participants from the Helsinki Birth Cohort Study had their body composition evaluated as lean mass and fat mass (Lean Mass Index [LMI, kg/m2] + Fat Mass Index [FMI kg/m2] = Body Mass Index). Participants were evaluated for depressive symptoms utilizing the Beck depression inventory, and had laboratory assessments including an oral glucose tolerance test. Higher than average FMI was associated with a higher percentage (mean [%], 95% CI) of participants scoring in the depressive range of the Beck depression inventory (20.2, 17.2–23.2) compared to those with low FMI (16.3, 13.8–18.9; p = 0.048) when adjusted for age, sex, education, and fasting plasma glucose concentration. Higher FMI was associated with a higher likelihood of having depressive symptoms (OR per 1-SD FMI = 1.37, 95% CI 1.13–1.65), whereas higher LMI was associated with a lower likelihood of having depressive symptoms (OR per 1-SD LMI = 0.76, 95% CI 0.64–0.91). Participants with an above average FMI more frequently (mean [%], 95% CI) had non-melancholic depressive symptoms (14.7, 11.8–17.7) as compared to those with low FMI (9.7, 7.6–11.9; p = 0.008) regardless of LMI levels. There was no difference between the body composition groups in the likelihood of having melancholic depressive symptoms. The non-melancholic group had higher (mean [kg/m2], SD) FMI (9.6, 4.1) than either of the other groups (BDI < 10: 7.7, 3.1; melancholic: 7.9, 3.6; p < 0.001), and a higher (mean [mmol/l], SD) 2-h glucose concentration (7.21, 1.65) than the non-depressed group (6.71, 1.70; p = 0.005). As hypothesized, non-melancholic depressive symptoms are most closely related to high fat mass index and dysfunctional glucose metabolism.
Collapse
Affiliation(s)
- Mia D Eriksson
- Primary Health Care Unit, Helsinki University Hospital (HUS), Helsinki, Finland. .,Folkhälsan Research Center, Helsinki, Finland.
| | - Johan G Eriksson
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Obstetrics and Gynecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Päivi Korhonen
- Department of General Practice, Turku University Hospital and University of Turku, Turku, Finland
| | - Minna K Salonen
- Folkhälsan Research Center, Helsinki, Finland.,Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tuija M Mikkola
- Folkhälsan Research Center, Helsinki, Finland.,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Niko S Wasenius
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mikaela von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland.,Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Merja K Laine
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
34
|
Stapel B, Jelinic M, Drummond GR, Hartung D, Kahl KG. Adipose Tissue Compartments, Inflammation, and Cardiovascular Risk in the Context of Depression. Front Psychiatry 2022; 13:831358. [PMID: 35444568 PMCID: PMC9013771 DOI: 10.3389/fpsyt.2022.831358] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/07/2022] [Indexed: 12/20/2022] Open
Abstract
The neurobiological and behavioral underpinnings linking mental disorders, in particular, major depressive disorder (MDD), with cardiovascular disorders are a matter of debate. Recent research focuses on visceral (intra-abdominal and epicardial) adipose tissue and inflammation and their impact on the development of cardiometabolic disorders. Intra-abdominal adipose tissue is defined as an endocrine active fat compartment surrounding inner organs and is associated with type 2 diabetes mellitus, a risk factor for the later development of cardiovascular disorders. Epicardial (pericardial) adipose tissue is a fat compartment surrounding the heart with close proximity to the arteries supporting the heart. Visceral adipose tissue (VAT) is an important source of inflammatory mediators that, in concert with other risk factors, plays a leading role in cardiovascular diseases. In conjunction with the behavioral (physical inactivity, sedentary lifestyle), psychological (adherence problems), and hormonal (dysfunction of the hypothalamus-pituitary-adrenal axis with subsequent hypercortisolism) alterations frequently accompanying MDD, an enhanced risk for cardiovascular disorders results.
Collapse
Affiliation(s)
- Britta Stapel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Maria Jelinic
- Department of Physiology, Anatomy and Microbiology, Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora, VIC, Australia
| | - Grant R. Drummond
- Department of Physiology, Anatomy and Microbiology, Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora, VIC, Australia
| | - Dagmar Hartung
- Hannover Medical School, Institute for Diagnostic and Interventional Radiology, Hanover, Germany
| | - Kai G. Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| |
Collapse
|
35
|
Aleti G, Kohn JN, Troyer EA, Weldon K, Huang S, Tripathi A, Dorrestein PC, Swafford AD, Knight R, Hong S. Salivary bacterial signatures in depression-obesity comorbidity are associated with neurotransmitters and neuroactive dipeptides. BMC Microbiol 2022; 22:75. [PMID: 35287577 PMCID: PMC8919597 DOI: 10.1186/s12866-022-02483-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/25/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Depression and obesity are highly prevalent, often co-occurring conditions marked by inflammation. Microbiome perturbations are implicated in obesity-inflammation-depression interrelationships, but how the microbiome mechanistically contributes to pathology remains unclear. Metabolomic investigations into microbial neuroactive metabolites may offer mechanistic insights into host-microbe interactions. Using 16S sequencing and untargeted mass spectrometry of saliva, and blood monocyte inflammation regulation assays, we identified key microbes, metabolites and host inflammation in association with depressive symptomatology, obesity, and depressive symptomatology-obesity comorbidity. RESULTS Gram-negative bacteria with inflammation potential were enriched relative to Gram-positive bacteria in comorbid obesity-depression, supporting the inflammation-oral microbiome link in obesity-depression interrelationships. Oral microbiome was more highly predictive of depressive symptomatology-obesity co-occurrences than of obesity or depressive symptomatology independently, suggesting specific microbial signatures associated with obesity-depression co-occurrences. Mass spectrometry analysis revealed significant changes in levels of signaling molecules of microbiota, microbial or dietary derived signaling peptides and aromatic amino acids among depressive symptomatology, obesity and comorbid obesity-depression. Furthermore, integration of the microbiome and metabolomics data revealed that key oral microbes, many previously shown to have neuroactive potential, co-occurred with potential neuropeptides and biosynthetic precursors of the neurotransmitters dopamine, epinephrine and serotonin. CONCLUSIONS Together, our findings offer novel insights into oral microbial-brain connection and potential neuroactive metabolites involved.
Collapse
Affiliation(s)
- Gajender Aleti
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA
| | - Jordan N Kohn
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA
| | - Emily A Troyer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA
| | - Kelly Weldon
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, 92093, USA
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, 92093, USA
| | - Shi Huang
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, 92093, USA
- Department of Pediatrics, University of California San Diego, La Jolla, CA, 92093, USA
| | - Anupriya Tripathi
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, 92093, USA
- Department of Pediatrics, University of California San Diego, La Jolla, CA, 92093, USA
| | - Pieter C Dorrestein
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, 92093, USA
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, 92093, USA
- Department of Pediatrics, University of California San Diego, La Jolla, CA, 92093, USA
- Collaborative Mass Spectrometry Innovation Center, University of California San Diego, La Jolla, CA, 92093, USA
| | - Austin D Swafford
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, 92093, USA
| | - Rob Knight
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, 92093, USA
- Department of Pediatrics, University of California San Diego, La Jolla, CA, 92093, USA
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA, 92093, USA
- Department of Bioengineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Suzi Hong
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA.
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, 92093, USA.
| |
Collapse
|
36
|
Archer M, Niemelä O, Hämäläinen M, Moilanen E, Leinonen E, Kampman O. The role of alcohol use and adiposity in serum levels of IL-1RA in depressed patients. BMC Psychiatry 2022; 22:158. [PMID: 35232419 PMCID: PMC8889691 DOI: 10.1186/s12888-022-03784-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 01/25/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The role of Interleukin-1 Receptor antagonist (IL-1Ra), an innate antagonist to pro-inflammatory cytokine IL-1, has attracted increasing attention due to its potential pathogenic and therapeutic implications in depression. However, the role of alcohol and adiposity in modulating IL-1Ra cytokine pathway in depressed patients has remainned unknown. The aim of this study was to follow the changes in IL-1Ra serum levels in depressed patients with or without simultaneous alcohol use disorder (AUD) and different degrees of adiposity during 6 months of follow-up. MATERIALS AND METHODS A total of 242 patients with depression were followed for 6 months. At baseline 99 patients had simultaneous AUD. Levels of serum IL-1Ra and common mediators of inflammation (IL-6, hs-CRP) were measured. Clinical assessments included Body Mass Index (BMI), Montgomery-Asberg Depression Rating Scale (MADRS) and Alcohol Use Disorders Identification Test (AUDIT) scores. RESULTS Significant reductions in clinical symptoms and IL-1Ra were observed during 6-month follow-up. In hierarchical linear regression analysis, the effect of MADRS score, age, gender, and smoking had a combined effect of 2.4% in the model. The effect of AUDIT score increased the effect to 4.2% of variance (p = 0.08), whereas adding BMI increased the effect to 18.5% (p < 0.001). CONCLUSION Adiposity may influence the IL-1Ra anti-inflammatory response in depressed patients, whereas the effect of alcohol consumption in these patients seems insignificant. These findings should be considered in studies on the role of IL-1Ra in depression. TRIAL REGISTRATION Ostrobothnia Depression Study in ClinicalTrials.gov , Identifier NCT02520271 .
Collapse
Affiliation(s)
- Mari Archer
- Tampere University, Faculty of Medicine and Health Technology, P.O. Box 100, 33014, Tampere, Finland.
| | - Onni Niemelä
- grid.415465.70000 0004 0391 502XDepartment of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, 60220 Seinäjoki, Finland
| | - Mari Hämäläinen
- grid.412330.70000 0004 0628 2985The Immunopharmacology Research Group, Tampere University, Faculty of Medicine and Health Technology, and Tampere University Hospital, 33014 Tampere, Finland
| | - Eeva Moilanen
- grid.412330.70000 0004 0628 2985The Immunopharmacology Research Group, Tampere University, Faculty of Medicine and Health Technology, and Tampere University Hospital, 33014 Tampere, Finland
| | - Esa Leinonen
- grid.412330.70000 0004 0628 2985Tampere University, Faculty of Medicine and Health Technology, P.O. Box 100, 33014 University of Tampere, and Tampere University Hospital, 33014 Tampere, Finland
| | - Olli Kampman
- grid.502801.e0000 0001 2314 6254Tampere University, Faculty of Medicine and Health Technology, P.O. Box 100, 33014 University of Tampere and Pirkanmaa Hospital District, Department of Psychiatry, 33521 Tampere, Finland
| |
Collapse
|
37
|
Navinés R, Oriolo G, Horrillo I, Cavero M, Aouizerate B, Schaefer M, Capuron L, Meana JJ, Martin-Santos R. High S100B Levels Predict Antidepressant Response in Patients With Major Depression Even When Considering Inflammatory and Metabolic Markers. Int J Neuropsychopharmacol 2022; 25:468-478. [PMID: 35176771 PMCID: PMC9211008 DOI: 10.1093/ijnp/pyac016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/31/2022] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The relationship between antidepressant response and glial, inflammatory, and metabolic markers is poorly understood in depression. This study assessed the ability of biological markers to predict antidepressant response in major depressive disorder (MDD). METHODS We included 31 MDD outpatients treated with escitalopram or sertraline for 8 consecutive weeks. The Montgomery-Åsberg Depression Rating Scale (MADRS) was administered at baseline and at week 4 and 8 of treatment. Concomitantly, blood samples were collected for the determination of serum S100B, C-reactive protein (CRP), and high-density lipoprotein cholesterol (HDL)-C levels. Treatment response was defined as ≥50% improvement in the MADRS score from baseline to either week 4 or 8. Variables associated with treatment response were included in a linear regression model as predictors of treatment response. RESULTS Twenty-seven patients (87%) completed 8 weeks of treatment; 74% and 63% were responders at week 4 and 8, respectively. High S100B and low HDL-C levels at baseline were associated with better treatment response at both time points. Low CRP levels were correlated with better response at week 4. Multivariate analysis showed that high baseline S100B levels and low baseline HDL-C levels were good predictors of treatment response at week 4 (R2 = 0.457, P = .001), while S100B was at week 8 (R2 = 0.239, P = .011). Importantly, baseline S100B and HDL-C levels were not associated with depression severity and did not change over time with clinical improvement. CONCLUSIONS Serum S100B levels appear to be a useful biomarker of antidepressant response in MDD even when considering inflammatory and metabolic markers.
Collapse
Affiliation(s)
- Ricard Navinés
- Department of Psychiatry and Psychology, Hospital Clinic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Barcelona, Spain
| | - Giovanni Oriolo
- Department of Psychiatry and Psychology, Hospital Clinic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Barcelona, Spain,Hospital de día Córcega, Centre Psicoterapèutic Barcelona (CPB); and Department of Experimental and Health Sciences, Psychiatry Unit, Universitat Pompeu Fabra, Barcelona, Spain
| | - Igor Horrillo
- Department of Pharmacology, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain; CIBERSAM, Leioa, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Myriam Cavero
- Department of Psychiatry and Psychology, Hospital Clinic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Barcelona, Spain
| | - Bruno Aouizerate
- University of Bordeaux, INRAE, Bordeaux INP, NutriNeuro, UMR 1286, Bordeaux, France,CH Charles Perrens, Pole de Psychiatrie Générale et Universitaire, Centre de référence régional des pathologies anxieuses et de la dépression, Bordeaux, France
| | - Martin Schaefer
- Department of Psychiatry and Psychotherapy, Charité-Universitâtsmedizin Berlin, Campus Charité Mitte, Berlin, Germany,Department of Psychiatry, Psychotherapy, Psychosomatics and Addiction Medicine, Evang. Kliniken Es-sen-Mitte, Essen, Germany
| | - Lucile Capuron
- University of Bordeaux, INRAE, Bordeaux INP, NutriNeuro, UMR 1286, Bordeaux, France
| | - J Javier Meana
- Department of Pharmacology, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain; CIBERSAM, Leioa, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Rocio Martin-Santos
- Correspondence: Rocio Martin-Santos, MD, PhD, Senior Consultant, Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM; and Department of Medicine, Institute of Neuroscience, University of Barcelona, 08036-Barcelona, Spain ()
| |
Collapse
|
38
|
Rojas Y. Debt Problem of One Partner and Depressive Morbidity in the Other: A 2-Year Follow-up Register Study of Different-Sex Couples in Sweden. JOURNAL OF FAMILY AND ECONOMIC ISSUES 2022; 44:1-15. [PMID: 35153462 PMCID: PMC8821787 DOI: 10.1007/s10834-022-09817-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
This study sets out to examine whether depressive morbidity varies by status of financial indebtedness of a spouse or cohabiting partner. For this purpose, individuals aged between 20 and 60 with a different-sex spouse/cohabiting partner with a registration date for a debt at the Swedish Enforcement Authority (SEA) during 2017 (n = 6979) are followed-up for a 2-year period for prescriptions of antidepressants and compared with a sample from the general Swedish population (n = 29,708). The analysis is based on penalized maximum likelihood logistic regressions. Both women and men were more likely to suffer from depressive morbidity if the spouse/cohabiting partner had been registered at the SEA in 2017 and was still active for a debt in the SEA's register in 2018 (OR 1.31 and OR 1.57, respectively), irrespective of their own health, employment, socioeconomic status, and other background variables. This also held true for men if a wife/cohabiting partner had been registered at the SEA in 2017 but was no longer active for a debt in the SEA's register in 2018 (OR 1.29). For women, on the other hand, only those with no history (11-year period) of prescription of psychotropic medications were also at an enhanced risk of depressive morbidity if a husband/cohabiting partner had gone from being registered for a debt at the SEA in 2017, to not being registered as active for a debt in the SEA's register in 2018 (OR 1.24). The results reinforce the importance of acknowledging that negative effects of financial indebtedness extend beyond the individual debtor.
Collapse
Affiliation(s)
- Yerko Rojas
- School of Social Sciences, Södertörn University, 141 89 Huddinge, Sweden
| |
Collapse
|
39
|
Anand SS, Friedrich MG, Lee DS, Awadalla P, Després JP, Desai D, de Souza RJ, Dummer T, Parraga G, Larose E, Lear SA, Teo KK, Poirier P, Schulze KM, Szczesniak D, Tardif JC, Vena J, Zatonska K, Yusuf S, Smith EE. Evaluation of Adiposity and Cognitive Function in Adults. JAMA Netw Open 2022; 5:e2146324. [PMID: 35103790 PMCID: PMC8808326 DOI: 10.1001/jamanetworkopen.2021.46324] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
IMPORTANCE Excess adipose tissue increases other cardiovascular risk factors, which may be associated with vascular brain injury and cognitive impairment. However, the extent to which the amount and distribution of adipose tissue may be associated with lower cognitive scores, independent of its association with cardiovascular risk factors, is not well characterized. OBJECTIVE To investigate the association of adiposity on vascular brain injury and cognitive scores. DESIGN, SETTING, AND PARTICIPANTS A total of 9189 participants from the Canadian Alliance for Healthy Hearts and Minds (CAHHM) and the Prospective Urban Rural Epidemiological-Mind (PURE-MIND) cohort studies were included in this cross-sectional analysis. Of these adults, 9166 underwent bioelectrical impedance analysis to assess body fat (BF) percentage, and 6773 underwent magnetic resonance imaging to assess vascular brain injury and measure visceral adipose tissue (VAT) volume. Participants from CAHHM were recruited from January 1, 2014, to December 31, 2018, and PURE-MIND participants were recruited from January 1, 2010, to December 31, 2018. Both CAHHM and PURE-MIND comprise multisite, population-based cohorts. Participants from CAHHM are from Canada, and PURE-MIND participants are from Canada or Poland. Data analysis was performed from May 3 to November 24, 2021. EXPOSURES The percentage of BF and VAT were modeled as sex-specific quartiles. Vascular brain injury was defined as high white matter hyperintensities or silent brain infarction. Multivariable mixed models were used to examine factors associated with reduced cognitive scores. MAIN OUTCOMES AND MEASURES Cognitive function was assessed using the Digital Symbol Substitution Test (DSST; scores range from 0 to 133, with lower scores indicating lower cognitive function) and Montreal Cognitive Assessment (scores range from 0 to 30, with a score of ≥26 denoting normal cognitive function). Reduced cognition was defined as a DSST score less than 1 SD below the mean. Cardiovascular risk was assessed using the INTERHEART Risk Score (IHRS; scores range from 0 to 48; low risk is defined as a score of 0 to 9, moderate risk as 10 to 16, and high risk as 17 or higher). RESULTS A total of 9189 adults (mean [SD] age, 57.8 [8.8] years; 5179 [56.4%] women; and 1013 [11.0%] East and Southeast Asian; 295 [3.2%] South Asian; 7702 [83.8%] White European; and 179 [1.9%] other, including Black, Indigenous, mixed, and unknown ethnicity) participated in the study. Visceral adipose tissue was highly correlated with body adiposity measured by BF percentage (r = 0.76 in women; r = 0.70 in men). Cardiovascular risk factors increased with increasing BF percentage with the fourth quartile IHRS at 13.8 (95% CI, 13.5-14.0; P < .001 for trend) and with VAT with the fourth quartile IHRS at 13.3 (95% CI, 13.0-13.5; P < .001 for trend). Vascular brain injury increased with increasing BF percentage with the fourth quartile value at 8.6% (95% CI, 7.5%-9.8%; P = .007 for trend) and with increasing VAT with fourth quartile value at 7.2% (95% CI, 6.0-8.4; P = .05 for trend). Cognitive scores were lower with increasing BF percentage with the fourth quartile score of 70.9 (95% CI, 70.4-71.5; P < .001 for trend) and for VAT with the fourth quartile score of 72.8 (95% CI, 72.1-73.4; P < .001 for trend). For every 1-SD increase in BF percentage (9.2%) or VAT (36 mL), the DSST score was lower by 0.8 points (95% CI, 0.4-1.1; P < .001) for BF percentage and lower by 0.8 points (95% CI, 0.4-1.2; P < .001) for VAT, adjusted for cardiovascular risk factors and vascular brain injury. The population attributable risk for reduced DSST score for higher BF percentage was 20.5% (95% CI, 7.0%-33.2%) and for VAT was 19.6% (95% CI, 2.0%-36.0%). Higher BF percentage and VAT were not associated with Montreal Cognitive Assessment scores. CONCLUSIONS AND RELEVANCE In this cross-sectional study, generalized and visceral adiposity were associated with reduced cognitive scores, after adjustment for cardiovascular risk factors, educational level, and vascular brain injury. These results suggest that strategies to prevent or reduce adiposity may preserve cognitive function.
Collapse
Affiliation(s)
- Sonia S. Anand
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
- Department of Medicine and Epidemiology, McMaster University, Hamilton, Ontario, Canada
| | - Matthias G. Friedrich
- Department of Cardiology and Diagnostic Radiology, McGill University, Montreal, Quebec, Canada
| | - Douglas S. Lee
- Programming and Biostatistics, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Division of Cardiology, Peter Munk Cardiac Centre and University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Phillip Awadalla
- Department of Molecular Genetics, Ontario Institute for Cancer Research, University of Toronto, Toronto, Ontario, Canada
| | - J. P. Després
- Department of Kinesiology, University of Laval, Quebec City, Quebec, Canada
| | - Dipika Desai
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Russell J. de Souza
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Trevor Dummer
- Department of Epidemiology, Biostatistics, and Public Health Practice, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Grace Parraga
- Department of Medical Biophysics, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Eric Larose
- Department of Medicine, University of Laval, Quebec City, Quebec, Canada
| | - Scott A. Lear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Koon K. Teo
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Paul Poirier
- Faculté de Pharmacie, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Quebec, Canada
| | - Karleen M. Schulze
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Dorota Szczesniak
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | - Jean-Claude Tardif
- Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Jennifer Vena
- Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, Alberta, Canada
| | - Katarzyna Zatonska
- Department of Social Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Eric E. Smith
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Alberta, Canada
- University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Ontario, Canada
| |
Collapse
|
40
|
Porter GA, O’Connor JC. Brain-derived neurotrophic factor and inflammation in depression: Pathogenic partners in crime? World J Psychiatry 2022; 12:77-97. [PMID: 35111580 PMCID: PMC8783167 DOI: 10.5498/wjp.v12.i1.77] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/21/2021] [Accepted: 12/02/2021] [Indexed: 02/06/2023] Open
Abstract
Major depressive disorder is a debilitating disorder affecting millions of people each year. Brain-derived neurotrophic factor (BDNF) and inflammation are two prominent biologic risk factors in the pathogenesis of depression that have received considerable attention. Many clinical and animal studies have highlighted associations between low levels of BDNF or high levels of inflammatory markers and the development of behavioral symptoms of depression. However, less is known about potential interaction between BDNF and inflammation, particularly within the central nervous system. Emerging evidence suggests that there is bidirectional regulation between these factors with important implications for the development of depressive symptoms and anti-depressant response. Elevated levels of inflammatory mediators have been shown to reduce expression of BDNF, and BDNF may play an important negative regulatory role on inflammation within the brain. Understanding this interaction more fully within the context of neuropsychiatric disease is important for both developing a fuller understanding of biological pathogenesis of depression and for identifying novel therapeutic opportunities. Here we review these two prominent risk factors for depression with a particular focus on pathogenic implications of their interaction.
Collapse
Affiliation(s)
- Grace A Porter
- Department of Pharmacology, UT Health San Antonio, San Antonio, TX 78229, United States
| | - Jason C O’Connor
- Department of Pharmacology, University of Texas Health San Antonio, San Antonio, TX 78229, United States
- Audie L. Murphy VA Hospital, South Texas Veterans Health System, San Antonio, TX 78229, United States
| |
Collapse
|
41
|
Relationship between CRP and depression: A genetically sensitive study in Sri Lanka. J Affect Disord 2022; 297:112-117. [PMID: 34653513 DOI: 10.1016/j.jad.2021.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Previous studies have shown associations between major depression and C-reactive protein (CRP) levels. Few studies have considered the extent to which shared genetic and environmental factors contribute to this association, nor have they considered the relationship outside of European populations. We examined the association between CRP levels and depression and their aetiology in a Sri Lankan population. METHODS Data were collected from 2577 twins and 899 singletons in Colombo, Sri Lanka. Depression symptoms were assessed using the revised Beck Depression Inventory (BDI-II). High-sensitive CRP blood levels were assessed using immunoturbidimetry. Linear regressions were performed to test the association between CRP and depression. The heritability of CRP levels was estimated using Structural Equation Modelling. RESULTS CRP was significantly associated with BMI (p < 0.01) but not depression (p > 0.05). In males, variance in CRP levels was explained by shared environment (51% 95%CIs: 13-62) and non-shared environment (45% 95%CIs: 36-54). In contrast, in females, CRP variance was explained by genetic (41% 95%CIs: 10-52) and non-shared environment (56% 95%CIs: 47-67). A genetic correlation between CRP and BMI was observed in females only. LIMITATIONS CRP level was based on a single data collection point, longer term data collection would give a more accurate picture of an individual's state of inflammation. CONCLUSIONS The lack of association between depression and CRP strengthens the hypothesis that inflammation might contribute to the development of some, but not all types of depression. CRP levels were moderated by the environment, suggesting interventions aimed at reducing CRP levels and risk for inflammatory conditions, particularly in males.
Collapse
|
42
|
Association between the indole pathway of tryptophan metabolism and subclinical depressive symptoms in obesity: a preliminary study. Int J Obes (Lond) 2022; 46:885-888. [PMID: 35001078 DOI: 10.1038/s41366-021-01049-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 12/13/2022]
Abstract
Converging data support the role of chronic low-grade inflammation in depressive symptomatology in obesity. One mechanism likely to be involved relies on the effects of inflammation on tryptophan (TRP) metabolism. While recent data document alterations in the indole pathway of TRP metabolism in obesity, the relevance of this mechanism to obesity-related depressive symptoms has not been investigated. The aim of this preliminary study was to assess the association between plasma levels of TRP and indole metabolites and depressive symptoms in 44 subjects with severe or morbid obesity, free of clinically relevant neuropsychiatric disorders. The interaction effect of inflammation, reflected in serum high-sensitive C-reactive protein (hsCRP) levels, and indoles on depressive symptoms was also determined. Higher serum levels of hsCRP and lower concentrations of TRP and indoles, particularly indole-3-carboxaldehyde (IAld), correlated with more severe depressive symptoms. Interestingly, the effect of high hsCRP levels in predicting greater depressive symptoms was potentiated by low IAld levels. These results comfort the link between inflammation, the indole pathway of TRP metabolism, and obesity-related depressive symptoms.
Collapse
|
43
|
Abstract
ABSTRACT Inflammatory phenomena are found in many psychiatric disorders-notably, depression, schizophrenia, and posttraumatic stress disorder. Inflammation has been linked to severity and treatment resistance, and may both contribute to, and result from, the pathophysiology of some psychiatric illnesses. Emerging research suggests that inflammation may contribute to symptom domains of reward, motor processing, and threat reactivity across different psychiatric diagnoses. Reward-processing deficits contribute to motivational impairments in depression and schizophrenia, and motor-processing deficits contribute to psychomotor slowing in both depression and schizophrenia. A number of experimental models and clinical trials suggest that inflammation produces deficits in reward and motor processing through common pathways connecting the cortex and the striatum, which includes the nucleus accumbens, caudate nucleus, and putamen.The observed effects of inflammation on psychiatric disorders may cut across traditional conceptualizations of psychiatric diagnoses. Further study may lead to targeted immunomodulating treatments that address difficult-to-treat symptoms in a number of psychiatric disorders. In this review, we use a Research Domain Criteria framework to discuss proposed mechanisms for inflammation and its effects on the domains of reward processing, psychomotor slowing, and threat reactivity. We also discuss data that support contributing roles of metabolic dysregulation and sex differences on the behavioral outcomes of inflammation. Finally, we discuss ways that future studies can help disentangle this complex topic to yield fruitful results that will help advance the field of psychoneuroimmunology.
Collapse
Affiliation(s)
- David S Thylur
- From the Department of Psychiatry and Behavioral Sciences, Emory University
| | | |
Collapse
|
44
|
Leyrolle Q, Cserjesi R, Demeure R, Neyrinck AM, Amadieu C, Rodriguez J, Kärkkäinen O, Hanhineva K, Paquot N, Cnop M, Cani PD, Thissen JP, Bindels LB, Klein O, Luminet O, Delzenne NM. Microbiota and Metabolite Profiling as Markers of Mood Disorders: A Cross-Sectional Study in Obese Patients. Nutrients 2021; 14:nu14010147. [PMID: 35011021 PMCID: PMC8746987 DOI: 10.3390/nu14010147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/26/2022] Open
Abstract
Obesity is associated with an increased risk of several neurological and psychiatric diseases, but few studies report the contribution of biological features in the occurrence of mood disorders in obese patients. The aim of the study is to evaluate the potential links between serum metabolomics and gut microbiome, and mood disturbances in a cohort of obese patients. Psychological, biological characteristics and nutritional habits were evaluated in 94 obese subjects from the Food4Gut study stratified according to their mood score assessed by the Positive and Negative Affect Schedule (PANAS). The fecal gut microbiota and plasma non-targeted metabolomics were analysed. Obese subjects with increased negative mood display elevated levels of Coprococcus as well as decreased levels of Sutterella and Lactobacillus. Serum metabolite profile analysis reveals in these subjects altered levels of several amino acid-derived metabolites, such as an increased level of L-histidine and a decreased in phenylacetylglutamine, linked to altered gut microbiota composition and function rather than to differences in dietary amino acid intake. Regarding clinical profile, we did not observe any differences between both groups. Our results reveal new microbiota-derived metabolites that characterize the alterations of mood in obese subjects, thereby allowing to propose new targets to tackle mood disturbances in this context. Food4gut, clinicaltrial.gov: NCT03852069.
Collapse
Affiliation(s)
- Quentin Leyrolle
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium; (Q.L.); (R.D.); (A.M.N.); (C.A.); (J.R.); (P.D.C.); (L.B.B.)
| | - Renata Cserjesi
- Center for Social and Cultural Psychology, Université Libre de Bruxelles, 1000 Brussels, Belgium; (R.C.); (O.K.)
- Institute of Psychology, Eötvös Loránd University, 1053 Budapest, Hungary
| | - Romane Demeure
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium; (Q.L.); (R.D.); (A.M.N.); (C.A.); (J.R.); (P.D.C.); (L.B.B.)
| | - Audrey M. Neyrinck
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium; (Q.L.); (R.D.); (A.M.N.); (C.A.); (J.R.); (P.D.C.); (L.B.B.)
| | - Camille Amadieu
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium; (Q.L.); (R.D.); (A.M.N.); (C.A.); (J.R.); (P.D.C.); (L.B.B.)
| | - Julie Rodriguez
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium; (Q.L.); (R.D.); (A.M.N.); (C.A.); (J.R.); (P.D.C.); (L.B.B.)
| | - Olli Kärkkäinen
- School of Pharmacy, University of Eastern Finland, 70211 Kuopio, Finland;
| | - Kati Hanhineva
- Food Chemistry and Food Development Unit, Department of Life Technologies, University of Turku, 20014 Turku, Finland;
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
| | - Nicolas Paquot
- Laboratory of Immunometabolism and Nutrition, GIGA-Inflammation, Infection & Immunity, University of Liège, 4000 Liège, Belgium;
| | - Miriam Cnop
- ULB Center for Diabetes Research, Medical Faculty, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium;
- Division of Endocrinology, Erasmus Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Patrice D. Cani
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium; (Q.L.); (R.D.); (A.M.N.); (C.A.); (J.R.); (P.D.C.); (L.B.B.)
- WELBIO-Walloon Excellence in Life Sciences and BIOtechnology, UCLouvain, 1200 Brussels, Belgium
| | - Jean-Paul Thissen
- Pole of Endocrinology, Diabetes and Nutrition, Institut de Recherche Expérimentale et Clinique IREC, UCLouvain, 1200 Brussels, Belgium;
| | - Laure B. Bindels
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium; (Q.L.); (R.D.); (A.M.N.); (C.A.); (J.R.); (P.D.C.); (L.B.B.)
| | - Olivier Klein
- Center for Social and Cultural Psychology, Université Libre de Bruxelles, 1000 Brussels, Belgium; (R.C.); (O.K.)
| | - Olivier Luminet
- Research Institute for Psychological Sciences, UCLouvain, 1348 Louvain-la-Neuve, Belgium;
| | - Nathalie M. Delzenne
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, 1200 Brussels, Belgium; (Q.L.); (R.D.); (A.M.N.); (C.A.); (J.R.); (P.D.C.); (L.B.B.)
- Correspondence: ; Tel.: +32-2-764-73-69
| |
Collapse
|
45
|
Prevention of Stress-Induced Depressive-like Behavior by Saffron Extract Is Associated with Modulation of Kynurenine Pathway and Monoamine Neurotransmission. Pharmaceutics 2021; 13:pharmaceutics13122155. [PMID: 34959434 PMCID: PMC8709346 DOI: 10.3390/pharmaceutics13122155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/06/2021] [Accepted: 12/09/2021] [Indexed: 12/28/2022] Open
Abstract
Depressive disorders are a major public health concern. Despite currently available treatment options, their prevalence steadily increases, and a high rate of therapeutic failure is often reported, together with important antidepressant-related side effects. This highlights the need to improve existing therapeutic strategies, including by using nutritional interventions. In that context, saffron recently received particular attention for its beneficial effects on mood, although the underlying mechanisms are poorly understood. This study investigated in mice the impact of a saffron extract (Safr’Inside™; 6.25 mg/kg, per os) on acute restraint stress (ARS)-induced depressive-like behavior and related neurobiological alterations, by focusing on hypothalamic–pituitary–adrenal axis, inflammation-related metabolic pathways, and monoaminergic systems, all known to be altered by stress and involved in depressive disorder pathophysiology. When given before stress onset, Safr’Inside administration attenuated ARS-induced depressive-like behavior in the forced swim test. Importantly, it concomitantly reversed several stress-induced monoamine dysregulations and modulated the expression of key enzymes of the kynurenine pathway, likely reducing kynurenine-related neurotoxicity. These results show that saffron pretreatment prevents the development of stress-induced depressive symptoms and improves our understanding about the underlying mechanisms, which is a central issue to validate the therapeutic relevance of nutritional interventions with saffron in depressed patients.
Collapse
|
46
|
A new experimental design to study inflammation-related versus non-inflammation-related depression in mice. J Neuroinflammation 2021; 18:290. [PMID: 34895261 PMCID: PMC8666053 DOI: 10.1186/s12974-021-02330-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/24/2021] [Indexed: 12/28/2022] Open
Abstract
Background Major depressive disorder (MDD) represents a major public health concern, particularly due to its steadily rising prevalence and the poor responsiveness to standard antidepressants notably in patients afflicted with chronic inflammatory conditions, such as obesity. This highlights the need to improve current therapeutic strategies, including by targeting inflammation based on its role in the pathophysiology and treatment responsiveness of MDD. Nevertheless, dissecting the relative contribution of inflammation in the development and treatment of MDD remains a major issue, further complicated by the lack of preclinical depression models suitable to experimentally dissociate inflammation-related vs. inflammation-unrelated depression. Methods While current models usually focus on one particular MDD risk factor, we compared in male C57BL/6J mice the behavioral, inflammatory and neurobiological impact of chronic exposure to high-fat diet (HFD), a procedure known to induce inflammation-related depressive-like behaviors, and unpredictable chronic mild stress (UCMS), a stress-induced depression model notably renowned for its responsivity to antidepressants. Results While both paradigms induced neurovegetative, depressive-like and anxiety-like behaviors, inflammation and downstream neurobiological pathways contributing to inflammation-driven depression were specifically activated in HFD mice, as revealed by increased circulating levels of inflammatory factors, as well as brain expression of microglial activation markers and enzymes from the kynurenine and tetrahydrobiopterin (BH4) pathways. In addition, serotoninergic and dopaminergic systems were differentially impacted, depending on the experimental condition. Conclusions These data validate an experimental design suitable to deeply study the mechanisms underlying inflammation-driven depression comparatively to non-inflammatory depression. This design could help to better understand the pathophysiology of treatment resistant depression. Supplementary Information The online version contains supplementary material available at 10.1186/s12974-021-02330-9.
Collapse
|
47
|
Ma Y, Li R, Zhan W, Huang X, Zhang Z, Lv S, Wang J, Liang L, Jia X. Role of BMI in the Relationship Between Dietary Inflammatory Index and Depression: An Intermediary Analysis. Front Med (Lausanne) 2021; 8:748788. [PMID: 34869441 PMCID: PMC8634657 DOI: 10.3389/fmed.2021.748788] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/11/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: This study investigated this association and the role of BMI in the inflammatory process in a large population-based observational study. Methods: A total of 1,865 elderly people (≥55 years) were followed from the Community Cohort Study of Nervous System Diseases (CCSNSD) cohort study from 2018 to 2019 (Mean [SD] age, 66.31 [0.32] years; 716 [38.4%] males). The semi-quantitative FFQ and geriatric depression scale (GDS) were used to evaluate the diet and depressive symptoms of the elderly, respectively. The multivariable logistic regression model estimated the OR and 95% CI between Empirical Dietary Inflammatory Index (E-DII) and depression. The interaction of E-DII and BMI on depressive events was tested, and the mediation analysis of BMI was performed. Results: As measured by E-DII, the mean (SE) value of the inflammatory potential of the diet in our study was 1.56 (0.12). E-DII ranged from 5.23 to 5.58. In comparison with the first quartile, the elderly from the second quartile (OR: 1.15 [95% CI: 1.09, 1.28]) to the fourth quartile (OR: 1.31 [95% CI: 1.16, 1.42]) have a higher risk of depression before adjustment for BMI. An interaction was observed between E-DII and BMI in terms of the risk of depression (PInteraction < 0.001). The whole related part is mediated by BMI (31.06%). Conclusion: Our findings indicate that the higher pro-inflammatory potential of diet is associated with a higher risk of depression, and this association may be mediated by BMI. Further research is needed to verify our findings and clarify the latent mechanism.
Collapse
Affiliation(s)
- Yuxia Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Ruiqiang Li
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Wenqiang Zhan
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Huang
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Zechen Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Shuaishuai Lv
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Jiaqi Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Luyao Liang
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Xiaofang Jia
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
48
|
Verbiest I, Michels N, Tanghe A, Braet C. Inflammation in obese children and adolescents: Association with psychosocial stress variables and effects of a lifestyle intervention. Brain Behav Immun 2021; 98:40-47. [PMID: 34333112 DOI: 10.1016/j.bbi.2021.07.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 07/16/2021] [Accepted: 07/24/2021] [Indexed: 01/06/2023] Open
Abstract
Obesity in childhood and adolescence is a complex health issue that has detrimental effects on the physical and psychological health of the youngster, both in the short and long term. A characteristic of obesity is the associated chronic low-grade inflammation which can result in insulin resistance. Previous research suggested that biomarkers referring to such increased inflammation may help in understanding resistance to weight loss. Whether and how psychosocial factors are related with inflammation remains to be proven. The current study consisted of 594 children and adolescents (7-19 years), of whom 480 had follow-up data, who enrolled for a ten-month inpatient multidisciplinary obesity treatment consisting of healthy food routines, physical activities and psychological treatment. The purpose of the study was to explore (1) the relationship between inflammation and psychosocial stress variables (i.e., depressive symptoms, eating behavior, concerns about eating/shape/weight, insecure parent-child attachment) (correlational and multiple regression analysis), (2) whether a lifestyle intervention for obese youngsters results in decreased C-reactive protein (CRP) values (paired t-test) and (3) which psychosocial variables influence this CRP change as indication of treatment success (multiple regression analysis with change in BMI as control variable). Results showed that the psychosocial stress variables emotional eating, external eating and attachment anxiety are related to higher CRP values. Our data further suggested that a lifestyle intervention decreases the CRP values. This significant reduction in blood inflammatory marker was besides being influenced by weight loss also dependent on psychosocial variables, more specific on self-reported attachment avoidance, as this latter was related to less CRP decrease.
Collapse
Affiliation(s)
- I Verbiest
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000 Ghent, Belgium.
| | - N Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - A Tanghe
- Zeepreventorium vzw, De Haan, Belgium
| | - C Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000 Ghent, Belgium
| |
Collapse
|
49
|
Loh HH, Francis B, Lim L, Lim QH, Yee A, Loh HS. Improvement in mood symptoms after post-bariatric surgery among people with obesity: A systematic review and meta-analysis. Diabetes Metab Res Rev 2021; 37:e3458. [PMID: 33891377 PMCID: PMC9285936 DOI: 10.1002/dmrr.3458] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/28/2021] [Accepted: 04/19/2021] [Indexed: 12/28/2022]
Abstract
AIMS We aimed to examine if bariatric surgery was associated with a reduction in the prevalence of depressive and anxiety symptoms among people with obesity. MATERIALS AND METHODS We pooled data from 49 studies involving 11,255 people with obesity who underwent bariatric surgery. The study outcomes were the prevalence of depressive and anxiety symptoms among these patients pre- and post-surgery. RESULTS There was a significant reduction in body mass index (BMI) post-operatively (pooled d+: -13.3 kg/m2 [95% confidence interval [CI] 15.19, -11.47], p < 0.001). The pooled proportion of patients with anxiety symptoms reduced from 24.5% pre-operatively to 16.9% post-operatively, with an odds ratio (OR) of 0.58 (95% CI 0.51, 0.67, p < 0.001). The reduction remained significant in women aged ≥40 years and irrespective of post-operative BMI. There were significant reductions in Hospital Anxiety and Depression Score (HADS) (anxiety component) by 0.64 (pooled d+: -0.64 [95% CI -1.06, -0.22], p = 0.003) and Generalized Anxiety Disorder Assessment-7 score by 0.54 (pooled d+: -0.54 [95% CI -0.64, -0.44], p < 0.001). The pooled proportion of depressive symptoms reduced from 34.7% pre-operatively to 20.4% post-operatively, with an OR of 0.49 (95% CI 0.37, 0.65, p < 0.001). The reduction remained significant irrespective of patient's age and post-operative BMI. There were also significant reductions in HADS score (depressive component) (pooled d+: -1.34 [95% CI -1.93, -0.76], p < 0.001), Beck's Depression Inventory score (pooled d+: -1.04 [95% CI -1.46, -0.63], p < 0.001) and Patient Health Questionnaire-9 score (pooled d+: -1.11 [95% CI -1.21, -1.01], p < 0.001). CONCLUSION Bariatric surgery was associated with significant reduction in the prevalence and severity of depressive and anxiety symptoms among people with obesity.
Collapse
Affiliation(s)
- Huai Heng Loh
- Department of MedicineFaculty of Medicine and Health SciencesUniversiti Malaysia SarawakSarawakMalaysia
| | - Benedict Francis
- Department of Psychological MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Lee‐Ling Lim
- Department of MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
- Asia Diabetes FoundationShatinHong Kong Special Administrative Region, People's Republic of China
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongShatinHong Kong Special Administrative RegionPeople's Republic of China
| | - Quan Hziung Lim
- Department of MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Anne Yee
- Department of Psychological MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Huai Seng Loh
- Clinical Academic UnitNewcastle University Medicine MalaysiaJohorMalaysia
| |
Collapse
|
50
|
Robles B, Kuo T, Galván A. Understanding the Neuroscience Underpinnings of Obesity and Depression: Implications for Policy Development and Public Health Practice. Front Public Health 2021; 9:714236. [PMID: 34490195 PMCID: PMC8417597 DOI: 10.3389/fpubh.2021.714236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/29/2021] [Indexed: 01/22/2023] Open
Affiliation(s)
- Brenda Robles
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Tony Kuo
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Family Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States.,Population Health Program, Clinical and Translational Science Institute, University of California, Los Angeles, Los Angeles, CA, United States
| | - Adriana Galván
- Department of Psychology, Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, United States
| |
Collapse
|