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Fukushima M, Miyaaki H, Nakao Y, Sasaki R, Haraguchi M, Takahashi K, Ozawa E, Miuma S, Akazawa Y, Soyama A, Eguchi S, Okano S, Nakao K. Characterizing alcohol-related and metabolic dysfunction-associated steatotic liver disease cirrhosis via fibrotic pattern analysis. Sci Rep 2024; 14:23679. [PMID: 39390024 PMCID: PMC11466976 DOI: 10.1038/s41598-024-73739-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 09/20/2024] [Indexed: 10/12/2024] Open
Abstract
This study aimed to address the diagnostic challenges in distinguishing between alcohol-related liver disease (ALD) and metabolic dysfunction-associated steatotic liver disease (MASLD). We utilized whole-slide imaging technology to conduct a comprehensive digital analysis of liver specimens collected from patients undergoing transplantation. This study included 36 and 17 patients with ALD and MASLD cirrhosis, respectively, who underwent transplantation at our institution. Digital slides were analyzed for fibrosis patterns using FibroNest™. Patient background characteristics were comparable between ALD (n = 36) and MASLD (n = 17) groups, except for sex. The ALD group exhibited thicker collagen per strand, longer and more flexural fibrosis, and a more heterogeneous distribution than the MASLD group. In patients with ALD and concomitant metabolic dysfunction, fiber distribution became relatively uniform, resembling MASLD. Application of the phenotypic fibrosis composite score achieved 100% sensitivity and specificity for ALD/MASLD diagnosis. Digital pathological analysis of the fibrosis patterns showed morphological differences between ALD and MASLD. This approach holds promise for histological differentiation, providing valuable insights beyond the current definitions based solely on alcohol intake. This study emphasizes the potential of digital pathology in refining the diagnostic criteria for hepatic disorders.
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Affiliation(s)
- Masanori Fukushima
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan.
| | - Hisamitsu Miyaaki
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Yasuhiko Nakao
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Ryu Sasaki
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Masafumi Haraguchi
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Kosuke Takahashi
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Eisuke Ozawa
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Satoshi Miuma
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Yuko Akazawa
- Department of Histology and Cell Biology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Akihiko Soyama
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shinji Okano
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuhiko Nakao
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
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Ayuthaya BIN, Lertpimonchai A, Samaranayake L, Vathesatogkit P, Thienpramuk L, Wisitrasameewong W, Tamsailom S. The Potential Effect of Periodontal Disease on the Development of Metabolic Syndrome: A 10-Year Observational Study in a Thai Adult Cohort. J Clin Periodontol 2024. [PMID: 39256912 DOI: 10.1111/jcpe.14068] [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: 03/28/2024] [Revised: 07/26/2024] [Accepted: 08/22/2024] [Indexed: 09/12/2024]
Abstract
AIM As data are sparse on the long-term association between periodontal diseases and development of metabolic syndrome (MetS), we investigated their relationship in a Thai cohort over a 10-year observational period. METHODS Medical records and data on periodontal assessments of 2161 employees of the Electricity Generating Authority of Thailand collected at two time points, 2003 and 2013, were used. Experienced periodontists used standard national and international criteria to define periodontitis and MetS. The impact of baseline periodontitis on subsequent MetS incidence and its components was evaluated using regression analyses. RESULTS The severity and extent of periodontitis significantly predicted MetS incidence over a decade, with a higher incidence of MetS in individuals with poorer periodontal health. A single percentage increase in the periodontitis extent raised the risk of MetS incidence by 0.4% and the risk of developing individual components of MetS by 0.2%. Independent of periodontal health, age of an individual emerged as a factor impacting MetS development. CONCLUSION This study highlights the potential effect of the severity and extent of periodontitis on the increased incidence and progression of MetS. Hyperglycaemia and hypertension were the two MetS components most significantly affected by the existence of periodontitis.
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Affiliation(s)
- Benjar Issaranggun Na Ayuthaya
- Department of Periodontology, Centre of Excellence in Periodontal Disease and Implant Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Attawood Lertpimonchai
- Department of Periodontology, Centre of Excellence in Periodontal Disease and Implant Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Lakshman Samaranayake
- Department of Periodontology, Centre of Excellence in Periodontal Disease and Implant Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong, China
| | - Prin Vathesatogkit
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Lalitsara Thienpramuk
- Health Division, Medical and Health Department, Electricity Generating Authority of Thailand, Nonthaburi, Thailand
| | - Wichaya Wisitrasameewong
- Department of Periodontology, Centre of Excellence in Periodontal Disease and Implant Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Suphot Tamsailom
- Department of Periodontology, Centre of Excellence in Periodontal Disease and Implant Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Shen MR, Owusu-Boaitey K, Holsen LM, Suzuki J. The Efficacy of GLP-1 Agonists in Treating Substance Use Disorder in Patients: A Scoping Review. J Addict Med 2024; 18:488-498. [PMID: 39092831 DOI: 10.1097/adm.0000000000001347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
ABSTRACT Substance use disorder (SUD) continues to be a leading cause of morbidity and mortality with limited treatments. There is interest in expanding the use of GLP-1 agonists in treating SUD. However, evidence for safety and efficacy in humans is limited. This review aims to bridge the existing knowledge gap by establishing a baseline of literature in this area to inform future trials and clinical practice. Our inclusion criteria were English peer-reviewed manuscripts reporting on use of GLP-1, GIP, and/or glucagon receptor agonists in treatment of SUDs, excluding case studies. The literature search was performed in accordance to PRISMA guidelines. Five studies were included in this review examining the use of this medication in tobacco use disorder, alcohol use disorder, and cocaine use disorder. No studies regarding substance withdrawal syndrome were identified. The included studies varied widely in terms of patient selection, dose/formulation of GLP-1 agonists, and follow-up. The results of this scoping review are mixed, with 3 studies demonstrating positive results and 2 studies finding no efficacy of this medication on SUD outcomes. It is premature to prescribe this medication off-label to patients. Further research is needed to determine the efficacy of GLP-1 agonists in treating SUD.
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Affiliation(s)
- Mary R Shen
- From the Department of Psychiatry, Brigham and Women's Hospital, Boston, MA (MRS, KO-B, JS); Harvard Medical School, Boston, MA (MRS, KO-B, LMH, JS); and Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA (LMH)
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Wang T, Tyler RE, Ilaka O, Cooper D, Farokhnia M, Leggio L. The crosstalk between fibroblast growth factor 21 (FGF21) system and substance use. iScience 2024; 27:110389. [PMID: 39055947 PMCID: PMC11269927 DOI: 10.1016/j.isci.2024.110389] [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] [Indexed: 07/28/2024] Open
Abstract
Existing literature indicates that communication between the central nervous system and the peripheral nervous system is disrupted by substance use disorders (SUDs), including alcohol use disorder (AUD). Fibroblast growth factor 21 (FGF21), a liver-brain axis hormone governing energy homeostasis, has been shown to modulate alcohol intake/preference and other substances. To further elucidate the relationship between FGF21, alcohol use, and other substance use, we conducted a scoping review to explore the association between FGF21 and SUDs. Increases in FGF21 reduce alcohol consumption while suppressing FGF21 increases alcohol consumption, demonstrating an inverse relationship. Alcohol elevates FGF21 levels primarily via the liver, subsequently promoting neuronal signals to curb alcohol intake. FGF21 activation engages molecular pathways that defend against alcohol-induced fat accumulation, oxidative stress, and inflammation. Considering the bidirectional association between FGF21 and alcohol, further studies on the FGF21 system as a potential pharmacotherapy for AUD and alcohol-associated liver disease are warranted.
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Affiliation(s)
- Tammy Wang
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA
- Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA
| | - Ryan E. Tyler
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA
| | - Oyenike Ilaka
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA
- Albany Medical College, Albany, NY, USA
| | - Diane Cooper
- National Institutes of Health, Bethesda, MD, USA
| | - Mehdi Farokhnia
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA
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Cifuentes M, Vahid F, Devaux Y, Bohn T. Biomarkers of food intake and their relevance to metabolic syndrome. Food Funct 2024; 15:7271-7304. [PMID: 38904169 DOI: 10.1039/d4fo00721b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Metabolic syndrome (MetS) constitutes a prevalent risk factor associated with non communicable diseases such as cardiovascular disease and type 2 diabetes. A major factor impacting the etiology of MetS is diet. Dietary patterns and several individual food constituents have been related to the risk of developing MetS or have been proposed as adjuvant treatment. However, traditional methods of dietary assessment such as 24 h recalls rely greatly on intensive user-interaction and are subject to bias. Hence, more objective methods are required for unbiased dietary assessment and efficient prevention. While it is accepted that some dietary-derived constituents in blood plasma are indicators for certain dietary patterns, these may be too unstable (such as vitamin C as a marker for fruits/vegetables) or too broad (e.g. polyphenols for plant-based diets) or reflect too short-term intake only to allow for strong associations with prolonged intake of individual food groups. In the present manuscript, commonly employed biomarkers of intake including those related to specific food items (e.g. genistein for soybean or astaxanthin and EPA for fish intake) and novel emerging ones (e.g. stable isotopes for meat intake or microRNA for plant foods) are emphasized and their suitability as biomarker for food intake discussed. Promising alternatives to plasma measures (e.g. ethyl glucuronide in hair for ethanol intake) are also emphasized. As many biomarkers (i.e. secondary plant metabolites) are not limited to dietary assessment but are also capable of regulating e.g. anti-inflammatory and antioxidant pathways, special attention will be given to biomarkers presenting a double function to assess both dietary patterns and MetS risk.
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Affiliation(s)
- Miguel Cifuentes
- Luxembourg Institute of Health, Department of Precision Health, Strassen, Luxembourg.
- Doctoral School in Science and Engineering, University of Luxembourg, 2, Avenue de l'Université, 4365 Esch-sur-Alzette, Luxembourg
| | - Farhad Vahid
- Luxembourg Institute of Health, Department of Precision Health, Strassen, Luxembourg.
| | - Yvan Devaux
- Luxembourg Institute of Health, Department of Precision Health, Strassen, Luxembourg.
| | - Torsten Bohn
- Luxembourg Institute of Health, Department of Precision Health, Strassen, Luxembourg.
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Kar N, Barreto S. Influence of Lifestyle Factors on Metabolic Syndrome in Psychiatric Patients Attending a Community Mental Health Setting: A Cross-sectional Study. Indian J Psychol Med 2024; 46:313-322. [PMID: 39056040 PMCID: PMC11268271 DOI: 10.1177/02537176231219770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2024] Open
Abstract
Background Metabolic syndrome (MetS) is a concern in psychiatric patients. We aimed to study the influence of the modifiable lifestyle factors on MetS in adult psychiatric patients along with associated clinical factors and quality of life. Methods Factors such as diet (Healthy Eating Index), exercise, substance use, cardiovascular risk (QRISK), illness severity (Clinical Global Impression), medications, adverse events (Systematic Monitoring of Adverse Events Related to Treatments), and quality of life (Recovering Quality of Life Scale) were assessed along with clinical components for MetS in 323 psychiatric patients receiving routine care and monitoring in a Community Mental Health Team. Results MetS was present in 50.5% (95% CI: 45.0-55.9). It was significantly associated with higher age, duration of mental illness, body mass index (BMI), QTc, QRISK, and antipsychotic drugs. In logistic regression, age, QTc, QRISK, and BMI remained significantly linked to MetS. Patients with or without MetS were comparable in their lifestyle factors such as diet, exercise, and substance use, along with the family history of metabolic disorders, age at onset of mental illness, duration of antipsychotic medication, side effects, psychiatric diagnoses, and quality of life. However, many patients with or without MetS had poorer diet and physical inactivity, indicating scope for interventions. Conclusions Around half of the psychiatric patients had MetS, and modifiable lifestyle factors did not differentiate individuals with or without MetS. The need for further research on the prevention and management of MetS in psychiatric patients is highlighted.
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Affiliation(s)
- Nilamadhab Kar
- University of Wolverhampton, United Kingdom
- Dept. of Psychiatry, Black Country Healthcare NHS Foundation Trust, Wolverhampton, United Kingdom
| | - Socorro Barreto
- Dept. of Psychiatry, Black Country Healthcare NHS Foundation Trust, Wolverhampton, United Kingdom
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Hallgren M, Moller EB, Andreasson S, Dunstan DW, Vancampfort D, Ekblom Ö. Associations of device-measured and self-reported physical activity with alcohol consumption: Secondary analyses of a randomized controlled trial (FitForChange). Drug Alcohol Depend 2024; 259:111315. [PMID: 38685154 DOI: 10.1016/j.drugalcdep.2024.111315] [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: 09/04/2023] [Revised: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Physical activity (PA) is increasingly used as an adjunct treatment for alcohol use disorder (AUD). Previous studies have relied on self-report measures of PA, which are prone to measurement error. In the context of a randomized controlled trial of PA for AUD, we examined: (1) associations between device-measured and self-reported PA, (2) associations between PA measurements and alcohol use, and (3) the feasibility of obtaining device-measured PA data in this population. METHOD One-hundred and forty individuals with clinician-diagnosed AUD participated in a 12-week intervention comparing usual care (phone counselling) to yoga-based exercise and aerobic exercise. Device-measured PA (Actigraph GT3x), self-reported PA (International Physical Activity Questionnaire) and alcohol consumption (Timeline Follow Back Method) were assessed before and after the trial. Effects of the interventions on PA levels were assessed using linear mixed models. RESULTS In total, 42% (n=59) of participants returned usable device-measured PA data (mean age= 56±10 years, 73% male). Device-measured and self-reported vigorous-intensity PA were correlated (β= -0.02, 95%CI= -0.03, -0.00). No associations were found for moderate-intensity PA. Compared to usual care, time spent in device-measured light-intensity PA increased in the aerobic exercise group (∆= 357, 95%CI= 709, 5.24). Increases in device-measured light-intensity PA were associated with fewer standard drinks (∆= -0.24, 95%CI= -0.03, -0.44), and fewer heavy drinking days (∆= -0.06, 95%CI=-0.01, -0.10). CONCLUSION Increases in light-intensity/habitual PA were associated with less alcohol consumption in adults with AUD. Self-reported PA data should be interpreted with caution. Incentives are needed to obtain device-measured PA data in AUD populations.
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Affiliation(s)
- Mats Hallgren
- Department of Global Public Health Sciences, Karolinska Institutet, Sweden; Institute for Physical Activity and Nutrition (IPAN), Faculty of Health, Deakin University, Melbourne, Australia.
| | | | - Sven Andreasson
- Department of Global Public Health Sciences, Karolinska Institutet, Sweden
| | - David W Dunstan
- Institute for Physical Activity and Nutrition (IPAN), Faculty of Health, Deakin University, Burwood, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Davy Vancampfort
- Research Group for Adapted Physical Activity and Psychomotor Rehabilitation, University of Leuven, Belgium
| | - Örjan Ekblom
- The Swedish School of Sports and Health Sciences (GIH), Sweden; Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Sweden
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Zuluaga P, Casado-Carbajo J, Hernández-Rubio A, Bueno-Vélez M, García-Martin C, Muga R, Fuster D. Vitamin D Deficiency Is Associated with Advanced Liver Fibrosis and Impaired Fasting Glucose in Alcohol Use Disorder. Nutrients 2024; 16:1099. [PMID: 38674789 PMCID: PMC11054091 DOI: 10.3390/nu16081099] [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: 02/23/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Vitamin D deficiency is a risk factor for liver disease, insulin resistance, and beta cell dysfunction. Individuals with alcohol use disorder (AUD) have many comorbidities, with a heavy burden of liver disease and metabolic complications, including type 2 diabetes mellitus (T2DM). OBJECTIVE We aimed to analyze the prevalence and associations of vitamin D deficiency in patients admitted for in-hospital treatment of AUD. METHODS A cross-sectional study was conducted in patients consecutively admitted for the treatment of AUD between January 2017 and October 2023. Sociodemographic data, substance use characteristics, and blood parameters were available at admission. Vitamin D status was assessed through the serum concentrations of 25-hydroxyvitamin D [25(OH)D] levels using a direct competitive chemiluminescent immunoassay method. Deficiency of vitamin D was defined as a concentration less than 20 ng/mL; impaired fasting glucose (IFG) was defined by fasting blood glucose >100 mg/dL (5.6 mmol/L), and advanced liver fibrosis by an FIB-4 index >3.25. RESULTS Two hundred and forty-three patients were included (75% male) with a mean age of 49 ± 10 years, mean BMI of 26.4 ± 7.3, mean alcohol consumption of 163 ± 81 g/day, and a mean duration of AUD of 18.1 ± 11.2 years. Mean 25(OH)D, fasting blood glucose, AST, ALT, and platelets were 14.4 ± 10.2 ng/mL, 103.4 ± 40.9 mg/dL, 55.1 ± 75.8 U/L, 44.8 ± 76.6 U/L, and 206.3 ± 84.8 × 109/L, respectively. The prevalence of vitamin D deficiency was 80.6%, and 41.1% of patients had levels less than 10 ng/mL. IFG was present in 32.3% of patients, and 20.5% had FIB-4 values >3.25. In the multivariable analysis, IFG (OR, 2.51; 95% CI: 1.02-6.17, p = 0.04) and advanced liver fibrosis (OR, 4.27; 95% CI: 1.21-15.0, p = 0.02) were the only factors associated with vitamin D deficiency. CONCLUSIONS Vitamin D deficiency was very prevalent in this series of patients with AUD and was associated with impaired fasting glucose and advanced liver fibrosis.
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Affiliation(s)
- Paola Zuluaga
- Addiction Unit, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain; (P.Z.); (J.C.-C.); (A.H.-R.); (M.B.-V.); (R.M.)
- Department of Medicine, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Spanish Society of Internal Medicine-SEMI-“Alcohol and Other Drugs” Work Group, 28016 Madrid, Spain
| | - Julia Casado-Carbajo
- Addiction Unit, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain; (P.Z.); (J.C.-C.); (A.H.-R.); (M.B.-V.); (R.M.)
- Department of Medicine, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Spanish Society of Internal Medicine-SEMI-“Alcohol and Other Drugs” Work Group, 28016 Madrid, Spain
| | - Anna Hernández-Rubio
- Addiction Unit, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain; (P.Z.); (J.C.-C.); (A.H.-R.); (M.B.-V.); (R.M.)
- Department of Medicine, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Spanish Society of Internal Medicine-SEMI-“Alcohol and Other Drugs” Work Group, 28016 Madrid, Spain
| | - Marvin Bueno-Vélez
- Addiction Unit, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain; (P.Z.); (J.C.-C.); (A.H.-R.); (M.B.-V.); (R.M.)
- Department of Medicine, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Spanish Society of Internal Medicine-SEMI-“Alcohol and Other Drugs” Work Group, 28016 Madrid, Spain
| | - Carmen García-Martin
- Laboratori Clinic Metropolitana Nord, Department of Biochemistry, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain;
| | - Robert Muga
- Addiction Unit, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain; (P.Z.); (J.C.-C.); (A.H.-R.); (M.B.-V.); (R.M.)
- Department of Medicine, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Spanish Society of Internal Medicine-SEMI-“Alcohol and Other Drugs” Work Group, 28016 Madrid, Spain
| | - Daniel Fuster
- Addiction Unit, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain; (P.Z.); (J.C.-C.); (A.H.-R.); (M.B.-V.); (R.M.)
- Department of Medicine, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Spanish Society of Internal Medicine-SEMI-“Alcohol and Other Drugs” Work Group, 28016 Madrid, Spain
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Druckrey-Fiskaaen KT, Vold JH, Madebo T, Midgard H, Dalgard O, Leiva RA, Fadnes LT. Liver stiffness and associated risk factors among people with a history of injecting drugs: a prospective cohort study. Subst Abuse Treat Prev Policy 2024; 19:21. [PMID: 38532435 DOI: 10.1186/s13011-024-00603-z] [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: 09/15/2023] [Accepted: 03/16/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Persons with opioid use disorders (OUD) and persons with substance use disorders (SUD) who inject substances have a reduced life expectancy of up to 25 years compared with the general population. Chronic liver diseases are a substantial cause of this. Screening strategies based on liver stiffness measurements (LSM) may facilitate early detection, timely intervention, and treatment of liver disease. This study aims to investigate the extent of chronic liver disease measured with transient elastography and the association between LSM and various risk factors, including substance use patterns, hepatitis C virus (HCV) infection, alcohol use, body mass index, age, type 2 diabetes mellitus, and high-density lipoprotein (HDL) cholesterol among people with OUD or with SUD who inject substances. METHODS Data was collected from May 2017 to March 2022 in a cohort of 676 persons from Western Norway. The cohort was recruited from two populations: Persons receiving opioid agonist therapy (OAT) (81% of the sample) or persons with SUD injecting substances but not receiving OAT. All participants were assessed at least once with transient elastography. A linear mixed model was performed to assess the impact of risk factors such as HCV infection, alcohol use, lifestyle-associated factors, and substance use on liver stiffness at baseline and over time. Baseline was defined as the time of the first liver stiffness measurement. The results are presented as coefficients (in kilopascal (kPa)) with 95% confidence intervals (CI). RESULTS At baseline, 12% (n = 83) of the study sample had LSM suggestive of advanced chronic liver disease (LSM ≥ 10 kPa). Advanced age (1.0 kPa per 10 years increments, 95% CI: 0.68;1.3), at least weekly alcohol use (1.3, 0.47;2.1), HCV infection (1.2, 0.55;1.9), low HDL cholesterol level (1.4, 0.64;2.2), and higher body mass index (0.25 per increasing unit, 0.17;0.32) were all significantly associated with higher LSM at baseline. Compared with persistent chronic HCV infection, a resolved HCV infection predicted a yearly reduction of LSM (-0.73, -1.3;-0.21) from baseline to the following liver stiffness measurement. CONCLUSIONS More than one-tenth of the participants in this study had LSM suggestive of advanced chronic liver disease. It underscores the need for addressing HCV infection and reducing lifestyle-related liver risk factors, such as metabolic health factors and alcohol consumption, to prevent the advancement of liver fibrosis or cirrhosis in this particular population.
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Affiliation(s)
- Karl Trygve Druckrey-Fiskaaen
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Jørn Henrik Vold
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Tesfaye Madebo
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Respiratory Medicine, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Håvard Midgard
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Olav Dalgard
- Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway
| | | | - Lars T Fadnes
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Richard SL, Renn BN, Tran DMT, Kim J, Feng D. Metabolic Syndrome, Modifiable Lifestyle Factors, and Sleep-Disordered Breathing: The Hispanic Community Health Study. Ann Behav Med 2024; 58:179-191. [PMID: 38175927 PMCID: PMC10858308 DOI: 10.1093/abm/kaad071] [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] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND US Hispanics/Latinos are disproportionately susceptible to metabolic syndrome (MetS), attributed in part to systemic inequities related to health and lifestyle factors such as low physical activity (PA) levels, diet quality, alcohol use, tobacco use, and sleep disorder. Gender and heritage group differences are vastly understudied and need to be examined in this heterogeneous population. PURPOSE To examine the relationships between select health and lifestyle factors and MetS among Hispanic gender and heritage subgroups (Hypothesis 1) and determine whether gender and heritage moderate those relationships (Hypothesis 2). METHODS Participants included 14,155 Hispanic Americans aged 18-76 (59% female, mean age 45.92 ± 13.97) from seven heritage subgroups. This secondary analysis of cross-sectional data from the observational Hispanic Community Health Study/Study of Latinos (HCHS/SOL) dataset used hierarchical multinomial logistic regression to test Hypothesis 1; the dependent variable, MetS, included three categories delineating absence of MetS and presence of MetS with or without related medication use. Hayes' PROCESS macro tested Hypothesis 2. RESULTS Low PA and sleep-disordered breathing (SDB) each had significant (p < .001) predictive value of MetS group membership, whereas both low and high alcohol use (p < .001) were associated with decreased MetS risk. Cigarette pack-years were not significantly associated with MetS outcomes. Gender moderated the association between MetS and alcohol use (p < .001), cigarette pack-years (p < .001), and SDB (p < .001) such that the effects on MetS were higher in females than males. The association between MetS and diet quality (p < .001) was stronger among males than in females. CONCLUSIONS Gender and heritage differences were prominent among study variables.
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Affiliation(s)
- Shannon L Richard
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Brenna N Renn
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Dieu-My T Tran
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Jinyoung Kim
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Du Feng
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
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Leggio L, Hendershot CS, Farokhnia M, Fink-Jensen A, Klausen MK, Schacht JP, Simmons WK. GLP-1 receptor agonists are promising but unproven treatments for alcohol and substance use disorders. Nat Med 2023; 29:2993-2995. [PMID: 38001271 DOI: 10.1038/s41591-023-02634-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Affiliation(s)
- Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA.
| | - Christian S Hendershot
- Bowles Center for Alcohol Studies and Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mehdi Farokhnia
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA
| | - Anders Fink-Jensen
- Psychiatric Centre Copenhagen, Mental Health Services in the Capitol Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Kruse Klausen
- Psychiatric Centre Copenhagen, Mental Health Services in the Capitol Region of Denmark, Copenhagen, Denmark
| | - Joseph P Schacht
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - W Kyle Simmons
- Department of Pharmacology & Physiology, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- OSU Biomedical Imaging Center, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Abdul Rahim Y, Fernandez-Aranda F, Jimenez-Murcia S, Håkansson A. A nationwide case-control study on cardiovascular and respiratory-related disorders in patients with gambling disorder in Sweden. Public Health 2023; 224:45-50. [PMID: 37716175 DOI: 10.1016/j.puhe.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVES We aimed to examine potential relationships and gender differences between cardiovascular disease (CVD), diabetes, obesity, respiratory-related disorders, and gambling disorder (GD). We hypothesized that (1) GD patients would be more likely than controls to have CVD, diabetes, obesity, and respiratory-related diseases; and (2) females with GD would be more likely than men with GD to have CVD, diabetes, obesity, and respiratory-related diseases. STUDY DESIGN National retrospective case-control study. METHODS We used data from the Swedish National Board of Health and Welfare between 2005 and 2019. A total of 10,766 patients were included, and 3592 of them had GD. Every GD patient was matched with two age- and gender-matched controls. Patient data, including the history of medical diagnoses, were extracted. Descriptive statistics, Chi-squared and Fisher's exact tests were used to compare GD patients and controls. RESULTS GD patients had a higher prevalence of CVD and respiratory-related disorders than controls. Diabetes rates were 5% for GD patients and 2% for controls; CVD (18% vs 12%); respiratory-related disease (7% vs 4%); and obesity (7% vs 3%). Women with a diagnosis of GD have a higher prevalence of obesity and somatic comorbidities other than diabetes compared to men. CONCLUSIONS This is the largest case-control study conducted to date showing GD patients have a higher prevalence of CVD, diabetes, obesity, and respiratory-related disorders than controls. Women with GD appear to be more susceptible than men to CVD, obesity, and respiratory-related disorders; however, this may be partially explained by differences in help-seeking behavior. Thus, our findings highlight the importance of early identification of GD patients who may also have somatic conditions requiring treatment. This can be accomplished by implementing a screening program for GD, CVD, diabetes, obesity, and respiratory-related disorders, and by including healthy lifestyle management strategies.
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Affiliation(s)
- Y Abdul Rahim
- Helsingborg Hospital, Skåne Region, Helsingborg, Sweden; Malmö Addiction Center, Clinical Research Unit, Skåne Region, Malmö, Sweden; Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden.
| | - F Fernandez-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain.
| | - S Jimenez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain.
| | - A Håkansson
- Malmö Addiction Center, Clinical Research Unit, Skåne Region, Malmö, Sweden; Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden.
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Bolstad I, Toft H, Lien L, Moe JS, Rolland B, Bramness JG. Longitudinal determinants of insomnia among patients with alcohol use disorder. Alcohol 2023; 108:10-20. [PMID: 36356647 DOI: 10.1016/j.alcohol.2022.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022]
Abstract
Insomnia is common among patients with AUD and can impair quality of life and cognitive functioning, as well as cause psycho-social problems and increased risk of relapse. Nonetheless, determinants of insomnia in patients with AUD have scarcely been studied. We aimed to examine prevalence and development of self-perceived insomnia among inpatients in treatment for AUD, and to examine factors in this group known to be associated with sleep disturbance in the general population. We examined self-reported information about sleep from 94 AUD inpatients in long-term treatment (up to 9 months) using a questionnaire identifying probable insomnia. Potential predictors identified in bivariate tests were used in binomial logistic regressions to examine the effect on sleep at baseline and at 6-week follow-up. Longitudinal multilevel analyses were used to examine factors affecting development of sleep quality during the treatment stay. At baseline, 54% of the patients reported sleep problems indicating insomnia. This was reduced to 35% at 6-week follow-up. In a cross-sectional analysis of sleep at baseline, we found that being male (OR 0.18, p = 0.042) and engaging in physical activity (OR 0.09, p < 0.001) were negatively associated with insomnia, while a high level of depressive symptoms (OR 1.10, p = 0.010) was positively associated after adjustment for age, history of trauma, and severity of dependence. Multilevel analyses of data over a 6-month period showed time interactions with physical activity, such that sleep improvement was greater in patients who initially had a low level of physical activity. This longitudinal study corroborates findings of high prevalence of insomnia among AUD patients and identifies factors in this group associated with insomnia, such as sex, depression, and physical activity. Future longitudinal studies are needed to examine the causal directions between sleep, depression, and physical activity and how these might be targeted in clinical settings.
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Affiliation(s)
- Ingeborg Bolstad
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; Blue Cross East, Oslo, Norway; Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway.
| | - Helge Toft
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Jenny Skumsnes Moe
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; Institute Clinical of Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, 69500, Bron, France; Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, Lyon, France; INSERM U1028, CNRS UMR 5292, CRNL, Université de Lyon, UCBL1, Bron, France
| | - Jørgen G Bramness
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Oslo, Norway; Institute Clinical of Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
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14
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Welford P, Gunillasdotter V, Andreasson S, Herring MP, Vancampfort D, Hallgren M. Sticking with it? Factors associated with exercise adherence in people with alcohol use disorder. Addict Behav 2023; 144:107730. [PMID: 37094457 DOI: 10.1016/j.addbeh.2023.107730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Emerging evidence suggests that exercise may be an efficacious treatment for alcohol use disorder (AUD), but adherence is suboptimal. We examined factors associated with adherence to an exercise intervention for non-treatment seeking adults with AUD. METHODS This secondary analysis of a randomized controlled trial included 95 physically inactive adults aged 18-75 years with clinician-diagnosed AUD. Study participants were randomly assigned to 12-weeks fitness centre-based, supervised aerobic exercise or yoga classes and asked to attend at least three times/week. Adherence was assessed both objectively (based on use of a keycard at entry) and subjectively using an activity calendar. The association between AUD and other predictor variables with adherence was assessed using logistic and Poisson regression models. RESULTS Just under half of participants (47/95, 49%) completed ≥ 12 supervised exercise sessions. When both supervised classes and self-reported sessions were included, 32/95 (34%) participants completed ≤ 11 sessions, 28/95 (29%) did 12-23 sessions and 35/95 (37%) completed ≥ 24 sessions. In univariate logistic regression analyses, lower education was associated with non-adherence (<12 sessions) (OR = 3.02, 95%CI = 1.19-7.61). In models adjusted for demographic and clinical variables, moderate AUD (OR = 0.11, 95%CI = 0.02-0.49) and severe AUD (OR = 0.12, 95%CI = 0.02-0.69) were associated with non-adherence, when compared to low severity AUD. Higher body mass index (OR = 0.80, 95%CI = 0.68-0.93) was also associated with non-adherence. Results were materially the same when objective and subjective adherence data were combined. CONCLUSION Adults with AUD can be supported to engage in yoga and aerobic exercise. Additional support may be required for those with moderate or severe AUD, higher BMI, and lower education.
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Affiliation(s)
- Paul Welford
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Victoria Gunillasdotter
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden; Centre for Psychiatry Research, Sweden, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Services, 114 35 Stockholm, Sweden
| | - Sven Andreasson
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden; Centre for Psychiatry Research, Sweden, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Services, 114 35 Stockholm, Sweden
| | - Matthew P Herring
- Physical Activity for Health Research Centre, Health Research Institute & Department of Physical Education and Sports Science, University of Limerick, Ireland
| | - Davy Vancampfort
- Research Group for Adapted Physical Activity and Psychomotor Rehabilitation, University of Leuven, Belgium
| | - Mats Hallgren
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
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15
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Metabolic Syndrome and Combination Antiretroviral Therapy in HIV Patients in Periurban Hospital in Ghana: A Case-Control Study. AIDS Res Treat 2023; 2023:1566001. [PMID: 36846379 PMCID: PMC9957619 DOI: 10.1155/2023/1566001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 01/09/2023] [Accepted: 01/20/2023] [Indexed: 02/19/2023] Open
Abstract
Background There is an increasing prevalence of cardiovascular diseases (CVDs) and risk factors in HIV patients as the levels of AIDS-related mortality and morbidity decrease. Metabolic syndrome (MetS) is the accumulation of various CVD risk factors that predict the occurrence of CVDs. We investigated the prevalence of MetS and associated risk factors in HIV patients treated with combination antiretroviral therapy (cART), cART-naïve HIV patients, and non-HIV controls. Methods In a case-control design, 158 cART-treated HIV patients, 150 cART-naïve HIV patients, and 156 non-HIV controls were recruited from a periurban hospital in Ghana. A structured questionnaire was used to collect data on demography, lifestyle, and medication. Anthropometric indices and blood pressure were measured. Fasting blood samples were collected to measure the plasma levels of glucose, lipid profile, and CD4+ cells. The presence of MetS was defined using the joint scientific statement criteria. Results The prevalence of MetS was higher in cART-treated HIV patients compared with cART-naïve HIV patients and non-HIV controls (57.3% vs. 23.6% vs. 19.2% and p < 0.001, respectively). MetS was associated with cART-treated HIV patients (odds ratio (95% CI) = 7.24 (3.41-15.39) and p < 0.001), cART-naïve HIV patients (2.04 (1.01-4.15), p=0.048), and female gender (2.42 (1.39-4.23) and p=0.002). In cART-treated HIV patients, those on zidovudine (AZT)-based regimens were associated with increased likelihood (3.95 (1.49-10.43) and p < 0.006), while those on tenofovir (TDF)-based had decreased likelihood (0.32 (0.13-0.8) and p=0.015) of having MetS. Conclusion In our study population, there was a high prevalence of MetS in cART-treated HIV patients compared to cART-naïve HIV patients and non-HIV controls. HIV patients on AZT-based regimens had an increased likelihood of having MetS, while those on TDF-based regimens had a reduced likelihood of having MetS.
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Skarstein S, Lien L, Abebe DS. The burden of somatic diseases among people with alcohol- and drug use disorders are influenced by mental illness and low socioeconomic status. A registry-based cohort study in Norway. J Psychosom Res 2023; 165:111137. [PMID: 36608508 DOI: 10.1016/j.jpsychores.2022.111137] [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: 03/02/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Persons with alcohol use disorder (AUD) and drug use disorder (DUD) have a lower life expectancy than the general population. We examined the burden of somatic diseases among persons with AUD or DUD and investigated impact of socioeconomic status (SES) and mental health disorders on the co-occurrence of somatic diseases in these groups. METHODS We performed a retrospective, register-based cohort study with a 6-year follow-up of persons (aged ≥18 y) with AUD (13,478) or DUD (16,659). Cox regression analyses were used to estimate hazard ratios (HRs) of somatic diseases. RESULTS Patients with DUD were, on average, 10 years younger at the point of diagnosis than patients with AUD. Mental illnesses were prominent in both groups (AUD: 40.5%, and DUD: 46.9% vs 3.5% in controls). Adjusting for mental disorders, the risk of all somatic diseases among the AUD and DUD groups was reduced by 30%. Some of the elevated risk of somatic diseases among persons with AUD and DUD is explained by low SES, though less than that explained by the presence of mental disorders. The diseases with highest risk among AUD patients were metabolic disorders (16.9-fold) and hypertension (14.8-fold), and among AUD patients, viral hepatitis (23.3-fold), after adjusting for low SES and mental disorders. CONCLUSIONS Persons with AUD had a higher risk of most somatic diseases, while those with DUD had specific risks for infections and viral hepatitis. Mental health disorders and SES adjusted the associations regarding most somatic diseases. In general, improvement of socio-economic conditions, preferably in combination with professional support to self-manage mental health problems, will reduce the risk of somatic illness in both groups. For DUD patients, available sterile user equipment will reduce the risk of viral hepatis.
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Affiliation(s)
- Siv Skarstein
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
| | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Ottestad, Norway; Faculty of Social and Health Sciences, Inland University of Applied Sciences, Norway.
| | - Dawit Shawel Abebe
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway; Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Ottestad, Norway.
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Saki N, Hashemi SJ, Hosseini SA, Rahimi Z, Rahim F, Cheraghian B. Socioeconomic status and metabolic syndrome in Southwest Iran: results from Hoveyzeh Cohort Study (HCS). BMC Endocr Disord 2022; 22:332. [PMID: 36575435 PMCID: PMC9795639 DOI: 10.1186/s12902-022-01255-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/16/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Socioeconomic status (SES) strongly predicts morbidity and premature mortality, especially for non-communicable diseases (NCDs). However, the effect of these factors on Metabolic Syndrome (MetS) is not clear yet. This study was conducted to assess the relationship between socioeconomic indicators and MetS. METHODS In this prospective cohort study, 10,009 people aged 35-70 enrolled from May 2016 to August 2018. The MetS was defined according to The Standard National Cholesterol Education Program (NCEP)-adult treatment panel III (ATP III) or NCEP-ATP III criteria. Demographics and socioeconomic data were gathered face-to-face through trained interviews. Also, lab, anthropometrics, and blood pressure measurements were assayed for participants. Logistic regression was used to estimate the association between SES and MetS, adjusted for the potential confounding factors. RESULTS The overall prevalence of MetS in the participants was 39.1%. The crude odds ratios were statistically significant for all the assessed variables (p < 0.05). After adjustment for age, sex, physical activity, smoking, and alcohol use as potential confounders, the results indicated significant direct independent associations between skill level (p = 0.006) and Townsend index (p = 0.002) with MetS. In contrast, no significant associations between educational level and wealth status with MetS. CONCLUSION The results of our study showed that SES is related to MetS. Among the four assessed SES indicators, skilled levels and Townsend score are strongly associated with MetS. We recommend considering people's SES when interventional programs are planned and conducted on MetS in similar communities.
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Affiliation(s)
- Nader Saki
- Hearing Research Center, Clinical Sciences Research Institute, Department of Otolaryngology, Head and Neck Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Jalal Hashemi
- Department of Internal Medicine, School of Medicine, Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Ahmad Hosseini
- Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Rahimi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fakher Rahim
- Thalassemia and Hemoglobinopathy Research Center, Research Institute of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Gunillasdotter V, Andréasson S, Hallgren M, Jirwe M. Exercise as treatment for alcohol use disorder: A qualitative study. Drug Alcohol Rev 2022; 41:1642-1652. [PMID: 36073088 PMCID: PMC9826429 DOI: 10.1111/dar.13527] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/18/2022] [Accepted: 07/26/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Exercise is a promising treatment option for individuals with alcohol use disorder, but qualitative studies are lacking. Our aim was to explore experiences of yoga and aerobic exercise among non-treatment-seeking adults with alcohol use disorder. METHODS Semi-structured qualitative interviews (face-to-face or telephone) with 12 participants from a randomised controlled trial. Qualitative content analysis was used to analyse data. RESULTS One main category was identified, motivating and maintaining a lifestyle change, including four generic categories: (i) Initiating factors for lifestyle change, which describes how the concept of a lifestyle change initiated participants change; (ii) Influencing lifestyle change, explains how mood-enhancing effects from exercise influence exercise behaviours; (iii) Influencing physical and mental health, which describes how improvements in physical and mental health influence self-confidence and self-esteem; and (iv) Influencing alcohol consumption, which describes how exercise reduced alcohol cravings and that success in changing exercise behaviours made participants take healthier decisions regarding their alcohol intake. DISCUSSION AND CONCLUSIONS Exercise may help reduce alcohol intake, especially when presented in the context of a lifestyle change. Being able to self-select the type of exercise may increase compliance and optimise these benefits. Intentional planning and positive results from exercise may strengthen the individual's self-efficacy and increase the motivation to change behaviours associated with alcohol consumption.
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Affiliation(s)
- Victoria Gunillasdotter
- Department of Global Public HealthKarolinska InstitutetStockholmSweden,Centre for Psychiatry Research SwedenStockholm Health ServicesStockholmSweden
| | - Sven Andréasson
- Department of Global Public HealthKarolinska InstitutetStockholmSweden,Centre for Psychiatry Research SwedenStockholm Health ServicesStockholmSweden
| | - Mats Hallgren
- Department of Global Public HealthKarolinska InstitutetStockholmSweden
| | - Maria Jirwe
- Department of Health SciencesSwedish Red Cross UniversityHuddingeSweden,Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
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Alfaifi AA, Althemery AU. Sociodemographic characteristics and health-related quality of life of individuals undergoing antidepressant therapy. Sci Rep 2022; 12:17518. [PMID: 36266422 DOI: 10.1038/s41598-022-22164-6a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 10/11/2022] [Indexed: 05/28/2023] Open
Abstract
An important factor for averting depression and creating awareness about clinical treatment is patient preference. Therefore, investigating health-related quality of life associated with different antidepressants is necessary. A retrospective cohort study was performed using the 2018 Medical Expenditure Panel Survey. The MEPS is a nationally representative database of the civilian and noninstitutionalized population spanning different ages, both sexes, and a wide range of sociodemographic and economic backgrounds. Differences in clinical and sociodemographic characteristics among patients using different antidepressant classes were explored. The differences in Veterans RAND 12-Item Health Survey (VR-12) results among groups were examined. The VR-12 metric was used since it measures a patient's overall perspective of their health. Approximately 34.6 million of the patients reported using at least one antidepressant during 2018. Most patients receiving tricyclic therapy reported substantially better mental HRQoL than patients receiving selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or combination therapy. Patients receiving atypical antidepressants reported substantially better mental HRQoL than those receiving other types of antidepressants. Most patients reported a substantial decline in HRQoL after SNRIs or combination therapy. This study found that HRQoL varied across antidepressant users. Thus, health care providers could benefit from taking into consideration quality of life when prescribing antidepressant agents. Moreover, further research is needed to explore other factors that could contribute to the quality of care for patients with depression.
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Affiliation(s)
- Abdullah A Alfaifi
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia.
| | - Abdullah U Althemery
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
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Alfaifi AA, Althemery AU. Sociodemographic characteristics and health-related quality of life of individuals undergoing antidepressant therapy. Sci Rep 2022; 12:17518. [PMID: 36266422 PMCID: PMC9584901 DOI: 10.1038/s41598-022-22164-6] [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: 11/16/2021] [Accepted: 10/11/2022] [Indexed: 01/12/2023] Open
Abstract
An important factor for averting depression and creating awareness about clinical treatment is patient preference. Therefore, investigating health-related quality of life associated with different antidepressants is necessary. A retrospective cohort study was performed using the 2018 Medical Expenditure Panel Survey. The MEPS is a nationally representative database of the civilian and noninstitutionalized population spanning different ages, both sexes, and a wide range of sociodemographic and economic backgrounds. Differences in clinical and sociodemographic characteristics among patients using different antidepressant classes were explored. The differences in Veterans RAND 12-Item Health Survey (VR-12) results among groups were examined. The VR-12 metric was used since it measures a patient's overall perspective of their health. Approximately 34.6 million of the patients reported using at least one antidepressant during 2018. Most patients receiving tricyclic therapy reported substantially better mental HRQoL than patients receiving selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or combination therapy. Patients receiving atypical antidepressants reported substantially better mental HRQoL than those receiving other types of antidepressants. Most patients reported a substantial decline in HRQoL after SNRIs or combination therapy. This study found that HRQoL varied across antidepressant users. Thus, health care providers could benefit from taking into consideration quality of life when prescribing antidepressant agents. Moreover, further research is needed to explore other factors that could contribute to the quality of care for patients with depression.
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Affiliation(s)
- Abdullah A. Alfaifi
- grid.449553.a0000 0004 0441 5588Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942 Saudi Arabia
| | - Abdullah U. Althemery
- grid.449553.a0000 0004 0441 5588Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942 Saudi Arabia
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Sex Differences in the Relationship between Excessive Alcohol Consumption and Metabolic Abnormalities: A Community-Based Study in Taiwan. Nutrients 2022; 14:nu14142957. [PMID: 35889913 PMCID: PMC9317740 DOI: 10.3390/nu14142957] [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: 07/03/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 12/10/2022] Open
Abstract
Excessive alcohol consumption, as part of an unhealthy lifestyle, can contribute to metabolic abnormalities. This study investigated the sex differences in the relationship between excessive drinking and the risk of metabolic abnormalities. This community-based study included 3387 participants (age range: 30–103 years, mean age ± SD: 57 ± 13.5 years, 38.2% males) from the northeastern region of Taiwan. All participants completed a demographic survey and were subjected to blood tests. The risks of excessive drinking were evaluated using the Alcohol Use Disorder Identification Test (AUDIT). The results showed that males were at higher risks of obesity, hypertension, and hypertriglyceridemia, but at a lower risk of abdominal obesity than females. Males with hazardous drinking were at greater risks of hypertension, hyperglycemia, low serum levels of high-density lipoprotein cholesterol, and hypertriglyceridemia compared to those with no drinking. Females with hazardous drinking were at a greater risk of hypertension than those with no drinking. There was no interaction effect of sex and excessive drinking on the risks of metabolic abnormalities after controlling for demographics and lifestyle-related habits. Future studies are warranted to explore the sex-specific risk factors for metabolic abnormalities and to elucidate the mechanism underlying this association between alcohol consumption and metabolic abnormalities.
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Gunillasdotter V, Andréasson S, Jirwe M, Ekblom Ö, Hallgren M. Effects of exercise in non-treatment seeking adults with alcohol use disorder: A three-armed randomized controlled trial (FitForChange). Drug Alcohol Depend 2022; 232:109266. [PMID: 35033949 DOI: 10.1016/j.drugalcdep.2022.109266] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Most individuals with alcohol use disorder (AUD) do not seek treatment. Stigma and the desire to self-manage the problem are likely explanations. Exercise is an emerging treatment option but studies in non-treatment seeking individuals are lacking. We compared the effects of aerobic exercise, yoga, and treatment as usual (phone-based support) on alcohol consumption in non-treatment seeking adults with AUD. METHODS Three-group parallel, single blind, randomized controlled trial. 140 physically inactive adults aged 18-75 diagnosed with AUD were included in this community-based trial. Participants were randomized to either aerobic exercise (n = 49), yoga (n = 46) or treatment as usual (n = 45) for 12-weeks. The primary study outcome was weekly alcohol consumption at week 13 (Timeline Follow-back). RESULTS A significant decrease in weekly alcohol consumption was seen in all three groups: aerobic exercise (mean ∆ = - 5.0, 95% C = - 10.3, - 3.5), yoga group (mean ∆ = - 6.9, 95% CI = - 10.3, - 3.5) and TAU (mean ∆ = - 6.6, 95% CI = - 8.8, - 4.4). The between group changes were not statistically significant at follow-up. Per-protocol analyzes showed that the mean number of drinks per week reduced more in both TAU (mean ∆ = - 7.1, 95% CI = - 10.6, - 3.7) and yoga (mean ∆ = - 8.7, 95% CI = - 13.2, - 4.1) compared to aerobic exercise (mean ∆ = - 1.7, 95% CI = - 4.4, 1. 0), [F(2, 55) = 4.9, p = 0.011]. CONCLUSIONS Participation in a 12-week stand-alone exercise program was associated with clinically meaningful reductions in alcohol consumption comparable to usual care (phone counseling) by an alcohol treatment specialist.
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Affiliation(s)
- Victoria Gunillasdotter
- Epidemiology of Psychiatric Conditions, Substance use and Social Environment (EPiCSS), Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden; Centre for Psychiatry Research, Sweden, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Services, 114 35 Stockholm, Sweden
| | - Sven Andréasson
- Epidemiology of Psychiatric Conditions, Substance use and Social Environment (EPiCSS), Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden; Centre for Psychiatry Research, Sweden, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Services, 114 35 Stockholm, Sweden
| | - Maria Jirwe
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Huddinge, Sweden; Department of Health Sciences, the Swedish Red Cross University College, 14121 Huddinge, Sweden
| | - Örjan Ekblom
- Swedish School of Sport and Health Science (GIH), Lidingövägen 1, 114 33 Stockholm, Sweden
| | - Mats Hallgren
- Epidemiology of Psychiatric Conditions, Substance use and Social Environment (EPiCSS), Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden.
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Brgdar A, Gharbin J, Elawad A, Yi J, Sanchez J, Bishaw A, Taha ME, Ameyaw EE, Allen N, Prafulla M. Effects of Substance Use Disorder on In-Hospital Outcomes of Young Patients Presenting With a Cardiovascular Event: A Nationwide Analysis. Cureus 2022; 14:e22737. [PMID: 35386479 PMCID: PMC8969757 DOI: 10.7759/cureus.22737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 11/20/2022] Open
Abstract
Background Substance use is widely prevalent among young adults and is associated with increased cardiovascular morbidity and mortality such as sudden cardiac arrest, acute coronary syndrome, arrhythmias, and cardiomyopathy. However, they are limited studies analyzing the impact of substance use disorder on in-hospital outcomes among young patients with cardiovascular events. Methods All patients aged 18-39 years admitted primarily for major cardiovascular events including acute myocardial infarction (AMI), arrhythmia, cardiac arrest, acute ischemic stroke, and venous thromboembolic events in 2019 were identified in the National Inpatient Sample database. They were then categorized into those with and without concomitant substance use disorder (SUD). The primary outcome was in-hospital mortality. Unadjusted and adjusted analysis was performed on appropriate variables of interest. Results Of 57,985 hospitalizations with cardiac events, 12,115 (20%) of young adults had concomitant SUD. SUD was significantly associated with cardiac arrest (OR 3.3; CI 2.4-4.4), atrial fibrillation (OR 1.5; CI 1.3-1.7), AMI (OR 1.3; CI 1.2-1.6), heart failure (OR 2.6; CI 2.4-3.0) (all p<0.05) despite a lower prevalence of traditional cardiovascular risk factors than non-users. Logistic regression showed acute kidney injury (aOR 1.5; CI 1.3-1.8; p<0.001) and inpatient mortality (aOR 1.6; CI 1.2-2.2; p<0.001) were also significantly higher in young patients presenting with cardiac events and concomitant SUD. There was no difference in the length of stay or incidence of gastrointestinal bleed between the two groups. Conclusion In young patients presenting with a cardiovascular event, concurrent substance use disorder was associated with increased in-hospital mortality despite significantly lower comorbidities.
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Prevalence and associations of metabolic syndrome in patients with alcohol use disorder. Sci Rep 2022; 12:2625. [PMID: 35173187 PMCID: PMC8850419 DOI: 10.1038/s41598-022-06010-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 01/14/2022] [Indexed: 11/14/2022] Open
Abstract
Excessive alcohol consumption has been associated with different components of the metabolic syndrome (MetS) such as arterial hypertension, dyslipidemia, type 2 diabetes or obesity. We aimed to analyze the prevalence and associations of MetS in patients with Alcohol Use Disorder (AUD). Cross-sectional study in heavy drinkers admitted for the treatment of AUD between 2013 and 2017. Medical comorbidity, anthropometric data, alcohol use and biological parameters were obtained. MetS was established according to the harmonized definition. A total of 728 patients (22% women) were included; median age was 47 years (IQR: 40–53.5), median alcohol consumption was 160 g/day (IQR: 115–240) and prevalence of MetS was 13.9%. The multivariate analysis showed a significant dose–response effect of estimated glomerular filtration (eGFR) and MetS: relative to patients with eGFR > 90 mL/min, those with eGFR (60–90 mL/min) and those with eGFR < 60 mL/min were 1.93 times (95% CI 1.18–3.15) and 5.61 times (95% CI 1.66–19.0) more likely to have MetS, respectively. MetS was significantly associated with hyperuricemia (OR 2.28, 95% CI 1.36–3.82) and elevated serum GGT (OR 3.67, 95% CI 1.80–7.46). Furthermore, for every increase of 1 year in age, the probability of MetS increased significantly (OR 1.03, 95% CI 1.01–1.05). MetS in heavy drinkers is independently associated with reduced kidney function and metabolic risk factors including hyperuricemia and elevated serum GGT.
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Morcuende A, Navarrete F, Nieto E, Manzanares J, Femenía T. Inflammatory Biomarkers in Addictive Disorders. Biomolecules 2021; 11:biom11121824. [PMID: 34944470 PMCID: PMC8699452 DOI: 10.3390/biom11121824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 12/21/2022] Open
Abstract
Substance use disorders are a group of diseases that are associated with social, professional, and family impairment and that represent a high socio-economic impact on the health systems of countries around the world. These disorders present a very complex diagnosis and treatment regimen due to the lack of suitable biomarkers supporting the correct diagnosis and classification and the difficulty of selecting effective therapies. Over the last few years, several studies have pointed out that these addictive disorders are associated with systemic and central nervous system inflammation, which could play a relevant role in the onset and progression of these diseases. Therefore, identifying different immune system components as biomarkers of such addictive disorders could be a crucial step to promote appropriate diagnosis and treatment. Thus, this work aims to provide an overview of the immune system alterations that may be biomarkers of various addictive disorders.
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Affiliation(s)
- Alvaro Morcuende
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (A.M.); (F.N.); (E.N.); (J.M.)
| | - Francisco Navarrete
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (A.M.); (F.N.); (E.N.); (J.M.)
- Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
| | - Elena Nieto
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (A.M.); (F.N.); (E.N.); (J.M.)
| | - Jorge Manzanares
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (A.M.); (F.N.); (E.N.); (J.M.)
- Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
| | - Teresa Femenía
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (A.M.); (F.N.); (E.N.); (J.M.)
- Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-965-919-553
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Abebe DS, Lien L, Bramness JG. Effects of age and gender on the relationship between alcohol use disorder and somatic diseases: a national register study in Norway. BMJ Open 2021; 11:e050608. [PMID: 34758993 PMCID: PMC8587343 DOI: 10.1136/bmjopen-2021-050608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study aimed to examine how age and gender moderate the associations between alcohol use disorders (AUD) and several somatic diseases. DESIGN AND SETTING We performed a retrospective, register-based cohort study with 6-year follow-up of patients with AUD and the general population. Data were acquired from the Norwegian Patient Registry. Cox regressions were used to estimate HRs of somatic diseases. PARTICIPANTS Patients with AUD (17 023; 0.4%) were compared with the population without AUD (4 271 559; 99.6%), with adults aged 18 years or older who were registered residents of Norway on 1 January 2008. MAIN OUTCOMES Dichotomous variables of 12 specific somatic diseases (cardiovascular diseases, endocrine, nutritional, and metabolic diseases, cancer, and infectious diseases) were assessed. Diagnoses were set in specialist healthcare services. RESULTS Patients with AUD, compared with a population without AUD, experienced a significantly greater burden of all studied somatic diseases. Middle-aged adults with AUD had increased risks (p<0.05) for hypertension; ischaemic diseases; pulmonary diseases; cerebrovascular diseases; malnutrition; metabolic disorders; cancer; and influenza and pneumonia than younger and older adults with AUD. For most somatic diseases, we found no differences between younger versus older adults with AUD, and between females versus males with AUD (p>0.05). Males with AUD had significantly higher risks for pulmonary heart diseases (HR=3.9, 95% CI 3.3 to 4.6) and metabolic disorders (HR 4.7, 95% CI 4.5 to 5.0), while females with AUD had a significantly higher risk for viral hepatitis (HR=4.4, 95% CI 3.8 to 5.1). CONCLUSIONS Age moderated the associations between AUD and most somatic diseases, with middle-aged adults with AUD having a greater increased risk of somatic diseases compared with younger and older adults with AUD. Gender only moderated associations between AUD and pulmonary heart diseases, metabolic disorders and viral hepatitis. This has implications for the prioritisation of somatic resources among patients with AUD.
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Affiliation(s)
- Dawit Shawel Abebe
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Jørgen Gustav Bramness
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Drug and Tobacco Research, Norwegian Institute of Public Health, Oslo, Norway
- Insitute of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
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Tanner-Smith EE, Cronce JM. Introduction to the Special Issue on Meta-Analyses and Systematic Reviews. Alcohol Alcohol 2021; 57:1-2. [PMID: 34625798 DOI: 10.1093/alcalc/agab068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Emily E Tanner-Smith
- Department of Counseling Psychology and Human Services, University of Oregon, 5251 University of Oregon, Eugene, OR 97403, USA
| | - Jessica M Cronce
- Department of Counseling Psychology and Human Services, University of Oregon, 5251 University of Oregon, Eugene, OR 97403, USA
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Klausen MK, Thomsen M, Wortwein G, Fink-Jensen A. The role of glucagon-like peptide 1 (GLP-1) in addictive disorders. Br J Pharmacol 2021; 179:625-641. [PMID: 34532853 DOI: 10.1111/bph.15677] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/21/2021] [Accepted: 06/19/2021] [Indexed: 11/29/2022] Open
Abstract
Drug-, alcohol- and tobacco use disorders are a global burden affecting millions of people. Despite decades of research, treatment options are sparse or missing, and relapse rates are high. Glucagon-like peptide-1 (GLP-1) is released in the small intestines, promotes blood glucose homeostasis, slows gastric emptying, and reduces appetite. GLP-1 receptor agonists approved for treating type 2 diabetes mellitus and obesity, have received attention as a potential anti-addiction treatment. Studies in rodents and non-human primates have demonstrated a reduction in intake of alcohol and drugs of abuse, and clinical trials have been initiated to investigate whether the preclinical findings can be translated to patients. This review will give an overview of current findings and discuss the possible mechanisms of action. We suggest that effects of GLP-1 in alcohol- and substance use disorder is mediated centrally, at least partly through dopamine signalling, but precise mechanisms are still to be uncovered.
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Affiliation(s)
- Mette Kruse Klausen
- Psychiatric Centre Copenhagen and University Hospital of Copenhagen, Copenhagen, Denmark
| | - Morgane Thomsen
- Laboratory of Neuropsychiatry, Psychiatric Centre Copenhagen and University Hospital of Copenhagen, Copenhagen, Denmark
| | - Gitta Wortwein
- Laboratory of Neuropsychiatry, Psychiatric Centre Copenhagen and University Hospital of Copenhagen, Copenhagen, Denmark
| | - Anders Fink-Jensen
- Laboratory of Neuropsychiatry, Psychiatric Centre Copenhagen and University Hospital of Copenhagen, Copenhagen, Denmark
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El Ayoubi H, Barrault S, Gateau A, Cortese S, Frammery J, Mollat E, Bonnet-Brilhault F, Grall-Bronnec M, Ballon N, Brunault P. Adult attention-deficit/hyperactivity disorder among alcohol use disorder inpatients is associated with food addiction and binge eating, but not BMI. Appetite 2021; 168:105665. [PMID: 34455024 DOI: 10.1016/j.appet.2021.105665] [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: 05/26/2020] [Revised: 07/09/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Attention-deficit/hyperactivity disorder (ADHD) is associated with binge eating (BE), food addiction (FA), and obesity/higher BMI in individuals without alcohol use disorder (AUD). ADHD is highly prevalent in patients with AUD, but it is unknown whether the presence of comorbid AUD might change the nature of the association between ADHD, BE, FA and BMI (food and alcohol may either compete for the same brain neurocircuitry or share vulnerability risk factors). Here, we filled this gap by testing the association between ADHD and FA/BE in adult patients hospitalized for AUD, with the strength of simultaneously assessing childhood and adult ADHD. We also investigated the association between ADHD and BMI, and the other factors associated with BMI (FA/BE, AUD severity). METHODS We included 149 AUD inpatients between November 2018 and April 2019. We assessed both childhood and adulthood ADHD (Wender Utah Render Scale and Adult ADHD Self-Report Scale), FA (modified Yale Food Addiction Scale 2.0), BE (Binge Eating Scale), and BMI and AUD (clinical assessment). RESULTS In multivariable analyses adjusted for age, adult ADHD was associated with higher BE scores (p = .048), but not significant BE (9% vs. 7%; p = .70). ADHD was also associated with FA diagnosis and the number or FA symptoms, with larger effect size for adult (ORs: 9.45[95%CI: 2.82-31.74] and 1.38[1.13-1.69], respectively) than childhood ADHD (ORs: 4.45[1.37-14.46] and 1.40[1.13-1.75], respectively). In multivariable analysis, BMI was associated with both significant BE (p < .001) and FA diagnosis (p = .014), but not adult ADHD nor AUD severity. CONCLUSION In patients hospitalized for AUD, self-reported adult ADHD was associated with FA and BE, but not BMI. Our results set the groundwork for longitudinal research on the link between ADHD, FA, BE, and BMI in AUD inpatients.
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Affiliation(s)
- Hussein El Ayoubi
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France; Centre Hospitalier Louis Sevestre, La Futaie, La Membrolle sur Choisille, France; CHRU de Tours, Service d'Addictologie Universitaire, Centre de Soins d'Accompagnement et de Prévention en Addictologie d'Indre-et-Loire (CSAPA-37), Tours, France.
| | - Servane Barrault
- CHRU de Tours, Service d'Addictologie Universitaire, Centre de Soins d'Accompagnement et de Prévention en Addictologie d'Indre-et-Loire (CSAPA-37), Tours, France; Université de Tours, Qualipsy EE 1901, Tours, France.
| | - Adrien Gateau
- CHRU de Tours, Centre Universitaire de Pédopsychiatrie, Tours, France.
| | - Samuele Cortese
- Center for Innovation in Mental Health, Academic Unit of Psychology, Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.
| | - Julie Frammery
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France; Centre Hospitalier Louis Sevestre, La Futaie, La Membrolle sur Choisille, France.
| | - Elodie Mollat
- Université de Tours, Faculté de Pharmacie Philippe Maupas, Tours, France.
| | - Fréderique Bonnet-Brilhault
- CHRU de Tours, Centre Universitaire de Pédopsychiatrie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
| | - Marie Grall-Bronnec
- Université de Nantes, Université de Tours, Inserm, UMR 1246, France; CHU Nantes, Addictology and Psychiatry Department, Nantes, France.
| | - Nicolas Ballon
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
| | - Paul Brunault
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France; Université de Tours, Qualipsy EE 1901, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
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Lardier DT, Coakley KE, Holladay KR, Amorim FT, Zuhl MN. Exercise as a Useful Intervention to Reduce Alcohol Consumption and Improve Physical Fitness in Individuals With Alcohol Use Disorder: A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:675285. [PMID: 34305729 PMCID: PMC8292965 DOI: 10.3389/fpsyg.2021.675285] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/31/2021] [Indexed: 01/06/2023] Open
Abstract
Objective: This meta-analysis and systematic review examined the effects of exercise interventions on alcohol consumption and binge drinking in individuals with alcohol use disorder (AUD). Data sources: PubMed, Web of Science, Google Scholar, SPORTDiscus, and ERIC databases. Study Inclusion and Exclusion Criteria: Peer-reviewed randomized controlled trials published in English between 1970 and 2021. All studies compared exercise (Ex) and treatment as usual (TAU) to TAU in adults with an alcohol-related diagnosis. All forms of exercise interventions were included (e.g., aerobic exercise, yoga, resistance exercise, etc.). Data Extraction: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols standard and the Meta-Analyses and Systematic Reviews of Observational Studies guidelines were followed. Risk of bias was assessed using the Cochrane risk-of-bias tool as described by the Cochrane Handbook for Systematic Reviews and Interventions. Results: The literature searches retrieved a combined 2527 studies, with 1,034 studies screened after removal of duplicates and 973 (94%) rejected after reviewing titles and abstracts. Full-text review was performed on 61 studies, with seven studies meeting inclusion criteria for qualitative and meta-analysis. Across seven studies (n = 492 participants), a significant effect (Z-value = -3.37; g = -0.30; 95% CI [-0.50--0.09]; p = 0.001) was found for Ex+TAU on drinking volume. There was no effect of Ex+TAU on binge drinking. The effect of Ex+TAU on physical fitness (VO2max, ml•kg-1•min-1) was significant (Z-score = 3.70; g = 0.64; 95% CI [0.19-1.08]; p < 0.001). Conclusions: Exercise interventions may decrease alcohol consumption and improve fitness and can be an effective adjunctive treatment for individuals with alcohol-related diagnoses including AUD.
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Affiliation(s)
- David T. Lardier
- Department of Individual, Family and Community Education, College of Education and Human Sciences, University of New Mexico, Albuquerque, NM, United States
- Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, University of New Mexico, Albuquerque, NM, United States
| | - Kathryn E. Coakley
- Department of Individual, Family and Community Education, College of Education and Human Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Kelley R. Holladay
- Department of Individual, Family and Community Education, University of New Mexico, Albuquerque, NM, United States
- College of Health Sciences, Jacksonville University, Jacksonville, FL, United States
| | - Fabiano T. Amorim
- Department of Health Education and Sports Sciences College of Education and Human Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Micah N. Zuhl
- School of Health Sciences, Central Michigan University, Mount Pleasant, MI, United States
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Bernardo M, Rico-Villademoros F, García-Rizo C, Rojo R, Gómez-Huelgas R. Real-World Data on the Adverse Metabolic Effects of Second-Generation Antipsychotics and Their Potential Determinants in Adult Patients: A Systematic Review of Population-Based Studies. Adv Ther 2021; 38:2491-2512. [PMID: 33826090 PMCID: PMC8107077 DOI: 10.1007/s12325-021-01689-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/26/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION To assess the risk of occurrence and potential determinants of metabolic disorders in adult patients treated with second-generation antipsychotics (SGAs) under real-world practice conditions. METHODS MEDLINE, EMBASE, and PsycInfo were searched in July 2019 from database inception. We included population-based, longitudinal, comparative studies that report the results of the outcomes of interest for adult participants, including diabetes, ketoacidosis, hyperosmolar hyperglycemic state, weight gain/obesity, dyslipidemia, hypertension, and metabolic syndrome. Two reviewers independently extracted data on the study design, study quality, and study outcomes. RESULTS We included 40 studies. Most studies showed that clozapine and olanzapine were associated with an increased likelihood of developing diabetes, while the results for risperidone and quetiapine were mixed. Although less well studied, ziprasidone and aripiprazole appeared to not be associated with the occurrence of diabetes. Information on antipsychotic-induced weight gain/obesity is extremely scarce. Regarding dyslipidemia, aripiprazole was not associated with an increased likelihood of developing dyslipidemia, clozapine was associated with an increased likelihood of developing dyslipidemia, and risperidone, olanzapine, quetiapine, and ziprasidone showed mixed results. Two studies suggested an association between ziprasidone and the occurrence of hypertension. Several studies found that the occurrence of a metabolic disorder acted as a risk factor for the development of other metabolic disorders. We did not find information on brexpiprazole, cariprazine, or lurasidone, and data on any long-acting SGA were lacking. CONCLUSION Although there are relevant differences among SGAs concerning the risk of metabolic disorders, it appears that none of the SGAs included in our review are fully devoid of these disturbances.
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Affiliation(s)
- Miquel Bernardo
- Department of Psychiatry, Hospital Clínic, University of Barcelona, Idibaps, Cibersam, Barcelona, Spain.
| | | | - Clemente García-Rizo
- Department of Psychiatry, Hospital Clínic, University of Barcelona, Idibaps, Cibersam, Barcelona, Spain
| | - Rosa Rojo
- Faculty of Health Sciences, Alfonso X El Sabio University, Villanueva de la Cañada, Madrid, Spain
| | - Ricardo Gómez-Huelgas
- Internal Medicine Department, Instituto de Investigación Biomedica de Malaga-IBIMA, Regional University Hospital of Malaga, Malaga, Spain
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Akhigbe R, Ajayi A. The impact of reactive oxygen species in the development of cardiometabolic disorders: a review. Lipids Health Dis 2021; 20:23. [PMID: 33639960 PMCID: PMC7916299 DOI: 10.1186/s12944-021-01435-7] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 01/26/2021] [Indexed: 02/07/2023] Open
Abstract
Oxidative stress, an alteration in the balance between reactive oxygen species (ROS) generation and antioxidant buffering capacity, has been implicated in the pathogenesis of cardiometabolic disorders (CMD). At physiological levels, ROS functions as signalling mediators, regulates various physiological functions such as the growth, proliferation, and migration endothelial cells (EC) and smooth muscle cells (SMC); formation and development of new blood vessels; EC and SMC regulated death; vascular tone; host defence; and genomic stability. However, at excessive levels, it causes a deviation in the redox state, mediates the development of CMD. Multiple mechanisms account for the rise in the production of free radicals in the heart. These include mitochondrial dysfunction and uncoupling, increased fatty acid oxidation, exaggerated activity of nicotinamide adenine dinucleotide phosphate oxidase (NOX), reduced antioxidant capacity, and cardiac metabolic memory. The purpose of this study is to discuss the link between oxidative stress and the aetiopathogenesis of CMD and highlight associated mechanisms. Oxidative stress plays a vital role in the development of obesity and dyslipidaemia, insulin resistance and diabetes, hypertension via various mechanisms associated with ROS-led inflammatory response and endothelial dysfunction.
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Affiliation(s)
- Roland Akhigbe
- Department of Physiology, College of Medicine, Ladoke Akintola University of Technology, Ogbomoso, Oyo State Nigeria
- Reproductive Biology and Toxicology Research Laboratories, Oasis of Grace Hospital, Osogbo, Osun State Nigeria
- Department of Chemical Sciences, Kings University, Odeomu, Osun Nigeria
| | - Ayodeji Ajayi
- Department of Physiology, College of Medicine, Ladoke Akintola University of Technology, Ogbomoso, Oyo State Nigeria
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Vancampfort D, Vandael H, Hallgren M, Van Damme T. Test-retest reliability and correlates of the 6-min walk test in people with alcohol use disorders. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2021; 26:e1900. [PMID: 33639026 DOI: 10.1002/pri.1900] [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: 07/03/2020] [Revised: 11/22/2020] [Accepted: 12/25/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES People with alcohol use disorders (AUD) are at a higher risk for physical co-morbidities. Consequently, their daily life functioning needs to be reliably assessed and followed-up. We examined the reliability of the 6-min walk test (6MWT) in a cohort of inpatients with AUD. Secondary aims were to assess minimal detectable changes (MDC95 ), practice effects and associations of the 6MWT with demographical and clinical variables. METHODS Two 6MWTs were administered within 3 days to 45 (32♂) inpatients with a DSM-5 diagnosis of AUD. Physical complaints before and after the 6MWT were recorded. Patients performed a standing broad jump to assess muscle strength and completed the International Physical Activity Questionnaire, the Positive Affect and Negative Affect Schedule (PANAS) and Alcohol Use Disorders Identification Test. RESULTS Patients walked 636.3 ± 82.3 meters and 638.1 ± 77.6 meters at the first and second test. The intraclass correlation coefficient was 0.94 (95% confidence interval 0.90-0.97). The MDC95 was 15 meters for men and 9 meters for women. No practice effect was detected. The presence of feet or ankle problems or pain before the test, dyspnea after the test, impaired muscle strength and lower PANAS positive affect scores were independently related to shorter 6MWT distance accounting for 67.3% of the variance. CONCLUSION The 6MWT is a reliable tool for evaluating the functional exercise capacity in inpatients with AUD. Health care professionals should consider musculoskeletal and respiratory symptoms when interpreting fitness test outcomes in this vulnerable population.
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Affiliation(s)
- Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,KU Leuven-University of Leuven, University Psychiatric Centre (UPC) KU Leuven, Leuven-Kortenberg, Belgium
| | - Hannelore Vandael
- KU Leuven-University of Leuven, University Psychiatric Centre (UPC) KU Leuven, Leuven-Kortenberg, Belgium
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinksa Institute, Stockholm, Sweden
| | - Tine Van Damme
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium
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Vancampfort D, Kimbowa S, Basangwa D, Hallgren M, Van Damme T, Rosenbaum S, Mugisha J. Test-retest reliability, concurrent validity and correlates of the two-minute walk test in outpatients with alcohol use disorder. Alcohol 2021; 90:74-79. [PMID: 33422571 DOI: 10.1016/j.alcohol.2020.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/18/2020] [Accepted: 12/04/2020] [Indexed: 02/07/2023]
Abstract
We investigated the test-retest reliability of the 2-min walk test (2MWT) and its concurrent validity with the 6-min walk test (6MWT) in Ugandan outpatients with alcohol use disorder (AUD). We also explored practice effects, and assessed the minimal detectable change (MDC) and correlations with the 2MWT. Fifty outpatients [7 women; median age = 32.0 years] performed the 2MWT twice, the 6MWT once, and completed the Simple Physical Activity Questionnaire, Brief Symptoms Inventory-18 (BSI-18), and Alcohol Use Disorders Identification Test. The median (interquartile) 2MWT score on the first and second test were 162.0 (49.0) meters and 161.0 (58.0) meters, respectively, without significant difference between the two trials (p = 0.20). The intraclass correlation between the two 2MWTs was 0.96 (95% confidence interval = 0.94-0.98). The Spearman Rho correlation between the second 2MWT and the 6MWT was 0.91 (p < 0.001). The MDC for the 2MWT was 18 m. There was no evidence of a practice effect. Variance in BSI-18 depression and the presence of leg pain following the 2MWT explained 18.7% of 2MWT score variance. The 2MWT is a reliable and valid fitness test, which can be conducted without any special equipment or substantial time demands in outpatients with AUD.
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Q P, KC W, CL E. Common genetic substrates of alcohol and substance use disorder severity revealed by pleiotropy detection against GWAS catalog in two populations. Addict Biol 2021; 26:e12877. [PMID: 32027075 PMCID: PMC7415504 DOI: 10.1111/adb.12877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 11/15/2019] [Accepted: 01/11/2020] [Indexed: 12/01/2022]
Abstract
Alcohol and other substance use disorders (AUD and SUD) are complex diseases that are postulated to have a polygenic inheritance and are often comorbid with other disorders. The comorbidities may arise partially through genetic pleiotropy. Identification of specific gene variants accounting for large parts of the variance in these disorders has yet to be accomplished. We describe a flexible strategy that takes a variant-trait association database and determines if a subset of disease/straits are potentially pleiotropic with the disorder under study. We demonstrate its usage in a study of use disorders in two independent cohorts: alcohol, stimulants, cannabis (CUD), and multi-substance use disorders (MSUD) in American Indians (AI) and AUD and CUD in Mexican Americans (MA). Using a machine learning method with variants in GWAS catalog, we identified 229 to 246 pleiotropic variants for AI and 153 to 160 for MA for each SUD. Inflammation was the most enriched for MSUD and AUD in AIs. Neurological disorder was the most significantly enriched for CUD in both cohorts, and for AUD and stimulants in AIs. Of the select pleiotropic genes shared among substances-cohorts, multiple biological pathways implicated in SUD and other psychiatric disorders were enriched, including neurotrophic factors, immune responses, extracellular matrix, and circadian regulation. Shared pleiotropic genes were significantly up-regulated in brain regions playing important roles in SUD, down-regulated in esophagus mucosa, and differentially regulated in adrenal gland. This study fills a gap for pleiotropy detection in understudied admixed populations and identifies pleiotropic variants that may be potential targets of interest for SUD.
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Affiliation(s)
- Peng Q
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037 USA
| | - Wilhelmsen KC
- Department of Genetics and Neurology, University of North Carolina, Chapel Hill, NC 27599 USA
| | - Ehlers CL
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037 USA
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Liu J. Alcohol consumption combined with dietary low-carbohydrate/high-protein intake increased the left ventricular systolic dysfunction risk and lethal ventricular arrhythmia susceptibility in apolipoprotein E/low-density lipoprotein receptor double-knockout mice. Alcohol 2020; 89:63-74. [PMID: 32702503 DOI: 10.1016/j.alcohol.2020.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/21/2020] [Accepted: 07/01/2020] [Indexed: 12/12/2022]
Abstract
Alcohol abuse is positively associated with cardiovascular disease. Dietary low-carbohydrate/high-protein (LCHP) intake confers a greater mortality risk. Here, the impact of ethanol consumption in combination with dietary LCHP intake on left ventricular (LV) systolic function and lethal ventricular arrhythmia susceptibility were investigated in apolipoprotein E/low-density lipoprotein receptor double-knockout (AL) mice. The underlying mechanisms, cardiac sympathovagal balance, beta-adrenergic receptor (ADRB) levels, and gap junction channel protein connexin 43 (Cx43) expression, were examined. Male AL mice fed an LCHP diet with or without ethanol were bred for 16 weeks. Age-matched male AL and wild-type mice received standard chow diet and served as controls. The following were used to assess LV systolic function, lethal ventricular arrhythmia susceptibility, cardiac sympathovagal balance, Cx43 expression, and ADRB levels: The results demonstrated that ethanol consumption in combination with dietary LCHP intake worsened LCHP-induced LV systolic dysfunction in AL mice and enhanced their susceptibility in the ventricular arrhythmia-evoked test. There were concomitant increases in LV weight, LF/HF ratio shown by HRV, TH, ADRB1, ADRB2, and Cx43 expressions by LV fluorescence immunohistochemistry, and LV Cx43 messenger ribonucleic acid expression by PCR. In AL mice, alcohol consumption combined with dietary LCHP intake may thus promote a shift in cardiac sympathovagal balance toward sympathetic predominance, the increases in beta-adrenergic receptors (ADRB1 and ADRB2), and then affect the gap junction channel protein Cx43, which in turn could contribute to increased risks of LV systolic dysfunction and susceptibility to lethal ventricular arrhythmia.
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Stubbs B, Perara G, Koyanagi A, Veronese N, Vancampfort D, Firth J, Sheehan K, De Hert M, Stewart R, Mueller C. Risk of Hospitalized Falls and Hip Fractures in 22,103 Older Adults Receiving Mental Health Care vs 161,603 Controls: A Large Cohort Study. J Am Med Dir Assoc 2020; 21:1893-1899. [PMID: 32321678 PMCID: PMC7723983 DOI: 10.1016/j.jamda.2020.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To investigate the risk of hospitalized fall or hip fracture among older adults using mental health services. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS Residents of a South London catchment aged >60 years receiving specialist mental health care between 2008 and 2016. MEASURES Falls and/or a hip fracture leading to hospitalization were ascertained from linked national records. Incidence rates and incidence rate ratios (IRRs) were age- and gender-standardized to the catchment population. Multivariable survival analyses were applied investigating falls and/or hip fractures as outcomes. RESULTS In 22,103 older adults, incidence rates were 60.1 per 1000 person-years for hospitalized falls and 13.7 per 1000 person-years for hip fractures, representing standardized IRRs of 2.17 [95% confidence interval (CI) 2.07-2.28] and 4.18 (3.79-4.60), respectively. The IRR for falls was high in those with substance-use disorder [IRR = 6.72 (5.35-8.33)], bipolar disorder [IRR = 3.62 (2.50-5.05)], depression [IRR = 2.28 (2.00-2.59)], and stress-related disorders [IRR = 2.57 (2.10-3.11)]. Hip fractures were increased in all populations (IRR > 2.5), with greatest risk in substance use disorders [IRR = 12.64 (7.22-20.52)], dementia [IRR = 4.38 (3.82-5.00)], and delirium [IRR = 4.03 (3.00-5.29)]. Comparing mental disorder subgroups with each other, after the adjustment for 25 potential confounders, patients with dementia and substance use had a significantly increased risk of falls, and patients with dementia also had an increased risk of hip fractures. CONCLUSION AND IMPLICATIONS Older people using mental health services have more than double the incidence of falls and 4 times the incidence of hip fractures compared to the general population. Although incidences differ between diagnostic subgroups, all groups have a higher incidence than the general population. Targeted interventions to prevent falls and hip fractures among older adult mental health service users are urgently needed.
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Affiliation(s)
- Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom.
| | - Gayan Perara
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, CIBERSAM, Barcelona, Spain; ICREA, Barcelona, Spain
| | - Nicola Veronese
- Primary Care Department, Azienda ULSS (Unità Locale Socio Sanitaria) 3 "Serenissima," Dolo, Venice, Italy
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium; University Psychiatric Centre, KU Leuven, University of Leuven, Kortenberg, Belgium
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia; Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Katie Sheehan
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, King's College London, London, United Kingdom
| | - Marc De Hert
- University Psychiatric Centre KU Leuven, Kortenberg, Belgium; Antwerp Health Law and Ethics Chair, University of Antwerp, Antwerp, Belgium
| | - Robert Stewart
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Christoph Mueller
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
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Meher T, Sahoo H. The epidemiological profile of metabolic syndrome in Indian population: A comparative study between men and women. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Hernández-Rubio A, Sanvisens A, Bolao F, Pérez-Mañá C, García-Marchena N, Fernández-Prendes C, Muñoz A, Muga R. Association of hyperuricemia and gamma glutamyl transferase as a marker of metabolic risk in alcohol use disorder. Sci Rep 2020; 10:20060. [PMID: 33208850 PMCID: PMC7674473 DOI: 10.1038/s41598-020-77013-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/04/2020] [Indexed: 12/19/2022] Open
Abstract
Excessive alcohol consumption leads to overproduction of urates and renal function plays a critical role in serum uric acid levels. We aimed to assess associations of hyperuricemia in patients with alcohol use disorder (AUD) and comparable Glomerular Filtration Rate (GFR). A total of 686 patients undergoing treatment for AUD between 2013 and 2017 were eligible (77% men); age at admission was 47 years [interquartile range (IQR), 40-53 years], age of onset of alcohol consumption was 16 years [IQR, 16-18 years] and the amount of alcohol consumed was 160 g/day [IQR, 120-240 g/day]. Body Mass Index was 24.7 kg/m2 [IQR, 21.9-28.4 kg/m2], eGFR was 105 mL/min/1.73 m2 [IQR, 95.7-113.0 mL], 9.7% had metabolic syndrome and 23% had advanced liver fibrosis (FIB-4 > 3.25). Prevalence of hyperuricemia was 12.5%. The eGFR-adjusted multivariate analysis showed that relative to patients with GGT ≤ 50, those with GGT between 51 and 300 U/L and those with GGT > 300 U/L were 4.31 (95% CI 1.62-11.46) and 10.3 (95% CI 3.50-29.90) times more likely to have hyperuricemia, respectively. Our data shows that hyperuricemia in the context of AUD is strongly associated with serum GGT levels and suggest an increased cardio-metabolic risk in this population.
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Affiliation(s)
- Anna Hernández-Rubio
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 08916, Badalona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain
| | - Arantza Sanvisens
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 08916, Badalona, Spain
| | - Ferran Bolao
- Department of Internal Medicine, Hospital Universitari de Bellvitge-IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Clara Pérez-Mañá
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Nuria García-Marchena
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 08916, Badalona, Spain
| | - Carla Fernández-Prendes
- Department of Clinical Analysis and Biochemistry, Laboratori Clinic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Alvaro Muñoz
- Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roberto Muga
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 08916, Badalona, Spain. .,Department of Medicine, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain.
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Simonetto DA, Shah VH, Kamath PS. Outpatient management of alcohol-related liver disease. Lancet Gastroenterol Hepatol 2020; 5:485-493. [PMID: 32277901 DOI: 10.1016/s2468-1253(19)30415-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/26/2019] [Accepted: 11/28/2019] [Indexed: 12/20/2022]
Abstract
Alcohol-related liver disease has become the leading indication for liver transplantation in the USA, partly due to an increase in the prevalence of high-risk drinking behaviour and alcohol use disorder, particularly among young women. Achieving sustained alcohol abstinence might not only prevent the development and progression of alcohol-related liver disease, but could also lead to clinically significant improvements, even in the advanced stages of disease. In this Series paper, we discuss the diagnosis and outpatient management of alcohol-related liver disease, with an emphasis on treatment options for alcohol use disorder and the assessment of nutritional status.
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Affiliation(s)
- Douglas A Simonetto
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science Rochester, MN, USA
| | - Vijay H Shah
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science Rochester, MN, USA
| | - Patrick S Kamath
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science Rochester, MN, USA.
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Vancampfort D, Byansi PK, Namutebi H, Lillian N, Kinyanda E, Bbosa RS, Ward PB, Lukwata H, Mugisha J. Correlates of physical activity stages of change in people living with HIV in a Ugandan community. Disabil Rehabil 2020; 44:443-448. [PMID: 32468877 DOI: 10.1080/09638288.2020.1770345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Purpose: The transtheoretical model (TTM) of behavioral change posits that individuals move through five stages of change when adopting new behaviors: pre-contemplation, contemplation, preparation, action, and maintenance. The aim of this study was to determine the proportion of patients with HIV/AIDS within a Ugandan fishing community in the different physical activity (PA) stages. We also explored differences in variables, motives, and barriers for PA across the stages.Methods: In total, 256 individuals (77 men, 40.5 ± 10.3 years) completed the Patient-centered Assessment and Counseling for Exercise Questionnaire, the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptoms, and the Alcohol Use Disorders Identification Test. They were also asked about their most important PA motive and barrier.Results: Seventy-five individuals (29%) were in the (pre-)preparatory stages, 140 (55%) in the action and 41 (16%) in the maintenance stage. Those in the (pre-)preparatory stages had higher PHQ-9 total scores (p < 0.001) and were more likely to report barriers than those in the later stages (p < 0.001). Compared with those in the (pre-)preparatory stage, patients in the action stage experienced less body weakness (p = 0.015).Conclusions: Depression and barriers to PA should be considered in people with HIV/AIDS in low-resource settings when implementing interventions to assist them to become more active.Implications for rehabilitationPeople with HIV/AIDS are among the most physically inactive clinical populations.Clinicians should consider depression when motivating patients with HIV in low resourced settings to become active.Clinicians should consider body weakness when motivating patients with HIV in low resourced settings to become active.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,University Psychiatric Centre KU Leuven, Kortenberg, Belgium
| | - Peter Kayiira Byansi
- Africa Social Development & Health Initiatives, Kampala, Uganda.,Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
| | - Hilda Namutebi
- Africa Social Development & Health Initiatives, Kampala, Uganda
| | | | - Eugene Kinyanda
- Department of Psychiatry, Makerere University, Kampala, Uganda.,Mental Health Project, MRC/LSHTM/UVRI and Senior Wellcome Trust Fellowship, Entebbe, Uganda
| | | | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - Hafsa Lukwata
- Mental Health Unit, Ministry of Health, Kampala, Uganda
| | - James Mugisha
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda.,Department of Sociology and Social Administration, Kyambogo University, Kampala, Uganda
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Malnick S, Maor Y. The Interplay between Alcoholic Liver Disease, Obesity, and the Metabolic Syndrome. Visc Med 2020; 36:198-205. [PMID: 32775350 DOI: 10.1159/000507233] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 03/11/2020] [Indexed: 12/16/2022] Open
Abstract
Background Fatty liver may be the result of several factors. The two main contributors are nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD). Summary NAFLD is the hepatic manifestation of the metabolic syndrome (MetS) and is the major cause of chronic liver disease worldwide as a result of the obesity epidemic. ALD is also a common cause of chronic liver disease. Obesity is a major contributory factor to MetS and is also common in individuals who consume large amounts of alcohol. There is a similar hepatic pathology and both can result in severe fibrosis, cirrhosis, and its complications including hepatocellular carcinoma. This review discusses the etiology, pathogenesis, and genetics of both NAFLD and ALD and their interaction. It is necessary to understand this better in order to prevent and treat these important causes of liver disease worldwide. Key Message Obesity, MetS, and alcohol consumption are linked to the development and progression of fatty liver disease. The coexistence of these factors in many patients requires a reassessment of many aspects of treatment of fatty liver disease.
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Affiliation(s)
- Stephen Malnick
- Department of Internal Medicine C, Kaplan Medical Center, Rehovot, Israel
| | - Yaakov Maor
- Institute of Gastroenterology and Hepatology, Kaplan Medical Center, Rehovot, Israel
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Gür F, Can Gür G. Is Exercise a Useful Intervention in the Treatment of Alcohol Use Disorder? Systematic Review and Meta-Analysis. Am J Health Promot 2020; 34:520-537. [PMID: 32212949 DOI: 10.1177/0890117120913169] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis examined the effects of exercise on individuals with alcohol use disorders (AUDs) across multiple health outcomes. DATA SOURCES PubMed, Medline, Web of Science, Scopus, Academic Search complete, Sport Discuss, and ERIC databases. STUDY INCLUSION AND EXCLUSION CRITERIA Interventional studies published between 2000 and 2018 focused on evaluating the effectiveness of exercise interventions in adults with AUD. DATA EXTRACTION This protocol was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols standard and the Meta-Analyses and Systematic Reviews of Observational Studies guidelines. DATA SYNTHESIS Physical activity levels/fitness [VO2 max (Oxygen Uptake) and HRmax (Maximum Heart Rate)], levels of depression, anxiety, self-efficacy, quality of life, and alcohol consumption (number of standard drinks consumed per day and per week). RESULTS The findings indicated that exercise significantly improved physical fitness as assessed by VO2 max (standardized mean difference [SMD]: 0.487, P < .05) and HRmax (SMD: 0.717, P < .05). Similarly, exercise significantly improved mental health as assessed by quality of life (SMD: 0.425, P < .05), but levels of depression, anxiety, self-efficacy, and alcohol consumption did not change significantly. Aerobic exercise alleviated depression and anxiety symptoms more than that of yoga and mixed types. Duration of exercise also had a similar effect on anxiety and depression. CONCLUSIONS Exercise can be an effective and persistent adjunctive treatment for individuals with AUDs.
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Affiliation(s)
- Fatih Gür
- Faculty of Sport Science, University of Pamukkale, Pamukkale, Turkey
| | - Ganime Can Gür
- Faculty of Sport Science, University of Pamukkale, Pamukkale, Turkey
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Functional exercise capacity in inpatients with alcohol use disorder versus healthy controls: A pilot study. Alcohol 2020; 82:47-52. [PMID: 31398459 DOI: 10.1016/j.alcohol.2019.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 07/07/2019] [Accepted: 07/31/2019] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to compare the functional exercise capacity of patients with alcohol use disorders (AUD) with an age-, gender-, and body mass index (BMI)-matched healthy control group. Thirty patients (22 males, 40.4 ± 10.5 years, illness duration = 9.7 ± 9.3 years) and healthy control subjects (22 males, 40.2 ± 10.7 years) participated. Participants performed a 6-min walk test (6MWT) to assess their functional exercise capacity, were asked about musculoskeletal problems and dyspnea, executed a standing broad jump to assess their muscular strength, and completed the International Physical Activity Questionnaire (IPAQ). Patients also filled in the Positive Affect and Negative Affect Schedule (PANAS) and Alcohol Use Disorders Identification Test (AUDIT). Our data show that patients with AUD walked a significantly shorter distance on the 6MWT (649.0 ± 72.9 m vs. 724.4 ± 89.0 m, p = 0.001). In patients with AUD, the variance in standing broad jump score explained 43.6% of the variance in the 6MWT score. The current study demonstrates that impaired muscle strength is negatively associated with functional outcomes in patients with AUD. Exercise interventions should be investigated in order to assess whether they can ameliorate muscle strength and daily life functioning of this vulnerable population.
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Coker MS, Ladd KR, Kim J, Murphy CJ, DeCort R, Newcomer BR, Wolfe RR, Coker RH. Essential Amino Acid Supplement Lowers Intrahepatic Lipid despite Excess Alcohol Consumption. Nutrients 2020; 12:E254. [PMID: 31963802 PMCID: PMC7019240 DOI: 10.3390/nu12010254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 12/18/2022] Open
Abstract
Excess alcohol consumption is a top risk factor for death and disability. Fatty liver will likely develop and the risk of liver disease increases. We have previously demonstrated that an essential amino acid supplement (EAAS) improved protein synthesis and reduced intrahepatic lipid in the elderly. The purpose of this exploratory pilot study was to initiate the evaluation of EAAS on intrahepatic lipid (IHL), body composition, and blood lipids in individuals with mild to moderate alcohol use disorder (AUD). Following consent, determination of eligibility, and medical screening, 25 participants (18 males at 38 ± 15 years/age and 7 females at 34 ± 18 years/age) were enrolled and randomly assigned to one of two dosages: a low dose (LD: 8 g of EAAS twice/day (BID)) or high dose (HD: 13 g of EAAS BID). Five of the twenty-five enrolled participants dropped out of the intervention. Both groups consumed the supplement BID for 4 weeks. Pre- and post-EAAS administration, IHL was determined using magnetic resonance imaging/spectroscopy, body composition was analyzed using dual-energy X-ray absorptiometry, and blood parameters were measured by LabCorp. T-tests were used for statistical analysis and considered significant at p < 0.05. While there was no significant change in IHL in the LD group, there was a significant 23% reduction in IHL in the HD group (p = 0.02). Fat mass, lean tissue mass, bone mineral content, and blood lipids were not altered. Post-EAAS phosphatidylethanol was elevated and remained unchanged in LD at 407 ± 141 ng/mL and HD at 429 ± 196 ng/mL, indicating chronic and excess alcohol consumption. The HD of the proprietary EAAS formulation consumed BID seemed to lower IHL in individuals with mild to moderate AUD. We suggest that further studies in a larger cohort be conducted to more completely address this important area of investigation.
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Affiliation(s)
- Melynda S. Coker
- Department of Natural Resources and Environment, University of Alaska Fairbanks, 505 South Chandalar Drive, Fairbanks, AK 99775, USA;
| | - Kaylee R. Ladd
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK 99775, USA; (K.R.L.); (J.K.)
| | - Jimin Kim
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK 99775, USA; (K.R.L.); (J.K.)
| | - Carl J. Murphy
- Institute of Arctic Biology, Department of Chemistry & Biochemistry, University of Alaska Fairbanks1930 Yukon Dr. Room 136, Fairbanks, AK 99775, USA;
| | - Ryan DeCort
- Bassett Army Community Hospital, 4076 Neely Road, FortWainwright, United States Army, Fairbanks, AK 99703, USA;
| | - Bradley R. Newcomer
- Honors College, 1501 251Warren Service Drive, Room 105, James Madison University, Harrisonburg, VA 22807, USA;
| | - Robert R. Wolfe
- Department of Geriatrics, Center for Translational Research in Aging & Longevity, Donald W. Reynolds Institute on Aging, 4301 West Markham, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Robert H. Coker
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK 99775, USA; (K.R.L.); (J.K.)
- Institute of Arctic Biology, Department of Chemistry & Biochemistry, University of Alaska Fairbanks1930 Yukon Dr. Room 136, Fairbanks, AK 99775, USA;
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Oon-Arom A, Likhitsathain S, Srisurapanont M. Efficacy and acceptability of varenicline for alcoholism: A systematic review and meta-analysis of randomized-controlled trials. Drug Alcohol Depend 2019; 205:107631. [PMID: 31678838 DOI: 10.1016/j.drugalcdep.2019.107631] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/10/2019] [Accepted: 08/13/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Current pharmacological treatment for alcoholism remains unsatisfactory. While there have been several clinical trials investigating the efficacy and safety of the therapeutic use of varenicline in alcoholism, no definitive review of this topic has been carried out. This systematic review aimed to determine the efficacy and acceptability of the use of varenicline in treating alcoholism. METHODS This systematic review included double-blinded, randomized, placebo-controlled trials reporting heavy drinking days, amount of alcohol consumption, overall dropouts, or dropouts due to adverse events. We searched PubMed, Scopus, Web of Science, ClinicalTrials.gov, and the Cochrane Library in January 2019. We independently selected the trials and assessed the quality of included studies. We calculated standardized mean differences on heavy drinking days and the amount of alcohol consumption. We calculated the relative risks for dropout rate. All data were pooled using random-effects models. RESULT This systematic review included nine double-blind, randomized, placebo-controlled trials (N = 585). The study duration ranged from 4 to 13 weeks. Varenicline therapy was not superior to placebo in decreasing heavy drinking days but significantly superior to placebo in decreasing alcohol consumption. There were no statistically significant differences between groups on dropout rates due to any reason or due to adverse events. CONCLUSION Varenicline therapy is effective in decreasing alcohol consumption over a period of time. It may be an option for decreasing heavy drinking days in patients with alcoholism. It is a well-accepted medication for alcoholism. More studies are needed to determine if varenicline is effective in decreasing heavy drinking.
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Affiliation(s)
- Awirut Oon-Arom
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Inthawaroros Road, Sri Phum, Muang Chiang Mai, Chiang Mai, 50200, Thailand.
| | - Surinporn Likhitsathain
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Inthawaroros Road, Sri Phum, Muang Chiang Mai, Chiang Mai, 50200, Thailand.
| | - Manit Srisurapanont
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Inthawaroros Road, Sri Phum, Muang Chiang Mai, Chiang Mai, 50200, Thailand.
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Harrison KH, Lee KK, Dobbins T, Wilson S, Hayman N, Ivers R, Haber PS, Conigrave JH, Johnson D, Hummerston B, Gray D, Conigrave K. Supporting Aboriginal Community Controlled Health Services to deliver alcohol care: protocol for a cluster randomised controlled trial. BMJ Open 2019; 9:e030909. [PMID: 31712335 PMCID: PMC6858116 DOI: 10.1136/bmjopen-2019-030909] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 08/07/2019] [Accepted: 09/05/2019] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Indigenous peoples who have experienced colonisation or oppression can have a higher prevalence of alcohol-related harms. In Australia, Aboriginal Community Controlled Health Services (ACCHSs) offer culturally accessible care to Aboriginal and Torres Strait Islander (Indigenous) peoples. However there are many competing health, socioeconomic and cultural client needs. METHODS AND ANALYSIS A randomised cluster wait-control trial will test the effectiveness of a model of tailored and collaborative support for ACCHSs in increasing use of alcohol screening (with Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)) and of treatment provision (brief intervention, counselling or relapse prevention medicines). SETTING Twenty-two ACCHSs across Australia. RANDOMISATION Services will be stratified by remoteness, then randomised into two groups. Half receive support soon after the trial starts (intervention or 'early support'); half receive support 2 years later (wait-control or 'late support'). THE SUPPORT Core support elements will be tailored to local needs and include: support to nominate two staff as champions for increasing alcohol care; a national training workshop and bimonthly teleconferences for service champions to share knowledge; onsite training, and bimonthly feedback on routinely collected data on screening and treatment provision. OUTCOMES AND ANALYSIS Primary outcome is use of screening using AUDIT-C as routinely recorded on practice software. Secondary outcomes are recording of brief intervention, counselling, relapse prevention medicines; and blood pressure, gamma glutamyltransferase and HbA1c. Multi-level logistic regression will be used to test the effectiveness of support. ETHICS AND DISSEMINATION Ethical approval has been obtained from eight ethics committees: the Aboriginal Health and Medical Research Council of New South Wales (1217/16); Central Australian Human Research Ethics Committee (CA-17-2842); Northern Territory Department of Health and Menzies School of Health Research (2017-2737); Central Queensland Hospital and Health Service (17/QCQ/9); Far North Queensland (17/QCH/45-1143); Aboriginal Health Research Ethics Committee, South Australia (04-16-694); St Vincent's Hospital (Melbourne) Human Research Ethics Committee (LRR 036/17); and Western Australian Aboriginal Health Ethics Committee (779). TRIAL REGISTRATION NUMBER ACTRN12618001892202; Pre-results.
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Affiliation(s)
- Kristie H Harrison
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006
| | - Ks Kylie Lee
- Discpline of Addiction Medicine, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria, Australia
| | - Timothy Dobbins
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Scott Wilson
- Discpline of Addiction Medicine, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Aboriginal Drug and Alcohol Council of South Australia, Underdale, South Australia, Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service), Inala, Queensland, Australia
- School of Medicine, Griffith University, Nathan, Queensland, Australia
| | - Rowena Ivers
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006
- Illawarra Aboriginal Medical Service, Wollongong, New South Wales, Australia
| | - Paul S Haber
- Discpline of Addiction Medicine, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Drug Health Services, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - James H Conigrave
- Discpline of Addiction Medicine, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - David Johnson
- Aboriginal Health Council of South Australia, Adelaide, South Australia, Australia
| | - Beth Hummerston
- Aboriginal Health Council of South Australia, Adelaide, South Australia, Australia
| | - Dennis Gray
- National Drug Research Institute, Curtin University Bentley Campus, Perth, Western Australia, Australia
| | - Katherine Conigrave
- Discpline of Addiction Medicine, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Drug Health Services, Sydney Local Health District, Camperdown, New South Wales, Australia
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de Caluwé L, van Buitenen N, Gelan PJ, Crunelle CL, Thomas R, Casseres S, Matthys F, van Harten P, Cahn W. Prevalence of metabolic syndrome and its associated risk factors in an African-Caribbean population with severe mental illness. Psychiatry Res 2019; 281:112558. [PMID: 31546147 DOI: 10.1016/j.psychres.2019.112558] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 12/31/2022]
Abstract
This cross-sectional study aims to determine the prevalence of metabolic syndrome (MetS) in patients with severe mental illness (SMI) on a Caribbean island, Curaçao, using the modified National Cholesterol Education Program Adult Treatment Panel III criteria. Among 350 patients (240 men and 110 women) with a mean age of 51.9 years (S.D.=13.5) MetS prevalence was 37.4%, significantly higher in female patients (63.6%) compared to male patients (25.4%). Increased waist circumference was present in 51.1%, low HDL in 50.6%, hypertension in 49.4%, hyperglycemia in 28.6% and 25.7% had hypertriglyceridemia. Except for hypertriglyceridemia, all criteria were more prevalent in female patients. Binary logistic regression analysis indicated that female gender, outpatient treatment setting and the absence of substance use disorder were all significant predictors for MetS. Compared to data from the general population obtained by the 2013 National Health Survey Curaçao, this study showed significantly higher prevalence of diabetes and hypertension in patients with SMI. Moreover, female patients had the highest prevalence of diabetes (28.2%), obesity (50.0%) and increased waist circumference (88.2%). This study demonstrates that African-Caribbean patients with SMI are at high-risk for MetS, especially female patients. Our data suggest to focus on modifiable lifestyle risk factors, as promoting physical activity and healthy dietary habits.
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Affiliation(s)
- Laura de Caluwé
- Department of Psychiatry, University Hospital Brussels, Laarbeeklaan 101, B-1090 Brussels, Belgium; Psychiatric Center, Dr. D.R. Capriles Hospital, GGz Curaçao, Willemstad, Curaçao.
| | - Nora van Buitenen
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Petra J Gelan
- Psychiatric Center, Dr. D.R. Capriles Hospital, GGz Curaçao, Willemstad, Curaçao
| | - Cleo L Crunelle
- Department of Psychiatry, University Hospital Brussels, Laarbeeklaan 101, B-1090 Brussels, Belgium
| | - Roeland Thomas
- Faculty of Medicine, Caribbean Medical University, Willemstad, Curaçao
| | - Sharon Casseres
- Psychiatric Center, Dr. D.R. Capriles Hospital, GGz Curaçao, Willemstad, Curaçao
| | - Frieda Matthys
- Department of Psychiatry, University Hospital Brussels, Laarbeeklaan 101, B-1090 Brussels, Belgium
| | - Peter van Harten
- Psychiatric Center GGz Centraal, Amersfoort, The Netherlands; Department of Psychiatry, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
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49
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Cocoman AM, Gallagher D. A Retrospective Chart Review of Screening on the Prevalence of Metabolic Syndrome (MetS) in an Irish Community Mental Health Service. Issues Ment Health Nurs 2019; 40:895-901. [PMID: 31295053 DOI: 10.1080/01612840.2019.1609636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Individuals who are treated with antipsychotic medications are at risk of developing metabolic syndrome (MetS). The comorbidity of a severe mental illness (SMI) and a physical illness has a major impact on the quality of life of these individuals. We conducted a retrospective chart review (RCR) of 214 individuals with a diagnosis of schizophrenia who had been receiving antipsychotic medications for at least 6 months, in five clinical settings in an Irish community mental health service. The aim was to determine the presence of MetS to assist in improving screening practices and directing future practice. The National Cholesterol Education Program High Blood Cholesterol Adult Treatment Panel 111 (NCEP ATP 111) metabolic diagnostic criteria were utilised to determine prevalence. After examining 214 charts we observed that waist circumference varied from 68 to 142 cm, elevated waist circumference over the recommended parameters was recorded in 145 charts. Forty-five percent (n = 98) had blood pressure (BP) readings over 130/85. The range for body mass index (BMI)'s varied from 16 to 54, BMIs over 25 was recorded in 44% (n = 95) of charts. Elevated triglycerides (TG) were recorded in 37% (n = 80) and 45% (n = 97) had reduced HDL-C levels. Elevated glucose levels were found in 25% (n = 54) of the charts examined. The chart review found an overall prevalence rate of 44% (n = 94) for this sample. Regular audit of screening data used for the presence of MetS in individuals with SMI is essential in the detection of physical comorbidities and to improving the quality of life and prevention of premature deaths.
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Affiliation(s)
- Angela M Cocoman
- Faculty of Science and Health, School of Nursing and Human Sciences, Dublin City University , Dublin , Ireland
| | - Darren Gallagher
- Faculty of Science and Health, School of Nursing and Human Sciences, Dublin City University , Dublin , Ireland
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50
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Firth J, Siddiqi N, Koyanagi A, Siskind D, Rosenbaum S, Galletly C, Allan S, Caneo C, Carney R, Carvalho AF, Chatterton ML, Correll CU, Curtis J, Gaughran F, Heald A, Hoare E, Jackson SE, Kisely S, Lovell K, Maj M, McGorry PD, Mihalopoulos C, Myles H, O'Donoghue B, Pillinger T, Sarris J, Schuch FB, Shiers D, Smith L, Solmi M, Suetani S, Taylor J, Teasdale SB, Thornicroft G, Torous J, Usherwood T, Vancampfort D, Veronese N, Ward PB, Yung AR, Killackey E, Stubbs B. The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. Lancet Psychiatry 2019; 6:675-712. [PMID: 31324560 DOI: 10.1016/s2215-0366(19)30132-4] [Citation(s) in RCA: 750] [Impact Index Per Article: 150.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/01/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Joseph Firth
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia; Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Najma Siddiqi
- Department of Health Sciences, University of York, Hull York Medical School, Bradford, UK; Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain; Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Dan Siskind
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia; School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Simon Rosenbaum
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Cherrie Galletly
- Ramsay Health Care Mental Health, Adelaide, SA, Australia; Northern Adelaide Local Health Network, Adelaide, SA, Australia; Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Stephanie Allan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Constanza Caneo
- Departamento de Psiquiatría, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rebekah Carney
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Andre F Carvalho
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Mary Lou Chatterton
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - Christoph U Correll
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Jackie Curtis
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Fiona Gaughran
- South London and Maudsley NHS Foundation Trust, London, UK; Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Adrian Heald
- Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Diabetes and Endocrinology, Salford Royal Hospital, Salford, UK
| | - Erin Hoare
- Food and Mood Centre, Deakin University, Melbourne, VIC, Australia
| | - Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
| | - Steve Kisely
- School of Medicine, University of Queensland, Brisbane, QLD, Australia; Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Mario Maj
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Patrick D McGorry
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Cathrine Mihalopoulos
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - Hannah Myles
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Brian O'Donoghue
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Toby Pillinger
- South London and Maudsley NHS Foundation Trust, London, UK; Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Medical Research Council London Institute of Medical Sciences, London, UK; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia; Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia; The Melbourne Clinic, Melbourne, VIC, Australia
| | - Felipe B Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - David Shiers
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Marco Solmi
- Neurosciences Department and Padua Neuroscience Centre, University of Padua, Padua, Italy
| | - Shuichi Suetani
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia; Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
| | - Johanna Taylor
- Department of Health Sciences, University of York, Hull York Medical School, Bradford, UK
| | - Scott B Teasdale
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Graham Thornicroft
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Tim Usherwood
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; Department of General Practice, Westmead Clinical School, University of Sydney, Westmead, NSW, Australia
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium; University Psychiatric Centre, Katholieke Universiteit Leuven, Kortenberg, Belgium
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Philip B Ward
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Alison R Yung
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Eoin Killackey
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, London, UK; Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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