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Wagner JA, Bermúdez-Millán A, Buckley TE, Buxton OM, Feinn RS, Kong S, Kuoch T, Scully MF. Community-based diabetes prevention randomized controlled trial in refugees with depression: effects on metabolic outcomes and depression. Sci Rep 2023; 13:8718. [PMID: 37253820 DOI: 10.1038/s41598-023-35738-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/23/2023] [Indexed: 06/01/2023] Open
Abstract
Depression and antidepressant medications increase risk for type 2 diabetes. Cambodian-Americans have exceedingly high rates of both depression and diabetes. This paper reports outcomes of a diabetes prevention trial for Cambodian-Americans with depression. Primary outcomes were HbA1c, insulin resistance and depressive symptoms. Participants were aged 35-75, Khmer speaking, at risk for diabetes, and met study criteria for likely depression by either (a) antidepressant medication and/or (b) prolonged elevated depressive symptoms. Participants were randomized to one of three community health worker (CHW) interventions: (1) lifestyle intervention called Eat, Walk, Sleep (EWS), (2) EWS plus medication therapy management sessions with a pharmacist/CHW team to resolve drug therapy problems (EWS + MTM), or, (3) social services (SS; control). Assessments were at baseline, post-treatment (12 months), and follow-up (15 months). The n = 188 participants were 78% female, average age of 55 years, half had a household income < $20,000, and modal educational attainment was 7.0 years. Compared to the other arms, EWS + MTM showed a significant decrease in HbA1c and a trend for reduced inflammation and stress hormones. Depressive symptoms improved for EWS and EWS + MTM relative to SS. There was no change in insulin resistance. Cardiometabolic and mental health can be improved in tandem among immigrant and refugee groups.
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Affiliation(s)
- Julie A Wagner
- University of Connecticut Schools of Medicine and Dental Medicine, UConn Health, 263 Farmington Ave., Farmington, CT, 06030, USA.
| | | | | | | | | | - Sengly Kong
- Khmer Health Advocates, West Hartford, CT, USA
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2
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Fully automated CT-based adiposity assessment: comparison of the L1 and L3 vertebral levels for opportunistic prediction. Abdom Radiol (NY) 2023; 48:787-795. [PMID: 36369528 DOI: 10.1007/s00261-022-03728-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE The purpose of this study is to compare fully automated CT-based measures of adipose tissue at the L1 level versus the standard L3 level for predicting mortality, which would allow for use at both chest (L1) and abdominal (L3) CT. METHODS This retrospective study of 9066 asymptomatic adults (mean age, 57.1 ± 7.8 [SD] years; 4020 men, 5046 women) undergoing unenhanced low-dose abdominal CT for colorectal cancer screening. A previously validated artificial intelligence (AI) tool was used to assess cross-sectional visceral and subcutaneous adipose tissue areas (SAT and VAT), as well as their ratio (VSR) at the L1 and L3 levels. Post-CT survival prediction was compared using area under the ROC curve (ROC AUC) and hazard ratios (HRs). RESULTS Median clinical follow-up interval after CT was 8.8 years (interquartile range, 5.2-11.6 years), during which 5.9% died (532/9066). No significant difference (p > 0.05) for mortality was observed between L1 and L3 VAT and SAT at 10-year ROC AUC. However, L3 measures were significantly better for VSR at 10-year AUC (p < 0.001). HRs comparing worst-to-best quartiles for mortality at L1 vs. L3 were 2.12 (95% CI, 1.65-2.72) and 2.22 (1.74-2.83) for VAT; 1.20 (0.95-1.52) and 1.16 (0.92-1.46) for SAT; and 2.26 (1.7-2.93) and 3.05 (2.32-4.01) for VSR. In women, the corresponding HRs for VSR were 2.58 (1.80-3.69) (L1) and 4.49 (2.98-6.78) (L3). CONCLUSION Automated CT-based measures of visceral fat (VAT and VSR) at L1 are predictive of survival, although overall measures of adiposity at L1 level are somewhat inferior to the standard L3-level measures. Utilizing predictive L1-level fat measures could expand opportunistic screening to chest CT imaging.
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Helman TJ, Headrick JP, Stapelberg NJC, Braidy N. The sex-dependent response to psychosocial stress and ischaemic heart disease. Front Cardiovasc Med 2023; 10:1072042. [PMID: 37153459 PMCID: PMC10160413 DOI: 10.3389/fcvm.2023.1072042] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Stress is an important risk factor for modern chronic diseases, with distinct influences in males and females. The sex specificity of the mammalian stress response contributes to the sex-dependent development and impacts of coronary artery disease (CAD). Compared to men, women appear to have greater susceptibility to chronic forms of psychosocial stress, extending beyond an increased incidence of mood disorders to include a 2- to 4-fold higher risk of stress-dependent myocardial infarction in women, and up to 10-fold higher risk of Takotsubo syndrome-a stress-dependent coronary-myocardial disorder most prevalent in post-menopausal women. Sex differences arise at all levels of the stress response: from initial perception of stress to behavioural, cognitive, and affective responses and longer-term disease outcomes. These fundamental differences involve interactions between chromosomal and gonadal determinants, (mal)adaptive epigenetic modulation across the lifespan (particularly in early life), and the extrinsic influences of socio-cultural, economic, and environmental factors. Pre-clinical investigations of biological mechanisms support distinct early life programming and a heightened corticolimbic-noradrenaline-neuroinflammatory reactivity in females vs. males, among implicated determinants of the chronic stress response. Unravelling the intrinsic molecular, cellular and systems biological basis of these differences, and their interactions with external lifestyle/socio-cultural determinants, can guide preventative and therapeutic strategies to better target coronary heart disease in a tailored sex-specific manner.
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Affiliation(s)
- Tessa J. Helman
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, NSW, Sydney, Australia
- Correspondence: Tessa J. Helman
| | - John P. Headrick
- Schoolof Pharmacy and Medical Sciences, Griffith University, Southport, QLD, Australia
| | | | - Nady Braidy
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, NSW, Sydney, Australia
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Fang T, Zhang Q, Wang Z, Liu JP. Bidirectional association between depression and diabetic nephropathy by meta-analysis. PLoS One 2022; 17:e0278489. [PMID: 36538528 PMCID: PMC9767359 DOI: 10.1371/journal.pone.0278489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 11/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Studies suggested that the association between depression and diabetic nephropathy may be bi-directional, but this hypothesis remains investigating. In this meta-analysis, the bi-directional relationship between depression and diabetic nephropathy was investigated. METHODS A search for the publications on depression and diabetic nephropathy in the databases of PubMed, Web of science, and Embase from the earliest available to August 2022 was conducted. Two sets of pooled risk estimates were calculated using random effects models: diabetic nephropathy predicting depression and depression predicting diabetic nephropathy. Cross-sectional studies were assessed using Agency for Healthcare Research and Quality (AHRQ), cohort and case-control studies were assessed using Newcastle-Ottawa Scale (NOS). RESULT Of the 974,121 patients in 30 clinical studies, 24 studies met eligibility for diabetic nephropathy predicting onset of depression, representing 28,438 incident cases. The other 6 studies met criteria for depression predicting onset of diabetic nephropathy, representing 945,683 incident cases. The pooled odds ratio (OR) of diabetic nephropathy predicting depression was 1.46 (95% CI 1.27-1.67). The OR of depression predicting diabetic nephropathy was 1.22 (95% CI 1.13-1.31). CONCLUSION This meta-analysis shows that the relationship between depression and diabetic nephropathy may be bidirectional. Diabetic nephropathy may be a predictor of depression, and depression may also be an indicator of diabetic nephropathy. The mechanisms underlying the bidirectional relationship need to be further investigated and interventions of the comorbidity of depression and diabetic nephropathy need be studied in clinical practice.
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Affiliation(s)
- Tingting Fang
- Institute of Ageing Research, Hangzhou Normal University, School of Basic Medicine, Hangzhou, Zhejiang Province, China
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
- * E-mail: (TF); (JPL)
| | - Qiuling Zhang
- Department of Endocrinology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Zhiguo Wang
- Institute of Ageing Research, Hangzhou Normal University, School of Basic Medicine, Hangzhou, Zhejiang Province, China
| | - Jun-Ping Liu
- Institute of Ageing Research, Hangzhou Normal University, School of Basic Medicine, Hangzhou, Zhejiang Province, China
- Monash University Department of Immunology and Pathology, Central Clinical School, Faculty of Medicine, Prahran, Victoria, Australia
- Hudson Institute of Medical Research, Clayton, Victoria, Australia
- * E-mail: (TF); (JPL)
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5
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Lee JI, Busler JN, Millett CE, Principe JL, Levin LL, Corrigan A, Burdick KE. Association between visceral adipose tissue and major depressive disorder across the lifespan: A scoping review. Bipolar Disord 2022; 24:375-391. [PMID: 34551182 DOI: 10.1111/bdi.13130] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Increasing evidence supports a bidirectional relationship between major depressive disorder (MDD) and obesity, but the role of visceral adipose tissue (VAT) as a measure of obesity in relation to MDD is not well understood. Here we review literature investigating the link between MDD and VAT in terms of biomarkers, sex differences, and aging. METHODS PubMed, EMBASE, PsycINFO, and CINAHL searches were conducted on December 11, 2020. No date or language limits were imposed. Major concepts searched were Depressive Disorder linked with Adipose Tissue, White, Hypothalmo-Hypophyseal System, and Pituitary-Adrenal System in addition to keywords. A final set of 32 items meeting criteria for inclusion. RESULTS Converging biological evidence suggests a significant bidirectional relationship between VAT and MDD across the lifespan. In adulthood, greater VAT was associated with increased risk for depression, especially in vulnerable groups such as individuals who are overweight/obese, postmenopausal women, and individuals with comorbid medical or psychiatric illness. In older adults, sarcopenia had an impact on the relationship between abnormal VAT and risk of depression. Additionally, sex differences emerged as a potential factor affecting the strength of the association between VAT and depression. CONCLUSIONS Elucidating the pathophysiological mechanisms associated with increased rates of depression in obese individuals will be crucial for developing specific treatment strategies that seek to improve outcomes in individuals with comorbid depression and obesity. Moreover, identifying age- and sex-specific risk factors may contribute to a more personalized medicine approach, thereby improving the quality of clinical care.
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Affiliation(s)
- Jia-In Lee
- Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jessica N Busler
- Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Caitlin E Millett
- Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Jessica L Principe
- Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Leonard L Levin
- Countway Library, Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Alexandra Corrigan
- Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Katherine E Burdick
- Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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6
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Li Z, Tong X, Ma Y, Bao T, Yue J. Prevalence of depression in patients with sarcopenia and correlation between the two diseases: systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2022; 13:128-144. [PMID: 34997702 PMCID: PMC8818614 DOI: 10.1002/jcsm.12908] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 10/02/2021] [Accepted: 11/29/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Depression may be the most common cause of emotional distress later in life and can significantly reduce the quality of life in elderly individuals. Sarcopenia is a syndrome characterized by the continuous loss of skeletal muscle mass and decreased strength and function. In recent years, many studies have shown a correlation between sarcopenia and depression. The present study aimed to investigate the prevalence of depression among individuals with sarcopenia and to ascertain whether sarcopenia is independently associated with depression. METHODS We systematically searched the PubMed, Embase, and Google Scholar databases for papers on sarcopenia published up to 31 August 2021. We reviewed the literature on the number of individuals with sarcopenia, the number of individuals with both sarcopenia and depression, and the odds ratio (OR) of sarcopenia to depression. Statistical analyses were performed using Meta-DiSc 1.4 software and Stata version 12.0. RESULTS Nineteen articles met the inclusion criteria for review: nine reported both prevalence and ORs, four described prevalence only, and six detailed the ORs only. Regarding prevalence, there were 1476 cases of sarcopenia and 364 of depression in the selected studies; the mean age of the patients was 75.5 years, and the overall prevalence of depression was 0.28 [95% confidence interval (CI): 0.21-0.36]. Significant heterogeneity was noted (P < 0.001; I2 = 92.2%). In the case of ORs, there were 16 869 subjects with a mean age of 73 years; the overall adjusted OR between sarcopenia and depression was 1.57 (95% CI: 1.32-1.86). Significant heterogeneity was noted in the adjusted ORs (P < 0.001; I2 = 75.1%). CONCLUSIONS The prevalence of depression in patients with sarcopenia was high relatively, and there was a correlation between sarcopenia and depression.
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Affiliation(s)
- Zhenzhen Li
- Health Management Center, National Clinical Research Center for Geriatrics, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Xiang Tong
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Yao Ma
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Ting Bao
- Health Management Center, National Clinical Research Center for Geriatrics, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
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7
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Stapel B, Jelinic M, Drummond GR, Hartung D, Kahl KG. Adipose Tissue Compartments, Inflammation, and Cardiovascular Risk in the Context of Depression. Front Psychiatry 2022; 13:831358. [PMID: 35444568 PMCID: PMC9013771 DOI: 10.3389/fpsyt.2022.831358] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/07/2022] [Indexed: 12/20/2022] Open
Abstract
The neurobiological and behavioral underpinnings linking mental disorders, in particular, major depressive disorder (MDD), with cardiovascular disorders are a matter of debate. Recent research focuses on visceral (intra-abdominal and epicardial) adipose tissue and inflammation and their impact on the development of cardiometabolic disorders. Intra-abdominal adipose tissue is defined as an endocrine active fat compartment surrounding inner organs and is associated with type 2 diabetes mellitus, a risk factor for the later development of cardiovascular disorders. Epicardial (pericardial) adipose tissue is a fat compartment surrounding the heart with close proximity to the arteries supporting the heart. Visceral adipose tissue (VAT) is an important source of inflammatory mediators that, in concert with other risk factors, plays a leading role in cardiovascular diseases. In conjunction with the behavioral (physical inactivity, sedentary lifestyle), psychological (adherence problems), and hormonal (dysfunction of the hypothalamus-pituitary-adrenal axis with subsequent hypercortisolism) alterations frequently accompanying MDD, an enhanced risk for cardiovascular disorders results.
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Affiliation(s)
- Britta Stapel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Maria Jelinic
- Department of Physiology, Anatomy and Microbiology, Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora, VIC, Australia
| | - Grant R Drummond
- Department of Physiology, Anatomy and Microbiology, Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora, VIC, Australia
| | - Dagmar Hartung
- Hannover Medical School, Institute for Diagnostic and Interventional Radiology, Hanover, Germany
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
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8
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Depressive symptoms and 5-year incident metabolic syndrome among older adults. Sci Rep 2021; 11:14842. [PMID: 34290362 PMCID: PMC8295297 DOI: 10.1038/s41598-021-94503-y] [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: 02/18/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022] Open
Abstract
Little is known regarding the association between depressive symptoms and metabolic syndrome (MetS) among older Chinese adults. This study aimed to examine the association of depressive symptoms with MetS and its components among Chinese elderly. Based on whether they showed depressive symptoms at baseline, 262 age-gender-matched participants from a community-based cohort study were included. The presence of depressive symptoms was measured using the nine-item Patient Health Questionnaire (PHQ-9). MetS was defined according to the Adult Treatment Panel III of the National Cholesterol Education Program. Linear regression and logistic regression analyses were performed to assess associations of depressive symptoms with MetS and its components. The incidence of MetS among the participants with depressive symptoms at baseline was 15.27% (20/131). The association of the presence of depressive symptoms with MetS was significant (odds ratio [OR] = 2.53, 95% confidence intervals [CI] = 1.07, 5.95). There was a negative association between depressive symptoms and hypertension (OR = 0.04, 95% CI = 0.002, 0.98). The change in mean arterial pressure varies approximately 1.03 mmHg with a 1-point change in PHQ-9 score. In this study, baseline depressive symptoms were associated with subsequent MetS. The presence of depressive symptoms was negatively associated with elevated mean arterial pressure.
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9
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Affiliation(s)
- Stephanie L Borgland
- From the Department of Physiology and Pharmacology, University of Calgary, Calgary, Alta., Canada
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10
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Cosan AS, Schweiger JU, Kahl KG, Hamann B, Deuschle M, Schweiger U, Westermair AL. Fat compartments in patients with depression: A meta-analysis. Brain Behav 2021; 11:e01912. [PMID: 33150726 PMCID: PMC7821617 DOI: 10.1002/brb3.1912] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/18/2020] [Accepted: 09/26/2020] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Depressive disorders are a common illness worldwide. Major depression is known as a significant predictor of the metabolic syndrome. However, the effects of depression on adipose tissue compartments are controversial. This meta-analysis aimed to evaluate the state of research on the relationship between patients with depression and adipose tissue compartments as compared to nondepressed individuals. METHODS The PubMed database was searched for human studies that measured adipose tissue compartments such as visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and/or organ-specific adipose tissue measurements using dual-energy X-ray absorptiometry, magnetic resonance imaging or computed tomography scan and reported the means and a measure of variance separately for depressed individuals and healthy controls. Twelve articles were identified, including a total of 1,141 depressed and 2,545 nondepressed individuals. RESULTS Major depressive disorder and self-reported depressive symptoms were associated with elevated visceral adipose tissue and elevated subcutaneous adipose tissue. Subanalyses for gender, age, method of adipose tissue measurement, and method of depression assessment showed elevated visceral adipose in depressed individuals. The results could be replicated when focussing on studies controlling for body mass index (BMI). Regarding other adipose tissue compartments, meta-analysis could not be carried out due to lack of studies. CONCLUSIONS Depression is associated with enlarged visceral and subcutaneous adipose tissue. Further, especially longitudinal, research is needed to identify the mechanism through which depressive disorders contribute to visceral adiposity.
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Affiliation(s)
- Alisa S Cosan
- Klinik für Psychiatrie und Psychotherapie, Universität zu Lübeck, Lubeck, Germany
| | | | - Kai G Kahl
- Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover, Hannover, Germany
| | | | - Michael Deuschle
- Zentralinstitut für Seelische Gesundheit, Fakultät für Medizin Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Ulrich Schweiger
- Klinik für Psychiatrie und Psychotherapie, Universität zu Lübeck, Lubeck, Germany
| | - Anna L Westermair
- Klinik für Psychiatrie und Psychotherapie, Universität zu Lübeck, Lubeck, Germany
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11
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Ng JS, Chin KY. Potential mechanisms linking psychological stress to bone health. Int J Med Sci 2021; 18:604-614. [PMID: 33437195 PMCID: PMC7797546 DOI: 10.7150/ijms.50680] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/30/2020] [Indexed: 02/06/2023] Open
Abstract
Chronic psychological stress affects many body systems, including the skeleton, through various mechanisms. This review aims to provide an overview of the factors mediating the relationship between psychological stress and bone health. These factors can be divided into physiological and behavioural changes induced by psychological stress. The physiological factors involve endocrinological changes, such as increased glucocorticoids, prolactin, leptin and parathyroid hormone levels and reduced gonadal hormones. Low-grade inflammation and hyperactivation of the sympathetic nervous system during psychological stress are also physiological changes detrimental to bone health. The behavioural changes during mental stress, such as altered dietary pattern, cigarette smoking, alcoholism and physical inactivity, also threaten the skeletal system. Psychological stress may be partly responsible for epigenetic regulation of skeletal development. It may also mediate the relationship between socioeconomic status and bone health. However, more direct evidence is required to prove these hypotheses. In conclusion, chronic psychological stress should be recognised as a risk factor of osteoporosis and stress-coping methods should be incorporated as part of the comprehensive osteoporosis-preventing strategy.
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Affiliation(s)
- Jia-Sheng Ng
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
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12
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Rothe N, Steffen J, Penz M, Kirschbaum C, Walther A. Examination of peripheral basal and reactive cortisol levels in major depressive disorder and the burnout syndrome: A systematic review. Neurosci Biobehav Rev 2020; 114:232-270. [DOI: 10.1016/j.neubiorev.2020.02.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/27/2020] [Accepted: 02/19/2020] [Indexed: 12/15/2022]
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13
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Saxton SN, Clark BJ, Withers SB, Eringa EC, Heagerty AM. Mechanistic Links Between Obesity, Diabetes, and Blood Pressure: Role of Perivascular Adipose Tissue. Physiol Rev 2019; 99:1701-1763. [PMID: 31339053 DOI: 10.1152/physrev.00034.2018] [Citation(s) in RCA: 136] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Obesity is increasingly prevalent and is associated with substantial cardiovascular risk. Adipose tissue distribution and morphology play a key role in determining the degree of adverse effects, and a key factor in the disease process appears to be the inflammatory cell population in adipose tissue. Healthy adipose tissue secretes a number of vasoactive adipokines and anti-inflammatory cytokines, and changes to this secretory profile will contribute to pathogenesis in obesity. In this review, we discuss the links between adipokine dysregulation and the development of hypertension and diabetes and explore the potential for manipulating adipose tissue morphology and its immune cell population to improve cardiovascular health in obesity.
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Affiliation(s)
- Sophie N Saxton
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom; School of Environment and Life Sciences, University of Salford, Salford, United Kingdom; and Department of Physiology, VU University Medical Centre, Amsterdam, Netherlands
| | - Ben J Clark
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom; School of Environment and Life Sciences, University of Salford, Salford, United Kingdom; and Department of Physiology, VU University Medical Centre, Amsterdam, Netherlands
| | - Sarah B Withers
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom; School of Environment and Life Sciences, University of Salford, Salford, United Kingdom; and Department of Physiology, VU University Medical Centre, Amsterdam, Netherlands
| | - Etto C Eringa
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom; School of Environment and Life Sciences, University of Salford, Salford, United Kingdom; and Department of Physiology, VU University Medical Centre, Amsterdam, Netherlands
| | - Anthony M Heagerty
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom; School of Environment and Life Sciences, University of Salford, Salford, United Kingdom; and Department of Physiology, VU University Medical Centre, Amsterdam, Netherlands
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Frangou S, Shirali M, Adams MJ, Howard DM, Gibson J, Hall LS, Smith BH, Padmanabhan S, Murray AD, Porteous DJ, Haley CS, Deary IJ, Clarke TK, McIntosh AM. Insulin resistance: Genetic associations with depression and cognition in population based cohorts. Exp Neurol 2019; 316:20-26. [PMID: 30965038 PMCID: PMC6503941 DOI: 10.1016/j.expneurol.2019.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/26/2019] [Accepted: 04/03/2019] [Indexed: 01/07/2023]
Abstract
Insulin resistance, broadly defined as the reduced ability of insulin to exert its biological action, has been associated with depression and cognitive dysfunction in observational studies. However, it is unclear whether these associations are causal and whether they might be underpinned by other shared factors. To address this knowledge gap, we capitalized on the stability of genetic biomarkers through the lifetime, and on their unidirectional relationship with depression and cognition. Specifically, we determined the association between quantitative measures of cognitive function and depression and genetic instruments of insulin resistance traits in two large-scale population samples, the Generation Scotland: Scottish Family Health Study (GS: SFHS; N = 19,994) and in the UK Biobank (N = 331,374). In the GS:SFHS, the polygenic risk score (PRS) for fasting insulin was associated with verbal intelligence and depression while the PRS for the homeostasis model assessment of insulin resistance was associated with verbal intelligence. Despite this overlap in genetic architecture, Mendelian randomization analyses in the GS:SFHS and in the UK Biobank samples did not yield evidence for causal associations from insulin resistance traits to either depression or cognition. These findings may be due to weak genetic instruments, limited cognitive measures and insufficient power but they may also indicate the need to identify other biological mechanisms that may mediate the relationship from insulin resistance to depression and cognition.
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Affiliation(s)
- Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Masoud Shirali
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Mark J Adams
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - David M Howard
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Jude Gibson
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Lynsey S Hall
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Blair H Smith
- Division of Population Health Sciences, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Sandosh Padmanabhan
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Alison D Murray
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UK
| | - David J Porteous
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Generation Scotland, Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Chris S Haley
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Toni-Kim Clarke
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Andrew M McIntosh
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
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Singh V, Garg B. Insulin resistance and depression: Relationship and treatment implications. JOURNAL OF MENTAL HEALTH AND HUMAN BEHAVIOUR 2019. [DOI: 10.4103/jmhhb.jmhhb_55_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Michels N, Matthys D, Thumann B, Marild S, De Henauw S. Children's stress-related reports and stress biomarkers interact in their association with metabolic syndrome risk. Stress Health 2018; 34:523-533. [PMID: 29733496 DOI: 10.1002/smi.2813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 01/27/2023]
Abstract
The purpose was to examine the cross-sectional associations of stress-related reports and stress biomarkers with metabolic syndrome (MetS) risk in children while also testing the interaction between stress biomarkers and stress reports. In 353 children (5-10 years old, 7.9% overweight/obese), MetS risk was measured by blood pressure, waist circumference, glucose homeostasis, triglycerides, and high-density cholesterol. Stress was measured by stress-related reports (events, emotions, and internalizing/externalizing problems) and two biomarkers: salivary cortisol (total-day and morning output) and heart rate variability (percentage of consecutive normal RR intervals differing more than 50 ms and low-to-high-frequency ratio). Cross-sectional regression analyses with z scored total MetS risk as outcome were adjusted for age, sex, and socio-economic status. Only internalizing problems were directly related to a higher MetS risk score (β = 0.236). Cortisol and heart rate variability were significant moderators: High cortisol morning output resulted in a positive (unfavourable) report-MetS relationship (β = 0.259-0.552), whereas low percentage of consecutive normal RR intervals differing more than 50 ms resulted in a negative (favourable) report-MetS relationship (β = -0.298) and low low-to-high-frequency ratio in a positive (unfavourable) report-MetS relationship (β = 0.478). In conclusion, stress can sometimes be a disadvantageous factor in metabolic health of otherwise healthy children. The cortisol biomarker seems relevant because metabolic risk was highest when stress-related reports were accompanied by high morning cortisol output.
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Affiliation(s)
- Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Dante Matthys
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Barbara Thumann
- Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
| | - Staffan Marild
- Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital, The Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Kahl KG, Deuschle M, Stubbs B, Schweiger U. Visceral adipose tissue in patients with severe mental illness. Horm Mol Biol Clin Investig 2018; 33:hmbci-2018-0007. [PMID: 29547392 DOI: 10.1515/hmbci-2018-0007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 02/15/2018] [Indexed: 12/25/2022]
Abstract
Background Severe mental illnesses (SMIs), i.e. major depression, schizophrenia and bipolar disorder, are associated with an elevated risk for the development of type-2 diabetes mellitus and cardiovascular disorders. Several factors have been associated with increased cardiometabolic morbidity and mortality in SMI, including lifestyle factors (smoking, inactivity, unhealthy diet), endocrine and immunologic alterations; however, the underlying mechanisms remain to be fully uncovered. It is now well accepted that visceral adipose tissue (VAT) promotes the development of cardiometabolic disorders, at least in part by inflammatory and metabolic functions. Methods This paper reviews studies concerning VAT, with special focus on intra-abdominal and pericardial adipose tissue, in SMI. Results In patients with SMI, several studies have been performed concerning VAT. Most of these studies reported alterations of VAT particularly in patients with major depression and schizophrenia, independent of body weight and body mass index. Some of the studies also reported an increased cardiometabolic risk. Conclusion Patients with SMI are at increased risk of developing cardiometabolic disorders, and display increased amounts of VAT. As studies so far were mainly performed on patients before the onset of cardiometabolic disorders, VAT may serve as a biomarker for patients with SMI to assess cardiometabolic risks beyond established risk scores. Further, interventions aiming at reducing VAT in SMI are highly recommended in long-term multimodal treatment plans.
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Affiliation(s)
- Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany, Phone: +49 511-5322495, Fax: +49 511-5328573
| | - Michael Deuschle
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK.,Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
| | - Ulrich Schweiger
- Department of Psychiatry and Psychotherapy, University of Lübeck Medical School, Lübeck, Germany
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Estrada CM, Ghisays V, Nguyen ET, Caldwell JL, Streicher J, Solomon MB. Estrogen signaling in the medial amygdala decreases emotional stress responses and obesity in ovariectomized rats. Horm Behav 2018; 98:33-44. [PMID: 29248436 DOI: 10.1016/j.yhbeh.2017.12.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 12/01/2017] [Accepted: 12/09/2017] [Indexed: 12/15/2022]
Abstract
Declining estradiol (E2), as occurs during menopause, increases risk for obesity and psychopathology (i.e., depression, anxiety). E2 modulates mood and energy homeostasis via binding to estrogen receptors (ER) in the brain. The often comorbid and bidirectional relationship between mood and metabolic disorders suggests shared hormonal and/or brain networks. The medial amygdala (MeA) is abundant in ERs and regulates mood, endocrine, and metabolic stress responses; therefore we tested the hypothesis that E2 in the MeA mitigates emotional and metabolic dysfunction in a rodent model of surgical menopause. Adult female rats were ovariectomized (OVX) and received bilateral implants of E2 or cholesterol micropellets aimed at the MeA. E2-MeA decreased anxiety-like (center entries, center time) and depression-like (immobility) behaviors in the open field and forced swim tests (FST), respectively in ovariectomized rats. E2-MeA also prevented hyperphagia, body weight gain, increased visceral adiposity, and glucose intolerance in ovariectomized rats. E2-MeA decreased caloric efficiency, suggestive of increased energy expenditure. E2-MeA also modulated c-Fos neural activity in amygdalar (central and medial) and hypothalamic (paraventricular and arcuate) brain regions that regulate mood and energy homeostasis in response to the FST, a physically demanding task. Given the shared neural circuitry between mood and body weight regulation, c-Fos expression in discrete brain regions in response to the FST may be due to the psychologically stressful and/or metabolic demands of the task. Together, these findings suggest that the MeA is a critical node for mediating estrogenic effects on mood and energy homeostasis.
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Affiliation(s)
- Christina M Estrada
- Department of Psychology Experimental Psychology Program, University of Cincinnati, Cincinnati, OH 45237, United States
| | - Valentina Ghisays
- Department of Psychology Experimental Psychology Program, University of Cincinnati, Cincinnati, OH 45237, United States
| | - Elizabeth T Nguyen
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, OH 45237, United States
| | - Jody L Caldwell
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH 45237, United States
| | - Joshua Streicher
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH 45237, United States
| | - Matia B Solomon
- Department of Psychology Experimental Psychology Program, University of Cincinnati, Cincinnati, OH 45237, United States; Neuroscience Graduate Program, University of Cincinnati, Cincinnati, OH 45237, United States; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH 45237, United States.
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Wingenfeld K, Kuehl LK, Boeker A, Schultebraucks K, Schulz A, Stenzel J, Spitzer C, Otte C. Are adverse childhood experiences and depression associated with impaired glucose tolerance in females? An experimental study. J Psychiatr Res 2017; 95:60-67. [PMID: 28783579 DOI: 10.1016/j.jpsychires.2017.07.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/20/2017] [Accepted: 07/31/2017] [Indexed: 01/01/2023]
Abstract
Adverse childhood experiences (ACE) enhance the risk for mental disorders, e.g. major depressive disorder (MDD). Increasing evidence suggests an association between ACE and impaired physical health, e.g. metabolic syndrome. The aim of this study was to assess several metabolic risk markers in healthy individuals with and without ACE and depressed patients with and without ACE. We examined glucose and insulin release in the oGTT in 33 women with MDD and ACE, 47 women with MDD without ACE, 21 women with ACE but no current or lifetime MDD and 36 healthy women without either MDD or ACE. Several metabolic markers such as triglycerides, cholesterol, LDL, HDL, HbA1c, BMI and waist to hip ratio were assessed. The four groups did neither differ in insulin release and glucose concentrations in the oGTT nor with respect to other metabolic variables. Depressed patients with and without psychotropic medication did not differ in any outcome variable, but there was a trend towards higher glucose concentrations in the oGTT in patients with current psychotropic medication. In this physically healthy sample neither ACE nor MDD were associated with metabolic risk factors. Thus, metabolic alterations might not directly be linked to ACE and depression.
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Affiliation(s)
- Katja Wingenfeld
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
| | - Linn K Kuehl
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Anita Boeker
- Asklepios Fachklinikum Tiefenbrunn, Rosdorf, Germany
| | - Katharina Schultebraucks
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Anne Schulz
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Julia Stenzel
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | | | - Christian Otte
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
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Webb M, Davies M, Ashra N, Bodicoat D, Brady E, Webb D, Moulton C, Ismail K, Khunti K. The association between depressive symptoms and insulin resistance, inflammation and adiposity in men and women. PLoS One 2017; 12:e0187448. [PMID: 29190710 PMCID: PMC5708702 DOI: 10.1371/journal.pone.0187448] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 10/19/2017] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Depression has been shown to be associated with elevated leptin levels, low-grade inflammation and insulin resistance. These derangements are often measured in mixed gender cohorts despite the different body compositions and hormonal environments of men and women and gender-specific prevalence and responses to depression. METHODS A cross-sectional analysis was carried out on a cohort of 639 participants from the ADDITION-Leicester dataset to assess differences in markers of diabetes risk, cardiovascular risk and inflammation in depressed and non-depressed individuals. Depressive symptoms were determined using the WHO (Five) well-being index. Multivariate linear and logistic regression analyses were adjusted for age, sex, ethnicity, body mass index, smoking, social deprivation and activity levels for continuous and binary variables respectively. Further analysis included stratifying the data by gender as well as assessing the interaction between depression and gender by including an interaction term in the model. RESULTS Women with depressive symptoms had a 5.3% larger waist circumference (p = 0.003), 28.7% higher HOMA IR levels (p = 0.026), 6.6% higher log-leptin levels (p = 0.01) and 22.37% higher TNF-α levels (p = 0.015) compared with women without. Conversely, depressive symptoms in men were associated with 7.8% lower body fat % (p = 0.015) but 48.7% higher CRP levels (p = 0.031) compared to men without. However, interaction analysis failed to show a significant difference between men and women. CONCLUSIONS Depressive symptoms are associated with metabolic derangements. Whilst women tended to show elevations in biomarkers related to an increased risk of type 2 diabetes (HOMA IR, leptin and TNF-α), men showed a marked increase in the cardiovascular disease risk biomarker CRP. However, perhaps due to the cohort size, interaction analysis did not show a significant gender difference.
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Affiliation(s)
- M’Balu Webb
- National Institute for Health Research Biomedical Research Centre—Leicester, University Hospitals of Leicester, Leicester, England
- The Leicester Diabetes Centre, University Hospitals of Leicester, Leicester General Hospital, Leicester, England
- * E-mail:
| | - Melanie Davies
- National Institute for Health Research Biomedical Research Centre—Leicester, University Hospitals of Leicester, Leicester, England
- The Leicester Diabetes Centre, University Hospitals of Leicester, Leicester General Hospital, Leicester, England
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, England
| | - Nuzhat Ashra
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, England
| | - Danielle Bodicoat
- National Institute for Health Research Biomedical Research Centre—Leicester, University Hospitals of Leicester, Leicester, England
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, England
| | - Emer Brady
- National Institute for Health Research Biomedical Research Centre—Leicester, University Hospitals of Leicester, Leicester, England
- The Leicester Diabetes Centre, University Hospitals of Leicester, Leicester General Hospital, Leicester, England
| | - David Webb
- National Institute for Health Research Biomedical Research Centre—Leicester, University Hospitals of Leicester, Leicester, England
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, England
| | - Calum Moulton
- Department of Psychological Medicine, Weston Education Centre, Kings College London, London, England
| | - Khalida Ismail
- Department of Psychological Medicine, Weston Education Centre, Kings College London, London, England
| | - Kamlesh Khunti
- National Institute for Health Research Biomedical Research Centre—Leicester, University Hospitals of Leicester, Leicester, England
- The Leicester Diabetes Centre, University Hospitals of Leicester, Leicester General Hospital, Leicester, England
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, England
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Kozieł S, Chakraborty R, Bose K. Relationship between temperament and fatness in 11-year-old children and 17-year-old adolescents from Wrocław, Poland. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2017; 68:479-486. [PMID: 29175059 DOI: 10.1016/j.jchb.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 10/12/2017] [Indexed: 11/29/2022]
Abstract
Childhood obesity is increasing globally, and Poland is no exception. Studies indicate that relationship between obesity and psychological well-being is a complex issue and this needs further research. The objective of the present cross sectional study was to analyze the relationship between some temperament components and fatness among children in two developmental periods, approximately before and after adolescence. Participants included 122 children aged 11 years (57 boys and 65 girls), and 153 adolescents aged 17 years (64 boys and 89 girls) from 6 primary and 4 secondary schools in Wrocław, Poland. Height, weight, triceps-, subscapular and abdominal skinfold thicknesses were measured. Temperament was assessed by a questionnaire of Buss and Plomin (1984) in two versions: EAS-C for children completed by parents and EAS-D for youth and adults. Physical activity (PAL) was also assessed by a questionnaire. Mean, median and standard deviation (SD) were calculated and Student's t tests were performed to test for significance of differences between groups. Chi squared (χ2) statistic was used to test the significance of differences in frequencies. Analyses of covariance (ANCOVA) were performed to show the effect of the social - psychological factors on fatness. Controlling for socioeconomic status and physical activity level, activity, as a component of temperament had a significant effect on body fatness. The only component of temperament, which significantly influenced level of fatness in girls, was emotionality. These relationships differed according to sex and the two age groups concerned.
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Affiliation(s)
- S Kozieł
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Science, Rudolf Weigiel 12, 53-114 Wroclaw, Poland.
| | - R Chakraborty
- Department of Anthropology, Dinabandhu Mahavidyalaya, Bongaon, West Bengal, India
| | - K Bose
- Department of Anthropology, Vidyasagar University, Midnapore, West Bengal, India
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Koksal UI, Erturk Z, Koksal AR, Ozsenel EB, Kaptanogullari OH. What is the Importance of Body Composition in Obesity-related Depression? Eurasian J Med 2017; 49:102-106. [PMID: 28638251 PMCID: PMC5469834 DOI: 10.5152/eurasianjmed.2017.16129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 03/12/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE It is known that depression is common in obese individuals. Besides the effects of obesity, pathogenic effects of increase in visceral and abdominal fat mass on depression are also being investigated. Our study aimed to show the relationship between visceral fat percentage detected with practical methods and the presence and severity of depression. MATERIALS AND METHODS Our study included 104 obese patients and 50 healthy controls. In all individuals, the severity of depression was assessed using the Beck Depression Inventory (BDI). Anthropometric measurements, visceral fat percentage, and body fat percentage were measured using the bioelectric impedance method. RESULTS The mean age was 51.5±12.3 years, and 65 participants (62.5%) were women. BDI scores were statistically higher in the obese group than in the control group (23.1±10.9 and 12.1±9.4, p<0.001). In the obese group, 63.5% of patients were depressed, and in the control group, this was 24%. Women were more depressed in the obese group, but there was no significant difference between men and women in the control group. Body fat percentage was the highest correlating parameter with depression severity. Positive correlation was found between depression severity and body mass index, waist circumference, hip circumference, and visceral fat percentage. In the logistic regression analysis, obesity was found as an independent risk factor for depression (OR: 4.84, 2.1-10.7, p<0.001). CONCLUSION According to the results of our study, obesity is a significant and independent risk factor for depression. Obesity type and body composition are important factors that determine the severity of depression.
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Affiliation(s)
- Ulkuhan Iner Koksal
- Department of Internal Medicine, Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Zeynep Erturk
- Department of Internal Medicine, Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Ali Riza Koksal
- Department of Gastroenterology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Ekmel Burak Ozsenel
- Department of Internal Medicine, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
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Use of antidepressants in patients with depression and comorbid diabetes mellitus: a systematic review. Acta Neuropsychiatr 2017; 29:127-139. [PMID: 27776567 DOI: 10.1017/neu.2016.54] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Depression may be difficult to treat and with comorbid diabetes mellitus (DM) it is an even bigger challenge. This article aims to evaluate antidepressants most suitable for patients with depression and comorbid DM. Design and methods Initially we searched for randomised, controlled double-blind trials of treatment with antidepressants in depressed with DM but there were only a few studies and many of them were small trials. Thus, we decided to include studies that were not only randomised-controlled trials. In total, we ended up with 18 articles for our purposes. RESULTS The combination of depression and DM may be harmful as depression has a strong impact on psychosocial and medical outcomes in patients with DM. Almost all of the trials in this review showed a reduction in depressive symptoms after treatment with an antidepressant in the acute as well as during maintenance phase. It showed that depression improvement had a favourable effect on glycaemic control that was weight independent. Some studies included only subjects with minor depression or with suboptimal-controlled diabetes making it difficult to show an effect. CONCLUSION From these data, we will recommend choosing an selective serotonin reuptake inhibitor (SSRI) if possible to treat a depression among patients with diabetes. If treatment with a tricyclic antidepressant is needed, closer glycaemic monitoring is recommended. Bear in mind that there is a possible risk of hypoglycemia when using SSRIs. Agomelatine and bupropion have shown promising results, but need to be investigated in more trials.
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Kahl KG, Herrmann J, Stubbs B, Krüger THC, Cordes J, Deuschle M, Schweiger U, Hüper K, Helm S, Birkenstock A, Hartung D. Pericardial adipose tissue and the metabolic syndrome is increased in patients with chronic major depressive disorder compared to acute depression and controls. Prog Neuropsychopharmacol Biol Psychiatry 2017; 72:30-35. [PMID: 27528109 DOI: 10.1016/j.pnpbp.2016.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/18/2016] [Accepted: 08/08/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is associated with an estimated fourfold risk for premature death, largely attributed to cardiovascular disorders. Pericardial adipose tissue (PAT), a fat compartment surrounding the heart, has been implicated in the development of coronary artery disease. An unanswered question is whether people with chronic MDD are more likely to have elevated PAT volumes versus acute MDD and controls (CTRL). METHODS The study group consists of sixteen patients with chronic MDD, thirty-four patients with acute MDD, and twenty-five CTRL. PAT and adrenal gland volume were measured by magnetic resonance tomography. Additional measures comprised factors of the metabolic syndrome, cortisol, relative insulin resistance, and pro-inflammatory cytokines (interleukin-6; IL-6 and tumor necrosis factor-α, TNF-α). RESULTS PAT volumes were significantly increased in patients with chronic MDD>patients with acute MDD>CTRL. Adrenal gland volume was slightly enlarged in patients with chronic MDD>acute MDD>CTRL, although this difference failed to reach significance. The PAT volume was correlated with adrenal gland volume, and cortisol concentrations were correlated with depression severity, measured by BDI-2 and MADRS. Group differences were found concerning the rate of the metabolic syndrome, being most frequent in chronic MDD>acute MDD>CTRL. Further findings comprised increased fasting cortisol, increased TNF-α concentration, and decreased physical activity level in MDD compared to CTRL. CONCLUSION Our results extend the existing literature in demonstrating that patients with chronic MDD have the highest risk for developing cardiovascular disorders, indicated by the highest PAT volume and prevalence of metabolic syndrome. The correlation of PAT with adrenal gland volume underscores the role of the hypothalamus-pituitary-adrenal system as mediator for body-composition changes. Metabolic monitoring, health advices and motivation for the improvement of physical fitness may be recommended in depressed patients, in particular in chronic depression.
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Affiliation(s)
- K G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany.
| | - J Herrmann
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, United Kingdom
| | - T H C Krüger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany
| | - J Cordes
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University, Düsseldorf, Germany
| | - M Deuschle
- Central Institute of Mental Health, Mannheim, Germany
| | - U Schweiger
- Dep. of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - K Hüper
- Institute for Diagnostic and Interventional Radiology, MHH, Hannover, Germany
| | - S Helm
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany
| | - A Birkenstock
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany
| | - D Hartung
- Institute for Diagnostic and Interventional Radiology, MHH, Hannover, Germany
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Beydoun MA, Fanelli-Kuczmarski MT, Shaked D, Dore GA, Beydoun HA, Rostant OS, Evans MK, Zonderman AB. Alternative Pathway Analyses Indicate Bidirectional Relations between Depressive Symptoms, Diet Quality, and Central Adiposity in a Sample of Urban US Adults. J Nutr 2016; 146:1241-9. [PMID: 27146916 PMCID: PMC4877632 DOI: 10.3945/jn.115.229054] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 03/21/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Temporality between socioeconomic status (SES), depressive symptoms (DS), dietary quality (DQ), and central adiposity (CA) is underexplored. OBJECTIVES Alternative pathways linking SES to DQ, DS, and CA were tested and models compared, stratified by race and sex. METHODS With the use of data from the Healthy Aging in Neighborhoods of Diversity across the Life Span (baseline age: 30-64 y; 2 visits; mean follow-up: 4.9 y), 12 structural equation models (SM) were conducted and compared. Time-dependent factors included the Center for Epidemiologic Studies-Depression [CES-D total score, baseline or visit 1 (v1), follow-up or visit 2 (v2), mean across visits (m), and annual rate of change (Δ)], 2010 Healthy Eating Index (HEI) (same notation), and central adiposity principal components' analysis score of waist circumference and trunk fat (kg) (Adipcent) (same notation). Sample sizes were white women (WW, n = 236), white men (WM, n = 159), African American women (AAW, n = 395), and African American men (AAM, n = 274), and a multigroup analysis within the SM framework was also conducted. RESULTS In the best-fitting model, overall, ∼31% of the total effect of SES→Adipcent(v2) (α ± SE: -0.10 ± 0.03, P < 0.05) was mediated through a combination of CES-D(v1) and ΔHEI. Two dominant pathways contributed to the indirect effect: SES→(-)CES-D(v1)→(+)Adipcent(v2) (-0.015) and SES→(+) ΔHEI→(-)Adipcent(v2) (-0.017), with a total indirect effect of -0.031 (P < 0.05). In a second best-fitting model, SES independently predicted Adipcent(v1, -0.069), ΔHEI(+0.037) and CES-D(v2, -2.70) (P < 0.05), with Adipcent(v1) marginally predicting ΔHEI(-0.014) and CES-D(v2, +0.67) (P < 0.10). These findings were indicative of DS's and CA's marginally significant bidirectional association (P < 0.10). Although best-fit-selected models were consistent across race × sex categories, path coefficients differed significantly between groups. Specifically, SES→Adipcent[v1(+0.11), v2(+0.14)] was positive among AAM (P < 0.05), and the overall positive association of Adipcent(v1)→CES-D(v2) was specific to AAW (+0.97, P < 0.10). CONCLUSIONS Despite consistent model fit, pathways linking SES to DQ, DS, and CA differed markedly among the race × sex groups. Our findings can inform the potential effectiveness of various mental health and dietary interventions.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD;
| | | | - Danielle Shaked
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD;,Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD; and
| | - Greg A Dore
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD
| | - Hind A Beydoun
- Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA
| | - Ola S Rostant
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD
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Kamkar MZ, Sanagoo A, Zargarani F, Jouybari L, Marjani A. Metabolic syndrome in patients with severe mental illness in Gorgan. J Nat Sci Biol Med 2016; 7:62-7. [PMID: 27003972 PMCID: PMC4780170 DOI: 10.4103/0976-9668.175073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Metabolic syndrome is commonly associated with cardiovascular diseases and psychiatric mental illness. Hence, we aimed to assess the metabolic syndrome among severe mental illness (SMI). Materials and Methods: The study included 267 patients who were referred to the psychiatric unit at 5th Azar Education Hospital of Golestan University of Medical Sciences in Gorgan, Iran. Results: The mean waist circumference, systolic and diastolic blood pressure, triglyceride and fasting blood glucose levels were significantly higher in the SMI with metabolic syndrome, but the high density lipoprotein (HDL)-cholesterol was significantly lower. The prevalence of metabolic syndrome in SMI patients was 20.60%. There were significant differences in the mean of waist circumference, systolic (except for women) and diastolic blood pressure, triglyceride, HDL-cholesterol and fasting blood glucose in men and women with metabolic syndrome when compared with subjects without metabolic syndrome. The prevalence of metabolic syndrome in SMI women was higher than men. The most age distribution was in range of 30-39 years old. The most prevalence of metabolic syndrome was in age groups 50-59 years old. The prevalence of metabolic syndrome was increased from 30 to 59 years old. Conclusion: The prevalence of metabolic syndrome in patients with SMI in Gorgan is almost similar to those observed in Asian countries. The prevalence of metabolic syndrome was lower than western countries. These observations may be due to cultural differences in the region. It should be mention that the families of mental illness subjects in our country believe that their patients must be cared better than people without mental illness. These findings of this study suggest that mental illness patients are at risk of metabolic syndrome. According to our results, risk factors such as age and gender differences may play an important role in the presence of metabolic syndrome. In our country, women do less physical activity than men; therefore, the incidence of metabolic syndrome is higher among women.
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Affiliation(s)
- Mohammad Zaman Kamkar
- Department of Psychiatry, Golestan Research Center of Psychiatry, Golestan University of Medical Sciences, Gorgan, Golestan Province, Iran
| | - Akram Sanagoo
- Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Golestan Province, Iran
| | - Fatemeh Zargarani
- Department of Psychiatry, Golestan University of Medical Sciences, Gorgan, Golestan Province, Iran
| | - Leila Jouybari
- Education Development Center, Golestan University of Medical Sciences, Gorgan, Golestan Province, Iran
| | - Abdoljalal Marjani
- Department of Biochemistry and Biophysics, Metabolic Disorders Research Center, Gorgan Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Golestan Province, Iran
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Kahl KG, Kerling A, Tegtbur U, Gützlaff E, Herrmann J, Borchert L, Ates Z, Westhoff-Bleck M, Hueper K, Hartung D. Effects of additional exercise training on epicardial, intra-abdominal and subcutaneous adipose tissue in major depressive disorder: A randomized pilot study. J Affect Disord 2016; 192:91-7. [PMID: 26707353 DOI: 10.1016/j.jad.2015.12.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 11/23/2015] [Accepted: 12/11/2015] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is associated with increased amounts of intra-abdominal and epicardial adipose tissue, risk factors for the development of cardio-metabolic disorders. Exercise has been shown to reduce intra-abdominal fat in different conditions such as obesity and diabetes mellitus, thereby reducing cardio-metabolic risks. Therefore we examined the effects of exercise on adipose tissue compartments in patients with MDD. METHODS Of thirty depressed patients included, twenty received supervised exercise training, and ten received no specific training. Volumes of subcutaneous, intra-abdominal and epicardial adipose tissue were measured using magnetic resonance imaging, and factors constituting the metabolic syndrome were determined. RESULTS Significant effects of the training condition were observed on the amount of epicardial adipose tissue (P=0.017), subcutaneous adipose tissue (P=0.023), weight (P=0.047), body-mass index (P=0.04), high density lipoproteins (P=0.021) and the number of metabolic syndrome factors (P=0.018). The amount of intra-abdominal adipose tissue decreased slightly, although not significantly, in the exercise group. CONCLUSION Exercise training reduces the amount of visceral, in particular epicardial adipose tissue, in patients with MDD, and ameliorates factors constituting the metabolic syndrome. Given the high prevalence of cardio-metabolic disorders in major depression, exercise training may be recommended as an additional treatment component.
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Affiliation(s)
- K G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Street 1, Hannover, Germany; Department of Neurology, MHH, Hannover, Germany.
| | - A Kerling
- Department of Neurology, MHH, Hannover, Germany; Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hannover, Germany
| | - U Tegtbur
- Department of Neurology, MHH, Hannover, Germany; Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hannover, Germany
| | - E Gützlaff
- Department of Neurology, MHH, Hannover, Germany; Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hannover, Germany
| | - J Herrmann
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Street 1, Hannover, Germany; Department of Neurology, MHH, Hannover, Germany
| | - L Borchert
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Street 1, Hannover, Germany; Department of Neurology, MHH, Hannover, Germany
| | - Zeynep Ates
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Street 1, Hannover, Germany; Department of Neurology, MHH, Hannover, Germany
| | - M Westhoff-Bleck
- Department of Neurology, MHH, Hannover, Germany; Dep. of Cardiology and Angiology, MHH, Hannover, Germany
| | - K Hueper
- Institute for Diagnostic and Interventional Radiology, MHH, Hannover, Germany; Department of Neurology, MHH, Hannover, Germany
| | - D Hartung
- Institute for Diagnostic and Interventional Radiology, MHH, Hannover, Germany; Department of Neurology, MHH, Hannover, Germany
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Deuschle M, Gilles M. Hypercortisolemic Depressed Women: Lean but Viscerally Obese? Neuroendocrinology 2016; 103:263-8. [PMID: 26138707 DOI: 10.1159/000437168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 06/22/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Activation of the hypothalamic-pituitary-adrenal (HPA) system in depressed patients has been related to visceral adiposity. In contrast, low HPA system activity is associated with increased body fat in the general population. Our study intended to clarify whether HPA system activity is related to body weight and composition in depressed inpatients. METHODS In a cohort of 51 female and 20 male depressed inpatients, we measured saliva cortisol (HPA system activity), body mass index (BMI), waist circumference as well as body composition as reflected by bioimpedance. RESULTS In female patients, cortisol in saliva was negatively associated with fat-to-muscle ratio and BMI. CONCLUSION In depressed inpatients, especially women, there is evidence that activation of the HPA system is related to relatively low body weight and low body fat content.
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Affiliation(s)
- Michael Deuschle
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Kim EY, Kim SH, Ha K, Lee HJ, Yoon DH, Ahn YM. Depression trajectories and the association with metabolic adversities among the middle-aged adults. J Affect Disord 2015; 188:14-21. [PMID: 26340078 DOI: 10.1016/j.jad.2015.08.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/08/2015] [Accepted: 08/12/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Despite both depression and metabolic disturbances confer substantial burden of disease, natural course of depressive symptoms and the relationship with metabolic adversities have not examined. We explore associations between trajectories of depressive symptoms and metabolic disturbance, lifestyle factors and comorbidities. METHODS This retrospective cohort study included 13,745 subjects (8113 men and 5632 women) 40-59 years of age who underwent health examinations at the Seoul National University Hospital Healthcare System, Gangnam Center, in Korea. The median follow-up duration was 4.0 years. We estimated the mean trajectories of the Beck Depression Inventory scores using latent-class growth-curve analysis. RESULTS We identified four distinctive trajectories of depressive symptoms in both sex. The probabilities of group membership were 35.1% (n=2374) in minimal, 47.4% (n=4545) in persistent-mild, 14.4% (n=987) in persistent-moderate, and 3.0% (n=207) in persistent-severe in men, and 36.3% (n=1883), 50.0% (n=3069), 12.3% (n=601) and 1.5% (n=79) in women. We found significant increasing trend in the prevalence of metabolic abnormalities in more severe depressive trajectory. The adjusted odds ratios of persistent-severe were significantly increased for the following variables: low HDL, hypertriglyceridemia, and metabolic syndrome (MetS) in men and hypertriglyceridemia, MetS in women, and smoking, alcohol consumption and lack of exercise in both genders. LIMITATIONS Medical and psychiatric histories were obtained using a self-reported questionnaire rather than formal diagnostic assessments. CONCLUSIONS The higher level of depressive symptoms trajectory was associated with MetS, especially lipid abnormalities, and several modifiable lifestyle factors. Our findings provide important implications for developing health policy and guidelines for reducing depressive symptom burden.
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Affiliation(s)
- Eun Young Kim
- Mental Health Clinic, National Cancer Center, Goyang, Republic of Korea
| | - Se Hyun Kim
- Department of Neuropsychiatry, Dongguk University Medical School, Dongguk University International Hospital, Goyang, Republic of Korea
| | - Kyooseob Ha
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Seoul National Hospital, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyun Jeong Lee
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Dae Hyun Yoon
- Department of Psychiatry, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.
| | - Yong Min Ahn
- Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Hébert JR, Braun KL, Kaholokula JK, Armstead CA, Burch JB, Thompson B. Considering the Role of Stress in Populations of High-Risk, Underserved Community Networks Program Centers. Prog Community Health Partnersh 2015. [PMID: 26213406 DOI: 10.1353/cpr.2015.0028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cancer disparities are associated with a broad range of sociocultural determinants of health that operate in community contexts. High-risk populations may be more vulnerable to social and environmental factors that lead to chronic stress. Theoretical and empirical research indicates that exposure to contextual and sociocultural stress alters biological systems, thereby influencing cancer risk, progression, and, ultimately, mortality. OBJECTIVE We sought to describe contextual pathways through which stress likely increases cancer risk in high-risk, underserved populations. METHODS This review presents a description of the link between contextual stressors and disease risk disparities within underserved communities, with a focus on 1) stress as a proximal link between biological processes, such as cytokine responses, inflammation, and cancer and 2) stress as a distal link to cancer through biobehavioral risk factors such as poor diet, physical inactivity, circadian rhythm or sleep disruption, and substance abuse. These concepts are illustrated through application to populations served by three National Cancer Institute-funded Community Networks Program Centers (CNPCs): African Americans in the Deep South (the South Carolina Cancer Disparities Community Network [SCCDCN]), Native Hawaiians ('Imi Hale-Native Hawaiian Cancer Network), and Latinos in the Lower Yakima Valley of Washington State (The Center for Hispanic Health Promotion: Reducing Cancer Disparities). CONCLUSIONS Stress experienced by the underserved communities represented in the CNPCs is marked by social, biological, and behavioral pathways that increase cancer risk. A case is presented to increase research on sociocultural determinants of health, stress, and cancer risk among racial/ethnic minorities in underserved communities.
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MDCT Linear and Volumetric Analysis of Adrenal Glands: Normative Data and Multiparametric Assessment. Eur Radiol 2015; 26:2494-501. [PMID: 26515550 DOI: 10.1007/s00330-015-4063-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 10/05/2015] [Accepted: 10/09/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To study linear and volumetric adrenal measurements, their reproducibility, and correlations between total adrenal volume (TAV) and adrenal micronodularity, age, gender, body mass index (BMI), visceral (VAAT) and subcutaneous adipose tissue volume (SAAT), presence of diabetes, chronic alcoholic abuse and chronic inflammatory disease (CID). METHODS We included 154 patients (M/F, 65/89; mean age, 57 years) undergoing abdominal multidetector row computed tomography (MDCT). Two radiologists prospectively independently performed adrenal linear and volumetric measurements with semi-automatic software. Inter-observer reliability was studied using inter-observer correlation coefficient (ICC). Relationships between TAV and associated factors were studied using bivariate and multivariable analysis. RESULTS Mean TAV was 8.4 ± 2.7 cm(3) (3.3-18.7 cm(3)). ICC was excellent for TAV (0.97; 95 % CI: 0.96-0.98) and moderate to good for linear measurements. TAV was significantly greater in men (p < 0.0001), alcoholics (p = 0.04), diabetics (p = 0.0003) and those with micronodular glands (p = 0.001). TAV was lower in CID patients (p = 0.0001). TAV correlated positively with VAAT (r = 0.53, p < 0.0001), BMI (r = 0.42, p < 0.0001), SAAT (r = 0.29, p = 0.0003) and age (r = 0.23, p = 0.005). Multivariable analysis revealed gender, micronodularity, diabetes, age and BMI as independent factors influencing TAV. CONCLUSIONS Adrenal gland MDCT-based volumetric measurements are more reproducible than linear measurements. Gender, micronodularity, age, BMI and diabetes independently influence TAV. KEY POINTS • Volumetric measurements are more reproducible than linear measurements for adrenal glands. • Inter-observer reproducibility of adrenal gland volume is excellent using semiautomatic software. • Gender, age, BMI, and diabetes independently influence total adrenal gland volume. • Adrenal micronodularity is associated with increased total adrenal gland volume.
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Adrenal gland volume, intra-abdominal and pericardial adipose tissue in major depressive disorder. Psychoneuroendocrinology 2015; 58:1-8. [PMID: 25935636 DOI: 10.1016/j.psyneuen.2015.04.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 04/07/2015] [Accepted: 04/08/2015] [Indexed: 11/20/2022]
Abstract
Major depressive disorder (MDD) is associated with an increased risk for the development of cardio-metabolic diseases. Increased intra-abdominal (IAT) and pericardial adipose tissue (PAT) have been found in depression, and are discussed as potential mediating factors. IAT and PAT are thought to be the result of a dysregulation of the hypothalamus-pituitary-adrenal axis (HPAA) with subsequent hypercortisolism. Therefore we examined adrenal gland volume as proxy marker for HPAA activation, and IAT and PAT in depressed patients. Twenty-seven depressed patients and 19 comparison subjects were included in this case-control study. Adrenal gland volume, pericardial, intraabdominal and subcutaneous adipose tissue were measured by magnetic resonance imaging. Further parameters included factors of the metabolic syndrome, fasting cortisol, fasting insulin, and proinflammatory cytokines. Adrenal gland and pericardial adipose tissue volumes, serum concentrations of cortisol and insulin, and serum concentrations tumor-necrosis factor-α were increased in depressed patients. Adrenal gland volume was positively correlated with intra-abdominal and pericardial adipose tissue, but not with subcutaneous adipose tissue. Our findings point to the role of HPAA dysregulation and hypercortisolism as potential mediators of IAT and PAT enlargement. Further studies are warranted to examine whether certain subtypes of depression are more prone to cardio-metabolic diseases.
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Kurhe Y, Mahesh R. Ondansetron attenuates co-morbid depression and anxiety associated with obesity by inhibiting the biochemical alterations and improving serotonergic neurotransmission. Pharmacol Biochem Behav 2015; 136:107-16. [PMID: 26188166 DOI: 10.1016/j.pbb.2015.07.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 07/05/2015] [Accepted: 07/08/2015] [Indexed: 10/23/2022]
Abstract
In our earlier study we reported the antidepressant activity of ondansetron in obese mice. The present study investigates the effect of ondansetron on depression and anxiety associated with obesity in experimental mice with biochemical evidences. Male Swiss albino mice were fed with high fat diet (HFD) for 14weeks to induce obesity. Then the subsequent treatment with ondansetron (0.5 and 1mg/kg, p.o.), classical antidepressant escitalopram (ESC) (10mg/kg, p.o.) and vehicle (distilled water 10ml/kg, p.o.) was given once daily for 28days. Behavioral assay for depression including sucrose preference test, forced swim test (FST) and anxiety such as light dark test (LDT) and hole board test (HBT) were performed in obese mice. Furthermore, in biochemical estimations oral glucose tolerance test (OGTT), plasma leptin, insulin, corticosterone, brain oxidative stress marker malonaldehyde (MDA), antioxidant reduced glutathione (GSH) and serotonin assays were performed. Results indicated that HFD fed obese mice showed severe depressive and anxiety-like behaviors. Chronic treatment with ondansetron inhibited the co-morbid depression and anxiety in obese mice by increasing sucrose consumption in sucrose preference test and reducing the immobility time in FST, increasing time and transitions of light chamber in LDT, improving head dip and crossing scores in HBT compared to HFD control mice. Ondansetron in obese mice inhibited glucose sensitivity in OGTT, improved plasma leptin and insulin sensitivity, reversed hypothalamic pituitary adrenal (HPA) axis hyperactivity by reducing the corticosterone concentration, restored brain pro-oxidant/anti-oxidant balance by inhibiting MDA and elevating GSH concentrations and facilitated serotonergic neurotransmission. In conclusion, ondansetron reversed the co-morbid depression and anxiety associated with obesity in experimental mice by attenuating the behavioral and biochemical abnormalities.
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Affiliation(s)
- Yeshwant Kurhe
- Department of Pharmacy, Birla Institute of Technology & Science, Pilani, Rajasthan 333031, India.
| | - Radhakrishnan Mahesh
- Department of Pharmacy, Birla Institute of Technology & Science, Pilani, Rajasthan 333031, India
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Concomitant psychiatric problems and hormonal treatment induced metabolic syndrome in gender dysphoria individuals: a 2 year follow-up study. J Psychosom Res 2015; 78:399-406. [PMID: 25691225 DOI: 10.1016/j.jpsychores.2015.02.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 01/31/2015] [Accepted: 02/04/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Several studies indicate increased prevalence of metabolic syndrome (MetS) among patients with psychiatric disorders as well as among individuals with gender dysphoria (GD) treated by cross-sex hormonal treatment. However, the MetS prevalence among hormone treated GD individuals suffering from psychiatric problems has not been detected. METHODS From a sample of 146 GD patients we selected 122 metabolically healthy individuals in order to investigate the prevalence of MetS after the beginning of the cross-sex hormonal treatment in a 2 year follow-up assessment. Furthermore, we assessed differences in MetS prevalence between hormone treated GD patients with and without concomitant psychiatric problems. RESULTS When treated with hormone therapy, GD patients reported changes in several parameters which are clustered in MetS, with statistically significant differences compared to baseline. Glyco-insulinemic alterations were more pronounced in male to female patients (MtFs). However, weight gain, waist circumference increases, blood pressure increases, and lipid alterations were similar in MtFs and female to male patients (FtMs). 14.8% of the sample at year 1 and 17.2% at year 2 developed MetS. Among patients with concomitant psychiatric problems, 50% at year 1 and 55% at year 2 developed MetS against 8% at year 1 and 10% at year 2 of patients without concomitant psychiatric problems. CONCLUSION This study indicates that sex hormones induce MetS in a relatively low proportion of healthy GD individuals and especially during the first year of hormonal treatment. Most importantly, concomitant psychiatric problems are associated with considerably greater MetS prevalence in hormone treated GD individuals.
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Cermolacce M, Belzeaux R, Adida M, Azorin JM. [Affective disorders: endocrine and metabolic comorbidities]. Encephale 2015; 40 Suppl 3:S33-9. [PMID: 25550238 DOI: 10.1016/s0013-7006(14)70129-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Links between affective and endocrine-metabolic disorders are numerous and complex. In this review, we explore most frequent endocrine-metabolic comorbidities. On the one hand, these comorbidities imply numerous iatrogenic effects from antipsychotics (metabolic side-effects) or from lithium (endocrine side-effects). On the other hand, these comorbidities are also associated with affective disorders independently from medication. We will successively examine metabolic syndrome, glycemic disturbances, obesity and thyroid disorders among patients with affective disorders. Endocrinemetabolic comorbidities can be individually encountered, but can also be associated. Therefore, they substantially impact morbidity and mortality by increasing cardiovascular risk factors. Two distinct approaches give an account of processes involved in these comorbidities: common environmental factors (iatrogenic effects, lifestyle), and/or shared physiological vulnerabilities. In conclusion, we provide a synthesis of important results and recommendations related to endocrine-metabolic comorbidities in affective disorders : heavy influence on morbidity and mortality, undertreatment of somatic diseases, importance of endocrine and metabolic side effects from main mood stabilizers, impact from sex and age on the prevalence of comorbidities, influence from previous depressive episodes in bipolar disorders, and relevance of systematic screening for subclinical (biological) disturbances.
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Affiliation(s)
- M Cermolacce
- Pôle universitaire de psychiatrie, CHU Sainte-Marguerite, 13274 Marseille cedex 9, France; Laboratoire de Neurosciences Cognitives, UMR CNRS 6155 & Aix-Marseille Université, Fédération 3C, Marseille, France.
| | - R Belzeaux
- Pôle universitaire de psychiatrie, CHU Sainte-Marguerite, 13274 Marseille cedex 9, France
| | - M Adida
- Pôle universitaire de psychiatrie, CHU Sainte-Marguerite, 13274 Marseille cedex 9, France
| | - J-M Azorin
- Pôle universitaire de psychiatrie, CHU Sainte-Marguerite, 13274 Marseille cedex 9, France
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Increased left ventricular mass in hypercortisolemic depressed patients: A hypothesis based on a case series. Med Hypotheses 2014; 83:730-2. [DOI: 10.1016/j.mehy.2014.09.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 09/28/2014] [Indexed: 11/18/2022]
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Rossetti C, Halfon O, Boutrel B. Controversies about a common etiology for eating and mood disorders. Front Psychol 2014; 5:1205. [PMID: 25386150 PMCID: PMC4209809 DOI: 10.3389/fpsyg.2014.01205] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 10/06/2014] [Indexed: 12/25/2022] Open
Abstract
Obesity and depression represent a growing health concern worldwide. For many years, basic science and medicine have considered obesity as a metabolic illness, while depression was classified a psychiatric disorder. Despite accumulating evidence suggesting that obesity and depression may share commonalities, the causal link between eating and mood disorders remains to be fully understood. This etiology is highly complex, consisting of multiple environmental and genetic risk factors that interact with each other. In this review, we sought to summarize the preclinical and clinical evidence supporting a common etiology for eating and mood disorders, with a particular emphasis on signaling pathways involved in the maintenance of energy balance and mood stability, among which orexigenic and anorexigenic neuropeptides, metabolic factors, stress responsive hormones, cytokines, and neurotrophic factors.
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Affiliation(s)
- Clara Rossetti
- Center for Psychiatric Neuroscience, Lausanne University Hospital Lausanne, Switzerland
| | - Olivier Halfon
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital Lausanne, Switzerland
| | - Benjamin Boutrel
- Center for Psychiatric Neuroscience, Lausanne University Hospital Lausanne, Switzerland ; Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital Lausanne, Switzerland
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Jiao JT, Jiang C, Huang J, Dai MC, Wang C, Cheng C, Shao JF. Metabolic syndrome factors and risk of postoperative depression in high-grade glioma patients in a 1.5-year prospective study. Med Oncol 2014; 31:234. [PMID: 25223530 DOI: 10.1007/s12032-014-0234-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 09/03/2014] [Indexed: 12/20/2022]
Abstract
To date, the relationship between metabolic syndrome factors and the risk of glioma-related depression is still unclear, and no study investigates this relationship. Our aim was to investigate the relationship between metabolic syndrome factors and the risk of postoperative depression in high-grade patients. A total of 386 high-grade glioma patients participated in blood sample collection for metabolic syndrome factors analysis and the hospital anxiety and depression scale testing. The association between metabolic syndrome factors and the risk of postoperative depression was assessed using Cox regression proportional hazards models, and Student's t tests were used to evaluate the differences in demographic variables and clinical characteristics in subgroups. The incidence of postoperative depression in our 1.5-year follow-up was 30.5%. We found the risk of postoperative depression was elevated with increased blood glucose level [hazard ratios (HR) 2.277, 95% confidence interval (CI) 1.201-4.320, top vs. bottom quartile]. The hazard ratio was increased for z-scores of blood glucose (HR 1.672 per unit standard deviation, 95% CI 1.311-2.133] and of the combined metabolic syndrome score (HR 1.080, 95% CI 1.000-1.167). In addition, risk of postoperative depression risk was increased in high-grade glioma patients with high blood glucose levels (≥6.0 mmol/l) (HR 2.084, 95% CI 1.235-3.515). However, we did not find significant associations between postoperative depression and other metabolic syndrome factors, including body mass index, systolic blood pressure, diastolic blood pressure, cholesterol, and triglycerides. Depression is prevalent among patients with high-grade glioma after operation. Blood glucose level is positively associated with the risk of postoperative depression, and might be involved in the etiology of postoperative depression, and may predict its development in high-grade glioma patients.
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Affiliation(s)
- Jian-Tong Jiao
- Department of Neurosurgery, Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, China
| | - Chen Jiang
- Department of Neurosurgery, Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, China
| | - Jin Huang
- Department of Neurosurgery, Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, China
| | - Min-Chao Dai
- Department of Neurosurgery, Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, China
| | - Cheng Wang
- Department of Neurosurgery, Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, China
| | - Chao Cheng
- Department of Neurosurgery, Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, China
| | - Jun-Fei Shao
- Department of Neurosurgery, Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, China.
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Difference by sex but not by race/ethnicity in the visceral adipose tissue-depressive symptoms association: the Multi-Ethnic Study of Atherosclerosis. Psychoneuroendocrinology 2014; 47:78-87. [PMID: 25001957 PMCID: PMC4134940 DOI: 10.1016/j.psyneuen.2014.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 05/06/2014] [Accepted: 05/06/2014] [Indexed: 01/20/2023]
Abstract
BACKGROUND Prior studies have investigated the association of clinical depression and depressive symptoms with body weight (i.e. body mass index (BMI) and waist circumference), but few have examined the association between depressive symptoms and intra-abdominal fat. Of these a limited number assessed the relationship in a multi-racial/ethnic population. METHODS Using data on 1017 men and women (45-84 years) from the Multi-Ethnic Study of Atherosclerosis (MESA) Body Composition, Inflammation and Cardiovascular Disease Study, we examined the cross-sectional association between elevated depressive symptoms (EDS) and CT-measured visceral fat mass at L2-L5 with multivariable linear regression models. EDS were defined as a Center for Epidemiological Studies Depression score ≥16 and/or anti-depressant use. Covariates included socio-demographics, inflammatory markers, health behaviors, comorbidities, and body mass index (BMI). Race/ethnicity (Whites [referent group], Chinese, Blacks and Hispanics) and sex were also assessed as potential modifiers. RESULTS The association between depressive symptoms and visceral fat differed significantly by sex (p=0.007), but not by race/ethnicity. Among men, compared to participants without EDS, those with EDS had greater visceral adiposity adjusted for BMI and age (difference=122.5 cm2, 95% CI=34.3, 210.7, p=0.007). Estimates were attenuated but remained significant after further adjustment by socio-demographics, inflammatory markers, health behaviors and co-morbidities (difference=94.7 cm2, 95% CI=10.5, 178.9, p=0.028). Among women, EDS was not significantly related to visceral adiposity in the fully adjusted model. CONCLUSIONS Sex, but not race/ethnicity, was found to modify the relationship between EDS and visceral fat mass. Among men, a significant positive association was found between depressive symptoms and visceral adiposity. No significant relationship was found among women.
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Abstract
Food is a potent natural reward and food intake is a complex process. Reward and gratification associated with food consumption leads to dopamine (DA) production, which in turn activates reward and pleasure centers in the brain. An individual will repeatedly eat a particular food to experience this positive feeling of gratification. This type of repetitive behavior of food intake leads to the activation of brain reward pathways that eventually overrides other signals of satiety and hunger. Thus, a gratification habit through a favorable food leads to overeating and morbid obesity. Overeating and obesity stems from many biological factors engaging both central and peripheral systems in a bi-directional manner involving mood and emotions. Emotional eating and altered mood can also lead to altered food choice and intake leading to overeating and obesity. Research findings from human and animal studies support a two-way link between three concepts, mood, food, and obesity. The focus of this article is to provide an overview of complex nature of food intake where various biological factors link mood, food intake, and brain signaling that engages both peripheral and central nervous system signaling pathways in a bi-directional manner in obesity.
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Affiliation(s)
- Minati Singh
- Department of Pediatrics, University of Iowa Iowa City, IA, USA ; Department of Pediatrics, HHMI, University of Iowa Iowa City, IA, USA
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Tirabassi G, Boscaro M, Arnaldi G. Harmful effects of functional hypercortisolism: a working hypothesis. Endocrine 2014; 46:370-86. [PMID: 24282037 DOI: 10.1007/s12020-013-0112-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Accepted: 10/31/2013] [Indexed: 01/15/2023]
Abstract
Functional hypercortisolism (FH) is caused by conditions able to chronically activate hypothalamic-pituitary-adrenal axis and usually occurs in cases of major depression, anorexia nervosa, bulimia nervosa, alcoholism, diabetes mellitus, simple obesity, polycystic ovary syndrome, obstructive sleep apnea syndrome, panic disorder, generalized anxiety disorder, shift work, and end-stage renal disease. Most of these states belong to pseudo-Cushing disease, a condition which is difficult to distinguish from Cushing's syndrome and characterized not only by biochemical findings but also by objective ones that can be attributed to hypercortisolism (e.g., striae rubrae, central obesity, skin atrophy, easy bruising, etc.). This hormonal imbalance, although reversible and generally mild, could mediate some systemic complications, mainly but not only of a metabolic/cardiovascular nature, which are present in these states and are largely the same as those present in Cushing's syndrome. In this review we aim to discuss the evidence suggesting the emerging negative role for FH.
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Affiliation(s)
- Giacomo Tirabassi
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
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Kahl KG, Hueper K, Schweiger U, Gutberlet M, Detlef AM, Weiss C, von Bohlen A, Pul R, Lichtinghagen R, Wacker F, Hartung D. Pericardial, intra-abdominal, and subcutaneous adipose tissue in patients with major depressive disorder. Acta Psychiatr Scand 2014; 130:137-43. [PMID: 24433292 DOI: 10.1111/acps.12242] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/03/2013] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is associated with an increased risk for developing coronary artery disease (CAD). Recently, pericardial adipose tissue, a metabolically active visceral fat depot surrounding the heart, has been implicated in the pathogenesis of CAD. Therefore, we investigated pericardial adipose tissue volumes in patients with MDD and compared them to healthy comparison subjects. METHOD In this case-control study at a university medical center, 50 male and female in-patients with MDD and 25 healthy men and women were examined. The main outcome measures were the volumes of pericardial adipose tissue, intra-abdominal adipose tissue (IaAT) and subcutaneous adipose tissue (ScAT) which were measured using magnetic resonance imaging. RESULTS The pericardial adipose tissue volumes were greater in men and women with MDD compared with the healthy comparison group following adjustments for the effects of age, weight, height, and physical activity. CONCLUSION This study expands our knowledge about the alterations in body composition that occur in patients with MDD. The findings are highly relevant for understanding the comorbidity between heart disease and depressive disorders.
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Affiliation(s)
- K G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany
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Depressive symptoms are not associated with forearm bone accrual during adolescence. Arch Osteoporos 2014; 9:173. [PMID: 24619250 DOI: 10.1007/s11657-014-0173-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 01/29/2014] [Indexed: 02/03/2023]
Abstract
UNLABELLED Although depression has been associated to worst bone physical properties in adulthood, this study showed that depressive symptoms were not significantly associated to bone mineral density measured at the forearm during adolescence. PURPOSE Depressive conditions have been related to the reduction of bone mineral density (BMD) in adulthood. Though it is possible to hypothesize that depressive symptoms present similar effects in bone mineral accrual during adolescence, such association is poorly researched. Therefore, we aimed to study the relation between depressive symptoms and forearm BMD during adolescence. METHODS The study is based on the Epidemiological Health Investigation of Teenagers cohort that sampled adolescents born in 1990 and enrolled in public and private schools of Porto during the 2003/2004 academic year. At baseline (n = 2,160) and at 17 years of age (n = 1,716), depressive symptoms were evaluated using the Beck Depression Inventory-II (BDI-II). BMD (grams per square centimetre) was measured at the non-dominant forearm using dual-energy X-ray absorptiometry. Sex-specific crude and adjusted linear regression coefficients (β) and the corresponding 95 % confidence intervals (95 % CIs) were calculated to estimate the cross-sectional and prospective associations between depressive symptoms and forearm BMD. RESULTS In both sexes, in early and late adolescence, depressive symptoms presented no statistically significant association with forearm BMD (β Girls13 = 0.09, 95 % CI = -0.43 to 0.61; β Girls17 = 0.10, 95 % CI = -0.43 to 0.64; β Boys13 = -0.10, 95 % CI = -0.96 to 0.76; β Boys17 = 0.49, 95 % CI = -0.96 to 1.93). Similarly, there were no significant associations between depressive symptoms and the annual forearm BMD change during adolescence in girls and boys (β Girls_BDI-II_13-17_remained_lowest = -0.85, 95 % CI = -4.62 to 2.92 vs. β Girls_BDI-II_13-17_remained_highest = -1.87, 95 % CI = -5.06 to 1.31; β Boys_BDI-II_13-17_remained_lowest = 0.48, 95 % CI = -5.30 to 6.26 vs. β Boys_BDI-II_13-17_remained_highest = 1.36, 95 % CI = -3.25 to 5.97). CONCLUSIONS Depressive symptoms, with the range of severity observed in the general adolescent population, were not associated with changes in forearm bone mineral density during adolescence. Further research based on measurements of different skeletal sites is needed in order to detect a systemic effect of depression on growing bone.
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Belvederi Murri M, Pariante C, Mondelli V, Masotti M, Atti AR, Mellacqua Z, Antonioli M, Ghio L, Menchetti M, Zanetidou S, Innamorati M, Amore M. HPA axis and aging in depression: systematic review and meta-analysis. Psychoneuroendocrinology 2014; 41:46-62. [PMID: 24495607 DOI: 10.1016/j.psyneuen.2013.12.004] [Citation(s) in RCA: 213] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 12/01/2013] [Accepted: 12/02/2013] [Indexed: 12/31/2022]
Abstract
One of the most consistent findings in the biology of depression is an altered activity of the hypothalamic-pituitary-adrenal (HPA) axis. However, data concerning this issue have never been examined with a focus on the older population. Here we present a systematic review and meta-analysis, based on studies investigating levels of cortisol, adrenocorticotropic hormone (ACTH) and corticotropin-releasing hormone (CRH) in depressed participants older than 60 and compared with healthy controls. We found 20 studies, for a total of 43 comparisons on different indices of HPA axis functioning. Depression had a significant effect (Hedges' g) on basal cortisol levels measured in the morning (0.89), afternoon (0.83) and night (1.39), but a smaller effect on cortisol measured continuously (0.51). The effect of depression was even higher on post-dexamethasone cortisol levels (3.22), whereas it was non-significant on morning ACTH and CRH levels. Subgroup analyses indicated that various methodological and clinical factors can influence the study results. Overall, older participants suffering from depression show a high degree of dysregulation of HPA axis activity, with differences compared with younger adults. This might depend on several mechanisms, including physical illnesses, alterations in the CNS and immune-endocrinological alterations. Further studies are needed to clarify the implications of altered HPA axis activity in older patients suffering from depression. Novel pharmacological approaches might be effective in targeting this pathophysiological feature, thus improving the clinical outcomes.
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Affiliation(s)
- Martino Belvederi Murri
- Institute of Psychiatry, Department of Psychological Medicine, King's College London, London, UK; Department of Neurosciences Division of Psychiatry, University of Parma, Parma, Italy.
| | - Carmine Pariante
- Institute of Psychiatry, Department of Psychological Medicine, King's College London, London, UK
| | - Valeria Mondelli
- Institute of Psychiatry, Department of Psychological Medicine, King's College London, London, UK
| | - Mattia Masotti
- Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - Anna Rita Atti
- Department of Biomedical and NeuroMotor Sciences - Psychiatry, University of Bologna, Italy
| | - Zefiro Mellacqua
- Institute of Psychiatry, Department of Psychosis Studies, King's College London, London, UK
| | - Marco Antonioli
- Department of Biomedical and NeuroMotor Sciences - Psychiatry, University of Bologna, Italy
| | - Lucio Ghio
- Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - Marco Menchetti
- Section of Psychiatry, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy
| | | | - Marco Innamorati
- Department of Neurosciences Division of Psychiatry, University of Parma, Parma, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
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Scharnholz B, Gilles M, Marzina A, Kommer M, Lederbogen F, Wudy SA, Hartmann MF, Westphal S, Roth HJ, Kahl KG, Meyer-Lindenberg A, Michaely HJ, Deuschle M. Do depressed patients without activation of the hypothalamus-pituitary-adrenal (HPA) system have metabolic disturbances? Psychoneuroendocrinology 2014; 39:104-110. [PMID: 24275009 DOI: 10.1016/j.psyneuen.2013.09.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 09/02/2013] [Accepted: 09/25/2013] [Indexed: 10/26/2022]
Abstract
This study compared features of the metabolic syndrome between healthy controls and depressed patients without activation of the hypothalamus-pituitary-adrenal (HPA) system. After exclusion of non-suppressors to 1mg dexamethasone, we included 20 depressed inpatients and 34 healthy controls in the analyses. We assessed HPA system activity (diurnal saliva cortisol profile, cortisol excretion), normetanephrine excretion as well as fasting glucose, lipid profile and blood pressure. With regard to body composition, we measured waist circumference as well as visceral fat and adrenal volume by magnetic resonance (MR) imaging. Five depressed patients (25%) and five healthy controls (15%) fulfilled the criteria of the metabolic syndrome according NCEP-ATP-III. Depression was significantly related with fasting glucose and negatively associated with mean blood pressure (BP) and, by trend, with low HDL-cholesterol. We conclude that depressed patients may have modest metabolic disturbances even in the complete absence of activation of stress-responsive systems. Hence some metabolic disturbances in depressed patients may not be explicable by HPA activation. Additional factors are required to mediate the link between affective and metabolic disorders.
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Affiliation(s)
- Barbara Scharnholz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany.
| | - Maria Gilles
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany
| | - Annika Marzina
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, 68167 Mannheim, Germany
| | - Marcel Kommer
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, 68167 Mannheim, Germany
| | - Florian Lederbogen
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany
| | - Stefan A Wudy
- Steroid Research and Mass Spectrometry Unit, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, 35390 Gießen, Germany
| | - Michaela F Hartmann
- Steroid Research and Mass Spectrometry Unit, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, 35390 Gießen, Germany
| | - Sabine Westphal
- Institute of Clinical Chemistry, Magdeburg University Hospital, 39120 Magdeburg, Germany
| | | | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, University of Hannover, 30625 Hannover, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany
| | - Henrik J Michaely
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, 68167 Mannheim, Germany
| | - Michael Deuschle
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany
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Hryhorczuk C, Sharma S, Fulton SE. Metabolic disturbances connecting obesity and depression. Front Neurosci 2013; 7:177. [PMID: 24109426 PMCID: PMC3791387 DOI: 10.3389/fnins.2013.00177] [Citation(s) in RCA: 194] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 09/16/2013] [Indexed: 12/14/2022] Open
Abstract
Obesity markedly increases the odds of developing depression. Depressed mood not only impairs motivation, quality of life and overall functioning but also increases the risks of obesity complications. Abdominal obesity is a better predictor of depression and anxiety risk than overall adipose mass. A growing amount of research suggests that metabolic abnormalities stemming from central obesity that lead to metabolic disease may also be responsible for the increased incidence of depression in obesity. As reviewed here, a higher mass of dysfunctional adipose tissue is associated with several metabolic disturbances that are either directly or indirectly implicated in the control of emotions and mood. To better comprehend the development of depression in obesity, this review pulls together select findings addressing the link between adiposity, diet and negative emotional states and discusses the evidence that alterations in glucocorticoids, adipose-derived hormones, insulin and inflammatory signaling that are characteristic of central obesity may be involved.
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Affiliation(s)
- Cecile Hryhorczuk
- Department of Nutrition, Faculty of Medicine, CRCHUM and Montreal Diabetes Research Center, Université de Montréal Montreal, QC, Canada
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Vlachaki C, Maridaki Kassotaki K. Coronary Heart Disease and Emotional Intelligence. Glob J Health Sci 2013; 5:156-65. [PMID: 24171883 PMCID: PMC4776881 DOI: 10.5539/gjhs.v5n6p156] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 08/18/2013] [Accepted: 09/23/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Coronary Heart Disease (CHD) is associated with emotions, especially negative ones, namely anxiety and depression. Emotional Intelligence (EI) is a psychological model that consists of a variety of emotional skills. AIMS The aim of the present study was to examine the relation between different dimensions of Emotional Intelligence and coronary heart disease. METHODS A total of 300 participants were studied during a 3-year period in an attempt to partially replicate and further expand a previous study conducted in Greece among CHD patients, which indicated a strong association between certain dimensions of Emotional Intelligence and the incidence of CHD. All participants completed a self-report questionnaire, assessing several aspects of Emotional Intelligence. FINDINGS The results showed that there is a link between the regulation of emotions and the occurrence of CHD. CONCLUSIONS The evidence reported in the present study makes stronger the claim that EI plays a significant role in the occurrence of CHD.
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Deuschle M, Schweiger U. Depression und Diabetes mellitus Typ 2. DER NERVENARZT 2012; 83:1410-22. [DOI: 10.1007/s00115-012-3656-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Lederbogen F, Ströhle A. Stress, psychische Erkrankungen und koronare Herzkrankheit. DER NERVENARZT 2012; 83:1448-57. [DOI: 10.1007/s00115-012-3666-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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