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Pengpid S, Peltzer K. Chronic conditions and incident and persistent depressive symptoms among ageing adults in rural South Africa. PSYCHOL HEALTH MED 2024; 29:712-720. [PMID: 36941203 PMCID: PMC10509316 DOI: 10.1080/13548506.2023.2190595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/07/2023] [Indexed: 03/23/2023]
Abstract
The study aimed to assess associations between chronic diseases and incident and persistent depressive symptoms (DSs) in a cohort study of ageing adults in South Africa. Participants in the baseline survey (in 2014/2015) were 5,059 persons (≥40 years) and at follow-up 4,176 (in 2018/2019). DSs were measured with the Center for Epidemiological Studies Depression scale. Logistic regression was used to estimate the associations between chronic conditions and incident and persistent DS. The prevalence of DS at baseline was 15.5%, incident DS (without DS and/or PTSD at baseline) was 25.1% and persistent DS (DS at both baseline and follow-up) was 4.8%. In unadjusted logistic regression analysis, diabetes had higher odds of incident DS. Participants with baseline heart attack/stroke/angina, dyslipidemia, tuberculosis, chronic bronchitis, kidney disease and three or more chronic conditions had a higher probability of persistent DS. In conclusion, of the eight chronic conditions evaluated, only diabetes (in unadjusted analysis) was associated with incident DS, and five chronic conditions (heart attack/stroke/angina, dyslipidaemia, tuberculosis, chronic bronchitis and kidney disease) and three or more chronic conditions were associated with persistent DS.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Khubchandani J, Banerjee S, Gonzales-Lagos R, Szirony GM. Depression increases the risk of mortality among people living with diabetes: Results from national health and nutrition examination survey, USA. Diabetes Metab Syndr 2023; 17:102892. [PMID: 37898065 DOI: 10.1016/j.dsx.2023.102892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION Type 2 Diabetes (T2D) and depression are leading global public health problems associated with profound disability and lower quality of life. Extensive evidence suggests that the two disorders are frequently comorbid. However, long-term effects such as the risk of mortality due to depression among people living with T2D are not well explored. METHODS Data from the National Health and Nutrition Examination Survey, 2005-2010 were linked with mortality files from the National Death Index up to December 31st, 2019. RESULTS A total of 14,920 American adults were included in the study sample; nearly a tenth of them had depression (9.08 %) or T2D (10 %). In adjusted analysis, individuals with T2D were 1.70 times more likely (95 % CI = 1.42-2.03) to die than those without T2D. Among people living with T2D without depression, the risk of mortality was 1.55 times higher, but those with both T2D and depression had a 4.24 times higher risk of mortality. CONCLUSIONS Given the greater risk of morbidity and premature mortality with cooccurring T2D and depression, widespread screening is warranted with a focus on high-risk groups. Integrated and collaborative care models can help address the psychosocial needs of people with T2D and should be widely implemented with the sensitization of clinicians and care teams in primary and specialist care for T2D.
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Affiliation(s)
- Jagdish Khubchandani
- College of Health, Education, and Social Transformation New Mexico State University Las Cruces, NM, 88003, USA.
| | - Srikanta Banerjee
- College of Health SciencesWalden University Minneapolis, MN, 55401, USA.
| | | | - G Michael Szirony
- School of Counseling, Walden University, Minneapolis, MN, 55401, USA.
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Peltzer K, Pengpid S. Impact of Somatic Conditions and Lifestyle Behaviours on Depressive Symptoms and Low Life Satisfaction among Middle-Aged and Older Adult Men in South Africa. JOURNAL OF MEN'S HEALTH 2023; 18:194. [PMID: 38107592 PMCID: PMC10723043 DOI: 10.31083/j.jomh1809194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
Objective The purpose of this study was to assess the association between somatic disorders, lifestyle factors, incident and persistent depressive symptoms, and low life satisfaction in a longitudinal study in South Africa. Methods We analyzed longitudinal data from two consecutive waves, 2346 men aged 40 years or older in 2014/2015 in wave 1 and 1864 men of wave 1 in 2018/2019 in wave 2 of the "Health and Ageing in Africa: A Longitudinal Study of an International Network for the Demographic Evaluation of Populations and their Health (INDEPTH) Community in South Africa (HAALSI)". Results In total, 360 of 1932 male participants without depressive symptoms in wave 1 (24.3%) had incident depressive symptoms in wave 2 and 77 of 349 men had depressive symptoms in both waves 1 and 2 (persistent depressive symptoms). In all, 457 of 1258 male participants without low life satisfaction in Wave 1 (47.6%) had incident low life satisfaction in Wave 2, and 360 of 998 men had low life satisfaction at both Wave 1 and 2 (persistent low life satisfaction). In the unadjusted logistic regression analysis, having kidney disease and living with HIV had greater odds of incident depressive symptoms. In adjusted analysis, alcohol dependence (Adjusted Odds Ratio-AOR: 4.54, 95% Confidence Interval-CI: 1.05-19.66) was positively correlated and 1-7 and 8-11 years of education (AOR: 0.45, 95% CI: 0.27-0.74, and AOR: 0.20, 95% CI: 0.07-0.54, respectively) were negatively associated with persistent depressive symptoms. Increasing age increased the odds (AOR: 1.03, 95% CI: 1.01-1.04), while higher education (≥12 years) (AOR: 0.50, 95% CI: 0.33-0.76), and high physical activity (AOR: 0.68, 95% CI: 0.52-0.89) decreased the odds of incident low life satisfaction. Increasing age (AOR: 1.03, 95% CI: 1.02-1.04) and tobacco use (AOR: 1.64, 95% CI: 1.23-2.19) increased the odds and high physical activity (AOR: 0.73, 95% CI: 0.56-0.96) decreased the odds of persistent low life satisfaction. Conclusions Of the seven chronic conditions and five lifestyle factors evaluated, alcohol dependence increased the odds of persistent depressive symptoms and low physical activity, and tobacco use increased the odds of incident and/or persistent low life satisfaction among men in rural South Africa.
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Affiliation(s)
- Karl Peltzer
- Department of Psychology, University of the Free State, 9300 Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Sciences, Asia University, Wufeng, 41354 Taichung, Taiwan
| | - Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health Mahidol University, 10400 Bangkok, Thailand
- Department of Research Administration and Development, University of Limpopo, 0727 Polokwane, South Africa
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4
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del Hoyo MLL, Rodrigo MTF, Urcola-Pardo F, Monreal-Bartolomé A, Ruiz DCG, Borao MG, Alcázar ABA, Casbas JPM, Casas AA, Funcia MTA, Delgado JFR. The TELE-DD Randomised Controlled Trial on Treatment Adherence in Patients with Type 2 Diabetes and Comorbid Depression: Clinical Outcomes after 18-Month Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:328. [PMID: 36612650 PMCID: PMC9819481 DOI: 10.3390/ijerph20010328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED Clinical depression is associated with poorer adherence to hypoglycaemic medication in patients with diabetes mellitus, leading to poorer glycaemic control, diabetes management, and increased complications. The main aim of the TELE-DD trial was to demonstrate the efficacy of a proactive and psychoeducational telephonic intervention based on motivational interviewing and collaborative care to reduce nonadherence and improve prognosis in individuals with diabetes mellitus and concurrent depression. DESIGN The TELE-DD project is a three-phased prospective study including a nested randomised controlled trial. METHODS The baseline cohort included the entire population of adult patients diagnosed with type 2 diabetes and concurrent depression. A randomised controlled trial was conducted in a selection of patients from the baseline cohort, distributed into a control group (n = 192) and an intervention group (n = 192). Monthly telephonic interventions delivered by specifically trained research nurses were centred on a psychoeducational individualised monitoring protocol including motivational interviewing and collaborative care strategies. Clinical and patient-centred data were systematically collected during an 18-month follow-up including HbA1c, Patient Health Questionnaire, and the Diabetes Distress Scale. RESULTS During the trial, 18-month follow-up HbA1C levels significantly (p < 0.001) decreased in the intervention group at every follow-up from an average of 8.72 (SD:1.49) to 7.03 (SD:1.09), but slightly increased in the control group from 8.65 (SD:1.40) to 8.84 (SD:1.38). Similar positive results were obtained in depression severity and diabetes distress, LDL-cholesterol, and systolic and diastolic blood pressure, but only at the 18-month follow-up in body mass index reduction. CONCLUSIONS This is the first trial to concurrently decrease biological and psychological outcomes with a monthly brief telephonic intervention, pointing out that a combined biopsychosocial intervention and collaborative care strategy is essential for current world health challenges. CLINICALTRIALS gov Identifier: NCT04097483. Patient or Public Contribution: Diabetic patients not belonging to the TELE-DD population or trial sample were consulted during the study design to review and guarantee the clarity and understanding of the trial psychoeducational materials.
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Affiliation(s)
- María Luisa Lozano del Hoyo
- Las Fuentes Norte Health Centre, Servicio Aragonés de Salud (SALUD), 50002 Zaragoza, Spain
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - María Teresa Fernandez Rodrigo
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
- Water and Environmental Health Research Group (DGA-B43-20R), 50009 Aragón, Spain
| | - Fernando Urcola-Pardo
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
- Water and Environmental Health Research Group (DGA-B43-20R), 50009 Aragón, Spain
| | - Alicia Monreal-Bartolomé
- Aragon Institute for Health Research (IIS Aragon), 50009 Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029 Madrid, Spain
| | | | - Mercedes Gómez Borao
- Sagasta Health Center, Servicio Aragonés de Salud (SALUD), 50006 Zaragoza, Spain
| | - Ana Belén Artigas Alcázar
- University Hospital Miguel Servet, Servicio Aragonés de Salud (SALUD), University of Zaragoza, 50009 Zaragoza, Spain
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Cárdenas L, Cabezas MDC, Muñoz A, Proaño JL, Miño C, Aguirre N. Prevalence and risk factors of depression, anxiety, and stress in an Ecuadorian outpatient population with type II diabetes mellitus: A cross-sectional study (STROBE). Medicine (Baltimore) 2022; 101:e30697. [PMID: 36181107 PMCID: PMC9524958 DOI: 10.1097/md.0000000000030697] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Type II diabetes mellitus (DM2) is a worldwide disease with an important economic and health impact. Currently, depression, anxiety and stress are common disorders among diabetic populations but their respective prevalence may well be underestimated. So far, Latin American countries have only reported limited information about the impact of mental diseases on DM2 outpatients. The objective of this study was to evaluate the prevalence and risk factors related to depression, anxiety, and stress among ambulatory DM2 populations from two third-level hospitals in Quito, Ecuador. A cross-sectional study based on a random sample was carried out in two hospitals. Patients were evaluated by the 21-item Depression, Anxiety and Stress Scale (DASS-21). In addition, a validated survey was used to grade socioeconomic, demographic, clinical, and comorbidity variables. Descriptive statistics and multiple logistic regression were used to analyze the data. Statistical analysis was performed by SPSS (version 22.0). STROBE guidelines were used for reporting this trial. A total of 208 adult patients with DM2 were included (women 58%; men 42%). The prevalence of depression, anxiety and stress was 31.7% (95% CI, 25.5-38.5%), 33.7% (95% CI, 27.3-40.5%), and 25.0% (95% CI, 19.3-31.5%), respectively. Male gender was associated with a decreased risk for depression (OR 0.39 [95% CI, 0.18-0.81]; P = .01), anxiety (OR 0.31 [95% CI, 0.16-0.65]; P = .002), and stress (OR 0.35 [95% CI, 0.15-0.77]; P = .009). A higher level of education was associated with low risk for depression (OR 0.23 [95% CI, 0.11-0.46]; P < .001), anxiety (OR 0.47 [95% CI, 0.25-0.90]; P = .02), and stress (OR 0.24 [95% CI, 0.12-0.49]; P = .001). In contrast, patients with DM2 complications were more likely to have depression (OR 2.96 [95% CI, 1.32-6.63]; P = .008) and anxiety (OR 2.56 [95% CI, 1.20-5.48]; P = .01). Finally, an income higher than the basic salary reduced the risk of depression alone (OR 0.39 [95% CI, 0.16-0.91]; P = .03). In conclusion, a high prevalence rate of depression, anxiety, and stress was found in the DM2 outpatient population. Thus, more tailored care surveillance for DM2 patients is needed considering the bio-psycho-social environment to provide an integral health management.
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Affiliation(s)
- Luisa Cárdenas
- School of Medicine, Pontifical Catholic University of Ecuador, Ave 12 de Octubre 170143, Quito, Ecuador
| | - María del Carmen Cabezas
- School of Medicine, Pontifical Catholic University of Ecuador, Ave 12 de Octubre 170143, Quito, Ecuador
| | - Angie Muñoz
- School of Medicine, Pontifical Catholic University of Ecuador, Ave 12 de Octubre 170143, Quito, Ecuador
| | - José Luis Proaño
- School of Medicine, Pontifical Catholic University of Ecuador, Ave 12 de Octubre 170143, Quito, Ecuador
| | - Camila Miño
- School of Medicine, Pontifical Catholic University of Ecuador, Ave 12 de Octubre 170143, Quito, Ecuador
| | - Nicole Aguirre
- School of Medicine, Pontifical Catholic University of Ecuador, Ave 12 de Octubre 170143, Quito, Ecuador
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6
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Wimberley T, Horsdal HT, Brikell I, Laursen TM, Astrup A, Fanelli G, Bralten J, Poelmans G, Gils VV, Jansen WJ, Vos SJB, Bertaina-Anglade V, Camacho-Barcia L, Mora-Maltas B, Fernandez-Aranda F, Bonet MB, Salas-Salvadó J, Franke B, Dalsgaard S. Temporally ordered associations between type 2 diabetes and brain disorders - a Danish register-based cohort study. BMC Psychiatry 2022; 22:573. [PMID: 36028833 PMCID: PMC9413891 DOI: 10.1186/s12888-022-04163-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/07/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is linked with several neurodegenerative and psychiatric disorders, either as a comorbid condition or as a risk factor. We aimed to expand the evidence by examining associations with a broad range of brain disorders (psychiatric and neurological disorders, excluding late-onset neurodegenerative disorders), while also accounting for the temporal order of T2DM and these brain disorders. METHODS In a population-based cohort-study of 1,883,198 Danish citizens, born 1955-1984 and followed until end of 2016, we estimated associations between T2DM and 16 brain disorders first diagnosed between childhood and mid-adulthood. We calculated odds ratios (OR) and hazard ratios (HR) with 95% confidence intervals (CI) in temporally ordered analyses (brain disorder diagnosis after T2DM and vice versa), adjusted for sex, age, follow-up, birth year, and parental factors. RESULTS A total of 67,660 (3.6%) of the study population were identified as T2DM cases after age 30 and by a mean age of 45 years (SD of 8 years). T2DM was associated with most psychiatric disorders. Strongest associations were seen with other (i.e. non-anorectic) eating disorders (OR [95% CI]: 2.64 [2.36-2.94]) and schizophrenia spectrum disorder (2.73 [2.63-2.84]). Among neurological disorders especially inflammatory brain diseases (1.73 [1.57-1.91]) and epilepsy (1.67 [1.60-1.75]) were associated with T2DM. Most associations remained in both directions in the temporally ordered analyses. For most psychiatric disorders, associations were strongest in females. CONCLUSIONS T2DM was associated with several psychiatric and neurological disorders, and most associations were consistently found for both temporal order of disorders. This suggests a shared etiology of T2DM and those brain disorders. This study can form the starting point for studies directed at further elucidating potential causal links between disorders and shared biological mechanisms.
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Affiliation(s)
- Theresa Wimberley
- NCRR - National Centre for Register-based Research, Aarhus BSS, Aarhus University, Fuglesangs Allé 26, DK-8210, Aarhus V, Denmark. .,CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark.
| | - Henriette T. Horsdal
- grid.7048.b0000 0001 1956 2722NCRR - National Centre for Register-based Research, Aarhus BSS, Aarhus University, Fuglesangs Allé 26, DK-8210 Aarhus V, Denmark ,grid.7048.b0000 0001 1956 2722CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Isabell Brikell
- grid.7048.b0000 0001 1956 2722NCRR - National Centre for Register-based Research, Aarhus BSS, Aarhus University, Fuglesangs Allé 26, DK-8210 Aarhus V, Denmark ,grid.4714.60000 0004 1937 0626Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Thomas M. Laursen
- grid.7048.b0000 0001 1956 2722NCRR - National Centre for Register-based Research, Aarhus BSS, Aarhus University, Fuglesangs Allé 26, DK-8210 Aarhus V, Denmark ,grid.7048.b0000 0001 1956 2722CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Aske Astrup
- grid.7048.b0000 0001 1956 2722NCRR - National Centre for Register-based Research, Aarhus BSS, Aarhus University, Fuglesangs Allé 26, DK-8210 Aarhus V, Denmark ,grid.7048.b0000 0001 1956 2722CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Giuseppe Fanelli
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands ,grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Janita Bralten
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Geert Poelmans
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Veerle Van Gils
- grid.5012.60000 0001 0481 6099Department of Psychiatry and Neuropsychology, School for Mental Health and NeuroScience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, Netherlands
| | - Willemijn J. Jansen
- grid.5012.60000 0001 0481 6099Department of Psychiatry and Neuropsychology, School for Mental Health and NeuroScience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, Netherlands
| | - Stephanie J. B. Vos
- grid.5012.60000 0001 0481 6099Department of Psychiatry and Neuropsychology, School for Mental Health and NeuroScience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, Netherlands
| | | | - Lucia Camacho-Barcia
- grid.411129.e0000 0000 8836 0780Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain ,grid.418284.30000 0004 0427 2257Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Bernat Mora-Maltas
- grid.411129.e0000 0000 8836 0780Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain ,grid.418284.30000 0004 0427 2257Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Fernando Fernandez-Aranda
- grid.411129.e0000 0000 8836 0780Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain ,grid.418284.30000 0004 0427 2257Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mònica B. Bonet
- grid.413448.e0000 0000 9314 1427Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain ,grid.410367.70000 0001 2284 9230Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain ,grid.411136.00000 0004 1765 529XInstitut d’Investigació Sanitària Pere Virgili (IISPV). Hospital Universitari San Joan de Reus, Reus, Spain
| | - Jordi Salas-Salvadó
- grid.413448.e0000 0000 9314 1427Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain ,grid.411136.00000 0004 1765 529XInstitut d’Investigació Sanitària Pere Virgili (IISPV). Hospital Universitari San Joan de Reus, Reus, Spain ,grid.410367.70000 0001 2284 9230Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Universitat Rovira i Virgili, Reus, Spain
| | - Barbara Franke
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department of Psychiatry, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Søren Dalsgaard
- grid.7048.b0000 0001 1956 2722NCRR - National Centre for Register-based Research, Aarhus BSS, Aarhus University, Fuglesangs Allé 26, DK-8210 Aarhus V, Denmark ,grid.452548.a0000 0000 9817 5300iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Aarhus, Denmark ,grid.466916.a0000 0004 0631 4836Center for Child and Adolescent Psychiatry, Mental Health Services of the Capital Region, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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7
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Ceresa A, Esposito CM, Surace T, Legnani F, Cirella L, Cetti D, Di Paolo M, Nosari G, Zanelli Quarantini F, Serati M, Ciappolino V, Caldiroli A, Capuzzi E, Buoli M. Gender differences in clinical and biochemical parameters of patients consecutively hospitalized for unipolar depression. Psychiatry Res 2022; 310:114476. [PMID: 35240393 DOI: 10.1016/j.psychres.2022.114476] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 02/14/2022] [Accepted: 02/20/2022] [Indexed: 10/19/2022]
Abstract
Major Depressive Disorder (MDD) is a medical illness twice as common in women than in men lifetime. Purpose of this study is to identify gender differences in clinical and biochemical parameters in subjects affected by MDD to implement individualized treatment strategies. We recruited 234 patients (112 males and 122 females) consecutively hospitalized for MDD in Milan (Italy). Data were obtained through a screening of the clinical charts and blood analyses. Univariate analyses, binary logistic regressions and a final logistic regression model were performed. The final logistic regression model showed that female patients (compared to males) had lower plasmatic levels of hemoglobin (p = 0.020) and uric acid (p = 0.002), higher levels of cholesterol (p < 0.001), had been treated with a lower number of antidepressants (p = 0.011), presented lower red blood cells (p < 0.001) and showed more frequently comorbidity with hypothyroidism (p = 0.036). Univariate analyses identified also that women had an earlier age at onset (p = 0.043), were less likely to have comorbidity with diabetes (p = 0.002) and were less frequently treated with a psychiatric polytherapy (p < 0.001). Finally, female patients had achieved more frequently remission in the last depressive episode (p = 0.001) and were more likely to have family history for psychiatric disorders (p < 0.001) than males. Female patients globally have a better response to treatments, but they seem to be more vulnerable to specific metabolic abnormalities as showed by more frequent hypercholesterolemia and lower plasma levels of uric acid. These results have to be confirmed by further studies.
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Affiliation(s)
- Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Cecilia Maria Esposito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Teresa Surace
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Via Santa Sofia 78, Catania 95123, Italy
| | - Francesca Legnani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Luisa Cirella
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy
| | - Denise Cetti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy
| | - Martina Di Paolo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy
| | - Francesco Zanelli Quarantini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy
| | - Marta Serati
- Department of Mental Health, ASST RHODENSE, Rho, Italy
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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8
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Plasonja N, Brytek-Matera A, Décamps G. Psychological Profiles of Treatment-Seeking Adults with Overweight and Obesity: A Cluster Analysis Approach. J Clin Med 2022; 11:jcm11071952. [PMID: 35407559 PMCID: PMC8999798 DOI: 10.3390/jcm11071952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Overweight and obesity are associated with depression and well-being. Some psychological characteristics play a role in explaining well-being and depression in obesity and in identifying specific patient profiles. However, subtyping individuals with overweight/obesity based on variables like self-esteem or stress has not often been done. Therefore, our objective was to explore the psychological profiles of treatment-seeking individuals overweight or with obesity and to compare their depression and well-being. METHODS Data regarding eating self-efficacy, well-being, depression, physical hunger, self-esteem, body satisfaction and perceived stress in individuals with overweight/obesity were collected from the ESTEAM cohort. Hierarchical cluster analysis and mean comparisons were performed on female (n = 1427) and male samples (n = 310). RESULTS Three psychological profiles were identified in both samples. The "High psychological concerns" profile and the "Low psychological concerns" profile were identical in both samples. The third profile, "Bodily concerns", differed by sex and was characterized by appearance dissatisfaction for women and by appearance and eating concerns for men. The "Low psychological concerns" profile presented the highest well-being and the lowest depression scores in both samples. DISCUSSION The findings support the hypothesis of the heterogeneity of individuals with overweight and obesity and suggest sex-related therapeutic approaches.
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Affiliation(s)
- Natalija Plasonja
- Department of Human Sciences, Faculty of Psychology, Université de Bordeaux, LabPsy, EA 4139, F-33000 Bordeaux, France;
- Correspondence:
| | | | - Greg Décamps
- Department of Human Sciences, Faculty of Psychology, Université de Bordeaux, LabPsy, EA 4139, F-33000 Bordeaux, France;
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9
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Yu HJ, Ho M, Liu X, Yang J, Chau PH, Fong DYT. Association of weight status and the risks of diabetes in adults: a systematic review and meta-analysis of prospective cohort studies. Int J Obes (Lond) 2022; 46:1101-1113. [PMID: 35197569 DOI: 10.1038/s41366-022-01096-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/30/2022]
Abstract
Obesity is a known risk factor for type 2 diabetes mellitus (T2DM); however, the associations between underweight and T2DM and between weight status and prediabetes have not been systematically reviewed. We aimed to estimate the relative risks (RRs) of prediabetes/T2DM in underweight/overweight/obesity relative to normal weight. PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to December 8, 2021. Prospective cohort studies with a minimum 12-month follow-up period reporting the association between baseline body mass index (BMI) categories and risk of prediabetes/T2DM in adults were included. Study quality was assessed using the Newcastle-Ottawa Scale. The main analyses of T2DM risk were performed using the ethnic-specific (Asian/non-Asian) BMI classification and additional analyses of prediabetes/T2DM risk by including all eligible studies. Random-effects models with inverse variance weighting were used. Subgroup analyses and meta-regression were conducted to explore the potential effects of pre-specified modifiers. The study protocol was registered with PROSPERO (CRD42020215957). Eighty-four articles involving over 2.69 million participants from 20 countries were included. The pooled RR of prediabetes risk was 1.24 (95% CI: 1.19-1.28, I2 = 9.7%, n = 5 studies) for overweight/obesity vs. normal weight. The pooled RRs of T2DM based on the ethnic-specific BMI categories were 0.93 (95% CI: 0.75-1.15, I2 = 55.5%, n = 12) for underweight, 2.24 (95% CI: 1.95-2.56, I2 = 92.0%, n = 47) for overweight, 4.56 (95% CI: 3.69-5.64, I2 = 96%, n = 43) for obesity, and 22.97 (95% CI: 13.58-38.86, I2 = 92.1%, n = 6) for severe obesity vs. normal weight. Subgroup analyses indicated that underweight is a protective factor against T2DM in non-Asians (RR = 0.68, 95% CI: 0.40-0.99, I2 = 56.1%, n = 6). The magnitude of the RR of T2DM in overweight/obesity decreased with age and varied by region and the assessment methods for weight and T2DM. Overweight/obesity was associated with an increased prediabetes/T2DM risk. Further studies are required to confirm the association between underweight and prediabetes/T2DM, particularly in Asian populations.
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Affiliation(s)
- Hong-Jie Yu
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Mandy Ho
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China.
| | | | - Jundi Yang
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Pui Hing Chau
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
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10
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Omar SM, Musa IR, Idrees MB, Adam I. Prevalence of depression and associated factors among patients with type 2 diabetes mellitus in eastern Sudan. BMC Psychiatry 2021; 21:336. [PMID: 34229659 PMCID: PMC8259025 DOI: 10.1186/s12888-021-03357-1] [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: 03/16/2021] [Accepted: 06/29/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) represents a global health threat and burden. It is associated with medical and psychological complications, especially depression. Depression among patients with DM may affect the general prognosis. Hence, we conducted a cross-sectional study in Gadarif, eastern Sudan to evaluate the prevalence of depression and its associated factors among patients with type 2 DM (T2DM). METHODS We performed a cross-sectional study. Data on anthropometric parameters, demographic characteristics and blood glucose levels were collected via questionnaire. Depression was assessed using the Patient Health Questionnaire (PHQ-9). RESULTS Three hundred and fifty patients with T2DM were enrolled in the study and 205 (58.6%) were women. The median (interquartile range) age and duration of diabetes were 56.0 (14.0) years and 8 (8) years, respectively. The prevalence of depression in patients with T2DM was 35.6%. Logistic regression analysis showed significant associations between depression and rural residence (adjusted odds ratio [AOR] = 2.11, 95% confidence interval [CI] = 1.20-3.72), non-employee (AOR = 2.32, 95% CI = 1.34-4.00), co-morbidity (AOR = 2.35, 95% CI = 1.43-3.86) and obesity AOR = 2.19, 95% CI = 1.48-4.18). CONCLUSION The prevalence of depression is high among Sudanese patients with T2DM. Rural residence, unemployment, co-morbidity and obesity are significant risk factors for developing depression among patients with T2DM.
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Affiliation(s)
- Saeed M. Omar
- grid.442372.40000 0004 0447 6305Faculty of Medicine, Gadarif University, Gadarif, Sudan
| | - Imad R. Musa
- Royal Commission Hospital, Al Jubail Industrial City, Al Jubail Kingdom of Saudi Arabia
| | - Maysoon B. Idrees
- grid.442372.40000 0004 0447 6305Faculty of Medicine, Gadarif University, Gadarif, Sudan
| | - Ishag Adam
- grid.412602.30000 0000 9421 8094Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
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11
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Abstract
Chronic diseases commonly entail disability and are highly comorbid with mental health problems, particularly depression. Prevalence of depression across different disabling conditions affecting adult patients, as well as risk factors for depression in these patient groups are reviewed in the current work, with a particular focus on the literature published in the past 5 years. The prevalence of depression in disabling conditions is higher than in the general population and is associated with different factors. Examples of disease-specific factors include neurological implications of stoke, diabetic related conditions (e.g. amputation), limitations imposed by vision loss caused by age-related eye diseases, fatigue in rheumatoid arthritis, and pain in cancer. Common factors identified across different conditions include pre-morbid depression, history of mental health problems, poor social support, disease-related disability, multi-morbidity, and less adaptive coping strategies. We also reviewed studies suggesting a potential bidirectional relationship between depression and chronic disease, particularly for stroke, cardiovascular disease, diabetes, and potential factors mediating that relationship. Current findings suggested that long-term depression might be associated with an increased risk of subsequent physical health problems, although the nature of that relationship and its underlying mechanisms are still unclear.
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Affiliation(s)
- Hugo Senra
- Centre for Research in Neuropsychology and Cognitive and Behavioural Intervention (CINEICC), University of Coimbra, Coimbra, Portugal.,School of Health and Social Care, University of Essex, Colchester, UK
| | - Susan McPherson
- School of Health and Social Care, University of Essex, Colchester, UK
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12
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Roy JF, Lozano Del Hoyo ML, Urcola-Pardo F, Monreal-Bartolomé A, Gracia Ruiz DC, Gómez Borao MM, Artigas Alcázar AB, Martínez Casbas JP, Aceituno Casas A, Andaluz Funcia MT, García-Campayo J, Fernández Rodrigo MT. The TELE-DD project on treatment nonadherence in the population with type 2 diabetes and comorbid depression. Sci Rep 2021; 11:8889. [PMID: 33903605 PMCID: PMC8076287 DOI: 10.1038/s41598-021-87410-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 03/19/2021] [Indexed: 11/13/2022] Open
Abstract
Diabetic patients have increased depression rates, diminished quality of life, and higher death rates due to depression comorbidity or diabetes complications. Treatment adherence (TA) and the maintenance of an adequate and competent self-care are crucial factors to reach optimal glycaemic control and stable quality of life in these patients. In this report, we present the baseline population analyses in phase I of the TELE-DD project, a three-phased population-based study in 23 Health Centres from the Aragonian Health Service Sector II in Zaragoza, Spain. The objectives of the present report are: (1) to determine the point prevalence of T2D and clinical depression comorbidity and treatment nonadherence; (2) to test if HbA1c and LDL-C, as primary DM outcomes, are related to TA in this population; and (3) to test if these DM primary outcomes are associated with TA independently of shared risk factors for DM and depression, and patients' health behaviours. A population of 7,271 patients with type-2 diabetes and comorbid clinical depression was investigated for inclusion. Individuals with confirmed diagnoses and drug treatment for both illnesses (n = 3340) were included in the current phase I. A point prevalence of 1.9% was found for the T2D-depression comorbidity. The prevalence of patients nonadherent to treatment for these diseases was 35.4%. Multivariate analyses confirmed that lower diabetes duration, increased yearly PCS visits, HbA1c and LDL-C levels were independently related to treatment nonadherence. These findings informed the development of a telephonic monitoring platform for treatment of nonadherence for people with diabetes and comorbid depression and further trial, cost-effectiveness, and prognostic studies (phases II and III).
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Affiliation(s)
| | - María Luisa Lozano Del Hoyo
- Centro de Salud Las Fuentes Norte, Servicio Aragonés de Salud (SALUD), 50002, Zaragoza, Spain
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009, Zaragoza, Spain
| | - Fernando Urcola-Pardo
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009, Zaragoza, Spain
- Water and Environmental Health Research Group (DGA-B43-20R), Zaragoza, Spain
| | - Alicia Monreal-Bartolomé
- Aragon Institute for Health Research, IIS Aragon, 50009, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029, Madrid, Spain
- Department of Medicine and Psychiatry, Faculty of Medicine, University of Zaragoza, 50009, Zaragoza, Spain
| | | | | | | | | | | | | | - Javier García-Campayo
- Aragon Institute for Health Research, IIS Aragon, 50009, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029, Madrid, Spain
- Department of Medicine and Psychiatry, Faculty of Medicine, University of Zaragoza, 50009, Zaragoza, Spain
- Miguel Servet University Hospital, Zaragoza, Spain
| | - María Teresa Fernández Rodrigo
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009, Zaragoza, Spain
- Water and Environmental Health Research Group (DGA-B43-20R), Zaragoza, Spain
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13
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Buch AM, Liston C. Dissecting diagnostic heterogeneity in depression by integrating neuroimaging and genetics. Neuropsychopharmacology 2021; 46:156-175. [PMID: 32781460 PMCID: PMC7688954 DOI: 10.1038/s41386-020-00789-3] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/07/2020] [Accepted: 07/16/2020] [Indexed: 12/12/2022]
Abstract
Depression is a heterogeneous and etiologically complex psychiatric syndrome, not a unitary disease entity, encompassing a broad spectrum of psychopathology arising from distinct pathophysiological mechanisms. Motivated by a need to advance our understanding of these mechanisms and develop new treatment strategies, there is a renewed interest in investigating the neurobiological basis of heterogeneity in depression and rethinking our approach to diagnosis for research purposes. Large-scale genome-wide association studies have now identified multiple genetic risk variants implicating excitatory neurotransmission and synapse function and underscoring a highly polygenic inheritance pattern that may be another important contributor to heterogeneity in depression. Here, we review various sources of phenotypic heterogeneity and approaches to defining and studying depression subtypes, including symptom-based subtypes and biology-based approaches to decomposing the depression syndrome. We review "dimensional," "categorical," and "hybrid" approaches to parsing phenotypic heterogeneity in depression and defining subtypes using functional neuroimaging. Next, we review recent progress in neuroimaging genetics (correlating neuroimaging patterns of brain function with genetic data) and its potential utility for generating testable hypotheses concerning molecular and circuit-level mechanisms. We discuss how genetic variants and transcriptomic profiles may confer risk for depression by modulating brain structure and function. We conclude by highlighting several promising areas for future research into the neurobiological underpinnings of heterogeneity, including efforts to understand sexually dimorphic mechanisms, the longitudinal dynamics of depressive episodes, and strategies for developing personalized treatments and facilitating clinical decision-making.
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Affiliation(s)
- Amanda M Buch
- Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, 413 East 69th Street, Box 240, New York, NY, 10021, USA
| | - Conor Liston
- Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, 413 East 69th Street, Box 240, New York, NY, 10021, USA.
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14
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Al-Qahtani WS, Al-Olayan E, Albani FG, Suliman RS, Aljarba NH, Al-Humaidhi EM, Almurshedi AS, Domiaty DM, Alduwish MA, Al-Otaibi AM, Elasbali AM, Ahmed HG, Almutlaq BA. Utility of KRAS Gene and Clinicopathological Features in the Assessment of the Risk of Type 2 Diabetes in the Etiology of Colon Cancer. Glob Med Genet 2020; 7:35-40. [PMID: 32939513 PMCID: PMC7490123 DOI: 10.1055/s-0040-1714415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background Cancer and diabetes have a tremendous impact on health globally. This study aimed to evaluate the KRAS gene in colon cancer tissues obtained from patients with type 2 diabetes mellitus (T2DM). Materials and Methods Data from 315 cases (156 colon diabetics and 159 patients were nondiabetics) were retrospectively retrieved. mRNA from surgically resected colon cancer tumors were also retrieved. Results The expression of KRAS mRNA was significantly higher in patients afflicted with T2DM than nondiabetic patients. The KRAS mRNA levels were significantly amplified from primary to metastatic lesions ( p < 0.001). Conclusion The association between T2DM and colon cancer was well-established in the present study.
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Affiliation(s)
- Wedad Saeed Al-Qahtani
- Department of Forensic Sciences, Naif Arab University for Security Sciences, Riyadh, Saudi Arabia
| | - Ebtesam Al-Olayan
- Department of Zoology, College of Science, King Saud University Riyadh, Riyadh, Saudi Arabia
| | - Fatimah Gh Albani
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Rania Saad Suliman
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Nada Hamad Aljarba
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - E M Al-Humaidhi
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Alanood S Almurshedi
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | | | - Manal Abdullah Alduwish
- Department of Biology, Prince Sattam bin Abdulaziz University, College of Science and Humanities, Alkarj, Saudi Arabia
| | - Aljohara M Al-Otaibi
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abdelbaset Mohamed Elasbali
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Qurayyat, Saudi Arabia
| | - Hussain Gadelkarim Ahmed
- College of Medicine, University of Hail, Hail, Saudi Arabia.,Molecular Diagnostics and Personalized Therapeutics Unit, University of Ha'il, Hail, Saudi Arabia.,Department of Histopathology and Cytology, CMLS, University of Khartoum, Sudan
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