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Khawagi WY, Al-Kuraishy HM, Hussein NR, Al-Gareeb AI, Atef E, Elhussieny O, Alexiou A, Papadakis M, Jabir MS, Alshehri AA, Saad HM, Batiha GES. Depression and type 2 diabetes: A causal relationship and mechanistic pathway. Diabetes Obes Metab 2024; 26:3031-3044. [PMID: 38802993 DOI: 10.1111/dom.15630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 05/29/2024]
Abstract
Depression is a mood disorder that may increase risk for the development of insulin resistance (IR) and type 2 diabetes (T2D), and vice versa. However, the mechanistic pathway linking depression and T2D is not fully elucidated. The aim of this narrative review, therefore, was to discuss the possible link between depression and T2D. The coexistence of T2D and depression is twice as great compared to the occurrence of either condition independently. Hyperglycaemia and dyslipidaemia promote the incidence of depression by enhancing inflammation and reducing brain serotonin (5-hydroxytryptamine [5HT]). Dysregulation of insulin signalling in T2D impairs brain 5HT signalling, leading to the development of depression. Furthermore, depression is associated with the development of hyperglycaemia and poor glycaemic control. Psychological stress and depression promote the development of T2D. In conclusion, T2D could be a potential risk factor for the development of depression through the induction of inflammatory reactions and oxidative stress that affect brain neurotransmission. In addition, chronic stress in depression may induce the development of T2D through dysregulation of the hypothalamic-pituitary-adrenal axis and increase circulating cortisol levels, which triggers IR and T2D.
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Affiliation(s)
- Wael Y Khawagi
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Nawar R Hussein
- College of Pharmacy, Pharmacology Department, Al-Farahidi University, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Esraa Atef
- Respiratory Therapy Department, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi Arabia
| | - Omnya Elhussieny
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Matrouh University, Marsa Matruh, Egypt
| | - Athanasios Alexiou
- University Centre for Research & Development, Chandigarh University Chandigarh-Ludhiana Highway, Mohali, India
- Department of Research and Development, Funogen, Athens, Greece
- Department of Research and Development, AFNP Med, Wien, Austria
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, New South Wales, Australia
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, University of Witten-Herdecke, Wuppertal, Germany
| | - Majid S Jabir
- Applied Science Department, University of Technology, Baghdad, Iraq
| | - Abdullah A Alshehri
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Hebatallah M Saad
- Department of Pathology, Faculty of Veterinary Medicine, Matrouh University, Marsa Matruh, Egypt
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
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2
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Zhu M, Ling S. Potential causal association of diabetes mellitus and blood glucose related indexes with the onset of epilepsy: a two-sample Mendelian randomization study. Front Neurol 2024; 15:1399504. [PMID: 38962478 PMCID: PMC11221190 DOI: 10.3389/fneur.2024.1399504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/14/2024] [Indexed: 07/05/2024] Open
Abstract
Aim Diabetes mellitus (DM) may promote the occurrence of epilepsy through mechanisms, such as inflammation, immune imbalance, and cerebrovascular injury, caused by metabolic abnormalities. However, evidence for the effects of DM and blood glucose (BG) on the risk of epilepsy is limited. Herein, this study used the Mendelian randomization (MR) method to investigate the potential causal associations of DM and BG-related indexes with epilepsy. Methods In this two-sample MR study, summary statistics data of the genome-wide association studies (GWASs) on exposures, including type 1 diabetes mellitus (T1DM), T2DM, fasting glucose, and glycated hemoglobin (HbAlc), were extracted from the MRC-Integrative Epidemiology Unit (MRC-IEU). The GWAS data on study outcomes, including epilepsy, focal epilepsy, and generalized epilepsy, were obtained from the FinnGen consortium. MR-Egger regression was used to examine horizontal pleiotropism of instrumental variables (IVs), and Cochran's Q statistics was used to quantify the heterogeneity. MR analysis methods including inverse variance weighted (IVW) tests, weighted median, and MR-Egger were utilized to investigate the causal associations between DM and BG-related indexes with epilepsy. The evaluation indexes were odds ratios (ORs) and 95% confidence intervals (CIs). Reverse causal association analyses were also performed. In addition, IVW-radial and leave-one-out tests were utilized for sensitivity analyses. Results IVW estimates suggested that T1DM has potential causal associations with epilepsy (OR = 1.057, 95% CI: 1.031-1.084) and generalized epilepsy (OR = 1.066, 95% CI: 1.018-1.116). No significant reverse causal associations of T1DM with epilepsy or generalized epilepsy were found (all P > 0.05). In addition, sensitivity analysis results identified no outlier, indicating that the associations of T1DM with epilepsy and generalized epilepsy were relatively robust. Conclusion Patients with T1DM had a potential risk of developing epilepsy, and prompt treatment of DM and dynamic monitoring may be beneficial to prevent epilepsy in this high-risk population. However, the causal associations of DM and BG with epilepsy may warrant further verification.
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Affiliation(s)
- Mengting Zhu
- Department of Neurology, The Fifth People's Hospital of Wujiang District, Suzhou, Jiangsu, China
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Wimberley T, Brikell I, Astrup A, Larsen JT, Petersen LV, Albiñana C, Vilhjálmsson BJ, Bulik CM, Chang Z, Fanelli G, Bralten J, Mota NR, Salas-Salvadó J, Fernandez-Aranda F, Bulló M, Franke B, Børglum A, Mortensen PB, Horsdal HT, Dalsgaard S. Shared familial risk for type 2 diabetes mellitus and psychiatric disorders: a nationwide multigenerational genetics study. Psychol Med 2024:1-10. [PMID: 38801094 DOI: 10.1017/s0033291724001053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
BACKGROUND Psychiatric disorders and type 2 diabetes mellitus (T2DM) are heritable, polygenic, and often comorbid conditions, yet knowledge about their potential shared familial risk is lacking. We used family designs and T2DM polygenic risk score (T2DM-PRS) to investigate the genetic associations between psychiatric disorders and T2DM. METHODS We linked 659 906 individuals born in Denmark 1990-2000 to their parents, grandparents, and aunts/uncles using population-based registers. We compared rates of T2DM in relatives of children with and without a diagnosis of any or one of 11 specific psychiatric disorders, including neuropsychiatric and neurodevelopmental disorders, using Cox regression. In a genotyped sample (iPSYCH2015) of individuals born 1981-2008 (n = 134 403), we used logistic regression to estimate associations between a T2DM-PRS and these psychiatric disorders. RESULTS Among 5 235 300 relative pairs, relatives of individuals with a psychiatric disorder had an increased risk for T2DM with stronger associations for closer relatives (parents:hazard ratio = 1.38, 95% confidence interval 1.35-1.42; grandparents: 1.14, 1.13-1.15; and aunts/uncles: 1.19, 1.16-1.22). In the genetic sample, one standard deviation increase in T2DM-PRS was associated with an increased risk for any psychiatric disorder (odds ratio = 1.11, 1.08-1.14). Both familial T2DM and T2DM-PRS were significantly associated with seven of 11 psychiatric disorders, most strongly with attention-deficit/hyperactivity disorder and conduct disorder, and inversely with anorexia nervosa. CONCLUSIONS Our findings of familial co-aggregation and higher T2DM polygenic liability associated with psychiatric disorders point toward shared familial risk. This suggests that part of the comorbidity is explained by shared familial risks. The underlying mechanisms still remain largely unknown and the contributions of genetics and environment need further investigation.
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Affiliation(s)
- Theresa Wimberley
- The National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Isabell Brikell
- The National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Aske Astrup
- The National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Janne T Larsen
- The National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Liselotte V Petersen
- The National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Clara Albiñana
- The National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Bjarni J Vilhjálmsson
- The National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Giuseppe Fanelli
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Janita Bralten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Nina R Mota
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Jordi Salas-Salvadó
- Department of Biochemistry & Biotechnology, School of Medicine, IISPV, Rovira i Virgili University. Reus, Spain
- Institute of Health Pere Virgili (IISPV), Reus, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII). Madrid, Spain
| | - Fernando Fernandez-Aranda
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII). Madrid, Spain
- Clinical Psychology Unit, University Hospital Bellvitge, Hospitalet del Llobregat, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Hospitalet del Llobregat, Spain
- Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet del Llobregat, Spain
| | - Monica Bulló
- Department of Biochemistry & Biotechnology, School of Medicine, IISPV, Rovira i Virgili University. Reus, Spain
- Institute of Health Pere Virgili (IISPV), Reus, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII). Madrid, Spain
- Center of Environmental, Food and Toxicological Technology - TecnATox, Rovira i Virgili University, 43201 Reus, Spain
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anders Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Preben B Mortensen
- The National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Henriette T Horsdal
- The National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Søren Dalsgaard
- The National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Child and Adolescent Psychiatry Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Chae WR, Kohring C, Rohde C, Köhler-Forsberg O, Otte C, Holstiege J. Eight-year nationwide study of the bidirectional association between type 2 diabetes and depression in nearly 8 million German outpatients. BMJ Open Diabetes Res Care 2024; 12:e003903. [PMID: 38719506 PMCID: PMC11085903 DOI: 10.1136/bmjdrc-2023-003903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/23/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Research linking type 2 diabetes and depression mostly relied on hospital-based diagnoses or prescription data, overlooking many outpatient diagnoses. We aimed to quantify the risks of depression in individuals newly diagnosed with type 2 diabetes, and type 2 diabetes in those newly diagnosed with depression, while exploring potential risk differences depending on age, sex, and follow-up time. RESEARCH DESIGN AND METHODS We conducted a matched cohort study using German nationwide outpatient claims data from 2012 to 2022. Participants were individuals newly diagnosed with type 2 diabetes (N=294 642) or depression (N=1 271 537) in 2015, matched in a 1:4 ratio to controls without these conditions by age, sex, and region. The bidirectional risk was evaluated over an 8-year period using mixed-effects Cox proportional hazards models, adjusting for the Charlson Comorbidity Index, urbanicity, and area-level deprivation. RESULTS New type 2 diabetes diagnosis was associated with higher depression risk over 8 years (N=54 561 with depression, HR=1.23, 99% CI=1.21 to 1.24). Similarly, depression diagnosis was linked to an increased type 2 diabetes risk (N=71 848 with type 2 diabetes, HR=1.15, 99% CI=1.14 to 1.17). The association between depression and type 2 diabetes was stronger in younger age groups, especially under 34 years. Findings held across sex-stratified analyses. Time stratification showed a more pronounced association between type 2 diabetes and depression risk during the earlier follow-up quarters, whereas the risk of developing type 2 diabetes after depression diagnosis remained constant throughout the follow-up period. CONCLUSIONS Our findings confirm a bidirectional link between type 2 diabetes and depression, particularly in younger individuals. As type 2 diabetes and depression are frequent, future research needs to study whether preventive approaches can reduce the risk of developing this comorbidity.
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Affiliation(s)
- Woo Ri Chae
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Neurosciences, Campus Benjamin Franklin, Berlin, Germany
- DZPG, German Center for Mental Health, partner site Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
| | - Claudia Kohring
- Central Research Institute of Ambulatory Health Care in Germany (Zi), Department of Epidemiology and Health Care Atlas, Berlin, Germany
| | - Christopher Rohde
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ole Köhler-Forsberg
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
| | - Christian Otte
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Neurosciences, Campus Benjamin Franklin, Berlin, Germany
- DZPG, German Center for Mental Health, partner site Berlin, Germany
| | - Jakob Holstiege
- Central Research Institute of Ambulatory Health Care in Germany (Zi), Department of Epidemiology and Health Care Atlas, Berlin, Germany
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Cho EB, Han K, Jung JH, Chung YH, Kwon S, Park J, Jin SM, Shin DW, Min JH. The risk of type 2 diabetes mellitus in multiple sclerosis and neuromyelitis optica spectrum disorder: A nationwide cohort study. Mult Scler Relat Disord 2024; 85:105519. [PMID: 38457883 DOI: 10.1016/j.msard.2024.105519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 02/19/2024] [Accepted: 02/25/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND AND OBJECTIVES An association has been suggested between premorbid type 2 diabetes mellitus (T2DM) and the risk of multiple sclerosis (MS). However, little is known about the risk of developing T2DM in MS and neuromyelitis optica spectrum disorder (NMOSD). This study aimed to determine the T2DM risk in patients with MS and NMSOD. METHODS The Korean National Health Insurance Service database was analyzed, and 1,801 and 1,721 adults with MS and NMOSD, respectively, who were free of T2DM between January 2010 and December 2017, were included. Matched controls were selected based on age, sex, and the presence of hypertension and dyslipidemia. RESULTS The risk of developing T2DM was 1.54 times higher in NMOSD than in the controls (adjusted hazard ratio [aHR], 95 % confidence interval [CI] = 1.20-1.96). However, increased T2DM risk was not observed in MS (aHR = 1.13, 95 % CI = 0.91-1.42). The T2DM risk in patients with NMOSD was higher in those who received steroid treatment (aHR = 1.77, 95 % CI = 1.36-2.30) but not in those who did not (aHR = 0.59, 95 % CI = 0.24-1.43, p for interaction = 0.02). DISCUSSION T2DM risk was increased in NMOSD but not in MS. Administering steroid treatment to patients with NMOSD may increase their T2DM risk.
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Affiliation(s)
- Eun Bin Cho
- Department of Neurology, College of Medicine, Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, South Korea; Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Jin-Hyung Jung
- Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, South Korea
| | - Yeon Hak Chung
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul 06351, South Korea; Department of Neurology, Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Soonwook Kwon
- Department of Neurology, Inha University Hospital, Incheon, South Korea
| | - Junhee Park
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul 06351, South Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dong Wook Shin
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul 06351, South Korea; Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
| | - Ju-Hong Min
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul 06351, South Korea; Department of Neurology, Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
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Behnoush AH, Mousavi A, Ghondaghsaz E, Shojaei S, Cannavo A, Khalaji A. The importance of assessing the triglyceride-glucose index (TyG) in patients with depression: A systematic review. Neurosci Biobehav Rev 2024; 159:105582. [PMID: 38360331 DOI: 10.1016/j.neubiorev.2024.105582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/08/2024] [Accepted: 02/10/2024] [Indexed: 02/17/2024]
Abstract
Insulin resistance (IR) has been proposed as a potential risk factor for depression, a major common disorder affecting a significant proportion of adults worldwide. Based on this premise, this study systematically investigated all the studies examining the triglyceride-glucose (TyG) index, a surrogate marker of IR, in patients with depression or suicidal ideas/attempts. Four online databases (PubMed, Scopus, Embase, and Web of Science) were comprehensively searched. After screening, seven studies were included, comprised of 58,981 participants and 46.4% male. While there were some discrepancies among the reports of studies, most of the included studies reported higher levels of TyG index in patients with depression. Moreover, in most cases, a 1-unit increase in the TyG index was associated with significantly higher odds of depression. At last, higher TyG levels were associated with suicidal ideation and attempts. Therefore, this study emphasizes the critical need to further research in this regard and possibly integrate the TyG index measure with routine depression screening to avoid fatal events in the future.
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Affiliation(s)
| | - Asma Mousavi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Elina Ghondaghsaz
- Undergraduate Program in Neuroscience, University of British Columbia, Vancouver, BC, Canada
| | - Shayan Shojaei
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alessandro Cannavo
- Department of Translational Medical Sciences, Federico II University of Naples, Italy
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7
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Fanelli G, Franke B, Fabbri C, Werme J, Erdogan I, De Witte W, Poelmans G, Ruisch IH, Reus LM, van Gils V, Jansen WJ, Vos SJ, Alam KA, Martinez A, Haavik J, Wimberley T, Dalsgaard S, Fóthi Á, Barta C, Fernandez-Aranda F, Jimenez-Murcia S, Berkel S, Matura S, Salas-Salvadó J, Arenella M, Serretti A, Mota NR, Bralten J. Local patterns of genetic sharing challenge the boundaries between neuropsychiatric and insulin resistance-related conditions. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.07.24303921. [PMID: 38496672 PMCID: PMC10942494 DOI: 10.1101/2024.03.07.24303921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
The co-occurrence of insulin resistance (IR)-related metabolic conditions with neuropsychiatric disorders is a complex public health challenge. Evidence of the genetic links between these phenotypes is emerging, but little is currently known about the genomic regions and biological functions that are involved. To address this, we performed Local Analysis of [co]Variant Association (LAVA) using large-scale (N=9,725-933,970) genome-wide association studies (GWASs) results for three IR-related conditions (type 2 diabetes mellitus, obesity, and metabolic syndrome) and nine neuropsychiatric disorders. Subsequently, positional and expression quantitative trait locus (eQTL)-based gene mapping and downstream functional genomic analyses were performed on the significant loci. Patterns of negative and positive local genetic correlations (|rg|=0.21-1, pFDR<0.05) were identified at 109 unique genomic regions across all phenotype pairs. Local correlations emerged even in the absence of global genetic correlations between IR-related conditions and Alzheimer's disease, bipolar disorder, and Tourette's syndrome. Genes mapped to the correlated regions showed enrichment in biological pathways integral to immune-inflammatory function, vesicle trafficking, insulin signalling, oxygen transport, and lipid metabolism. Colocalisation analyses further prioritised 10 genetically correlated regions for likely harbouring shared causal variants, displaying high deleterious or regulatory potential. These variants were found within or in close proximity to genes, such as SLC39A8 and HLA-DRB1, that can be targeted by supplements and already known drugs, including omega-3/6 fatty acids, immunomodulatory, antihypertensive, and cholesterol-lowering drugs. Overall, our findings underscore the complex genetic landscape of IR-neuropsychiatric multimorbidity, advocating for an integrated disease model and offering novel insights for research and treatment strategies in this domain.
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Affiliation(s)
- Giuseppe Fanelli
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Barbara Franke
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Josefin Werme
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Izel Erdogan
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ward De Witte
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Geert Poelmans
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - I. Hyun Ruisch
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lianne Maria Reus
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, California, United States
| | - Veerle van Gils
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Willemijn J. Jansen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Stephanie J.B. Vos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | | | - Aurora Martinez
- Department of Biomedicine, University of Bergen, Norway
- K.G. Jebsen Center for Translational Research in Parkinson’s Disease, University of Bergen, Norway
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Norway
| | - Theresa Wimberley
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
- iPSYCH - The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Aarhus, Denmark
| | - Søren Dalsgaard
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Child and Adolescent Psychiatry Glostrup, Mental Health Services of the Capital Region, Hellerup, Denmark
| | - Ábel Fóthi
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
| | - Csaba Barta
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
| | - Fernando Fernandez-Aranda
- Clinical Psychology Department, University Hospital of Bellvitge, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jimenez-Murcia
- Clinical Psychology Department, University Hospital of Bellvitge, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Psychological Services, University of Barcelona, Spain
| | - Simone Berkel
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Biochemistry and biotechnology Department, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, Unitat de Nutrició Humana, Reus, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Martina Arenella
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
| | | | - Nina Roth Mota
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Janita Bralten
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
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8
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Liu J, Wang Y, Mu W, Liu Y, Tong R, Lu Z, Yuan H, Jia F, Zhang X, Li Z, Yang W, Du X, Zhang X. Association between triglyceride glucose index (TyG) and psychotic symptoms in patients with first-episode drug-naïve major depressive disorder. Front Psychiatry 2024; 15:1342933. [PMID: 38463431 PMCID: PMC10920251 DOI: 10.3389/fpsyt.2024.1342933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/13/2024] [Indexed: 03/12/2024] Open
Abstract
Objective Major depressive disorder (MDD) sufferers frequently have psychotic symptoms, yet the underlying triggers remain elusive. Prior research suggests a link between insulin resistance (IR) and increased occurrence of psychotic symptoms. Hence, this study sought to investigate the potential association between psychotic symptoms in Chinese patients experiencing their first-episode drug-naïve (FEDN) MDD and the triglyceride glucose (TyG) index, an alternative measure of insulin resistance (IR). Methods Between September 2016 and December 2018, 1,718 FEDN MDD patients with an average age of 34.9 ± 12.4 years were recruited for this cross-sectional study at the First Hospital of Shanxi Medical University in China. The study collected clinical and demographic data and included assessments of anxiety, depression, and psychotic symptoms using the 14-item Hamilton Anxiety Rating Scale (HAMA), the 17-item Hamilton Depression Rating Scale (HAMD-17), and the positive subscales of the Positive and Negative Syndrome Scale (PANSS), respectively. Measurements of metabolic parameters, fasting blood glucose (FBG), and thyroid hormones were also gathered. To assess the correlation between the TyG index and the likelihood of psychotic symptoms, the study used multivariable binary logistic regression analysis. Additionally, two-segmented linear regression models were employed to investigate possible threshold effects in case non-linearity relationships were identified. Results Among the patients, 9.95% (171 out of 1,718) exhibited psychotic symptoms. Multivariable logistic regression analysis showed a positive correlation between the TyG index and the likelihood of psychotic symptoms (OR = 2.12, 95% CI: 1.21-3.74, P = 0.01) after adjusting for confounding variables. Moreover, smoothed plots revealed a nonlinear relationship with the TyG index, revealing an inflection point at 8.42. Interestingly, no significant link was observed to the left of the inflection point (OR = 0.50, 95% CI: 0.04-6.64, P = 0.60), whereas beyond this point, a positive correlation emerged between the TyG index and psychotic symptoms (OR = 2.42, 95% CI: 1.31-4.48, P = 0.01). Particularly, a considerable 142% rise in the probability of experiencing psychotic symptoms was found with each incremental elevation in the TyG index. Conclusions Understanding the non-linear link between the TyG index and the risk of psychotic symptoms in Chinese patients with FEDN MDD highlights the potential for targeted therapeutic approaches. By acknowledging the threshold effect observed, there is an opportunity to mitigate risk factors associated with IR-related psychiatric comorbidities through tailored interventions. These preliminary results stress the need for further longitudinal research to solidify these insights and contribute to more effective therapeutic strategies.
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Affiliation(s)
- Junjun Liu
- Soochow University, Suzhou, China
- Nanjing Meishan Hospital, Nanjing, China
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | | | - Wei Mu
- School of Ethnology and Sociology, Yunnan University, Kunming, China
| | - Yang Liu
- Nanjing Meishan Hospital, Nanjing, China
| | | | - Zhaomin Lu
- Nanjing Meishan Hospital, Nanjing, China
| | | | - Fengnan Jia
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiaobin Zhang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhe Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Wanqiu Yang
- School of Ethnology and Sociology, Yunnan University, Kunming, China
| | - Xiangdong Du
- Soochow University, Suzhou, China
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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9
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Zhang X, Zhou Y, Chen Y, Zhao S, Zhou B, Sun X. The association between neuroendocrine/glucose metabolism and clinical outcomes and disease course in different clinical states of bipolar disorders. Front Psychiatry 2024; 15:1275177. [PMID: 38328763 PMCID: PMC10847283 DOI: 10.3389/fpsyt.2024.1275177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/04/2024] [Indexed: 02/09/2024] Open
Abstract
Objective The treatment of bipolar disorder (BD) remains challenging. The study evaluated the impact of the hypothalamic-pituitary-adrenal (HPA) axis/hypothalamic-pituitary-thyroid (HPT) axis and glucose metabolism on the clinical outcomes in patients with bipolar depression (BD-D) and manic bipolar (BD-M) disorders. Methods The research design involved a longitudinal prospective study. A total of 500 BD patients aged between 18 and 65 years treated in 15 hospitals located in Western China were enrolled in the study. The Young Mania Rating Scale (YMRS) and Montgomery and Asberg Depression Rating Scale (MADRS) were used to assess the BD symptoms. An effective treatment response was defined as a reduction in the symptom score of more than 25% after 12 weeks of treatment. The score of symptoms was correlated with the homeostatic model assessment of insulin resistance (HOMA-IR) index, the HPA axis hormone levels (adrenocorticotropic hormone (ACTH) and cortisol), and the HPT axis hormone levels (thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free triiodothyronine (fT3), and free thyroxine (fT4)). Results In the BD-M group, the YMRS was positively correlated with baseline T4 (r = 0.349, p = 0.010) and fT4 (r = 0.335, p = 0.013) and negatively correlated with fasting insulin (r = -0.289, p = 0.013). The pre-treatment HOMA-IR was significantly correlated with adverse course (p = 0.045, OR = 0.728). In the BD-D group, the baseline MADRS was significantly positively correlated with baseline fT3 (r = 0.223, p = 0.032) and fT4 (r = 0.315, p = 0.002), while baseline T3 (p = 0.032, OR = 5.071) was significantly positively related to treatment response. Conclusion The HPT axis and glucose metabolism were closely associated with clinical outcomes at 12 weeks in both BD-D and BD-M groups. If confirmed in further longitudinal studies, monitoring T3 in BD-D patients and HOMA-IR for BD-M could be used as potential treatment response biomarkers.
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Affiliation(s)
- Xu Zhang
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
| | - Yaling Zhou
- The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Yuexin Chen
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
| | - Shengnan Zhao
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Bo Zhou
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xueli Sun
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
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10
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Poulos J, Normand SLT, Zelevinsky K, Newcomer JW, Agniel D, Abing HK, Horvitz-Lennon M. Antipsychotics and the risk of diabetes and death among adults with serious mental illnesses. Psychol Med 2023; 53:7677-7684. [PMID: 37753625 PMCID: PMC10758338 DOI: 10.1017/s0033291723001502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/17/2023] [Accepted: 05/03/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Individuals with schizophrenia exposed to second-generation antipsychotics (SGA) have an increased risk for diabetes, with aripiprazole purportedly a safer drug. Less is known about the drugs' mortality risk or whether serious mental illness (SMI) diagnosis or race/ethnicity modify these effects. METHODS Authors created a retrospective cohort of non-elderly adults with SMI initiating monotherapy with an SGA (olanzapine, quetiapine, risperidone, and ziprasidone, aripiprazole) or haloperidol during 2008-2013. Three-year diabetes incidence or all-cause death risk differences were estimated between each drug and aripiprazole, the comparator, as well as effects within SMI diagnosis and race/ethnicity. Sensitivity analyses evaluated potential confounding by indication. RESULTS 38 762 adults, 65% White and 55% with schizophrenia, initiated monotherapy, with haloperidol least (6%) and quetiapine most (26·5%) frequent. Three-year mortality was 5% and diabetes incidence 9.3%. Compared with aripiprazole, haloperidol and olanzapine reduced diabetes risk by 1.9 (95% CI 1.2-2.6) percentage points, or a 18.6 percentage point reduction relative to aripiprazole users' unadjusted risk (10.2%), with risperidone having a smaller advantage. Relative to aripiprazole users' unadjusted risk (3.4%), all antipsychotics increased mortality risk by 1.1-2.2 percentage points, representing 32.4-64.7 percentage point increases. Findings within diagnosis and race/ethnicity were generally consistent with overall findings. Only quetiapine's higher mortality risk held in sensitivity analyses. CONCLUSIONS Haloperidol's, olanzapine's, and risperidone's lower diabetes risks relative to aripiprazole were not robust in sensitivity analyses but quetiapine's higher mortality risk proved robust. Findings expand the evidence on antipsychotics' risks, suggesting a need for caution in the use of quetiapine among individuals with SMI.
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Affiliation(s)
- Jason Poulos
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Sharon-Lise T. Normand
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Katya Zelevinsky
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - John W. Newcomer
- Thriving Mind South Florida, Miami, FL, USA
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Haley K. Abing
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Marcela Horvitz-Lennon
- RAND Corporation, Boston, MA, USA
- Department of Psychiatry, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA, USA
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11
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Mu L, Chen D, Xiu M, Zhou H, Wang D, Zhang XY. Diabetes mellitus in patients with chronic bipolar disorder: prevalence, clinical correlates and relationship with homocysteine. Int Clin Psychopharmacol 2023:00004850-990000000-00110. [PMID: 37982306 DOI: 10.1097/yic.0000000000000504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Comorbid diabetes mellitus in patients with bipolar disorder may contribute to increased morbidity and mortality. To determine the prevalence of diabetes mellitus in bipolar disorder patients and its clinico-demographic and homocysteine correlates, we conducted a cross-sectional survey of 195 bipolar disorder inpatients. They received questionnaires, clinical measurements and laboratory tests to assess demographic characteristics, anthropometric variables, clinical variables and plasma homocysteine levels. The prevalence of diabetes mellitus (including type 1, type 2 and special types) in Chinese bipolar disorder patients was 14.9%. Analysis of variance or chi-square test showed that compared with non-diabetic bipolar disorder patients, diabetic bipolar disorder patients were older, more often married, had a longer duration of disease, took less olanzapine and had a higher frequency of hypertension. However, there were no significant differences in body mass index (BMI) and homocysteine levels between diabetic and non-diabetic bipolar disorder patients. Logistic regression analysis showed that marital status and duration of disease were independently associated with diabetes mellitus in patients with bipolar disorder after controlling for age, use of olanzapine, presence of hypertension, BMI and homocysteine levels. These findings shed light on the clinico-demographic correlates of the increased prevalence of diabetes mellitus in bipolar disorder patients, rather than the correlation with some metabolic risk factors.
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Affiliation(s)
- Li Mu
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University
- Key Laboratory of Brain and Cognitive Neuroscience, Liaoning Province, Dalian
| | - Dachun Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital
| | - Meihong Xiu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital
| | - Huixia Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Science
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Science
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Science
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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12
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Serretti A. The interplay of psychopharmacology and medical conditions. Int Clin Psychopharmacol 2023; 38:365-368. [PMID: 37767627 DOI: 10.1097/yic.0000000000000512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Affiliation(s)
- Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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13
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Weiss F, Brancati GE, Elefante C, Petrucci A, Gemmellaro T, Lattanzi L, Perugi G. Type 2 diabetes mellitus is associated with manic morbidity in elderly patients with mood disorders. Int Clin Psychopharmacol 2023:00004850-990000000-00101. [PMID: 37824397 DOI: 10.1097/yic.0000000000000515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
The association between mood disorders, especially bipolar disorder (BD), and metabolic disorders, is long known. However, to which extent metabolic disorders affect the course of mood disorders in late life is still open to inquiring. To assess the impact of type 2 diabetes mellitus (T2DM) on late-life mood disorders a retrospective chart review was performed. Elderly depressive patients (≥ 65 years) diagnosed with Major Depressive Disorder (N = 57) or BD (N = 43) and followed up for at least 18 months were included and subdivided according to the presence of T2DM comorbidity. Vascular encephalopathy (39.1% vs. 15.6%, P = 0.021) and neurocognitive disorders (21.7% vs. 5.2%, P = 0.028), were more frequently reported in patients with T2DM than in those without. Patients with T2DM showed a greater percentage of follow-up time in manic episodes (r = -0.23, P = 0.020) and a higher rate of manic episode(s) during follow-up (21.7% vs. 5.2%, P = 0.028) than those without. When restricting longitudinal analyses to patients with bipolar spectrum disorders, results were confirmed. In line with the well-known connection between BD and metabolic disorders, our data support an association between T2DM and unfavorable course of illness in the elderly with BD.
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Affiliation(s)
- Francesco Weiss
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa
| | | | - Camilla Elefante
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa
| | | | - Teresa Gemmellaro
- Department of Psychiatry, North-Western Tuscany Region, NHS, Local Health Unit, Cecina-LI
| | | | - Giulio Perugi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa
- Institute of Behavioral Science 'G. De Lisio', Pisa, Italy
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14
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Scala M, Fanelli G, De Ronchi D, Serretti A, Fabbri C. Clinical specificity profile for novel rapid acting antidepressant drugs. Int Clin Psychopharmacol 2023; 38:297-328. [PMID: 37381161 PMCID: PMC10373854 DOI: 10.1097/yic.0000000000000488] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023]
Abstract
Mood disorders are recurrent/chronic diseases with variable clinical remission rates. Available antidepressants are not effective in all patients and often show a relevant response latency, with a range of adverse events, including weight gain and sexual dysfunction. Novel rapid agents were developed with the aim of overcoming at least in part these issues. Novel drugs target glutamate, gamma-aminobutyric acid, orexin, and other receptors, providing a broader range of pharmacodynamic mechanisms, that is, expected to increase the possibility of personalizing treatments on the individual clinical profile. These new drugs were developed with the aim of combining a rapid action, a tolerable profile, and higher effectiveness on specific symptoms, which were relatively poorly targeted by standard antidepressants, such as anhedonia and response to reward, suicidal ideation/behaviours, insomnia, cognitive deficits, and irritability. This review discusses the clinical specificity profile of new antidepressants, namely 4-chlorokynurenine (AV-101), dextromethorphan-bupropion, pregn-4-en-20-yn-3-one (PH-10), pimavanserin, PRAX-114, psilocybin, esmethadone (REL-1017/dextromethadone), seltorexant (JNJ-42847922/MIN-202), and zuranolone (SAGE-217). The main aim is to provide an overview of the efficacy/tolerability of these compounds in patients with mood disorders having different symptom/comorbidity patterns, to help clinicians in the optimization of the risk/benefit ratio when prescribing these drugs.
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Affiliation(s)
- Mauro Scala
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
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15
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Wencel PL, Blecharz-Klin K, Piechal A, Pyrzanowska J, Mirowska-Guzel D, Strosznajder RP. Fingolimod Modulates the Gene Expression of Proteins Engaged in Inflammation and Amyloid-Beta Metabolism and Improves Exploratory and Anxiety-Like Behavior in Obese Mice. Neurotherapeutics 2023; 20:1388-1404. [PMID: 37432552 PMCID: PMC10480137 DOI: 10.1007/s13311-023-01403-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/12/2023] Open
Abstract
Obesity is considered a risk factor for type 2 diabetes mellitus, which has become one of the most important health problems, and is also linked with memory and executive function decline. Sphingosine-1-phosphate (S1P) is a bioactive sphingolipid that regulates cell death/survival and the inflammatory response via its specific receptors (S1PRs). Since the role of S1P and S1PRs in obesity is rather obscure, we examined the effect of fingolimod (an S1PR modulator) on the expression profile of genes encoding S1PRs, sphingosine kinase 1 (Sphk1), proteins engaged in amyloid-beta (Aβ) generation (ADAM10, BACE1, PSEN2), GSK3β, proapoptotic Bax, and proinflammatory cytokines in the cortex and hippocampus of obese/prediabetic mouse brains. In addition, we observed behavioral changes. Our results revealed significantly elevated mRNA levels of Bace1, Psen2, Gsk3b, Sphk1, Bax, and proinflammatory cytokines, which were accompanied by downregulation of S1pr1 and sirtuin 1 in obese mice. Moreover, locomotor activity, spatially guided exploratory behavior, and object recognition were impaired. Simultaneously, fingolimod reversed alterations in the expressions of the cytokines, Bace1, Psen2, and Gsk3b that occurred in the brain, elevated S1pr3 mRNA levels, restored normal cognition-related behavior patterns, and exerted anxiolytic effects. The improvement in episodic and recognition memory observed in this animal model of obesity may suggest a beneficial effect of fingolimod on central nervous system function.
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Affiliation(s)
- P L Wencel
- Laboratory of Preclinical Research and Environmental Agents, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego St., 02106, Warsaw, Poland.
| | - K Blecharz-Klin
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, 1B Banacha St., 02097, Warsaw, Poland
| | - A Piechal
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, 1B Banacha St., 02097, Warsaw, Poland
| | - J Pyrzanowska
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, 1B Banacha St., 02097, Warsaw, Poland
| | - D Mirowska-Guzel
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, 1B Banacha St., 02097, Warsaw, Poland
| | - R P Strosznajder
- Laboratory of Preclinical Research and Environmental Agents, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego St., 02106, Warsaw, Poland
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16
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Possidente C, Fanelli G, Serretti A, Fabbri C. Clinical insights into the cross-link between mood disorders and type 2 diabetes: A review of longitudinal studies and Mendelian randomisation analyses. Neurosci Biobehav Rev 2023; 152:105298. [PMID: 37391112 DOI: 10.1016/j.neubiorev.2023.105298] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 07/02/2023]
Abstract
Mood disorders and type 2 diabetes mellitus (T2DM) are prevalent conditions that often co-occur. We reviewed the available evidence from longitudinal and Mendelian randomisation (MR) studies on the relationship between major depressive disorder (MDD), bipolar disorder and T2DM. The clinical implications of this comorbidity on the course of either condition and the impact of antidepressants, mood stabilisers, and antidiabetic drugs were examined. Consistent evidence indicates a bidirectional association between mood disorders and T2DM. T2DM leads to more severe depression, whereas depression is associated with more complications and higher mortality in T2DM. MR studies demonstrated a causal effect of MDD on T2DM in Europeans, while a suggestive causal association in the opposite direction was found in East Asians. Antidepressants, but not lithium, were associated with a higher T2DM risk in the long-term, but confounders cannot be excluded. Some oral antidiabetics, such as pioglitazone and liraglutide, may be effective on depressive and cognitive symptoms. Studies in multi-ethnic populations, with a more careful assessment of confounders and appropriate power, would be important.
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Affiliation(s)
- Chiara Possidente
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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17
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Liu J, Zhu X, Liu Y, Jia F, Yuan H, Wang Q, Zhang X, Li Z, Du X, Zhang X. Association between triglyceride glucose index and suicide attempts in patients with first-episode drug-naïve major depressive disorder. Front Psychiatry 2023; 14:1231524. [PMID: 37575577 PMCID: PMC10416446 DOI: 10.3389/fpsyt.2023.1231524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023] Open
Abstract
Objective Triglyceride glucose (TyG) index has been suggested as an alternative indicator of insulin resistance (IR); however, the association between TyG index and suicide attempts (SA) in major depressive disorder (MDD) is unclear. The aim of this study was to investigate the relationship between TyG index and SA in Chinese patients with first-episode drug-naïve (FEDN) MDD. Methods This cross-sectional study enrolled 1,718 patients with FEDN MDD aged 34.9 ± 12.4 years from the First Hospital of Shanxi Medical University (Taiyuan, Shanxi Province, China) from September 2016 to December 2018. Multivariable binary logistic regression analysis was used to estimate the association between TyG index and the risk of SA. A two-piecewise linear regression model was used to investigate the threshold effects if non-linearity associations existed. Interaction and stratified analyses were performed based on sex, education, marital status, comorbid anxiety, and psychotic symptoms. Results Multivariable logistic regression analysis revealed that TyG index was positively associated with the risk of SA after adjusting for confounders (OR = 1.35, 95% CI: 1.04-1.75, p = 0.03). Smoothing plots also showed a nonlinear relationship between TyG index and SA, with the inflection point of TyG index being 9.29. On the right of the inflection point, a positive association between TyG index and SA was detected (OR = 3.47, 95% CI: 1.81 to 6.66, p < 0.001), while no significant association was observed on the left side of the inflection point (OR = 1.14, 95% CI: 0.79 to 1.66, p = 0.476). Conclusion The relationship between TyG index and SA risk was non-linear and exhibited a threshold effect in Chinese patients with FEDN MDD. When TyG index was greater than 9.29, they showed a significant positive correlation.
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Affiliation(s)
- Junjun Liu
- Nanjing Meishan Hospital, Nanjing, China
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
- Medical College of Soochow University, Suzhou, China
| | - Xiaomin Zhu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Yang Liu
- Nanjing Meishan Hospital, Nanjing, China
| | - Fengnan Jia
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
- Medical College of Soochow University, Suzhou, China
| | | | - Qingyuan Wang
- Clinical Medical Department, The Second Clinical Medical College, Nanjing Medical University, Nanjing, China
| | - Xiaobin Zhang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhe Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiangdong Du
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
- Medical College of Soochow University, Suzhou, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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18
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Brieler JA, Salas J, Keegan-Garrett E, Scherrer JF. Achievement of glycemic control and antidepressant medication use in comorbid depression and type 2 diabetes. J Affect Disord 2023; 324:1-7. [PMID: 36566931 DOI: 10.1016/j.jad.2022.12.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 11/22/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Existing studies designed to determine if depression treatment in patients with type 2 diabetes (T2D) is associated with improved glycemic control have produced inconsistent results. The present study investigated the link between acute phase antidepressant medication treatment and achievement of glycemic control in patients with T2D using nationally distributed electronic health record data. METHODS A retrospective cohort study (n = 7332) was conducted using nationally distributed Optum® de-identified electronic health record data from 2010 to 2018. Eligible patients were 18-64 years old and had T2D, depression, and poor glycemic control. Antidepressant medication treatment was categorized into acute phase treatment (≥12 weeks), less than acute phase (<12 weeks) or no treatment. Glycemic control was defined as HbA1c < 7.0 % (53 mmol/mol). Propensity scores (PS) and inverse probability of treatment weighting (IPTW) controlled for confounding. Extended Cox models measured the association between duration of antidepressant medication treatment and glycemic control at 0 to 36 months, 36 to 72 months and ≥72 months. RESULTS After controlling for confounding, compared to no treatment, acute phase treatment was significantly associated with achieving glycemic control within 36 months (HR 1.17, 95 % CI 1.02-1.34). No association was observed beyond 36 months. There was no association between acute vs. less than acute phase treatment and glycemic control. LIMITATIONS We were unable to measure decreased depression severity which could contribute to glycemic control. CONCLUSIONS For patients with T2D and hyperglycemia, acute phase antidepressant medication may enable glycemic control. Further research is needed to establish mechanisms for this association.
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Affiliation(s)
- Jay A Brieler
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA.
| | - Joanne Salas
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA; Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, 1008 S. Spring, St. Louis, MO 63110, USA
| | - Elizabeth Keegan-Garrett
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Jeffrey F Scherrer
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA; Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, 1008 S. Spring, St. Louis, MO 63110, USA; Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 S Grand Blvd, St. Louis, MO 63104, USA
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19
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Fanelli G, Mota NR, Salas-Salvadó J, Bulló M, Fernandez-Aranda F, Camacho-Barcia L, Testa G, Jiménez-Murcia S, Bertaina-Anglade V, Franke B, Poelmans G, van Gils V, Jansen WJ, Vos SJB, Wimberley T, Dalsgaard S, Barta C, Serretti A, Fabbri C, Bralten J. The link between cognition and somatic conditions related to insulin resistance in the UK Biobank study cohort: a systematic review. Neurosci Biobehav Rev 2022; 143:104927. [PMID: 36367493 DOI: 10.1016/j.neubiorev.2022.104927] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/14/2022] [Accepted: 10/23/2022] [Indexed: 11/09/2022]
Abstract
Clinical and genomic studies have shown an overlap between neuropsychiatric disorders and insulin resistance (IR)-related somatic conditions, including obesity, type 2 diabetes, and cardiovascular diseases. Impaired cognition is often observed among neuropsychiatric disorders, where multiple cognitive domains may be affected. In this review, we aimed to summarise previous evidence on the relationship between IR-related diseases/traits and cognitive performance in the large UK Biobank study cohort. Electronic searches were conducted on PubMed, Scopus, and Web of Science until April 2022. Eighteen articles met the inclusion criteria and were qualitatively reviewed. Overall, there is substantial evidence for an association between IR-related cardio-metabolic diseases/traits and worse performance on various cognitive domains, which is largely independent of possible confoundings. The most consistent findings referred to IR-related associations with poorer verbal and numerical reasoning ability, as well as slower processing speed. The observed associations might be mediated by alterations in immune-inflammation, brain integrity/connectivity, and/or comorbid somatic or psychiatric diseases/traits. Our findings provide impetus for further research into the underlying neurobiology and possible new therapeutic targets.
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Affiliation(s)
- Giuseppe Fanelli
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Nina Roth Mota
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Mònica Bulló
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Fernando Fernandez-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Lucía Camacho-Barcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain
| | - Giulia Testa
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | | | - Barbara Franke
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands; Department of Psychiatry, Radboud university medical center, Nijmegen, The Netherlands
| | - Geert Poelmans
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands
| | - Veerle van Gils
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and NeuroScience, Maastricht University, Maastricht, The Netherlands
| | - Willemijn J Jansen
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and NeuroScience, Maastricht University, Maastricht, The Netherlands
| | - Stephanie J B Vos
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and NeuroScience, Maastricht University, Maastricht, The Netherlands
| | - Theresa Wimberley
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Søren Dalsgaard
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Child and Adolescent Psychiatry, Mental Health Services of the Capital Region, Glostrup, Denmark
| | - Csaba Barta
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Janita Bralten
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
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20
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Wang Q, Qi Y, Li Y, Yan Z, Wang X, Ma Q, Tang C, Liu X, Wei M, Zhang H. Psychiatric traits and intracerebral hemorrhage: A Mendelian randomization study. Front Psychiatry 2022; 13:1049432. [PMID: 36684013 PMCID: PMC9850495 DOI: 10.3389/fpsyt.2022.1049432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Psychiatric traits have been associated with intracerebral hemorrhage (ICH) in observational studies, although their causal relationships remain uncertain. We used Mendelian randomization analyses to infer causality between psychiatric traits and ICH. METHODS We collected data from genome-wide association studies of ICH (n = 361,194) and eight psychiatric traits among Europeans, including mood swings (n = 451,619), major depressive disorder (n = 480,359), attention-deficit/hyperactivity disorder (n = 53,293), anxiety (n = 459,560), insomnia (n = 462,341), schizophrenia (n = 77,096), neuroticism (n = 374,323), and bipolar disorder (n = 51,710). We performed a series of bidirectional two-sample Mendelian randomization and related sensitivity analyses. A Bonferroni corrected threshold of p < 0.00625 (0.05/8) was considered to be significant, and p < 0.05 was considered suggestive of evidence for a potential association. RESULTS Mendelian randomization analyses revealed suggestive positive causality of mood swings on ICH (odds ratio = 1.006, 95% confidence interval = 1.001-1.012, p = 0.046), and the result was consistent after sensitivity analysis. However, major depressive disorder (p = 0.415), attention-deficit/hyperactivity disorder (p = 0.456), anxiety (p = 0.664), insomnia (p = 0.699), schizophrenia (p = 0.799), neuroticism (p = 0.140), and bipolar disorder (p = 0.443) are not significantly associated with the incidence of ICH. In the reverse Mendelian randomization analyses, no causal effects of ICH on mood swings (p = 0.565), major depressive disorder (p = 0.630), attention-deficit/hyperactivity disorder (p = 0.346), anxiety (p = 0.266), insomnia (p = 0.102), schizophrenia (p = 0.463), neuroticism (p = 0.261), or bipolar disorder (p = 0.985) were found. CONCLUSION Our study revealed that mood swings are suggestively causal of ICH and increase the risk of ICH. These results suggest the clinical significance of controlling mood swings for ICH prevention.
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Affiliation(s)
- Qingduo Wang
- Department of Neurosurgery, The Yangzhou School of Clinical Medicine of Dalian Medical University, Dalian, China
| | - Yajie Qi
- Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Yuping Li
- Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Zhengcun Yan
- Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Xiaodong Wang
- Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Qiang Ma
- Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Can Tang
- Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Xiaoguang Liu
- Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Min Wei
- Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Hengzhu Zhang
- Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, China
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