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Rabiller G, Ip Z, Zarrabian S, Zhang H, Sato Y, Yazdan-Shahmorad A, Liu J. Type-2 Diabetes Alters Hippocampal Neural Oscillations and Disrupts Synchrony between the Hippocampus and Cortex. Aging Dis 2024; 15:2255-2270. [PMID: 38029397 PMCID: PMC11346393 DOI: 10.14336/ad.2023.1106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) increases the risk of neurological diseases, yet how brain oscillations change as age and T2DM interact is not well characterized. To delineate the age and diabetic effect on neurophysiology, we recorded local field potentials with multichannel electrodes spanning the somatosensory cortex and hippocampus (HPC) under urethane anesthesia in diabetic and normoglycemic control mice, at 200 and 400 days of age. We analyzed the signal power of brain oscillations, brain state, sharp wave associate ripples (SPW-Rs), and functional connectivity between the cortex and HPC. We found that while both age and T2DM were correlated with a breakdown in long-range functional connectivity and reduced neurogenesis in the dentate gyrus and subventricular zone, T2DM further slowed brain oscillations and reduced theta-gamma coupling. Age and T2DM also prolonged the duration of SPW-Rs and increased gamma power during SPW-R phase. Our results have identified potential electrophysiological substrates of hippocampal changes associated with T2DM and age. The perturbed brain oscillation features and diminished neurogenesis may underlie T2DM-accelerated cognitive impairment.
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Affiliation(s)
- Gratianne Rabiller
- Department of Neurological Surgery, University of California at San Francisco, San Francisco, CA, USA
- San Francisco VA medical Center, San Francisco, CA, USA
| | - Zachary Ip
- Departments of Bioengineering, University of Washington, Seattle, WA, USA
| | - Shahram Zarrabian
- Department of Neurological Surgery, University of California at San Francisco, San Francisco, CA, USA
- San Francisco VA medical Center, San Francisco, CA, USA
| | - Hongxia Zhang
- Department of Neurological Surgery, University of California at San Francisco, San Francisco, CA, USA
- San Francisco VA medical Center, San Francisco, CA, USA
| | - Yoshimichi Sato
- Department of Neurological Surgery, University of California at San Francisco, San Francisco, CA, USA
- San Francisco VA medical Center, San Francisco, CA, USA
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Azadeh Yazdan-Shahmorad
- Departments of Bioengineering, University of Washington, Seattle, WA, USA
- Electrical and Computer Engineering, University of Washington, Seattle, WA, USA
| | - Jialing Liu
- Department of Neurological Surgery, University of California at San Francisco, San Francisco, CA, USA
- San Francisco VA medical Center, San Francisco, CA, USA
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Cheah YK, Syed Anera SN, Omar MA, Abd Manaf NH, Idris ZZ. Age, Education and Depression Among Older Adults: The Mediating Role of Physical Activity. Clin Gerontol 2024:1-13. [PMID: 38922336 DOI: 10.1080/07317115.2024.2371612] [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: 06/27/2024]
Abstract
OBJECTIVES Past geriatric studies related to the mediating role of physical activity in depression are scarce. This is perhaps the first study to examine the mediating effects of physical activity on the associations between depression and age, and education among older adults. METHODS Statistical analyses of cross-sectional data from a nationally representative survey on Malaysian older adult health were conducted. Structural equation modeling was used to assess the extent to which physical activity mediated the relationships between depression and age, and education. Associations between variables were explored using multivariable logistic regressions. RESULTS Analyses were based on a sample of 3974 older adults (aged ≥60 years). Only 12.2% of older adults had depression. Age was positively associated with the odds of depression. Better educated older adults were less likely to experience depression than less educated older adults. Physical activity fully mediated the association between depression and age, whereas it partially explained the depression-education relationship. CONCLUSIONS Older age and low educational levels were risk factors for depression, and physical activity was identified as a mediator. CLINICAL IMPLICATIONS Older and less-educated older adults should be encouraged to participate in physical activity, and those at risk of depression should be given special attention.
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Affiliation(s)
- Yong Kang Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, Sintok, Kedah, Malaysia
| | - Sharifah Nazeera Syed Anera
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Noor Hazilah Abd Manaf
- Kulliyyah of Economics and Management Sciences, International Islamic University Malaysia, Kuala Lumpur, Malaysia
| | - Zera Zuryana Idris
- Kulliyyah of Economics and Management Sciences, International Islamic University Malaysia, Kuala Lumpur, Malaysia
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Zaninotto P, Steptoe A, Shim EJ. CVD incidence and mortality among people with diabetes and/or hypertension: Results from the English longitudinal study of ageing. PLoS One 2024; 19:e0303306. [PMID: 38820248 PMCID: PMC11142434 DOI: 10.1371/journal.pone.0303306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 04/23/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND AND AIMS Diabetes and/or hypertension are the most common conditions in older people, and also related to higher cardiovascular disease (CVD) incidence and mortality. This study aims to explore the risk of CVD incidence and mortality among older people with diabetes and/or hypertension over a 16 years follow-up period and investigates the role of depression and obesity in these relationships. METHODS 6,855 participants aged 50+ from the English Longitudinal Study of Ageing (ELSA). The main exposure is having diabetes and/or hypertension at baseline (2002/2003) compared to not having, but excluded those with coronary heart disease (CHD) and/or stroke (CVD). Survival models are used for CVD incidence and mortality up to 2018, adjusted for socio-demographic, health, health behaviours, cognitive function, and physical function characteristics. RESULTS 39.3% of people at baseline had diabetes and/or hypertension. The risk of CVD incidence was 1.7 (95%CI: 1.5; 1.9) higher among people with diabetes and/or hypertension compared to those without and was independent of covariates adjustment. People with diabetes and/or hypertension were also 1.3 (95%CI: 1.1; 1.8) times more likely to die from CVD than those without. We did not find evidence for an elevated risk of CVD incidence and mortality among people with obesity nor among those with depression. CONCLUSIONS In order to effectively reduce the risk of CVD incidence and mortality among older people, treatment as well as management of hypertension and diabetes should be routinely considered for older people with diabetes and/or hypertension.
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Affiliation(s)
- Paola Zaninotto
- Department of Epidemiology and Public Health, UCL, London, United Kingdom
| | - Andrew Steptoe
- Department of Behavioural Science and Health, UCL, London, United Kingdom
| | - Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, Republic of Korea
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Perrelli M, Goparaju P, Postolache TT, del Bosque-Plata L, Gragnoli C. Stress and the CRH System, Norepinephrine, Depression, and Type 2 Diabetes. Biomedicines 2024; 12:1187. [PMID: 38927393 PMCID: PMC11200886 DOI: 10.3390/biomedicines12061187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/20/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024] Open
Abstract
Major depressive disorder (MDD) increases the risk of type 2 diabetes (T2D) by 60% in untreated patients, and hypercortisolism is common in MDD as well as in some patients with T2D. Patients with MDD, despite hypercortisolism, show inappropriately normal levels of corticotropin-releasing hormone (CRH) and plasma adrenocorticotropin (ACTH) in the cerebrospinal fluid, which might implicate impaired negative feedback. Also, a positive feedback loop of the CRH-norepinephrine (NE)-CRH system may be involved in the hypercortisolism of MDD and T2D. Dysfunctional CRH receptor 1 (CRHR1) and CRH receptor 2 (CRHR2), both of which are involved in glucose regulation, may explain hypercortisolism in MDD and T2D, at least in a subgroup of patients. CRHR1 increases glucose-stimulated insulin secretion. Dysfunctional CRHR1 variants can cause hypercortisolism, leading to serotonin dysfunction and depression, which can contribute to hyperglycemia, insulin resistance, and increased visceral fat, all of which are characteristics of T2D. CRHR2 is implicated in glucose homeostasis through the regulation of insulin secretion and gastrointestinal functions, and it stimulates insulin sensitivity at the muscular level. A few studies show a correlation of the CRHR2 gene with depressive disorders. Based on our own research, we have found a linkage and association (i.e., linkage disequilibrium [LD]) of the genes CRHR1 and CRHR2 with MDD and T2D in families with T2D. The correlation of CRHR1 and CRHR2 with MDD appears stronger than that with T2D, and per our hypothesis, MDD may precede the onset of T2D. According to the findings of our analysis, CRHR1 and CRHR2 variants could modify the response to prolonged chronic stress and contribute to high levels of cortisol, increasing the risk of developing MDD, T2D, and the comorbidity MDD-T2D. We report here the potential links of the CRH system, NE, and their roles in MDD and T2D.
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Affiliation(s)
| | - Pruthvi Goparaju
- Division of Endocrinology, Department of Medicine, Creighton University School of Medicine, Omaha, NE 68124, USA;
| | - Teodor T. Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
- Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO 80246, USA
- Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21090, USA
| | - Laura del Bosque-Plata
- Nutrigenetics, and Nutrigenomic Laboratory, National Institute of Genomic Medicine, Mexico City 14610, Mexico;
| | - Claudia Gragnoli
- Division of Endocrinology, Department of Medicine, Creighton University School of Medicine, Omaha, NE 68124, USA;
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, 8091 Zürich, Switzerland
- Molecular Biology Laboratory, Bios Biotech Multi-Diagnostic Health Center, 00197 Rome, Italy
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Wang Z, Du Z, Lu R, Zhou Q, Jiang Y, Zhu H. Causal relationship between diabetes and depression: A bidirectional Mendelian randomization study. J Affect Disord 2024; 351:956-961. [PMID: 38355055 DOI: 10.1016/j.jad.2024.02.031] [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: 08/22/2023] [Revised: 01/29/2024] [Accepted: 02/08/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE This study explores the causal relationship between diabetes and depression using a two-sample Mendelian Randomization (TSMR) method. METHODS The study selected single nucleotide polymorphisms (SNPs) closely associated with diabetes and depression in European populations from the Genome-Wide Association Study (GWAS) database, to serve as instrumental variables (IVs). The main evaluation method was inverse variance weighted analysis (IVW), supplemented by verification using Weighted median, Weighted mode, and MR Egger methods. The Odds Ratio (OR) and 95 % Confidence Interval (CI) were used as the main evaluation indicators, along with sensitivity analysis. RESULTS This study found a negative correlation between diabetes and depression, suggesting that diabetes may reduce the risk of depression [IVW(FE): OR: 0.901, 95 % CI: 0.823 to 0.987; P = 0.025 < 0.05]. This finding was further confirmed by the Weighted median [OR: 0.844, 95 % CI: 0.730 to 0.974; P = 0.021 < 0.05] and Weighted mode method [OR: 0.766, 95 % CI: 0.637 to 0.921; P = 0.006 < 0.05]. However, the reverse showed no causal relationship between depression and diabetes (P > 0.05). Sensitivity analysis found no pleiotropy, and there were no large influences from individual SNPs on the result's robustness; the results are stable and reliable. CONCLUSION For the first time, this study using TSMR analysis found a negative correlation between diabetes and the risk of depression onset in European populations, suggesting that diabetes might reduce the risk of depression. But as the mechanisms are still unclear, these findings warrant further study.
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Affiliation(s)
- Zhe Wang
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Zhiqiang Du
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Rongrong Lu
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Qin Zhou
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Ying Jiang
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China.
| | - Haohao Zhu
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China.
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Durante A, Klompstra L, Cezón-Serrano N, Deka P, Arnal-Gómez A, Querol-Giner F, Marques-Sule E. Psychological Health Among Older Adults During and After Quarantine: A Multi-Method Study. West J Nurs Res 2024; 46:44-51. [PMID: 37981724 DOI: 10.1177/01939459231214603] [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] [Indexed: 11/21/2023]
Abstract
OBJECTIVE Depression among older adults is a growing problem. With aging being a risk factor for COVID-19 infection, depression in this population may have been exacerbated. This study aimed to describe experiences and changes in depressive symptoms and well-being of older adults during and after the COVID-19 first wave in Spain. METHODS The study used a multi-method design. Participants self-reported depressive symptoms (Geriatric Depression Scale) and well-being (Cantril Ladder of Life). Participants were asked about changes in depressive symptoms or well-being during quarantine. If a change was perceived, they were asked to describe the change. In addition, the Patient Global Impression of Change scale was used. Both quantitative and qualitative analyses were performed on the data. RESULTS 111 participants (mean age: 71±5 years; 76% women) completed the study. Sixty-three percent reported mild and 2% reported major depressive symptoms. Nearly half (47.7%) reported changes in depressive symptoms during the lockdown. While 37% reported feeling better during the lockdown, about 11% reported depressive symptoms were worse now compared with during the lockdown. 60% reported worsening well-being during the quarantining period. The qualitative analysis revealed 2 main themes: (1) psychological discomfort (mood deflection, fear/worries, and boredom/inactivity) and (2) social issues (inability to go out, missing family members and others). CONCLUSIONS Worsening depressive symptoms and lowering of well-being were noticed in this sample of older adults during and post-COVID lockdowns. Evaluation of mental health in the primary care setting and providing referrals for mental health services is essential for older adults who experienced COVID-19-related lockdowns.
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Affiliation(s)
- Angela Durante
- Department of Nursing, GRUPAC, University of La Rioja, Logroño, Spain
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Natalia Cezón-Serrano
- Physiotherapy in Motion, Multispeciality Research Group (PTin MOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Pallav Deka
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Anna Arnal-Gómez
- Physiotherapy in Motion, Multispeciality Research Group (PTin MOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Felipe Querol-Giner
- Physiotherapy in Motion, Multispeciality Research Group (PTin MOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Elena Marques-Sule
- Physiotherapy in Motion, Multispeciality Research Group (PTin MOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
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Vas P, Chockalingam N. Improving Physical, Physiological, and Psychological Health Outcomes in Patients with Diabetic Foot Ulcers - State of the Art. Clin Cosmet Investig Dermatol 2023; 16:3547-3560. [PMID: 38107668 PMCID: PMC10725647 DOI: 10.2147/ccid.s333660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
Diabetic foot disease is a complex and challenging complication of diabetes mellitus, which imposes a significant burden of disease on patients, their carers, and the wider health systems. Recurrence rates are high, and current evidence indicates a high mortality associated with it. While management algorithms have primarily focused on the physical aspects of healing, there is increasing recognition of the critical role played by psychological and biomechanical factors in the development and resolution of diabetic foot disease. Therefore, in this paper, we aim to explore how diabetic foot outcomes can be improved by addressing not only the physical but also the psychological and biomechanical aspects that are integral to the development of this condition and its optimal resolution. We explore new technologies that allow for non-invasive objective assessment of the diabetic foot at risk, and we also explore the role of understanding biomechanics, which is essential to determining risk of foot disease, but also the potential for recurrence. In addition, we discuss the evidence linking depression and cognitive impairment to diabetic foot disease and offer our insight on the research direction required before implementing novel information into front-line clinics.
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Affiliation(s)
- Prashanth Vas
- Department of Diabetes and Diabetic Foot, King’s College Hospital NHS Foundation Trust, London, UK
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent, UK
- Department of Diabetes and Endocrinology, Guy’s and St Thomas’ Hospitals NHS Foundation Trust, London, UK
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent, UK
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Kraal AZ, Ellingrod VL, Zahodne LB. Depressive Symptoms Longitudinally Mediate the Effect of Hyperglycemia on Memory Decline in Type 2 Diabetes. Diabetes Care 2023; 46:1673-1680. [PMID: 37490632 PMCID: PMC10465988 DOI: 10.2337/dc23-0656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/08/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVE We sought to examine the mediating role of changes in depressive symptoms in the association between chronic hyperglycemia and longitudinal cognition in a sample of older adults with type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS We conducted a longitudinal mediation analysis using structural equation modeling of observational data collected over 6 years from 2,155 participants with T2D (aged ≥51 years) in the U.S.-wide Health and Retirement Study. T2D was defined using self-reported diagnosis, and HbA1c was assessed at study baseline. Self-reported depressive symptoms were assessed at two time points 4 years apart. Episodic memory was measured using a list-learning test administered at three time points over 6 years. We adjusted for sociodemographics, chronic health comorbidities, medication adherence, study enrollment year, and prior years' depressive symptoms and memory scores. RESULTS At baseline, participants' mean age was 69.4 (SD = 9.1), mean HbA1c was 7.2% (SD = 1.4%), 55.0% were women, 19.3% were non-Latinx Black, and 14.0% were Latinx. Higher baseline levels of HbA1c were associated with increases in depressive symptoms over 4 years, which, in turn, were associated with poorer memory 2 years later. Depressive symptoms accounted for 19% of the longitudinal effect of HbA1c on memory over the 6-year period. Sensitivity analyses ruled out alternative directions of associations. CONCLUSIONS Incident elevations in depressive symptoms mediated the longitudinal association between hyperglycemia and 6-year episodic memory scores. For older adults with T2D, interventions to prevent HbA1c-related incident depressive symptoms may be beneficial in reducing the neurotoxic effects of chronic hyperglycemia on cognition.
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Affiliation(s)
- A. Zarina Kraal
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY
| | | | - Laura B. Zahodne
- Department of Psychology, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI
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9
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Rabiller G, Ip Z, Zarrabian S, Zhang H, Sato Y, Yazdan-Shahmorad A, Liu J. Type-2 diabetes alters hippocampal neural oscillations and disrupts synchrony between hippocampus and cortex. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.25.542288. [PMID: 37292743 PMCID: PMC10245872 DOI: 10.1101/2023.05.25.542288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Type 2 diabetes mellitus (T2DM) increases the risk of neurological diseases, yet how brain oscillations change as age and T2DM interact is not well characterized. To delineate the age and diabetic effect on neurophysiology, we recorded local field potentials with multichannel electrodes spanning the somatosensory cortex and hippocampus (HPC) under urethane anesthesia in diabetic and normoglycemic control mice, at 200 and 400 days of age. We analyzed the signal power of brain oscillations, brain state, sharp wave associate ripples (SPW-Rs), and functional connectivity between the cortex and HPC. We found that while both age and T2DM were correlated with a breakdown in long-range functional connectivity and reduced neurogenesis in the dentate gyrus and subventricular zone, T2DM further slowed brain oscillations and reduced theta-gamma coupling. Age and T2DM also prolonged the duration of SPW-Rs and increased gamma power during SPW-R phase. Our results have identified potential electrophysiological substrates of hippocampal changes associated with T2DM and age. The perturbed brain oscillation features and diminished neurogenesis may underlie T2DM-accelerated cognitive impairment.
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10
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Gao J, Zhao L, Cheng Y, Lei W, Wang Y, Liu X, Zheng N, Shao L, Chen X, Sun Y, Ling Z, Xu W. Probiotics for the treatment of depression and its comorbidities: A systemic review. Front Cell Infect Microbiol 2023; 13:1167116. [PMID: 37139495 PMCID: PMC10149938 DOI: 10.3389/fcimb.2023.1167116] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/15/2023] [Indexed: 05/05/2023] Open
Abstract
Depression is one of the most common psychiatric conditions, characterized by significant and persistent depressed mood and diminished interest, and often coexists with various comorbidities. The underlying mechanism of depression remain elusive, evidenced by the lack of an appreciate therapy. Recent abundant clinical trials and animal studies support the new notion that the gut microbiota has emerged as a novel actor in the pathophysiology of depression, which partakes in bidirectional communication between the gut and the brain through the neuroendocrine, nervous, and immune signaling pathways, collectively known as the microbiota-gut-brain (MGB) axis. Alterations in the gut microbiota can trigger the changes in neurotransmitters, neuroinflammation, and behaviors. With the transition of human microbiome research from studying associations to investigating mechanistic causality, the MGB axis has emerged as a novel therapeutic target in depression and its comorbidities. These novel insights have fueled idea that targeting on the gut microbiota may open new windows for efficient treatment of depression and its comorbidities. Probiotics, live beneficial microorganisms, can be used to modulate gut dysbiosis into a new eubiosis and modify the occurrence and development of depression and its comorbidities. In present review, we summarize recent findings regarding the MGB axis in depression and discuss the potential therapeutic effects of probiotics on depression and its comorbidities.
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Affiliation(s)
- Jie Gao
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Longyou Zhao
- Department of Laboratory Medicine, Lishui Second People’s Hospital, Lishui, Zhejiang, China
| | - Yiwen Cheng
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Wenhui Lei
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yu Wang
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xia Liu
- Department of Intensive Care Unit, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Nengneng Zheng
- Department of Obstetrics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Li Shao
- School of Clinical Medicine, Institute of Hepatology and Metabolic Diseases, Hangzhou Normal University, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Xulei Chen
- Department of Psychiatry, Lishui Second People’s Hospital, Lishui, Zhejiang, China
| | - Yilai Sun
- Department of Psychiatry, Lishui Second People’s Hospital, Lishui, Zhejiang, China
| | - Zongxin Ling
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Weijie Xu
- Department of Psychiatry, Lishui Second People’s Hospital, Lishui, Zhejiang, China
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11
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Efendi F, Tonapa SI, Has EMM, Ho KHM. Effects of chair-based resistance band exercise on physical functioning, sleep quality, and depression of older adults in long-term care facilities: Systematic review and meta-analysis. Int J Nurs Sci 2022; 10:72-81. [PMID: 36860706 PMCID: PMC9969069 DOI: 10.1016/j.ijnss.2022.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/25/2022] [Accepted: 12/14/2022] [Indexed: 12/27/2022] Open
Abstract
Objective Chair-based resistance band exercise (CRBE) is a simple and safe physical activity for persons with limited mobility. This study aimed to review and analyze CRBE effects on physical functioning, sleep quality, and depression among older adults in long-term care facilities (LTCF). Method A systematic search guided by the PRISMA 2020 approach was performed on specific databases: AgeLine, CINAHL, PubMed, Embase, Cochrane Library, Scopus, and Web of Science. The randomized controlled trial studies that trialed CRBE for older adults in LTCF, peer-reviewed articles published in the English language from inception to March 2022 were retrieved. Methodological quality was established using the Physiotherapy Evidence Database scale. The random and fixed effects model were used to generate the pooled effect size. Results Nine studies met the eligibility criteria and were synthesized. The results revealed that CRBE significantly promoted the activity of daily living (six studies; SMD = 0.30, P = 0.001), lung capacity (three studies; MD = 40.35, P < 0.001), handgrip strength (five studies; MD = 2.17, P < 0.001), upper limb muscle endurance (five studies; MD = 2.23, P = 0.012), lower limb muscle endurance (four studies; MD = 1.32, P < 0.001), upper body flexibility (four studies; MD = 3.06, P = 0.022), lower body flexibility (four studies; MD = 5.34, P < 0.001), dynamic balance (three studies; MD = -0.35, P = 0.011), sleep quality (two studies; MD = -1.71, P < 0.001), and reduced depression (two studies; SMD = -0.33, P = 0.035). Conclusion The evidence suggests that CRBE improved physical functioning parameters, and sleep quality, and lowers depression among older adults in LTCF. This study could be used to persuade long-term care facilities to allow people with limited mobility to engage in physical activity.
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Affiliation(s)
- Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia,School of Nursing & Midwifery, La Trobe University, Melbourne, Australia,Corresponding author. Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia.
| | | | | | - Ken Hok Man Ho
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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12
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Amin M, Syed S, Wu R, Postolache TT, Gragnoli C. Familial Linkage and Association of the NR3C1 Gene with Type 2 Diabetes and Depression Comorbidity. Int J Mol Sci 2022; 23:ijms231911951. [PMID: 36233250 PMCID: PMC9569497 DOI: 10.3390/ijms231911951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/28/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022] Open
Abstract
Impairment in the hypothalamic-pituitary-adrenal (HPA) axis and cortisol pathway may be major contributing factors to the common pathogenesis of major depressive disorders (MDD) and type 2 diabetes (T2D). A significant player in the neuroendocrine HPA axis and cortisol response is the glucocorticoid receptor (GR), which is encoded by the nuclear receptor subfamily 3 group C member (NR3C1) gene. Variants in the NR3C1 gene have been reported in patients with MDD and obesity and found to confer reduced risk for quantitative metabolic traits and T2D in Cushing syndrome; variants have not been reported in T2D and MDD-T2D comorbid patients. We studied 212 original Italian families with a rich family history for T2D and tested 24 single nucleotide polymorphisms (SNPs) in the NR3C1 gene for linkage to and linkage disequilibrium (LD) with T2D and MDD across different inheritance models. We identified a total of 6 novel SNPs significantly linked/in LD to/with T2D (rs6196, rs10482633, rs13186836, rs13184611, rs10482681 and rs258751) and 1 SNP (rs10482668) significantly linked to/in LD with both T2D and MDD. These findings expand understanding of the role that NR3C1 variants play in modulating the risk of T2D-MDD comorbidity. Replication and functional studies are needed to confirm these findings.
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Affiliation(s)
- Mutaz Amin
- Institut National de la Santé et de la Recherche Médicale (INSERM), US14-Orphanet, 75014 Paris, France
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Al-Neelain University, Khartoum 11121, Sudan
| | - Shumail Syed
- Division of Endocrinology, Department of Medicine, Creighton University School of Medicine, Omaha, NE 68124, USA
| | - Rongling Wu
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA
- Department of Statistics, Penn State College of Medicine, Hershey, PA 17033, USA
| | - Teodor Tudorel Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Denver, CO 80246, USA
- Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21090, USA
| | - Claudia Gragnoli
- Division of Endocrinology, Department of Medicine, Creighton University School of Medicine, Omaha, NE 68124, USA
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA
- Molecular Biology Laboratory, Bios Biotech Multi-Diagnostic Health Center, 00197 Rome, Italy
- Correspondence: ; Tel.: +1-(508)-246-9330
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13
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Comorbidity of Novel CRHR2 Gene Variants in Type 2 Diabetes and Depression. Int J Mol Sci 2022; 23:ijms23179819. [PMID: 36077219 PMCID: PMC9456299 DOI: 10.3390/ijms23179819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 12/18/2022] Open
Abstract
The corticotropin-releasing hormone receptor 2 (CRHR2) gene encodes CRHR2, contributing to the hypothalamic–pituitary–adrenal stress response and to hyperglycemia and insulin resistance. CRHR2−/− mice are hypersensitive to stress, and the CRHR2 locus has been linked to type 2 diabetes and depression. While CRHR2 variants confer risk for mood disorders, MDD, and type 2 diabetes, they have not been investigated in familial T2D and MDD. In 212 Italian families with type 2 diabetes and depression, we tested 17 CRHR2 single nucleotide polymorphisms (SNPs), using two-point parametric-linkage and linkage-disequilibrium (i.e., association) analysis (models: dominant-complete-penetrance-D1, dominant-incomplete-penetrance-D2, recessive-complete-penetrance-R1, recessive-incomplete-penetrance-R2). We detected novel linkage/linkage-disequilibrium/association to/with depression (3 SNPs/D1, 2 SNPs/D2, 3 SNPs/R1, 3 SNPs/R2) and type 2 diabetes (3 SNPs/D1, 2 SNPs/D2, 2 SNPs/R1, 1 SNP/R2). All detected risk variants are novel. Two depression-risk variants within one linkage-disequilibrium block replicate each other. Two independent novel SNPs were comorbid while the most significant conferred either depression- or type 2 diabetes-risk. Although the families were primarily ascertained for type 2 diabetes, depression-risk variants showed higher significance than type 2 diabetes-risk variants, implying CRHR2 has a stronger role in depression-risk than type 2 diabetes-risk. In silico analysis predicted variants’ dysfunction. CRHR2 is for the first time linked to/in linkage-disequilibrium/association with depression-type 2 diabetes comorbidity and may underlie the shared genetic pathogenesis via pleiotropy.
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Shan Y, Zhao W, Hao W, Kimura T, Ukawa S, Ohira H, Kawamura T, Wakai K, Ando M, Tamakoshi A. Changes in behavioral activities and transition of depressive symptoms among younger-old community-dwelling adults during 6 years: An age-specific prospective cohort study. Int J Geriatr Psychiatry 2022; 37. [PMID: 35793449 DOI: 10.1002/gps.5778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/20/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Regular engagement in behavioral activities plays a crucial role against depressive symptoms in older adults. This study aims to explore the relationship between behavioral activities and the temporal evolution of depressive symptoms. METHODS We included community-dwelling Japanese adults aged 64 or 65 years with and without depressive symptoms enrolled in the New Integrated Suburban Seniority Investigation (NISSIN) project. Depressive symptoms at baseline and follow-up were assessed using the 15-item Geriatric Depression Scale. Behavioral activities were measured by self-reported questions. Risk ratios and 95% confidence intervals were calculated using modified Poisson regression, adjusting for relevant sociodemographic variables and health-related confounders. RESULTS During the 6 year follow-up period, 139 (10.1%) without depressive symptoms at baseline developed such symptoms over time, while 174 (51.6%) with depressive symptoms improved to the point of these symptoms being absent. The participants without depressive symptoms at baseline and those who engaged in social activity or daily walking at a continued regular frequency (CRF) or an increased frequency (IF) and exercise habits at CRF were the least likely to have depressive symptoms onset at follow-up. There was no significant difference between the changes in behavioral activities and the improvement of depressive symptoms after controlling for confounders. Participants engaging in a greater variety of behavioral activities at CRF were less likely to experience a new onset of depressive symptoms. CONCLUSIONS Consistent and regular participation in one or more behavioral activities was significantly associated with the onset of depressive symptoms in Japanese community-dwelling older adults.
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Affiliation(s)
- Yifan Shan
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Wenjing Zhao
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Wen Hao
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takashi Kimura
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shigekazu Ukawa
- Research Unit of Advanced Interdisciplinary Care Science, Graduate School of Human Life Science, Osaka City University, Osaka, Japan
| | - Hideki Ohira
- Department of Psychology, Graduate School of Informatics, Nagoya University, Nagoya, Japan
| | | | - Kenji Wakai
- Department of Preventive Medicine, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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15
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Dogra S, Dunstan DW, Sugiyama T, Stathi A, Gardiner PA, Owen N. Active Aging and Public Health: Evidence, Implications, and Opportunities. Annu Rev Public Health 2021; 43:439-459. [PMID: 34910580 DOI: 10.1146/annurev-publhealth-052620-091107] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
By 2050, 20% of the world's population will be over the age of 65 years, with projections that 80% of older adults will be living in low- to middle-income countries. Physical inactivity and sedentary time are particularly high in older adults, presenting unique public health challenges. In this article, we first review evidence that points to multiple beneficial outcomes of active aging, including better physical function, cognitive function, mental health, social health, and sleep and suggest the need to shift the research focus from chronic disease outcomes to more relevant outcomes that affect independence and quality of life. Second, we review the critical role of age-friendly environments in facilitating active aging equitably across different countries and cultures. Finally, we consider emerging opportunities related to social engagement and technology-enabled mobility that can facilitate active aging. In all these contexts, it is a priority to understand and address diversity within the global aging population. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Shilpa Dogra
- Faculty of Health Sciences (Kinesiology), University of Ontario Institute of Technology, Ontario, Canada;
| | - David W Dunstan
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne 3004, Victoria, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Takemi Sugiyama
- Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria, Australia.,Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne 3004, Victoria, Australia
| | - Afroditi Stathi
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Paul A Gardiner
- School of Health and Wellbeing, University of Southern Queensland, Ipswich, Queensland, Australia.,School of Kinesiology, The University of Western Ontario, London, Canada.,Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria, Australia.,Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne 3004, Victoria, Australia
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16
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Abell JG, Steptoe A. Why is living alone in older age related to increased mortality risk? A longitudinal cohort study. Age Ageing 2021; 50:2019-2024. [PMID: 34304269 PMCID: PMC8675439 DOI: 10.1093/ageing/afab155] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Living alone has been associated with increased mortality risk, but it is unclear whether this is a result of a selection effect or the impact of stressful life changes such as widowhood or divorce leading to changes in living arrangements. We therefore examined the association between living alone, transitions in living arrangements and all-cause mortality. METHOD We analysed data from 4,888 individuals who participated in both wave 2 (2004-2005) and wave 4 (2008-2009) of the English Longitudinal Study of Ageing. Transitions in living arrangements over this period were identified. Mortality status was ascertained from linked national mortality registers. Cox proportional hazards analysis was used to examine the association between living alone and mortality over an average 8.5 year follow-up period. RESULTS An association was found between living alone at wave 4 and mortality (hazard ratio (HR): 1.20, 95% CI 1.04-1.38) in a model adjusted for multiple factors including socioeconomic status, physical health, health behaviours and loneliness. We also found that participants who moved to living alone after divorce or bereavement had a higher risk of mortality compared with those who lived with others at both time points (HR: 1.34, 95% CI 1.01-1.79), while those who moved to living alone for other reasons did not show an increased mortality risk. CONCLUSIONS The relationship between living alone and mortality is complicated by the reasons underlying not living with others. A greater understanding of these dynamics will help to identify the individuals who are at particular health risk because of their living arrangements.
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Affiliation(s)
- Jessica G Abell
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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Chiu YJ, Tu HH, Kung ML, Wu HJ, Chen YW. Fluoxetine ameliorates high-fat diet-induced metabolic abnormalities partially via reduced adipose triglyceride lipase-mediated adipocyte lipolysis. Biomed Pharmacother 2021; 141:111848. [PMID: 34198047 DOI: 10.1016/j.biopha.2021.111848] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/15/2021] [Accepted: 06/24/2021] [Indexed: 02/06/2023] Open
Abstract
Patients with type 2 diabetes mellitus have more risk to develop depression. Fluoxetine (FLX), a selective serotonin reuptake inhibitor (SSRI), is drug for mood and anxiety disorders. Previous studies showed that FLX could induce weight loss in non-depressed clinically overweight individuals. Although the anti-appetite effect of FLX is well-documented, its potential effects on metabolic abnormalities have not been investigated. In this study, we want to investigate whether FLX could be a therapeutic drug against high fat diet (HFD)-induced metabolic disorder. We generated metabolic disorders and depressed mouse model by feeding HFD for 12 weeks at the age of 8 weeks. Then, mice were intraperitoneally injected once daily with FLX (10 mg/kg or 20 mg/kg) for four weeks. Our results showed that FLX alleviated the HFD-induced metabolic dysfunctions and depressive phenotypes in mice. FLX improved systemic glucose homeostasis, at least in part, by improving visceral white adipose tissue (vWAT) insulin signaling. Moreover, FLX reduced circulating plasma leptin level, and decreased the expression of adipose triglyceride lipase (ATGL) and peroxisome proliferator-activated receptor gamma (PPARγ) in vWAT. Our data revealed that FLX also reduced the triglyceride (TG) accumulation in vWAT. Therefore, these findings suggest that FLX exhibits significant potential on comorbidity of metabolic disorder and depression in mice.
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Affiliation(s)
- Yen-Ju Chiu
- Departments of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ho-Hsiang Tu
- Emergency Department, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Mei-Lang Kung
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Hung-Ju Wu
- Departments of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yun-Wen Chen
- Departments of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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18
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Panagi L, Hackett RA, Steptoe A, Poole L. Enjoyment of life predicts reduced type 2 diabetes incidence over 12 years of follow-up: findings from the English Longitudinal Study of Ageing. J Epidemiol Community Health 2021; 75:297-304. [PMID: 33087402 PMCID: PMC7892367 DOI: 10.1136/jech-2020-214302] [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: 05/19/2020] [Revised: 09/22/2020] [Accepted: 10/04/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Subjective well-being appears to be associated with reduced risk of type 2 diabetes (T2D). However, it is unknown whether this association is similar across different types of well-being. We examined the relationship between hedonic and eudaimonic well-being and incident T2D, and explored the role of sociodemographic, behavioural and clinical factors in these associations. METHODS We used data from 4134 diabetes-free participants from the English Longitudinal Study of Ageing (mean age =64.97). Enjoyment of life and purpose in life were assessed using items from the CASP-19 to reflect hedonic and eudaimonic well-being, respectively. Participants reported T2D diagnosis over 12 years. We used Cox proportional hazards regression analyses and also explored the percentage of association explained by different covariates. RESULTS Results revealed a protective role for enjoyment of life in T2D rate adjusting for sociodemographic (age, sex, wealth, ethnicity, marital status), behavioural (physical activity, smoking, alcohol consumption, body mass index) and clinical (hypertension, coronary heart disease and glycated haemoglobin) characteristics (HR =0.93, p=0.021, 95% CI (0.87, 0.99)). Sociodemographic, behavioural and clinical factors accounted for 27%, 27% and 18% of the association, respectively. The relationship between purpose in life and T2D was non-significant (adjusted HR =0.92, p=0.288, 95% CI (0.78, 1.08)). CONCLUSION This study illustrates how the link between subjective well-being and T2D varies between well-being components. It also demonstrates that sociodemographic, behavioural and clinical factors partially explain this association. Intervention studies examining whether changes in enjoyment of life can help delay T2D onset are warranted.
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Zhang S, Xiang K, Li S, Pan HF. Physical activity and depression in older adults: the knowns and unknowns. Psychiatry Res 2021; 297:113738. [PMID: 33515871 DOI: 10.1016/j.psychres.2021.113738] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 01/15/2021] [Indexed: 12/12/2022]
Abstract
This study provides a comprehensive and updated review of the literature with respect to the relationship between physical activity and depression in older adults. The evidence from both observational studies and experimental studies are collected to present a discussion on the type and dose of physical activity, as well as the underlying mechanisms of physical activity and depression in older adults. Overall, the results from previous studies support a solid inverse relationship between physical activity and depression in older adults, while the dose-effect relationship between them, as well as different effects among different types of physical activities, remains largely unexplored. Depression in older adults is related to an array of negative health outcomes and is more chronic compared to that in younger adults. Physical activity has been regarded as a promising non-pharmaceutical method in treating and preventing depression in older adults. Further experimental work and research need to be done to develop theoretically grounded and evidence-based interventions to better advance our knowledge of this topic and effectively promote physical activity in older adults.
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Affiliation(s)
- Su Zhang
- Department of Physical Education, Anhui University of Finance & Economics, 960 Cao Shan Road, Bengbu, Anhui, China.
| | - Kun Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China.
| | - Shujing Li
- School of Life Science, Bengbu Medical College, 2600 Donghai Avenue, Bengbu, Anhui, China.
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China.
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20
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Siyu Y, Hong L, Qun Y, Hua Q, Kang W, Yibiao D, Wenping W, Qian S, Bo F, Xiaonan R. Effects of exercise training combined with psychological intervention compared to exercise training alone in prediabetes subjects. J Public Health (Oxf) 2020; 42:388-394. [PMID: 32115662 DOI: 10.1093/pubmed/fdaa024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 12/16/2019] [Accepted: 01/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Prior research has confirmed the efficacy of exercise training (ET) in patients with prediabetes. However, whether the effectiveness of a combination of exercise and psychological intervention (EP) is better than ET alone in prediabetes in terms of physiological function, psychological status and glycometabolism has rarely been investigated. METHODS Forty newly diagnosed prediabetes patients (65.3 ± 8.1 years) took part in the study. Subjects were divided into a pure ET group and a combined EP group. Interventions were conducted in 40-50-min sessions twice weekly for 32 weeks. Physiological, psychological and biochemical indicator measurements were taken after pre-, mid- and post-interventions, respectively. RESULTS The main finding confirmed a significant improvement in systolic blood pressure, diastolic blood pressure (DBP) and heart rate, high-density lipoprotein, fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) from pre- to mid- and post-test differentially in both groups (P < 0.05) by post hoc analyses. The EP group has a greater magnitude of improvement of DBP than the ET group. Significant differences were observed in FPG at mid-intervention and total cholesterol at post-intervention between the ET and EP groups. Self-Rating Anxiety Scale (SAS) scores of EP group were significantly less than ET group after post-intervention. CONCLUSION Our results suggest that EP might be a promising method lead to more apparent long-term effects on glycometabolism and psychological status for prediabetes patients. Other domains were improved by both interventions, but no typical pattern could be identified. Its underlying mechanisms need further study, and directions for future research are suggested.
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Affiliation(s)
- Yu Siyu
- Shanghai Pudong New Area Center for Disease Control and Prevention, Pudong Institute of Preventive Medicine, Fudan University, Shanghai 200136, China
| | - Liu Hong
- Health Service Center of Gaoqiao Community, Pudong New Area, Shanghai 200137, China
| | - Yan Qun
- Shanghai Dongfang Hospital, Shanghai 200120, China
| | - Qiu Hua
- Shanghai Pudong New Area Center for Disease Control and Prevention, Pudong Institute of Preventive Medicine, Fudan University, Shanghai 200136, China
| | - Wu Kang
- Shanghai Pudong New Area Center for Disease Control and Prevention, Pudong Institute of Preventive Medicine, Fudan University, Shanghai 200136, China
| | - Ding Yibiao
- Health Service Center of Gaoqiao Community, Pudong New Area, Shanghai 200137, China
| | - Wang Wenping
- Health Service Center of Gaoqiao Community, Pudong New Area, Shanghai 200137, China
| | - She Qian
- Health Service Center of Gaoqiao Community, Pudong New Area, Shanghai 200137, China
| | - Feng Bo
- Shanghai Dongfang Hospital, Shanghai 200120, China
| | - Ruan Xiaonan
- Shanghai Pudong New Area Center for Disease Control and Prevention, Pudong Institute of Preventive Medicine, Fudan University, Shanghai 200136, China
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Dang L, Dong L, Mezuk B. Shades of Blue and Gray: A Comparison of the Center for Epidemiologic Studies Depression Scale and the Composite International Diagnostic Interview for Assessment of Depression Syndrome in Later Life. THE GERONTOLOGIST 2020; 60:e242-e253. [PMID: 31112598 PMCID: PMC7228460 DOI: 10.1093/geront/gnz044] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Psychiatric research lacks the equivalent of a thermometer, that is, a tool that accurately measures mental disorder regardless of context. Instead, the psychometric properties of scales that purport to assess psychopathology must be continuously evaluated. To that end, this study evaluated the diagnostic agreement between the eight-item Center for Epidemiologic Studies Depression Scale (CESD-8) and the Composite International Diagnostic Interview-short form (CIDI-SF) in the Health and Retirement Study (HRS). RESEARCH DESIGN AND METHODS Data come from 17,613 respondents aged >50 from the 2014 wave of the HRS. Kappa coefficients were used to assess the agreement between the 2 instruments on depression classification across a range of thresholds for identifying case status, including variation across subgroups defined by age, race/ethnicity, and gender. RESULTS The point prevalence of depression syndrome estimated by the CESD was higher than that estimated by the CIDI-SF (CESD: 9.9%-19.5% depending on the cutoff applied to the CESD vs CIDI-SF: 7.7%). Assuming CIDI-SF as the gold standard, the CESD yielded a sensitivity of 56.2%-70.2% and specificity of 84.7%-94.0% across the range of cutoffs. The agreement on depression classification was weak (κ = 0.32-0.44). DISCUSSION AND IMPLICATIONS Depression cases identified by the CESD have poor agreement with those identified by the CIDI-SF. Conceptually, psychological distress as measured by the CESD is not interchangeable with depression syndrome as measured by the CIDI-SF. Population estimates of depression among older adults based on the CESD should be interpreted with caution.
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Affiliation(s)
- Linh Dang
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Liming Dong
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor
| | - Briana Mezuk
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor
- Research Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor
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Postolache TT, del Bosque-Plata L, Jabbour S, Vergare M, Wu R, Gragnoli C. Co-shared genetics and possible risk gene pathway partially explain the comorbidity of schizophrenia, major depressive disorder, type 2 diabetes, and metabolic syndrome. Am J Med Genet B Neuropsychiatr Genet 2019; 180:186-203. [PMID: 30729689 PMCID: PMC6492942 DOI: 10.1002/ajmg.b.32712] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 11/16/2018] [Accepted: 12/07/2018] [Indexed: 12/20/2022]
Abstract
Schizophrenia (SCZ) and major depressive disorder (MDD) in treatment-naive patients are associated with increased risk for type 2 diabetes (T2D) and metabolic syndrome (MetS). SCZ, MDD, T2D, and MetS are often comorbid and their comorbidity increases cardiovascular risk: Some risk genes are likely co-shared by them. For instance, transcription factor 7-like 2 (TCF7L2) and proteasome 26S subunit, non-ATPase 9 (PSMD9) are two genes independently reported as contributing to T2D and SCZ, and PSMD9 to MDD as well. However, there are scarce data on the shared genetic risk among SCZ, MDD, T2D, and/or MetS. Here, we briefly describe T2D, MetS, SCZ, and MDD and their genetic architecture. Next, we report separately about the comorbidity of SCZ and MDD with T2D and MetS, and their respective genetic overlap. We propose a novel hypothesis that genes of the prolactin (PRL)-pathway may be implicated in the comorbidity of these disorders. The inherited predisposition of patients with SCZ and MDD to psychoneuroendocrine dysfunction may confer increased risk of T2D and MetS. We illustrate a strategy to identify risk variants in each disorder and in their comorbid psychoneuroendocrine and mental-metabolic dysfunctions, advocating for studies of genetically homogeneous and phenotype-rich families. The results will guide future studies of the shared predisposition and molecular genetics of new homogeneous endophenotypes of SCZ, MDD, and metabolic impairment.
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Affiliation(s)
- Teodor T. Postolache
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, Maryland,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Denver, Colorado,Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, Maryland
| | - Laura del Bosque-Plata
- National Institute of Genomic Medicine, Nutrigenetics and Nutrigenomic Laboratory, Mexico City, Mexico
| | - Serge Jabbour
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolic Disease, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Michael Vergare
- Department of Psychiatry and Human Behavior, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Rongling Wu
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania,Department of Statistics, Penn State College of Medicine, Hershey, Pennsylvania
| | - Claudia Gragnoli
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolic Disease, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania,Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania,Molecular Biology Laboratory, Bios Biotech Multi-Diagnostic Health Center, Rome, Italy
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Poole L, Jackowska M. The association between depressive and sleep symptoms for predicting incident disease onset after 6-year follow-up: findings from the English Longitudinal Study of Ageing. Psychol Med 2019; 49:607-616. [PMID: 29807551 PMCID: PMC6378411 DOI: 10.1017/s0033291718001290] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 04/10/2018] [Accepted: 04/18/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The independent effects of depressive symptoms and sleep problems for future physical illness risk have yet to be studied systematically across a variety of disease endpoints. METHODS We analysed data from 7395 participants (65.81 ± 9.39 years; 54.8% female) from the English Longitudinal Study of Ageing (ELSA). Baseline was wave 4 and participants were followed up for 6 years until wave 7. Sleep was measured using an adapted version of the Jenkins Sleep Problems questionnaire and depressive symptoms using the Centre for Epidemiological Studies Depression scale. Participants with the illness of interest at baseline [coronary heart disease (CHD), cancer, diabetes/high blood glucose, arthritis] were excluded from models predicting the onset of that illness at follow-up. Logistic regression was used, entering depressive symptoms and sleep problems simultaneously into models controlling for a wide range of covariates. RESULTS In fully adjusted models depressive symptoms predicted incident CHD (OR 1.11, 95% CI 1.04-1.20, p = 0.004) and diabetes/high blood glucose (OR 1.13, 95% CI 1.04-1.22, p = 0.002) independent of sleep problems; both depressive symptoms (OR 1.10, 95% CI 1.04-1.16, p = 0.002) and sleep problems (OR 1.14, 95% CI 1.02-1.26, p = 0.019) predicted incident arthritis. CONCLUSIONS Sleep problems and depressive symptoms, and a combination of both, were differentially associated with physical illness onset 6 years later. Our findings highlight the importance of taking into account somatic and affective experiences when looking across a variety of different physical illnesses.
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Affiliation(s)
- Lydia Poole
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Marta Jackowska
- Department of Psychology, University of Roehampton, London, SW15 4JD, UK
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24
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Luo Y, Zhu D, Nicholas S, He P. Depressive symptoms, health behaviors and risk of diabetes in Chinese mid-aged and older adults. J Affect Disord 2019; 246:783-788. [PMID: 30623824 DOI: 10.1016/j.jad.2018.12.131] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/25/2018] [Accepted: 12/26/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE While diabetes links with comorbidity of depression, there is no evidence in China regarding whether health behaviors modified the effect of depressive symptoms on diabetes. This study examined the influence of depressive symptoms on the incident diabetes, and investigated whether health behavior was a moderator in the depression-diabetes relationship in Chinese mid-aged and older adults. METHODS Using data from the China Health and Retirement Longitudinal 2011-2015 Study, the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) short form was used to measure depressive symptoms in 47,671 Chinese mid-aged and older adults. Diabetes was diagnosed through self-reported measures. We used random effect logistic regression models to examine the effect of depressive symptoms on the incidence of depressive symptoms. RESULTS Participants with depressive symptoms were more likely to suffer from diabetes than their non-depressive symptoms counterparts, with an odds ratio (OR) of 1.33 (95% CI: 1.13, 1.58). We found that unhealthy behaviors moderated the influence of depressive symptoms on risk of diabetes (OR = 1.01, 95% CI = 1.01, 1.02), indicating that depressive symptoms patients with two or more unhealthy behaviors had a higher risk of diabetes compared with their peers without unhealthy behaviors. CONCLUSION Our findings suggested that depressive symptoms were a risk factor in developing diabetes, and that response to this factor varied by individuals' health behaviors. Clinicians should be aware of increased risk of elevated diabetes in population with depressive symptoms and consider routine screening for depressive symptoms among them.
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Affiliation(s)
- Yanan Luo
- Institute of Population Research, Peking University, Beijing, China
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China. Tel/Fax: 86-010-82805709
| | - Stephen Nicholas
- School of Economics and School of Management, Tianjin Normal University, West Bin Shui Avenue, Tianjin 300074, China; Guangdong Research Institute for International Strategies, Guangdong University of Foreign Studies, 2 Baiyun North Avenue, Baiyun, Guangzhou, Guangdong 510420, China; Top Education Institute, 1 Central Avenue, Australian Technology Park, Eveleigh, Sydney, NSW 2015, Australia; Newcastle Business School, University of Newcastle, University Drive, Newcastle, NSW, Australia
| | - Ping He
- China Center for Health Development Studies, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China. Tel/Fax: 86-010-82805709.
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25
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Panagi L, Poole L, Hackett RA, Steptoe A. Sex differences in interleukin-6 stress responses in people with Type 2 diabetes. Psychophysiology 2019; 56:e13334. [PMID: 30666661 PMCID: PMC6563423 DOI: 10.1111/psyp.13334] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/31/2018] [Accepted: 11/28/2018] [Indexed: 12/17/2022]
Abstract
People with Type 2 diabetes (T2D) show dysregulated inflammatory responses to acute stress, but the effect of sex on inflammatory responses in T2D remains unclear. The purpose of this study was to investigate differences in interleukin (IL)-6 stress responses between older men and women with T2D. One hundred and twenty-one people (76 men; mean age = 64.09, SD = 7.35, 45 women; mean age = 63.20, SD = 6.70) with doctor-verified T2D took part in this laboratory-based stress testing study. Participants carried out acute mental stress tasks, and blood was sampled at baseline, immediately poststress, 45 min poststress, and 75 min poststress to detect plasma IL-6 concentrations. IL-6 change scores were computed as the difference between the baseline measurement and the three time points poststress. Main effects and interactions were tested using mixed model analysis of covariance. We found a significant main effect of time on IL-6 levels, and a significant Sex × Time interaction. In adjusted analyses including the three change scores and all the covariates, the significant Sex × Time interaction was maintained; IL-6 responses were greater in women at 45 and 75 min poststress compared with men, adjusting for age, body mass index, smoking, household income, glycated hemoglobin, oral antidiabetic medication, insulin/other injectable antidiabetic medication, depressive symptoms, and time of day of testing. Different inflammatory stress response pathways are present in men and women with T2D, with women producing larger IL-6 increases. The long-term implications of these differences need to be elucidated in future studies.
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Affiliation(s)
- Laura Panagi
- Research Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Lydia Poole
- Research Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Ruth A Hackett
- Research Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Andrew Steptoe
- Research Department of Behavioural Science and Health, University College London, London, United Kingdom
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26
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Schrempft S, Jackowska M, Hamer M, Steptoe A. Associations between social isolation, loneliness, and objective physical activity in older men and women. BMC Public Health 2019; 19:74. [PMID: 30651092 PMCID: PMC6335852 DOI: 10.1186/s12889-019-6424-y] [Citation(s) in RCA: 263] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/10/2019] [Indexed: 02/08/2023] Open
Abstract
Background The impact of social isolation and loneliness on health risk may be mediated by a combination of direct biological processes and lifestyle factors. This study tested the hypothesis that social isolation and loneliness are associated with less objective physical activity and more sedentary behavior in older adults. Methods Wrist-mounted accelerometers were worn over 7 days by 267 community-based men (n = 136) and women (n = 131) aged 50–81 years (mean 66.01), taking part in the English Longitudinal Study of Ageing (ELSA; wave 6, 2012–13). Associations between social isolation or loneliness and objective activity were analyzed using linear regressions, with total activity counts and time spent in sedentary behavior and light and moderate/vigorous activity as the outcome variables. Social isolation and loneliness were assessed with standard questionnaires, and poor health, mobility limitations and depressive symptoms were included as covariates. Results Total 24 h activity counts were lower in isolated compared with non-isolated respondents independently of gender, age, socioeconomic status, marital status, smoking, alcohol consumption, self-rated health, limiting longstanding illness, mobility limitations, depressive symptoms, and loneliness (β = − 0.130, p = 0.028). Time spent in sedentary behavior over the day and evening was greater in isolated participants (β = 0.143, p = 0.013), while light (β = − 0.143, p = 0.015) and moderate/vigorous (β = − 0.112, p = 0.051) physical activity were less frequent. Physical activity was greater on weekdays than weekend days, but associations with social isolation were similar. Loneliness was not associated with physical activity or sedentary behavior in multivariable analysis. Conclusions These findings suggest that greater social isolation in older men and women is related to reduced everyday objective physical activity and greater sedentary time. Differences in physical activity may contribute to the increased risk of ill-health and poor wellbeing associated with isolation.
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Affiliation(s)
- Stephanie Schrempft
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Marta Jackowska
- Department of Psychology, University of Roehampton, London, SW15 5PJ, UK.,Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Mark Hamer
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.,Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
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27
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Poole L, Steptoe A. Depressive symptoms predict incident chronic disease burden 10 years later: Findings from the English Longitudinal Study of Ageing (ELSA). J Psychosom Res 2018; 113:30-36. [PMID: 30190045 DOI: 10.1016/j.jpsychores.2018.07.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/18/2018] [Accepted: 07/18/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess the association between depressive symptoms and incident chronic illness burden in prospective longitudinal analyses. METHODS We analysed data from 2472 participants (62.88 ± 8.49 years old; 50.8% female) from the English Longitudinal Study of Ageing (ELSA). Depressive symptoms were measured using the Centre for Epidemiological Studies Depression (CES-D) scale at baseline in 2004, and participants were followed up for 10 years. Participants with prevalent illness at baseline (coronary heart disease [CHD], other cardiac illness, stroke, cancer, diabetes/high blood glucose, arthritis, lung disease, osteoporosis and Parkinson's disease) were excluded from models predicting illness burden (the sum of illnesses reported) over follow-up. Linear regression was used controlling for a wide range of covariates. RESULTS The mean chronic illness burden was 0.57, with 43.1% experiencing at least one incident physical illness. Baseline continuous CES-D score was a significant predictor of incident chronic illness burden up to 10 years later (incident rate ratio = 1.05, 95% confidence intervals = 0.05-0.21, p = .003), independent of sociodemographic, behavioural, cognitive and clinical covariates. Sensitivity analyses excluding participants who developed a chronic illness within the 2 years following baseline corroborated the main results. CONCLUSION Depressive symptoms were associated with greater incident chronic illness burden 10 years later. These findings have clinical implications for the treatment of depression in physically healthy older adults.
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Affiliation(s)
- Lydia Poole
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom.
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom
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Subjective social status and mortality: the English Longitudinal Study of Ageing. Eur J Epidemiol 2018; 33:729-739. [PMID: 29779203 PMCID: PMC6061136 DOI: 10.1007/s10654-018-0410-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 05/10/2018] [Indexed: 11/05/2022]
Abstract
Self-perceptions of own social position are potentially a key aspect of socioeconomic inequalities in health, but their association with mortality remains poorly understood. We examined whether subjective social status (SSS), a measure of the self-perceived element of social position, was associated with mortality and its role in the associations between objective socioeconomic position (SEP) measures and mortality. We used Cox regression to model the associations between SSS, objective SEP measures and mortality in a sample of 9972 people aged ≥ 50 years from the English Longitudinal Study of Ageing over a 10-year follow-up (2002–2013). Our findings indicate that SSS was associated with all-cause, cardiovascular, cancer and other mortality. A unit decrease in the 10-point continuous SSS measure increased by 24 and 8% the mortality risk of people aged 50–64 and ≥ 65 years, respectively, after adjustment for age, sex and marital status. The respective estimates for cardiovascular mortality were 36 and 11%. Adjustment for all covariates fully explained the association between SSS and cancer mortality, and partially the remaining associations. In people aged 50–64 years, SSS mediated to a varying extent the associations between objective SEP measures and all-cause mortality. In people aged ≥ 65 years, SSS mediated to a lesser extent these associations, and to some extent was associated with mortality independent of objective SEP measures. Nevertheless, in both age groups, wealth partially explained the association between SSS and mortality. In conclusion, SSS is a strong predictor of mortality at older ages, but its role in socioeconomic inequalities in mortality appears to be complex.
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29
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Graham E, Au B, Schmitz N. Depressive symptoms, prediabetes, and incident diabetes in older English adults. Int J Geriatr Psychiatry 2017; 32:1450-1458. [PMID: 27892613 DOI: 10.1002/gps.4634] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The objective of this study was to assess the risk of diabetes in older adults with elevated depressive symptoms, prediabetes, or both. METHOD This study included 4129 participants from the English Longitudinal Study of Ageing. Participants were followed from Wave 2 (2004-2005) to Wave 6 (2012-2013). The 8-item Centre for Epidemiologic Studies Depression (CESD) scale was used to measure depressive symptoms in the past week, which were categorized as no/low, mild, or high. Normal glucose levels and prediabetes were defined using baseline haemoglobin A1c measurements. Incident diagnosed diabetes was reported by participants. Cox regression estimated hazard ratios of incident diabetes associated with depressive symptoms and prediabetes. RESULTS A total of 157 participants were diagnosed with diabetes over a mean of 6.7 years. Relative to participants with normal glucose levels and no/low depressive symptoms at baseline, the adjusted hazard ratios were 0.85 (95% CI 0.40-1.82) and 1.62 (95% CI 0.84-3.15) for those with normal glucose levels and mild depressive symptoms and normal glucose levels and high depressive symptoms. The adjusted hazard ratios for participants with prediabetes and no/low depressive symptoms, mild depressive symptoms, and high depressive symptoms were 4.84 (95% CI 3.08-7.60), 7.17 (95% CI 4.00-12.88), and 7.77 (95% CI 4.33-13.93), respectively. CONCLUSIONS Older adults with elevated depressive symptoms and prediabetes have an increased risk of diabetes compared to those with only one of these risk factors. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Eva Graham
- Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Bonnie Au
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Norbert Schmitz
- Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Montreal Diabetes Research Centre, Montreal, Quebec, Canada
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30
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Zhuang QS, Shen L, Ji HF. Quantitative assessment of the bidirectional relationships between diabetes and depression. Oncotarget 2017; 8:23389-23400. [PMID: 28177893 PMCID: PMC5410312 DOI: 10.18632/oncotarget.15051] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/09/2017] [Indexed: 01/07/2023] Open
Abstract
Diabetes and depression impose an enormous public health burden and the present study aimed to assess quantitatively the bidirectional relationships between the two disorders. We searched databases for eligible articles published until October 2016. A total of 51 studies were finally included in the present bidirectional meta-analysis, among which, 32 studies were about the direction of depression leading to diabetes, and 24 studies about the direction of diabetes leading to depression. Pooled results of the 32 eligible studies covering 1274337 subjects showed that depression patients were at higher risk for diabetes (odds ratio (OR) = 1.34, 95% confidence intervals (CI) = [1.23, 1.46]) than non-depressive subjects. Further gender-subgroup analysis found that the strength of this relationship was stronger in men (OR = 1.63, 95%CI = [1.48, 1.78]) than in women (OR = 1.29, 95%CI = [1.07, 1.51]). For the direction of diabetes leading to depression, pooled data of 24 articles containing 329658 subjects showed that patients with diabetes were at higher risk for diabetes (OR = 1.28, 95%CI = [1.15, 1.42]) than non-diabetic subjects. The available data supports that the relationships between diabetes and depression are bidirectional and the overall strengths are similar in both directions. More mechanistic studies are encouraged to explore the molecular mechanisms underlying the relationships between the two diseases.
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Affiliation(s)
- Qi-Shuai Zhuang
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, P. R. China
| | - Liang Shen
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, P. R. China
| | - Hong-Fang Ji
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, P. R. China
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31
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Su WJ, Peng W, Gong H, Liu YZ, Zhang Y, Lian YJ, Cao ZY, Wu R, Liu LL, Wang B, Wang YX, Jiang CL. Antidiabetic drug glyburide modulates depressive-like behavior comorbid with insulin resistance. J Neuroinflammation 2017; 14:210. [PMID: 29084550 PMCID: PMC5663104 DOI: 10.1186/s12974-017-0985-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/23/2017] [Indexed: 12/12/2022] Open
Abstract
Background Abundant reports indicated that depression was often comorbid with type 2 diabetes and even metabolic syndrome. Considering they might share common biological origins, it was tentatively attributed to the chronic cytokine-mediated inflammatory response which was induced by dysregulation of HPA axis and overactivation of innate immunity. However, the exact mechanisms remain obscure. Herein, we mainly focused on the function of the NLRP3 inflammasome to investigate this issue. Methods Male C57BL/6 mice were subjected to 12 weeks of chronic unpredictable mild stress (CUMS), some of which were injected with glyburide or fluoxetine. After CUMS procedure, behavioral and metabolic tests were carried out. In order to evaluate the systemic inflammation associated with inflammasome activation, IL-1β and inflammasome components in hippocampi and pancreases, as well as corticosterone and IL-1β in serum were detected separately. Moreover, immunostaining was performed to assess morphologic characteristics of pancreases. Results In the present study, we found that 12 weeks’ chronic stress resulted in depressive-like behavior comorbid with insulin resistance. Furthermore, antidiabetic drug glyburide, an inhibitor of the NLRP3 inflammasome, was discovered to be effective in preventing the experimental comorbidity. In brief, it improved behavioral performance, ameliorated insulin intolerance as well as insulin signaling in the hippocampus possibly through inhibiting NLRP3 inflammasome activation by suppressing the expression of TXNIP. Conclusions All these evidence supported our hypothesis that chronic stress led to comorbidity of depressive-like behavior and insulin resistance via long-term mild inflammation. More importantly, based on the beneficial effects of blocking the activation of the NLRP3 inflammasome, we provided a potential therapeutic target for clinical comorbidity and a new strategy for management of both diabetes and depression.
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Affiliation(s)
- Wen-Jun Su
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Wei Peng
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Hong Gong
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Yun-Zi Liu
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Yi Zhang
- Department of Psychiatry, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Yong-Jie Lian
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Zhi-Yong Cao
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China.,Department of Psychiatry, The 102nd Hospital of PLA, 55 North Heping Road, Changzhou, China
| | - Ran Wu
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Lin-Lin Liu
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Bo Wang
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Yun-Xia Wang
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Chun-Lei Jiang
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China.
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32
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Symptoms of anxiety and depression in type 2 diabetes: Associations with clinical diabetes measures and self-management outcomes in the Norwegian HUNT study. Psychoneuroendocrinology 2017; 84:116-123. [PMID: 28704763 DOI: 10.1016/j.psyneuen.2017.07.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 05/28/2017] [Accepted: 07/04/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To determine if symptoms of depression and anxiety are differentially associated with clinical diabetes measures and self-management behaviours in individuals with Type 2 diabetes, and whether these associations vary by patient sex. RESEARCH DESIGN AND METHODS A cross-sectional analysis using data from 2035 adults with Type 2 diabetes in the Nord-Trøndelag Health Study. Multivariate logistic regression was used to explore associations between symptoms of depression and anxiety and waist girth, HDL cholesterol, systolic blood pressure, triglycerides, c-reactive protein, glycemic control, diet adherence, exercise, glucose monitoring, foot checks for ulcers, and the subjective patient experience. Analyses were stratified by sex. RESULTS Depression was associated with a lower likelihood of avoiding saturated fats (OR=0.20 [95% CI: 0.06, 0.68]) and increased odds of physical inactivity (OR=1.69 [95% CI: 1.37, 2.72]). Anxiety was associated with increased odds of eating vegetables (OR=1.66 [95% CI: 1.02, 2.73]), and an over two-fold increase of feeling that having diabetes is difficult. In women, anxiety was associated with elevated c-reactive protein levels (OR=1.57 [95% CI: 1.05, 2.34]). In men, depressive symptoms were associated with elevated HbA1c (OR=5.00 [95% CI: 1.15, 8.23). CONCLUSIONS Symptoms of depression and anxiety were differentially associated with some key diabetes-related measures. Our results suggest sex-specific differences with respect to two important clinical outcomes (i.e., anxiety and CRP in women and depression and glycemic control in men). These findings should alert practitioners to the importance of detection and management of psychological symptoms in individuals with Type 2 diabetes.
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Hwa Hsu C, Tung HH, Clinciu DL, Chen LK, Yin WH, Iqbal U, Wang TJ. Physical activity: A primary health quality determinant among community-dwelling geriatric women in Taiwan. Int J Qual Health Care 2017; 29:792-796. [DOI: 10.1093/intqhc/mzx101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 08/03/2017] [Indexed: 01/10/2023] Open
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Laursen KR, Hulman A, Witte DR, Terkildsen Maindal H. Social relations, depressive symptoms, and incident type 2 diabetes mellitus: The English Longitudinal Study of Ageing. Diabetes Res Clin Pract 2017; 126:86-94. [PMID: 28236722 DOI: 10.1016/j.diabres.2017.01.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 12/10/2016] [Accepted: 01/10/2017] [Indexed: 12/21/2022]
Abstract
AIMS We examined whether social relations are associated with the risk of developing type 2 diabetes mellitus (T2DM) and furthermore, whether social relations modify the association between depressive symptoms and incident T2DM. We hypothesized that the risk of developing T2DM would be lower for individuals with stronger social relations compared to those with weaker social relations, and that the association between depressive symptoms and incident T2DM would be attenuated for those with stronger social relations. METHODS Non-diabetic participants (n=7662) of the "English Longitudinal Study of Ageing" (3398 men) aged 50-91years were followed until 2012/2013, after baseline assessment of depressive symptoms, social support, relational strain, and network size. Hazard ratios (HR) for incident diabetes were calculated using Cox proportional hazard models, adjusting for relevant confounders. RESULTS Age and sex adjusted HRs showed that social relations were associated with incident diabetes (Support: HR 0.98 95% CI 0.97; 0.99, Strain: HR 1.02 95% CI 1.01; 1.04, Networklimited: HR 1.19 95% CI 0.98; 1.44), however, when adjusted for age, sex, ethnicity, marital status, household wealth, health behaviour, and body mass index the associations were attenuated and were no longer statistically significant. Depressive symptoms were associated with higher diabetes risk. This effect was not modified by any of the social variables. CONCLUSIONS People with stronger social relations are at lower risk of developing T2DM; however, this effect is largely explained by known diabetes risk factors. No evidence was found that stronger social relations reduce the association between depressive symptoms and incident T2DM.
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Affiliation(s)
| | - Adam Hulman
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark; Danish Diabetes Academy, Sdr. Boulevard 29, 5000 Odense, Denmark
| | - Daniel R Witte
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark; Danish Diabetes Academy, Sdr. Boulevard 29, 5000 Odense, Denmark
| | - Helle Terkildsen Maindal
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark; Steno Diabetes Center, Health Promotion Research, Niels Steensens Vej 2, 2820 Gentofte, Denmark
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Impact of Muscarinic M 3 Receptor Antagonism on the Risk of Type 2 Diabetes in Antidepressant-Treated Patients: A Case-Controlled Study. CNS Drugs 2017; 31:483-493. [PMID: 28527131 PMCID: PMC5488147 DOI: 10.1007/s40263-017-0436-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND M3 muscarinic receptor antagonism has been associated with glucose intolerance and disturbance of insulin secretion. OBJECTIVE Our objective was to examine the risk of type 2 diabetes mellitus (T2DM) in patients using antidepressants with and without M3 muscarinic receptor antagonism (AD_antaM3 and AD_nonantaM3, respectively). METHODS We designed a case-control study using a pharmacy prescription database. We selected a cohort of patients who initiated antidepressant use between the ages of 20 and 40 years and who did not receive any anti-diabetic prescriptions at baseline. Cases were defined as those who developed T2DM [i.e., receiving oral anti-diabetic medication, Anatomical Therapeutic Chemical (ATC) code A10B] during the follow-up period (1994-2014), and ten random controls were picked for each case from the cohort of patients who did not develop T2DM. RESULTS A total of 530 cases with incident T2DM and 5300 controls were included. Compared with no use of antidepressants during the previous 2 years, recent (within the last 6 months) exposure to AD_antaM3 was associated with a moderately increased risk of T2DM: adjusted odds ratio 1.55 (95% confidence interval 1.18-2.02). In the stratified analyses, this association was dose dependent (>365 defined daily doses) and significant for patients who were in the younger age group (<45 years at the end of follow-up), were female and had no co-morbidity. On the other hand, recent exposure to AD_nonantaM3 was not associated with a risk for T2DM in any of our analyses. CONCLUSION Our results suggest that exposure to AD_antaM3 was associated with the development of T2DM among antidepressant users.
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Zaninotto P, Wardle J, Steptoe A. Sustained enjoyment of life and mortality at older ages: analysis of the English Longitudinal Study of Ageing. BMJ 2016; 355:i6267. [PMID: 27965194 PMCID: PMC5154976 DOI: 10.1136/bmj.i6267] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To test whether the number of reports of enjoyment of life over a four year period is quantitatively associated with all cause mortality, and with death from cardiovascular disease and from other causes. DESIGN AND SETTING Longitudinal observational population study using the English Longitudinal Study of Ageing (ELSA), a nationally representative sample of older men and women living in England. PARTICIPANTS 9365 men and women aged 50 years or older (mean 63, standard deviation 9.3) at recruitment. MAIN OUTCOME MEASURES Time to death, based on mortality between the third phase of data collection (wave 3 in 2006) and March 2013 (up to seven years). RESULTS Subjective wellbeing with measures of enjoyment of life were assessed in 2002 (wave 1), 2004 (wave 2), and 2006 (wave 3). 2264 (24%) respondents reported no enjoyment of life on any assessment, with 1833 (20%) reporting high enjoyment on one report of high enjoyment of life, 2063 (22%) on two reports, and 3205 (34%) on all three occasions. 1310 deaths were recorded during follow-up. Mortality was inversely associated with the number of occasions on which participants reported high enjoyment of life. Compared with the no high enjoyment group, the hazard ratio for all cause mortality was 0.83 (95% confidence interval 0.70 to 0.99) for two reports of enjoyment of life, and 0.76 (0.64 to 0.89) for three reports, after adjustment for demographic factors, baseline health, mobility impairment, and depressive symptoms. The same association was observed after deaths occurring within two years of the third enjoyment measure were excluded (0.90 (0.85 to 0.95) for every additional report of enjoyment), and in the complete case analysis (0.90 (0.83 to 0.96)). CONCLUSIONS This is an observational study, so causal conclusions cannot be drawn. Nonetheless, the results add a new dimension to understanding the significance of subjective wellbeing for health outcomes by documenting the importance of sustained wellbeing over time.
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Affiliation(s)
- Paola Zaninotto
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Jane Wardle
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
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Freitas C, Deschênes S, Au B, Smith K, Schmitz N. Risk of Diabetes in Older Adults with Co-Occurring Depressive Symptoms and Cardiometabolic Abnormalities: Prospective Analysis from the English Longitudinal Study of Ageing. PLoS One 2016; 11:e0155741. [PMID: 27227974 PMCID: PMC4882076 DOI: 10.1371/journal.pone.0155741] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 05/03/2016] [Indexed: 11/18/2022] Open
Abstract
High depressive symptoms and cardiometabolic abnormalities are independently associated with an increased risk of diabetes. The purpose of this study was to assess the association of co-occurring depressive symptoms and cardiometabolic abnormalities on risk of diabetes in a representative sample of the English population aged 50 years and older. Data were from the English Longitudinal Study of Ageing. The sample comprised of 4454 participants without diabetes at baseline. High depressive symptoms were based on a score of 4 or more on the 8-item binary Centre for Epidemiologic Studies–Depression scale. Cardiometabolic abnormalities were defined as 3 or more cardiometabolic risk factors (hypertension, impaired glycemic control, systemic inflammation, low high-density lipoprotein cholesterol, high triglycerides, and central obesity). Cox proportional hazards regressions assessed the association between co-occurring depressive symptoms and cardiometabolic abnormalities with incidence of diabetes. Multiple imputation by chained equations was performed to account for missing data. Covariates included age, sex, education, income, smoking status, physical activity, alcohol consumption, and cardiovascular comorbidity. The follow-up period consisted of 106 months, during which 193 participants reported a diagnosis of diabetes. Diabetes incidence rates were compared across the following four groups: 1) no or low depressive symptoms and no cardiometabolic abnormalities (reference group, n = 2717); 2) high depressive symptoms only (n = 338); 3) cardiometabolic abnormalities only (n = 1180); and 4) high depressive symptoms and cardiometabolic abnormalities (n = 219). Compared to the reference group, the hazard ratio for diabetes was 1.29 (95% CI 0.63, 2.64) for those with high depressive symptoms only, 3.88 (95% CI 2.77, 5.44) for those with cardiometabolic abnormalities only, and 5.56 (95% CI 3.45, 8.94) for those with both high depressive symptoms and cardiometabolic abnormalities, after adjusting for socio-demographic, lifestyle and clinical variables. These findings suggest that those with high depressive symptoms and cardiometabolic abnormalities are at a particularly increased risk of type 2 diabetes.
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Affiliation(s)
- Cassandra Freitas
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
- * E-mail:
| | - Sonya Deschênes
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Bonnie Au
- Primary Care Research Unit, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Kimberley Smith
- Department of Life Sciences, Brunel University London, Uxbridge, Middlesex, England
| | - Norbert Schmitz
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Schmitz N, Deschênes S, Burns R, Smith KJ. Depressive symptoms and glycated hemoglobin A1c: a reciprocal relationship in a prospective cohort study. Psychol Med 2016; 46:945-955. [PMID: 26620309 DOI: 10.1017/s0033291715002445] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the dynamic association between depressive symptoms and glycated hemoglobin A1c (HbA1c) levels using data from the English Longitudinal Study of Ageing (ELSA). METHOD The sample was comprised of 2886 participants aged ⩾50 years who participated in three clinical assessments over an 8-year period (21% with prediabetes and 7% with diabetes at baseline). Structural equation models were used to address reciprocal associations between depressive symptoms and HbA1c levels and to evaluate the mediating effects of lifestyle-related behaviors and cardiometabolic factors. RESULTS We found a reciprocal association between depressive symptoms and HbA1c levels: depressive symptoms at one assessment point predicted HbA1c levels at the next assessment point (standardized β = 0.052) which in turn predicted depressive symptoms at the following assessment point (standardized β = 0.051). Mediation analysis suggested that both lifestyle-related behaviors and cardiometabolic factors might mediate the association between depressive symptoms and HbA1c levels: depressive symptoms at baseline predicted lifestyle-related behaviors and cardiometabolic factors at the next assessment, which in turn predicted HbA1c levels 4 years later. A similar association was observed for the other direction: HbA1c levels at baseline predicted lifestyle-related behaviors and cardiometabolic factors at the next assessment, which in turn predicted depressive symptoms 4 years later. CONCLUSIONS Our results suggest a dynamic relationship between depressive symptoms and HbA1c which might be mediated by both lifestyle and cardiometabolic factors. This has important implications for investigating the pathways which could link depressive symptoms and increased risk of diabetes.
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Affiliation(s)
- N Schmitz
- Department of Psychiatry,McGill University,Montreal,Quebec,Canada
| | - S Deschênes
- Department of Psychiatry,McGill University,Montreal,Quebec,Canada
| | - R Burns
- Department of Psychiatry,McGill University,Montreal,Quebec,Canada
| | - K J Smith
- Department of Life Sciences,Brunel University London,Uxbridge,Middlesex,UK
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Elucidating the Biological Mechanisms Linking Depressive Symptoms With Type 2 Diabetes in Men: The Longitudinal Effects of Inflammation, Microvascular Dysfunction, and Testosterone. Psychosom Med 2016; 78:221-32. [PMID: 26575859 DOI: 10.1097/psy.0000000000000263] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This prospective cohort study sought to examine key biological measures linking depressive symptoms with Type 2 diabetes, specifically inflammation, microvascular dysfunction, and androgens. METHODS A cohort of 688 men without diabetes who were 35 years or older were followed up for 5 years. Venous interleukin-6, high-sensitivity C-reactive protein, sE-selectin, endogenous total testosterone, fasting glucose, and glycated hemoglobin (HbA1c) were quantified at baseline and 5 years later. Depressive symptoms were assessed using the Beck Depression Inventory-I, and men were categorized into persistent, remitted, incident, and nondepressed groups (reference). Logistic regression was used to determine odds ratios (ORs) for diabetes adjusted for propensity score calculated from 18 established risk factors. RESULTS Diabetes developed in 112 men (16.3% of sample). Persistent depressive symptoms were associated with diabetes (adjusted OR = 2.45, 95% confidence interval [CI] = 1.16-5.20, p = .019). Baseline testosterone (OR = 0.43, 95% CI = 0.22-0.81, p = .01) and follow-up testosterone (OR = 0.51, 95% CI = 0.31-0.84, p = .008) were inversely associated with Type 2 diabetes. Annualized HbA1c was positively associated with annualized change in cognitive Beck Depression Inventory symptoms (β = 0.14, p = .001) and inversely associated with annualized change in testosterone (β = -0.10, p = .014). Annualized change in fasting glucose was associated with sE-selectin (β = 0.12, p < .001) and somatic depressive symptoms (β = -0.12, p = .002). CONCLUSIONS The findings suggest that lower endogenous total testosterone levels and persistent depressive symptoms were associated with Type 2 diabetes risk and HbA1c in men over a 5-year period.
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Freitas C, Deschênes S, Au B, Smith K, Schmitz N. Evaluating lifestyle and health-related characteristics of older adults with co-occurring depressive symptoms and cardiometabolic abnormalities. Int J Geriatr Psychiatry 2016; 31:66-75. [PMID: 25827712 DOI: 10.1002/gps.4290] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/05/2015] [Accepted: 03/06/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Comorbid depression and cardiometabolic abnormalities might represent an important subgroup of depression. The aim of the present study was to evaluate lifestyle and health-related characteristics of individuals with both depressive symptoms and cardiometabolic abnormalities. METHODS Data were from the English Longitudinal Study of Ageing. The sample was comprised of 5365 adults aged 50-80 years. High depressive symptoms were based on the eight-item Center for Epidemiologic Studies - Depression scale. Cardiometabolic abnormalities were defined as having ≥3 cardiometabolic risk factors (hypertension, impaired glycemic control, systemic inflammation, low high-density lipoprotein cholesterol, hypertriglyceridemia, and central obesity). Four groups were created based on Center for Epidemiologic Studies - Depression scores and cardiometabolic abnormalities: those with (i) comorbid depressive symptoms and cardiometabolic abnormalities (DCM); (ii) depressive symptoms only (DnoCM); (iii) cardiometabolic abnormalities only; and (iv) neither depressive symptoms nor cardiometabolic abnormalities. Lifestyle and health-related characteristics of the four groups were compared using chi-square tests. A modified Poisson regression analysis was performed to compare the DCM and the DnoCM groups with respect to lifestyle and health-related characteristics. RESULTS Those in the DCM group were significantly less physically active (p = 0.003), had poorer self-rated health (p < 0.001), had lower income (p = 0.001), and were more likely to be retired (p < 0.001) than those in the DnoCM group. The pattern of results remained after controlling for other lifestyle and health-related factors. CONCLUSION These results provide support for a cardiometabolic subgroup of depression that is associated with physical inactivity, poorer self-rated health, lower income, and retirement. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Cassandra Freitas
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Sonya Deschênes
- Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Bonnie Au
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Kimberley Smith
- Department of Life Sciences, Brunel University London, Uxbridge, Middlesex, England
| | - Norbert Schmitz
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Psychosocial Predictors of Weight Loss among American Indian and Alaska Native Participants in a Diabetes Prevention Translational Project. J Diabetes Res 2015; 2016:1546939. [PMID: 26649314 PMCID: PMC4662977 DOI: 10.1155/2016/1546939] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 04/13/2015] [Indexed: 12/04/2022] Open
Abstract
The association of psychosocial factors (psychological distress, coping skills, family support, trauma exposure, and spirituality) with initial weight and weight loss among American Indians and Alaska Natives (AI/ANs) in a diabetes prevention translational project was investigated. Participants (n = 3,135) were confirmed as prediabetic and subsequently enrolled in the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project implemented at 36 Indian health care programs. Measures were obtained at baseline and after completing a 16-session educational curriculum focusing on weight loss through behavioral changes. At baseline, psychological distress and negative family support were linked to greater weight, whereas cultural spirituality was correlated with lower weight. Furthermore, psychological distress and negative family support predicted less weight loss, and positive family support predicted greater weight loss, over the course of the intervention. These bivariate relationships between psychosocial factors and weight remained statistically significant within a multivariate model, after controlling for sociodemographic characteristics. Conversely, coping skills and trauma exposure were not significantly associated with baseline weight or change in weight. These findings demonstrate the influence of psychosocial factors on weight loss in AI/AN communities and have substantial implications for incorporating adjunctive intervention components.
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Depression and Risk for Diabetes: A Meta-Analysis. Can J Diabetes 2015; 39:266-72. [DOI: 10.1016/j.jcjd.2014.11.006] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 11/28/2014] [Accepted: 11/28/2014] [Indexed: 12/20/2022]
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Demographic, lifestyle, and health characteristics of older adults with prediabetes in England. Prev Med 2015; 77:74-9. [PMID: 25976519 DOI: 10.1016/j.ypmed.2015.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 03/19/2015] [Accepted: 05/05/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To describe the demographic, lifestyle, and health characteristics of older adults with prediabetes compared to those with normal glucose levels or diabetes. METHOD Participants were from the English Longitudinal Study of Aging 2004-2005 (n=4168). Statistical analyses examined differences between people with prediabetes and 1) people with normal glucose levels and 2) people with diabetes. Design-based F-statistics and t-tests tested differences for each characteristic individually and multinomial logistic regression examined adjusted associations. Survey weighting and cluster information was used to generalize to the older English population. RESULTS Compared to people with normal glucose levels, people with prediabetes were older (RR=1.05 95% CI 1.04-1.07), more likely to be employed (RR=1.27 95% CI 1.01-1.60), more likely to smoke (RR=2.21 95% CI 1.74-2.80), and had higher BMIs (RR=1.08 95% CI 1.06-1.10). Compared to people with diabetes, people with prediabetes were more likely to be women (RR=2.12 95% CI 1.57-2.86), more likely to be employed (RR=1.54 95% CI 1.02-2.33), had lower BMIs (RR=0.95 95% CI 0.93-0.98), were less likely to have a cardiovascular condition (RR=0.34 95% CI 0.24-0.47), and had higher self-rated health (χ(2)=26.08, p<0.001). CONCLUSION Older adults with prediabetes have a unique set of characteristics that may inform prevention or intervention schemes.
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Hao H, Haas MJ, Wu R, Gragnoli C. T2D and Depression Risk Gene Proteasome Modulator 9 is Linked to Insomnia. Sci Rep 2015; 5:12032. [PMID: 26166263 PMCID: PMC4648424 DOI: 10.1038/srep12032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 06/15/2015] [Indexed: 12/18/2022] Open
Abstract
Insomnia increases type-2 diabetes (T2D) risk. The 12q24 locus is linked to T2D, depression, bipolar disorder and anxiety. At the 12q24 locus, the Proteasome-Modulator 9 (PSMD9) single nucleotide polymorphisms (SNPs) rs74421874 [intervening sequence (IVS) 3+nt460-G>A], rs3825172 (IVS3+nt437-C>T) and rs14259 (E197G-A>G) are linked to: T2D, depression, anxiety, maturity-onset-diabetes-of the young 3/MODY3, obesity, waist circumference, hypertension, hypercholesterolemia, T2D-macrovascular disease, T2D-microvascular disease, T2D-neuropathy, T2D-carpal-tunnel syndrome, T2D-nephropathy, T2D-retinopathy and non-diabetic retinopathy. PSMD9 SNP rs1043307/rs14259 (E197G-A>G) plays a role in anti-depressant therapy response, depression and schizophrenia. We aimed at determining PSMD9 rs74421874/rs3825172/rs14259 SNPs potential linkage to primary insomnia and sleep hours in T2D families. We recruited 200 Italian T2D families phenotyping them for primary insomnia and sleep hours per night. PSMD9-T2D-risk SNPs rs74421874/rs3825172 and rs1043307/rs14259 were tested for linkage with insomnia and sleep hours. Non-parametric-linkage analysis, linkage-disequilibrium-model analysis, single-SNP analysis, cluster-based-parametric analysis, quantitative-trait and variant-component analysis were performed using Merlin software. To validate data, 1000 replicates were executed for the significant non-parametric data. PSMD9 rs74421874 (IVS3+nt460-G>A), rs3825172 (IVS3+nt437-C>T) and rs1043307/rs14259 (E197G-A>G) SNPs are linked to insomnia in our Italian families.
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Affiliation(s)
- Han Hao
- Department of Statistics, Penn State University, State College, PA, USA
| | - Michael J. Haas
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Florida College of Medicine, Jacksonville, FL
| | - Rongling Wu
- Department of Statistics, Penn State University, State College, PA, USA
| | - Claudia Gragnoli
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Florida College of Medicine, Jacksonville, FL
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
- Center for Biotechnology and Department of Biology, Temple University’s College of Science & Technology, Philadelphia, PA, USA
- Molecular Biology Laboratory, Bios Biotech Multi-Diagnostic Health Center, Rome, Italy
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Formiga F, Rodríguez Mañas L. [Diabetes, depression and dementia. Three interrelated «d's» in the elderly]. Rev Esp Geriatr Gerontol 2015; 50:107-108. [PMID: 25725902 DOI: 10.1016/j.regg.2015.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 01/22/2015] [Indexed: 06/04/2023]
Affiliation(s)
- Francesc Formiga
- Programa de Geriatría, Servicio de Medicina Interna, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España.
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Adams J, Stamp E, Nettle D, Milne EMG, Jagger C. Anticipated survival and health behaviours in older English adults: cross sectional and longitudinal analysis of the English Longitudinal Study of Ageing. PLoS One 2015; 10:e0118782. [PMID: 25799199 PMCID: PMC4370669 DOI: 10.1371/journal.pone.0118782] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 01/22/2015] [Indexed: 11/27/2022] Open
Abstract
Background Individuals may make a rational decision not to engage in healthy behaviours based on their assessment of the benefits of such behaviours to them, compared to other uncontrollable threats to their health. Anticipated survival is one marker of perceived uncontrollable threats to health. We hypothesised that greater anticipated survival: a) is cross-sectionally associated with healthier patterns of behaviours; b) increases the probability that behaviours will be healthier at follow up than at baseline; and c) decreases the probability that behaviours will be ‘less healthy’ at follow than at baseline. Methods Data from waves 1 and 5 of the English Longitudinal Survey of Ageing provided 8 years of follow up. Perceptions of uncontrollable threats to health at baseline were measured using anticipated survival. Health behaviours considered were self-reported cigarette smoking, physical activity level, and frequency of alcohol consumption. A wide range of socio-economic, demographic, and health variables were adjusted for. Results Greater anticipated survival was cross-sectionally associated with lower likelihood of smoking, and higher physical activity levels, but was not associated with alcohol consumption. Lower anticipated survival was associated with decreased probability of adopting healthier patterns of physical activity, and increased probability of becoming a smoker at follow up. There were no associations between anticipated survival and change in alcohol consumption. Conclusions Our hypotheses were partially confirmed, though associations were inconsistent across behaviours and absent for alcohol consumption. Individual assessments of uncontrollable threats to health may be an important determinant of smoking and physical activity.
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Affiliation(s)
- Jean Adams
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
- * E-mail:
| | - Elaine Stamp
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Daniel Nettle
- Centre for Behaviour & Evolution, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Eugene M. G. Milne
- Institute of Ageing & Health, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Carol Jagger
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
- Institute of Ageing & Health, Newcastle University, Newcastle upon Tyne, United Kingdom
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Hintsa T, Kouvonen A, McCann M, Jokela M, Elovainio M, Demakakos P. Higher effort-reward imbalance and lower job control predict exit from the labour market at the age of 61 years or younger: evidence from the English Longitudinal Study of Ageing. J Epidemiol Community Health 2015; 69:543-9. [PMID: 25631860 PMCID: PMC4453492 DOI: 10.1136/jech-2014-205148] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 12/30/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND We examined whether higher effort-reward imbalance (ERI) and lower job control are associated with exit from the labour market. METHODS There were 1263 participants aged 50-74 years from the English Longitudinal Study on Ageing with data on working status and work-related psychosocial factors at baseline (wave 2; 2004-2005), and working status at follow-up (wave 5; 2010-2011). Psychosocial factors at work were assessed using a short validated version of ERI and job control. An allostatic load index was formed using 13 biological parameters. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Exit from the labour market was defined as not working in the labour market when 61 years old or younger in 2010-2011. RESULTS Higher ERI OR=1.62 (95% CI 1.01 to 2.61, p=0.048) predicted exit from the labour market independent of age, sex, education, occupational class, allostatic load and depression. Job control OR=0.60 (95% CI 0.42 to 0.85, p=0.004) was associated with exit from the labour market independent of age, sex, education, occupation and depression. The association of higher effort OR=1.32 (95% CI 1.01 to 1.73, p=0.045) with exit from the labour market was independent of age, sex and depression but attenuated to non-significance when additionally controlling for socioeconomic measures. Reward was not related to exit from the labour market. CONCLUSIONS Stressful work conditions can be a risk for exiting the labour market before the age of 61 years. Neither socioeconomic position nor allostatic load and depressive symptoms seem to explain this association.
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Affiliation(s)
- T Hintsa
- Institute of Behavioural Science, University of Helsinki, Helsinki, Finland
| | - A Kouvonen
- Department of Social Research, University of Helsinki, Helsinki, Finland Faculty in Wroclaw, University of Social Sciences and Humanities, Wroclaw, Poland UKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University Belfast, Belfast, UK
| | - M McCann
- UKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University Belfast, Belfast, UK MRC/CSO Social and Public Health Sciences Unit University of Glasgow, Glasgow, UK
| | - M Jokela
- Institute of Behavioural Science, University of Helsinki, Helsinki, Finland
| | - M Elovainio
- Institute of Behavioural Science, University of Helsinki, Helsinki, Finland National Institute for Health and Welfare, Helsinki, Finland
| | - P Demakakos
- Division of Population Health, Department of Epidemiology & Public Health, University College London, London, UK
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Pomytkin IA, Cline BH, Anthony DC, Steinbusch HW, Lesch KP, Strekalova T. Endotoxaemia resulting from decreased serotonin tranporter (5-HTT) function: A reciprocal risk factor for depression and insulin resistance? Behav Brain Res 2015; 276:111-7. [DOI: 10.1016/j.bbr.2014.04.049] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 04/25/2014] [Accepted: 04/28/2014] [Indexed: 12/31/2022]
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3-Hydroxykynurenic Acid and Type 2 Diabetes: Implications for Aging, Obesity, Depression, Parkinson’s Disease, and Schizophrenia. TRYPTOPHAN METABOLISM: IMPLICATIONS FOR BIOLOGICAL PROCESSES, HEALTH AND DISEASE 2015. [DOI: 10.1007/978-3-319-15630-9_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Iversen MM, Tell GS, Espehaug B, Midthjell K, Graue M, Rokne B, Berge LI, Østbye T. Is depression a risk factor for diabetic foot ulcers? 11-years follow-up of the Nord-Trøndelag Health Study (HUNT). J Diabetes Complications 2015; 29:20-5. [PMID: 25283486 DOI: 10.1016/j.jdiacomp.2014.09.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/06/2014] [Accepted: 09/08/2014] [Indexed: 01/28/2023]
Abstract
AIM To prospectively examine whether depressive symptoms increase the risk of diabetes and a diabetic foot ulcer. METHODS The Nord-Trøndelag Health Study (HUNT) is a community-based longitudinal study. The Hospital Anxiety and Depression Scale (HADS-D subscale) assessed depressive symptoms. We followed individuals with complete HADS-D data from HUNT2 (1995-97) and assessed whether they reported diabetes with or without a history of diabetic foot ulcer (DFU) in HUNT3 (2006-08) (n=36,031). Logistic regression was used to investigate the effect of depressive symptoms on subsequent development of diabetes and of DFU. RESULTS Unadjusted odds for reporting diabetes at follow-up was higher among individuals who reported a HADS-D score≥8 at baseline (OR 1.30 95% CI, 1.07-1.57) than among those reporting a lower score. After adjusting for age, gender and BMI, this association was no longer significant. The odds of developing a DFU was almost two-fold (OR=1.95 95% CI, 1.02-3.74) for those reporting a HADS-D score of 8-10, and 3-fold (OR=3.06 95% CI, 1.24-7.54) for HADS-D scores≥11, compared to HADS-D scores<8, after adjusting for age, gender and serum glucose. CONCLUSIONS Symptoms of depression at baseline are associated with an increased risk of a diabetic foot ulcer in a dose response manner during this 11-year follow-up.
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Affiliation(s)
- Marjolein M Iversen
- Faculty of Health and Social Sciences, Bergen University College, PO Box 7030, N-5020 Bergen, Norway; Department of Endocrinology, Stavanger University Hospital, PO Box 8100, 4068 Stavanger, Norway.
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7800, 5020 Bergen, Norway
| | - Birgitte Espehaug
- Faculty of Health and Social Sciences, Bergen University College, PO Box 7030, N-5020 Bergen, Norway
| | - Kristian Midthjell
- The HUNT Research Center, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
| | - Marit Graue
- Faculty of Health and Social Sciences, Bergen University College, PO Box 7030, N-5020 Bergen, Norway
| | - Berit Rokne
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7800, 5020 Bergen, Norway
| | - Line Iden Berge
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7800, 5020 Bergen, Norway
| | - Truls Østbye
- Duke Global Health Institute, Duke University, Box 90519 Durham, NC 27708, USA
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