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Fatima M, Wang Z, Din ZU, Juan L, Ke C, Xie P. Evidence based prevalence of diabetes related depression in Kohat, Pakistan: a cross-sectional study. BMC Public Health 2025; 25:1938. [PMID: 40420067 PMCID: PMC12105383 DOI: 10.1186/s12889-025-23151-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2025] [Accepted: 05/12/2025] [Indexed: 05/28/2025] Open
Abstract
BACKGROUND Patients suffering from chronic health conditions such as pulmonary diseases, cancer, cardiovascular problems, and diabetes mellitus (DM) are facing psychological disturbance while struggling to handle their physical illnesses. Among all chronic health conditions, DM Type II is one of the main reasons for depression across the population. OBJECTIVES The study aimed to investigate the prevalence of depression among the diabetic population and to determine the relationship between depression severity and diabetic duration. METHODS We designed a questionnaire-based study to identify the prevalence of depression in the diabetic population visited tertiary care hospital in Kohat, Khyber Pakhtunkhwa, Pakistan. Patients aged above 15 were included, and their health condition was evaluated according to the Patient Health Questionnaire 9 (PHQ-9) score. We investigated 1573 diabetic individuals, including 831 males and 742 females, for depression symptoms. Data was analyzed by the Chi-square test to obtain the association between diabetes and depression. The statistical significance between variables was determined by calculating the p-value. RESULTS Among the patients who suffered from DM Type II, 32.8% of patients showed minimal depression, and 7.9% were found severely depressed. As diabetic duration prolongs, depression severity also rises, and among patients who have been suffering from DM type II for more than 13 years, most patients were suffering from moderately severe and severe depression. Moreover, depression severity was high in the patients aged over 60 years. CONCLUSION The overall results showed that more than half of the total diabetic population was facing mild to severe depression. Based on our results, we suggest including a psychological and mental health investigation during the evaluation of diabetes in the patients. The study might help healthcare workers assess the psychological complications of diabetic patients.
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Affiliation(s)
- Madiha Fatima
- Department of Neurology, The Affiliated Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
- Department of Neurology, NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Zhao Wang
- Department of Neurology, The Affiliated Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
- Central Laboratory of Yongchuan Hospital, The Affiliated Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Zia Ud Din
- District Head Quarter (DHQ) Hospital Kohat, Kohat Development Authority (KDA), Kohat, Khyber Pakhtunkhwa, 26000, Pakistan
| | - Liao Juan
- Central Laboratory of Yongchuan Hospital, The Affiliated Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Cheng Ke
- Department of Neurology, The Affiliated Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China.
- Department of Neurology, NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 402160, China.
| | - Peng Xie
- Department of Neurology, NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 402160, China.
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Zhang Y, Wu L, Zheng C, Xu H, Lin W, Chen Z, Cao L, Qu Y. Exploring potential diagnostic markers and therapeutic targets for type 2 diabetes mellitus with major depressive disorder through bioinformatics and in vivo experiments. Sci Rep 2025; 15:16834. [PMID: 40369032 PMCID: PMC12078483 DOI: 10.1038/s41598-025-01175-z] [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: 12/05/2024] [Accepted: 05/05/2025] [Indexed: 05/16/2025] Open
Abstract
Type 2 diabetes mellitus (T2DM) and Major depressive disorder (MDD) act as risk factors for each other, and the comorbidity of both significantly increases the all-cause mortality rate. Therefore, studying the diagnosis and treatment of diabetes with depression (DD) is of great significance. In this study, we progressively identified hub genes associated with T2DM and depression through WGCNA analysis, PPI networks, and machine learning, and constructed ROC and nomogram to assess their diagnostic efficacy. Additionally, we validated these genes using qRT-PCR in the hippocampus of DD model mice. The results indicate that UBTD1, ANKRD9, CNN2, AKT1, and CAPZA2 are shared hub genes associated with diabetes and depression, with ANKRD9, CNN2 and UBTD1 demonstrating favorable diagnostic predictive efficacy. In the DD model, UBTD1 (p > 0.05) and ANKRD9 (p < 0.01) were downregulated, while CNN2 (p < 0.001), AKT1 (p < 0.05), and CAPZA2 (p < 0.01) were upregulated. We have discussed their mechanisms of action in the pathogenesis and therapy of DD, suggesting their therapeutic potential, and propose that these genes may serve as prospective diagnostic candidates for DD. In conclusion, this work offers new insights for future research on DD.
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Affiliation(s)
- Yikai Zhang
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
| | - Linyue Wu
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
| | - Chuanjie Zheng
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
| | - Huihui Xu
- Institute of Orthopedics and Traumatology, Zhejiang Provincial Hospital of Chinese Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Weiye Lin
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zheng Chen
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
| | - Lingyong Cao
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.
| | - Yiqian Qu
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.
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Pierret ACS, Mizuno Y, Saunders P, Lim E, De Giorgi R, Howes OD, McCutcheon RA, McGowan B, Sen Gupta P, Smith D, Ismail K, Pillinger T. Glucagon-Like Peptide 1 Receptor Agonists and Mental Health: A Systematic Review and Meta-Analysis. JAMA Psychiatry 2025:2833558. [PMID: 40366681 PMCID: PMC12079569 DOI: 10.1001/jamapsychiatry.2025.0679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Accepted: 02/19/2025] [Indexed: 05/15/2025]
Abstract
Importance People with obesity and diabetes have poorer psychiatric and cognitive outcomes and lower quality of life (QOL) compared with those without. Glucagon-like peptide 1 receptor agonists (GLP1-RAs) are treatments for diabetes and obesity that may also influence psychiatric outcomes. Objective To conduct a meta-analysis of randomized placebo-controlled trials to evaluate psychiatric, cognitive, and QOL outcomes with GLP1-RA treatment. Data Sources MEDLINE, Embase, PsycINFO, and CENTRAL databases were searched from inception through June 24, 2024. Study Selection Double-blind placebo-controlled trials comparing GLP1-RA to placebo in adults with overweight/obesity and/or diabetes, reporting on psychiatric, cognition, or QOL outcomes, were included. Data Extraction and Synthesis Data extraction was performed in parallel by 2 reviewers. Random-effects meta-analysis was performed. Effect size measures were log risk ratios (log[RR]) and standardized mean differences (Hedges g). The quality of studies was appraised using the Cochrane risk-of-bias tool (RoB2). Certainty of evidence was assessed via GRADEpro. Main Outcomes and Measures Main outcomes were risk of psychiatric adverse events (serious and nonserious) and change in mental health symptom severity, health-related quality of life, and cognition. Results Eighty randomized clinical trials involving 107 860 patients were included in the meta-analysis. The mean (SD) age of participants across studies in the meta-analysis was 60.1 (7.1) years; 43 251 were female (40.1%) and 64 608 male (59.9%). GLP1-RA treatment was not associated with a significant difference in risk of serious psychiatric adverse events (log[RR] = -0.02; 95% CI, -0.20 to 0.17; P = .87) and nonserious psychiatric adverse events (log[RR] = -0.03; 95% CI, -0.21 to 0.16], P = .76), or depressive symptom change (g = 0.02; 95% CI, -0.51 to 0.55; P = .94), compared with placebo. GLP1-RA treatment was associated with improvements in restrained eating (g = 0.35; 95% CI, 0.13 to 0.57; P = .002) and emotional eating behavior (g = 0.32; 95% CI, 0.11 to 0.54; P = .003) and in mental health-related QOL (g = 0.15; 95% CI, 0.07 to 0.22; P < .001), physical health-related QOL (g = 0.20; 95% CI, 0.14 to 0.26; P < .001), diabetes-related QOL (g = 0.23; 95% CI, 0.15 to 0.32; P < .001), and weight-related QOL (g = 0.27; 95% CI, 0.18 to 0.35; P < .001) compared with placebo. Conclusions and Relevance In patients with overweight/obesity and/or diabetes , GLP1-RA treatment is not associated with increased risk of psychiatric adverse events or worsening depressive symptoms relative to placebo and is associated with improvements in QOL, restrained eating, and emotional eating behavior. These findings provide reassurance regarding the psychiatric safety profile of GLP1-RAs and suggest that GLP1-RA treatment contributes to both physical and emotional well-being.
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Affiliation(s)
- Aureliane C. S. Pierret
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
- Section of Endocrinology and Investigative Medicine, Imperial College London, London, United Kingdom
| | - Yuya Mizuno
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Pippa Saunders
- Imperial College School of Medicine, London, United Kingdom
| | - Eshaya Lim
- Imperial College School of Medicine, London, United Kingdom
| | - Riccardo De Giorgi
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Oliver D. Howes
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Imperial College London, London, United Kingdom
| | - Robert A. McCutcheon
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Barbara McGowan
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- Diabetes, Endocrinology and Obesity Clinical Academic Group, King’s Health Partners, London, United Kingdom
| | - Piya Sen Gupta
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- Diabetes, Endocrinology and Obesity Clinical Academic Group, King’s Health Partners, London, United Kingdom
| | - Daniel Smith
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Khalida Ismail
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
- Diabetes, Endocrinology and Obesity Clinical Academic Group, King’s Health Partners, London, United Kingdom
| | - Toby Pillinger
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Imperial College London, London, United Kingdom
- Diabetes, Endocrinology and Obesity Clinical Academic Group, King’s Health Partners, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Sághy E, Erdősi D, Németh B, Kovács S, Wittmann I, Zemplényi A. Patient-Reported Experience and Outcome Measures of Patients Living With Diabetes: Associations Among Different Factors. Value Health Reg Issues 2025; 47:101082. [PMID: 40054088 DOI: 10.1016/j.vhri.2025.101082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 12/11/2024] [Accepted: 12/16/2024] [Indexed: 05/03/2025]
Abstract
OBJECTIVES This study aimed to explore the association between demographic characteristics and patient-reported experiences (PREs) and patient-reported outcomes (PROs) in individuals living with diabetes, using the Swedish National Diabetes Register questionnaire. The study sought to understand how baseline attributes such as age, gender, and education affect patients' experiences and management of diabetes. METHODS We used a cross-sectional survey approach with 544 patients diagnosed as having type 1 or type 2 diabetes mellitus at the University of Pécs. An exploratory factor analysis was conducted to identify the key dimensions of diabetes-related experiences, followed by a confirmatory factor analysis to validate these dimensions. Regression analysis was used to examine the impact of demographic variables on the derived factors. RESULTS The factor analysis revealed 5 key dimensions: diabetes-related obstacles, diabetes coping mechanisms, flexibility of healthcare providers, general well-being, and social support. Regression analysis indicated that older patients perceived fewer obstacles and demonstrated better coping mechanisms. Higher educational levels were significantly associated with greater satisfaction with healthcare provider flexibility. Females reported poorer overall well-being but better coping mechanisms than males. CONCLUSIONS The findings suggest that demographic characteristics significantly influence patient experiences and outcomes in diabetes care. Tailored interventions that address specific demographic needs can enhance patient-centered care and improve management strategies. These insights underscore the importance of considering patient diversity in developing healthcare interventions and underscore the utility of the Swedish National Diabetes Register questionnaire in assessing diverse patient experiences in diabetes management.
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Affiliation(s)
- Eszter Sághy
- Faculty of Pharmacy, University of Pécs, Pécs, Hungary.
| | - Dalma Erdősi
- Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | | | - Sándor Kovács
- Faculty of Pharmacy, University of Pécs, Pécs, Hungary
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Pierret ACS, Benton M, Sen Gupta P, Ismail K. A qualitative study of the mental health outcomes in people being treated for obesity and type 2 diabetes with glucagon-like peptide-1 receptor agonists. Acta Diabetol 2025; 62:731-742. [PMID: 39520512 PMCID: PMC12116896 DOI: 10.1007/s00592-024-02392-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 10/13/2024] [Indexed: 11/16/2024]
Abstract
OBJECTIVE Obesity and type 2 diabetes (T2D) are associated with increased rates of mental disorders, particularly depression, anxiety and binge-eating disorder. GLP-1 receptor agonists are a novel class of pharmacological agents for obesity and T2D. We aimed to describe participants' experiences of GLP-1 receptor agonists on their mental health. METHODS Qualitative, individual, semi-structured interviews were conducted in nine participants who were prescribed GLP-1 receptor agonists for the treatment of obesity and/or T2D. Mental health status was measured at time of GLP-1 receptor agonist initiation and assessed again at 12-16 weeks when the semi-structured interview took place. Data were analysed using reflexive thematic analysis. RESULTS Three main themes were generated from the analysis: (1) acceptance of negative side effects for long term physical health benefits; (2) reflections on the diverse impact on mental health; (3) reduced appetite and increased control of eating behaviours. DISCUSSION Overall, participants with obesity and/or T2D described a positive impact of GLP-1 receptor agonists on their mental health, especially perception of improved control of eating behaviours. This suggests GLP-1 receptor agonists should be further studied for their potential effectiveness for treatment of binge-eating disorder.
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Affiliation(s)
- Aureliane C S Pierret
- Department of Diabetes, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
- Department of Psychological Medicine, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK.
| | - Madeleine Benton
- Department of Psychological Medicine, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Piya Sen Gupta
- Department of Diabetes, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
| | - Khalida Ismail
- Department of Psychological Medicine, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK
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Alshaikhi SA, Alfaqih FH, Alrashdi AK, Alamri FA, Alzubaidi AS, Alnashri AI, Alsharidi BM, Alshreef SM, Almantashri AS, Alshaikhi OA, Alshaikh AA, Alshaikhi MA, Ghazy RM. Assessment of self-efficacy, quality of life, and well-being of patients with diabetes mellitus in Alqunfudah, Saudi Arabia. BMC Endocr Disord 2025; 25:91. [PMID: 40189525 PMCID: PMC11974028 DOI: 10.1186/s12902-025-01894-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Accepted: 03/04/2025] [Indexed: 04/09/2025] Open
Abstract
BACKGROUND Patients with diabetes mellitus (DM) often experience psychological challenges, such as feelings of loss of control, self-care stress, and fear of complications. This study aimed to assess the prevalence of uncontrolled DM, self-efficacy, quality of life (QoL), and well-being among patients with DM in Alqunfudah, Saudi Arabia, and to investigate the associations between these factors and diabetes control. METHODS A cross-sectional study employing an online questionnaire was conducted among adults with DM. The questionnaire assessed demographic characteristics, diabetes-related history, and glycemic control based on glycated hemoglobin A1c (HbA1c) level. Self-efficacy was evaluated using the validated Arabic version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale, and the Arabic version of the World Health Organization Quality of Life Brief Version was utilized to assess QoL. Well-being was measured using the Arabic version of the World Health Organization-Five Well-being Index (WHO-5). RESULTS Four hundred patients with diabetes were included with a mean age of 49.3 ± 14.6 years, 40.8% were males, and 49.25% had uncontrolled DM. Compared to the controlled group, the uncontrolled group had a lower percentage of patients living in urban areas (16.8% vs. 25.6%, p = 0.037), a larger proportion of participants having DM for > 10 years (42.6% vs. 26.6%, p < 0.001), lower median (interquartile [IQR]) self-efficacy score [39.0 (30.0-46.0) vs. 47.0 (34.0-54.0), p < 0.001], lower physical QoL [75.0(60.7-85.7) vs. 67.8 (50.0-82.1), p < 0.001], and lower environmental QoL [(78.1(62.5-87.5) vs. 68.7(59.3-84.3), p = 0.005]. Predictors of glycemic control included the physical domain of QoL [adjusted odd ratio (aOR) = 1.02 (95% CI: 1.01-1.03), p < 0.001] duration of DM for 1-2 years [aOR = 2.53 (95% CI: 1.08-5.91), p= 0.032], 3-5 years [aOR = 3.76 (95% CI: 1.90-7.43), p< 0.001 ], and 6-10 years [aOR = 1.85 (95% CI: 1.04-3.32), p = 0.036], and urban residence [aOR = 1.88 (95% CI: 1.11-3.18), p = 0.017]. CONCLUSIONS A large sector of patients with diabetes had uncontrolled blood sugar with greater affection of QoL and self-efficacy compared to the controlled group. Physical QoL, duration of DM, and residence were the key factors to be targeted for improved diabetes management.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Ayoub Ali Alshaikh
- Family and Community Medicine Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | - Ramy Mohamed Ghazy
- Family and Community Medicine Department, College of Medicine, King Khalid University, Abha, Saudi Arabia.
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
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Liu Z, Zhai G. Cardiometabolic index and major depressive disorder: Stroke and diabetes as mediators. Prog Neuropsychopharmacol Biol Psychiatry 2025; 138:111340. [PMID: 40147810 DOI: 10.1016/j.pnpbp.2025.111340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2024] [Revised: 03/08/2025] [Accepted: 03/22/2025] [Indexed: 03/29/2025]
Abstract
BACKGROUND Major depressive disorder (MDD) is a severe affective disorder that is clearly linked to stroke and diabetes. This study aimed to investigate the mediating role of stroke and diabetes in the association between the cardiometabolic index (CMI) and MDD. METHODS This cross-sectional study analyzed data from 8312 participants in the National Health and Nutrition Examination Survey (NHANES, 2005-2018). MDD was diagnosed using the Patient Health Questionnaire-9 (PHQ-9 score > 10). Associations were evaluated using multivariate logistic/linear regression, stratified interaction analyses, restricted cubic spline (RCS) models for nonlinearity, and bootstrap mediation testing. RESULTS There was a robust positive correlation between the incidence of MDD [OR = 1.36 (95 % CI: 1.21-1.51)] and the PHQ-9 score [β = 0.55 (95 % CI: 0.37-0.73)], with a one-unit increase in CMI. The participants in CMIQ4 had a 64 % greater risk of stroke than did the participants in CMIQ1 [OR = 1.64 (95 % CI: 1.17-2.29)]. The forest plot shows that the results remained stable under the grouping of stroke, diabetes, race, gender, and age. Moreover, stroke and diabetes both exhibited partial mediating roles, with indirect effects accounting for 4.03 % and 5.37 % of the total effect, respectively. Through RCS analysis, a nonlinear correlation was observed between CMI and MDD and between CMI and diabetes. There is a linear relationship between stroke and MDD, and maintaining CMI levels below 0.518 may mitigate the risk of MDD. CONCLUSION Stroke and diabetes partially mediated the associations between CMI and MDD. However, additional prospective studies are warranted to scrutinize the impact of CMI on MDD.
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Affiliation(s)
- Zhenyu Liu
- Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, No. 82, Xinhua South Road, Tongzhou District, Beijing 101199, China.
| | - Guangyao Zhai
- Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, No. 82, Xinhua South Road, Tongzhou District, Beijing 101199, China.
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Liu Z, Zhai G. Cardiometabolic index and major depressive disorder: Stroke and diabetes as mediators. Prog Neuropsychopharmacol Biol Psychiatry 2025; 138:111340. [DOI: https:/doi.org/10.1016/j.pnpbp.2025.111340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2025]
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Fang T, Shen N, Shi Z, Luo W, Di Y, Liu X, Ma S, Wang J, Hou S. Biological mechanism and functional verification of key genes related to major depressive disorder and type 2 diabetes mellitus. Mamm Genome 2025; 36:66-82. [PMID: 39656235 DOI: 10.1007/s00335-024-10090-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Accepted: 11/24/2024] [Indexed: 03/06/2025]
Abstract
Major depressive disorder (MDD) and type 2 diabetes (T2D) have been shown to be linked, but a comprehensive understanding of the underlying molecular mechanisms remains elusive. The purpose of this study was to explore the biological relationship between MDD and T2D and verify the functional roles of key genes. We used the Gene Expression Omnibus database to investigate the targets associated with MDD and T2D. Using linear models for microarray data, differentially expressed genes associated with MDD and T2D were identified in GSE76826 and GSE95849, respectively, and 126 shared genes were significantly upregulated. Weighted gene coexpression network analysis identified modules associated with MDD and T2D in the GSE38206 and GSE20966 datasets and identified 8 common genes. Functional enrichment analysis revealed that these genes were enriched in cell signaling, enzyme activity, cell structure and amino acid biosynthesis and involved in cell death pathways. Finally, combined with the CTD and GeneCards databases, lysophosphatidylglycerol acyltransferase 1 (LPGAT1) was identified as a key gene. LPGAT1 was validated in GSE201332 and GSE182117, and the subject operating characteristic curve showed good diagnostic potential for MDD and T2D. Additionally, we used an in vitro model of MDD related to T2D to verify the expression of LPGAT1. A subsequent gene knockdown assay revealed that the downregulation of LPGAT1 improved mitochondrial function and reduced apoptosis in damaged neurons. Taken together, our results highlight the role of LPGAT1 in the connection between MDD and T2D, and these findings provide new insights into potential therapeutic targets for depression associated with diabetes.
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Affiliation(s)
- Tao Fang
- Tianjin Fourth Central Hospital, Tianjin University, Tianjin, 300072, China
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, 300072, China
| | - Na Shen
- Tianjin Fourth Central Hospital, Tianjin University, Tianjin, 300072, China
| | - Zhemin Shi
- Department of Histology and Embryology, Tianjin Key Laboratory of Cellular and Molecular Immunology, Key Laboratory of Immune Microenvironment and Disease of Ministry of Education, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, 300070, China
| | - Weishun Luo
- Pharmacy Department, Tianjin Fourth Central Hospital, Tianjin, 300140, China
| | - Yanbo Di
- Tianjin Fourth Central Hospital, Tianjin University, Tianjin, 300072, China
| | - Xuan Liu
- Pharmaceutical Clinical Trial Institution Office, Tianjin Fourth Central Hospital, Tianjin, 300140, China
| | - Shengnan Ma
- Pharmacy Department, Tianjin Fourth Central Hospital, Tianjin, 300140, China
| | - Jing Wang
- Department of Medicine, Tianjin Medical College, Tianjin, 300222, China.
| | - Shike Hou
- Tianjin Fourth Central Hospital, Tianjin University, Tianjin, 300072, China.
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, 300072, China.
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Ehrmann D, Krause-Steinrauf H, Uschner D, Wen H, Hoogendoorn CJ, Crespo-Ramos G, Presley C, Arends VL, Cohen RM, Garvey WT, Martens T, Willis HJ, Cherrington A, Gonzalez JS. Differential associations of somatic and cognitive-affective symptoms of depression with inflammation and insulin resistance: cross-sectional and longitudinal results from the Emotional Distress Sub-Study of the GRADE study. Diabetologia 2025:10.1007/s00125-025-06369-8. [PMID: 39951058 DOI: 10.1007/s00125-025-06369-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 01/03/2025] [Indexed: 02/19/2025]
Abstract
AIMS/HYPOTHESIS Insulin resistance and inflammation are components of a biological framework that is hypothesised to be shared by type 2 diabetes and depression. However, depressive symptoms include a large heterogeneity of somatic and cognitive-affective symptoms, and this may obscure the associations within this biological framework. Cross-sectional and longitudinal data were used to disentangle the contributions of insulin resistance and inflammation to somatic and cognitive-affective symptoms of depression. METHODS This secondary analysis used data from the Emotional Distress Sub-Study of the GRADE trial. Insulin resistance and inflammation were assessed using the HOMA-IR estimation and high-sensitivity C-reactive protein (hsCRP) levels, respectively, at baseline and at the study visits at year 1 and year 3 (HOMA-IR) and every 6 months (hsCRP) for up to 3 years of follow-up. Depressive symptoms were assessed at baseline using the Patient Health Questionnaire (PHQ-8), and a total score as well as symptom cluster scores for cognitive-affective and somatic symptoms were calculated. For the cross-sectional analyses, linear regression analyses were performed, with inflammation and insulin resistance at baseline as dependent variables. For the longitudinal analyses, linear mixed-effect regression analyses were performed, with inflammation and insulin resistance at the various time points as dependent variables. In all analyses, depressive symptoms (total score and symptom cluster scores) were the independent variables, controlled for important demographic, anthropometric and metabolic confounders. For the analysis of insulin resistance (HOMA-IR), data from 1321 participants were analysed. For the analysis of inflammation (hsCRP), data from 1739 participants were analysed. RESULTS In cross-sectional analysis and after adjustment for potential confounders, a one-unit increase in PHQ-8 total score was significantly associated with a 0.8% increase in HOMA-IR (p=0.007), but not with hsCRP (0.6% increase, p=0.283). The somatic symptom score was associated with a 5.8% increase in HOMA-IR (p=0.004). Single-item analyses of depressive symptoms showed that fatigue (3.6% increase, p=0.002) and increased/decreased appetite (3.5% increase, p=0.009) were significantly associated with HOMA-IR cross-sectionally. The cognitive-affective symptom score was not significantly associated with HOMA-IR at baseline. In longitudinal analyses, a one-unit increase in PHQ-8 total score was significantly associated with a 0.8% increase in hsCRP over time (p=0.014), but not with HOMA-IR over time (0.1% decrease, p=0.564). Again, only the somatic symptom cluster was significantly associated with hsCRP over time (5.2% increase, p=0.017), while the cognitive-affective symptom score was not. CONCLUSION/INTERPRETATION The results highlight the associations of depressive symptoms with markers of inflammation and insulin resistance, both cross-sectionally and longitudinally, in individuals with type 2 diabetes. In particular, somatic symptoms of depression appear to be the driver of these associations, even after controlling for concomitant conditions, with a potential role for fatigue and issues with appetite. TRIAL REGISTRATION ClinicalTrials.gov NCT01794143.
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Affiliation(s)
- Dominic Ehrmann
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany.
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany.
| | - Heidi Krause-Steinrauf
- The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD, USA
| | - Diane Uschner
- The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD, USA
| | - Hui Wen
- The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD, USA
| | - Claire J Hoogendoorn
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Gladys Crespo-Ramos
- Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Caroline Presley
- Department of Medicine (General Internal and Preventive Medicine), University of Alabama at Birmingham, Birmingham, AL, USA
| | - Valerie L Arends
- Advanced Research and Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Robert M Cohen
- Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, University of Cincinnati College of Medicine & Endocrine Section, Cincinnati VA Medical Center, Cincinnati, OH, USA
| | | | - Thomas Martens
- International Diabetes Center, HealthPartners Institute, Minneapolis, MN, USA
| | - Holly J Willis
- International Diabetes Center, HealthPartners Institute, Minneapolis, MN, USA
| | - Andrea Cherrington
- Department of Medicine (General Internal and Preventive Medicine), University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA
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11
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Abstract
Diabetes and depression have a bidirectional relationship, with negative impacts on glycemia, self-care, long-term complications, quality of life, and mortality. This review highlights key aspects of the interconnected and complex relationship between diabetes and depression, including how it affects health outcomes, depression duration and recurrence, age-specific manifestations, and recommendations for screening and nonpharmacological treatment.
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Affiliation(s)
- Elizabeth A. Beverly
- Department of Primary Care, Ohio University Heritage College of Osteopathic Medicine, Athens, OH
- Ohio University Diabetes Institute, Ohio University Heritage College of Osteopathic Medicine, Athens, OH
| | - Jeffrey S. Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Departments of Medicine, Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
- New York-Regional Center for Diabetes Translation Research, Bronx, NY
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12
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Lu W, Wang S, Tang H, Yuan T, Zuo W, Liu Y. Neuropsychiatric adverse events associated with Glucagon-like peptide-1 receptor agonists: a pharmacovigilance analysis of the FDA Adverse Event Reporting System database. Eur Psychiatry 2025; 68:e20. [PMID: 39901452 PMCID: PMC11823005 DOI: 10.1192/j.eurpsy.2024.1803] [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: 08/10/2024] [Revised: 10/18/2024] [Accepted: 10/19/2024] [Indexed: 02/05/2025] Open
Abstract
BACKGROUND Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used due to their profound efficacy in glycemic control and weight management. Real-world observations have revealed potential neuropsychiatric adverse events (AEs) associated with GLP-1RAs. This study aimed to comprehensively investigate and characterize these neuropsychiatric AEs with GLP-1RAs. METHODS We analyzed GLP-1RA adverse reaction reports using the FDA Adverse Event Reporting System database. Disproportionality analysis using reporting odds ratio (ROR) identified eight categories of neuropsychiatric AEs associated with GLP-1RAs. We conducted descriptive and time-to-onset (TTO) analyses and explored neuropsychiatric AE signals among individual GLP-1RAs for weight loss and diabetes mellitus (DM) indications. RESULTS We identified 25,110 cases of GLP-1RA-related neuropsychiatric AEs. GLP-1RAs showed an association with headache (ROR 1.74, 95% confidence interval [CI] 1.65-1.84), migraine (ROR 1.28, 95%CI 1.06-1.55), and olfactory and sensory nerve abnormalities (ROR 2.44, 95%CI 1.83-3.25; ROR 1.69, 95%CI 1.54-1.85). Semaglutide showed a moderate suicide-related AEs signal in the weight loss population (ROR 2.55, 95%CI 1.97-3.31). The median TTO was 16 days (interquartile range: 3-66 days). CONCLUSIONS In this study, we identified eight potential neuropsychiatric adverse events (AEs) associated with GLP-1RAs and, for the first time, detected positive signals for migraine, olfactory abnormalities, and sensory abnormalities. We also observed positive suicide-related signals of semaglutide, in weight loss population. This study provides a reliable basis for further investigation of GLP-1RA-related neuropsychiatric AEs. However, as an exploratory study, our findings require confirmation through large-scale prospective studies.
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Affiliation(s)
- Wenchao Lu
- Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shihan Wang
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huilin Tang
- Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA
| | - Tao Yuan
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Zuo
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuling Liu
- Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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13
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Kuntz J, Necyk C, Simpson SH. Incidence and factors associated with new depressive episodes in adults with newly treated type 2 diabetes: A cohort study. Prim Care Diabetes 2025; 19:21-28. [PMID: 39709235 DOI: 10.1016/j.pcd.2024.12.001] [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: 06/14/2024] [Revised: 11/06/2024] [Accepted: 12/05/2024] [Indexed: 12/23/2024]
Abstract
AIMS Several methods are available to help identify people with depression; however, there is little guidance on when to start screening. This study estimated the incidence of new depressive episodes and identified factors associated with onset in adults with newly treated type 2 diabetes. METHODS Administrative health data from Alberta, Canada was used to identify people starting metformin between April 2011 and March 2015. People with a history of depression before metformin initiation were excluded. Person-time analysis was used to calculate the incidence rate of new depressive episodes over the next 3 years, stratified by sex, age, and year. Multivariable logistic regression was used to identify factors independently associated with a new depressive episode. RESULTS 42,694 adults initiated metformin; mean age 56 years, 38 % female. A new depressive episode occurred in 2752 (6 %) individuals, mean time to onset was 1.4 years and overall incidence rate was 22.3/1000 person-years. Factors associated with a new depressive episode were female sex, younger age, previous mental health conditions, frequent healthcare utilization, and multiple comorbid conditions. CONCLUSIONS Screening for depression should begin within 1-2 years of metformin initiation and focus on females, those < 55 years old, those with a history of mental health conditions, and those with multiple comorbid conditions.
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Affiliation(s)
- Jessica Kuntz
- Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, University of Alberta, 2-35 Medical Sciences Building, 8613 - 114 Street, Edmonton, Alberta T6G 2H7, Canada
| | - Candace Necyk
- Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, University of Alberta, 2-35 Medical Sciences Building, 8613 - 114 Street, Edmonton, Alberta T6G 2H7, Canada
| | - Scot H Simpson
- Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, University of Alberta, 2-35 Medical Sciences Building, 8613 - 114 Street, Edmonton, Alberta T6G 2H7, Canada.
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14
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Ingul CB, Hollekim-Strand SM, Sandbakk MM, Grønseth TI, Rånes TIK, Dyrendahl LT, Eilertsen K, Kristensen S, Follestad T, Løfaldli BB. Empowerment in Type 2 diabetes: A patient-centred approach for lifestyle change. Diabetes Res Clin Pract 2025; 220:111998. [PMID: 39826650 DOI: 10.1016/j.diabres.2025.111998] [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: 10/06/2024] [Revised: 12/20/2024] [Accepted: 01/07/2025] [Indexed: 01/22/2025]
Abstract
AIMS To evaluate the effectiveness of personalized lifestyle intervention service for persons with Type 2 diabetes (T2D), implemented in a real-world setting at two Healthy Life Centers (HLC) in Norway. METHODS Persons with T2D were randomized into either an HLC intervention group or a usual care group for 12 weeks. All participants were screened using a questionnaire tool and had one initial patient-centred health conversation at the HLC. In the intervention group, participants chose interventions with support from HLC staff. The usual care group continued independently. Outcome variables were assessed at baseline, 12 weeks, and 24 weeks (if completing two interventions). RESULTS 110 participants were included (mean age 59.9, 59 % T2D duration < 10 years, 36 % females). There was no significant difference in HbA1c change between intervention and usual care groups (mean difference -1.2 mmol/l, 95 % CI: -3.7 to 1.3, p = 0.33). HbA1c was significantly reduced in both groups (mean reduction 3.8 mmol/l (95 % CI: 2.1 to 5.5, p < 0.001) vs. 2.6 mmol/l (95 % CI: 0.7 to 4.4, p = 0.006), respectively). CONCLUSIONS Both the HLC personalized follow-up and usual care groups reduced HbA1c with no significant differences between groups. This suggests that low-threshold municipal healthcare can effectively support lifestyle changes in individuals with T2D.
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Affiliation(s)
- Charlotte Björk Ingul
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Siri Marte Hollekim-Strand
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | | | - Lars Tung Dyrendahl
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | - Turid Follestad
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjarte Bye Løfaldli
- Faculty for Health and Social Sciences, Molde University College, Norway; Chief municipal executive stab, Kristiansund municipality, Norway
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15
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Shi P, Fang J, Lou C. Association between triglyceride-glucose (TyG) index and the incidence of depression in US adults with diabetes or pre-diabetes. Psychiatry Res 2025; 344:116328. [PMID: 39693799 DOI: 10.1016/j.psychres.2024.116328] [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: 08/23/2024] [Revised: 11/07/2024] [Accepted: 12/14/2024] [Indexed: 12/20/2024]
Abstract
BACKGROUND The relationship between the triglyceride glucose (TyG) index and the incidence of depression in populations with diabetes or pre-diabetes remains unclear. This study aims to investigate the association between the TyG index and depression incidence in diabetic/pre-diabetic populations. METHOD Data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. After adjustment for confounders, multivariate logistic regression models were fitted to investigate the association between TyG index and depression incidence. Restricted cubic splines (RCS), subgroup analysis, interaction analysis, and mediation analysis were also constructed. RESULTS A total of 8,970 participants with diabetes or pre-diabetes were enrolled. The linear positive association between TyG index and the incidence of depression was observed. Insulin resistance partly mediates this association in mediation analysis. There is a U-shape association between TyG index and the incidence of depression in diabetic/pre-diabetic populations whose ethnicity is Other Hispanic (p for nonlinearity =0.0237). Subgroup analysis evaluated the robustness of our findings and interaction analysis showed that this association can be modified by race/ethnicity. CONCLUSION There is a linear positive association between the TyG index and the incidence of depression in populations with diabetes or pre-diabetes.
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Affiliation(s)
- Pengfei Shi
- Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
| | - Jianbang Fang
- Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Chunyang Lou
- Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
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16
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Bezin J, Bénard-Laribière A, Hucteau E, Tournier M, Montastruc F, Pariente A, Faillie JL. Suicide and suicide attempt in users of GLP-1 receptor agonists: a nationwide case-time-control study. EClinicalMedicine 2025; 80:103029. [PMID: 39844933 PMCID: PMC11751538 DOI: 10.1016/j.eclinm.2024.103029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Revised: 12/09/2024] [Accepted: 12/12/2024] [Indexed: 01/24/2025] Open
Abstract
Background Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are extensively evaluated for the risk of suicidal behaviors or ideation; the influence of psychiatric history or obesity on this potential effect remains to be investigated. Therefore, we aimed to assess the association between GLP-1 RA and suicide or suicide attempt, considering these factors. Methods Patients ≥18 y who died by suicide or were hospitalized for suicide attempt (2013-2021) with at least one GLP-1 RA dispensing within the 180 preceding days were selected from the French National Health Data System (SNDS). A case-time-control design compared, for each patient, GLP-1 RA exposure in the 30 days preceding the outcome (composite of suicide or suicide attempt) to three earlier 30-day reference periods. Potential exposure trend bias was controlled using up to five time-controls matched on age, sex, psychiatric history, obesity, calendar time. Analyses were adjusted for time-varying confounders. Finally dipeptidyl peptidase-4 (DPP-4) inhibitors were studied as negative controls for potential biases. Findings This study included 1102 cases and 5494 controls. Mean case age was 57.4 years (SD 11.4); 44.6% were male, 67.6% had a recent psychiatric history and 51.3% had obesity. GLP-1 RA use was not associated with an increased risk of suicide or suicide attempt (OR, 0.62; 95% CI, 0.51-0.75), with consistent results for DPP-4 inhibitors (0.75; 0.67-0.84). Results obtained according to recent psychiatric history and obesity were comparable. Interpretation This large nationwide case-time-control study provides reassurance about the short-term psychiatric safety of GLP-1 RA, showing no specific risk for patients with psychiatric disorders or obesity. Funding French Medicines Agency.
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Affiliation(s)
- Julien Bezin
- University Bordeaux, INSERM, BPH, Team AHeaD, U1219, F-33000, Bordeaux, France
- CHU de Bordeaux, Clinical Pharmacology Unit, INSERM, U1219, F-33000, Bordeaux, France
| | | | - Emilie Hucteau
- University Bordeaux, INSERM, BPH, Team AHeaD, U1219, F-33000, Bordeaux, France
| | - Marie Tournier
- University Bordeaux, INSERM, BPH, Team AHeaD, U1219, F-33000, Bordeaux, France
- Hospital Charles Perrens, Bordeaux, France
| | - François Montastruc
- Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance and Pharmacoepidemiology, Faculty of Medicine, Toulouse University Hospital (CHU), Toulouse, France
- CIC 1436, Team PEPSS (Pharmacologie En Population cohorteS et biobanqueS), Toulouse University Hospital, Toulouse, France
| | - Antoine Pariente
- University Bordeaux, INSERM, BPH, Team AHeaD, U1219, F-33000, Bordeaux, France
- CHU de Bordeaux, Clinical Pharmacology Unit, INSERM, U1219, F-33000, Bordeaux, France
| | - Jean-Luc Faillie
- CHU Montpellier, Service de Pharmacologie Médicale et Toxicologie, Montpellier, France
- University Montpellier, INSERM, Institut Desbrest d’Épidémiologie et de Santé Publique, Montpellier, France
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Xue E, Zhao J, Ye J, Wu J, Chen D, Shao J, Li X, Ye Z. Green sanctuaries: residential green and garden space and the natural environment mitigate mental disorders risk of diabetic patients. BMC Med 2025; 23:31. [PMID: 39838414 PMCID: PMC11752615 DOI: 10.1186/s12916-025-03864-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 01/13/2025] [Indexed: 01/23/2025] Open
Abstract
BACKGROUND The co-occurrence of diabetes and mental disorders is an exceedingly common comorbidity with poor prognosis. We aim to investigate the impact of green space, garden space, and the natural environment on the risk of mental disorders among the population living with diabetes. METHODS We performed a longitudinal analysis based on 39,397 participants with diabetes from the UK Biobank. Residential green and garden space modeled from land use data and the natural environment from Land Cover Map were assigned to the residential address for each participant. Cox proportional hazards model was used to analyze the associations between nature exposures and mental disorders of diabetes. Casual mediation analysis was used to quantify indirect effect of air pollution. RESULTS During a mean follow-up of 7.55 years, 4513 incident mental disorders cases were identified, including 2952 depressive disorders and 1209 anxiety disorders. Participants with natural environment at 300 m buffer in the second and third tertiles had 7% (HR = 0.93, 95%CI: 0.86-0.99) and 12% (HR = 0.88, 95%CI: 0.82-0.94) lower risks of incident mental disorders compared with those in the first tertile, respectively. The risk of mental disorders incidence among diabetes patients will decrease by 13% when exposed to the third tertile of garden space at 300 m buffer. The natural environment and garden space individually prevented 6.65% and 10.18% of mental disorders incidents among diabetes patients. The risk of incident mental disorders was statistically decreased when exposed to the third tertile of green space at 1000 m buffer (HR = 0.84, 95% CI: 0.78-0.90). Protective effects of three nature exposures against depressive and anxiety disorders in diabetes patients were also observed. Air pollution, particularly nitrogen dioxide, nitrogen oxides, and fine particulate matter, significantly contributed to the associations between nature exposures and mental disorders, mediating 48.3%, 29.2%, and 62.4% of the associations, respectively. CONCLUSIONS Residential green and garden space and the natural environment could mitigate mental disorders risk in diabetes patients, with air pollution playing a vital mediator. This highlights the potential for local governments to enhance the sustainability of such interventions, grounded in public health and urban planning, through strategic planning initiatives.
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Affiliation(s)
- Erxu Xue
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China
- Department of Big Data in Health Science School of Public Health, The Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Institute of Nursing Research, School of Medicine, Zhejiang University, Hangzhou, 310058, China
| | - Jianhui Zhao
- Department of Big Data in Health Science School of Public Health, The Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| | - Jingyu Ye
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, 150086, China
| | - Jingjie Wu
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China
| | - Dandan Chen
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China
| | - Jing Shao
- Department of Nursing, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 313098, China
- Institute of Nursing Research, School of Medicine, Zhejiang University, Hangzhou, 310058, China
| | - Xue Li
- Department of Big Data in Health Science School of Public Health, The Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| | - Zhihong Ye
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China.
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18
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Gan YY, Yang J, Zhai L, Liao Q, Huo RR. Specific depressive symptoms, body mass index and diabetes in middle-aged and older Chinese adults: Analysis of data from the China Health and Retirement Longitudinal Study (CHARLS). J Affect Disord 2025; 369:671-680. [PMID: 39413885 DOI: 10.1016/j.jad.2024.10.048] [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: 05/30/2024] [Revised: 10/11/2024] [Accepted: 10/12/2024] [Indexed: 10/18/2024]
Abstract
BACKGROUND This study examined the association between specific depressive symptoms and incident diabetes, and whether overweight or obesity mediates this relationship among middle-aged and older adults in China. METHODS In a nationally representative prospective cohort study of 11,893 middle-aged and older Chinese adults without baseline diabetes, we used Cox models to assess the association between depressive symptoms and diabetes. The quantile g-computation (qgcomp) model evaluated the contribution of 10 specific depressive symptoms to diabetes risk, and a two-stage regression method explored the mediation effect of overweight or obesity. RESULTS Over a median follow-up of 7.1 years, 1,314 cases of diabetes were identified. Elevated depressive symptoms were associated with increased diabetes risk (HR 1.23; 95 % CI 1.09-1.38). Eight out of 10 depressive symptoms were significantly associated to diabetes, with loneliness (weight = 18 %; HR 1.23; 95 % CI 1.10-1.39), restless sleep (weight = 17 %; HR 1.16; 95 % CI 1.04-1.29), and bother (weight = 15 %; HR 1.19; 95 % CI 1.07-1.33) being the primary contributors. Mediation analysis showed that overweight and obesity reduced the depression-diabetes risk association by 8.21 % and 12.61 %, respectively. LIMITATIONS Diagnosis of diabetes was self-reported. CONCLUSIONS Eight out of ten specific depressive symptoms were associated to diabetes, overweight and obesity may partially mitigate the effect of depressive symptoms on diabetes among middle-aged and older adults in China. CLINICAL IMPLICATIONS Our results highlight the importance of tailoring diabetes prevention and management strategies according to specific depressive symptoms among middle-aged and older adults in China.
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Affiliation(s)
- Ying-Yuan Gan
- Department of Scientific Research, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jie Yang
- Department of Infection Control, The Second People's Hospital of Qinzhou, Qinzhou, China
| | - Lu Zhai
- Department of Smart Health Elderly Care Services and Management, School of Nursing, Guangxi Health Science College, Nanning, China
| | - Qian Liao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, China
| | - Rong-Rui Huo
- Department of Experimental Research, Guangxi Medical University Cancer Hospital, Nanning, China.
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Wal P, Kumar P, Bhardwaj H, Sharma K, Tripathi AK, Gupta A, Wal A, Sharma MC. Comorbidity of Depression and Diabetes: A Literature Review on Systemic Flaws in Healthcare and the Benefits of Collaborative Diagnosis and Treatment in Primary Care Settings. Curr Diabetes Rev 2025; 21:10-28. [PMID: 38798204 DOI: 10.2174/0115733998288090240509105717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/11/2024] [Accepted: 03/19/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND The increasing specialization and dispersion of healthcare systems have led to a shortage of resources to address comorbidities. Patients with coexisting mental and physical conditions are disadvantaged, as medical providers often only focus on the patient's mental illness while neglecting their physical needs, resulting in poorer health outcomes. OBJECTIVE This study aimed to shed light on the systemic flaws in healthcare systems that contribute to suboptimal health outcomes in individuals with comorbid diseases, including depression and diabetes. This paper also discusses the clinical and economic benefits of collaborative methods for diagnosing and treating depressive disorders in primary care settings. METHODS A comprehensive literature review of the relationship between depression and diabetes was conducted. The outcomes of the literature review were carefully analyzed. Several databases were searched using keywords such as "diabetes," "depression," "comorbidity," "prevalence," "epidemiology," and "risk factors" using Google Scholar and PubMed as search engines. The review and research papers written between 1961 and 2023 were our main focus. RESULTS This study revealed improved depressive symptoms and better blood sugar and blood pressure control. Additionally, individuals with comorbid depression and diabetes have higher direct and secondary medical costs. Antidepressants and psychological interventions are equally effective in treating depressive symptoms in patients with diabetes, although they have conflicting effects on glycemic control. For individuals with comorbid diabetes and depression, clear care pathways, including a multidisciplinary team, are essential for achieving the best medical and mental health outcomes. CONCLUSION Coordinated healthcare solutions are necessary to reduce the burden of illness and improve therapeutic outcomes. Numerous pathophysiological mechanisms interact with one another and may support the comorbidities of T2DM, and depressive disorders could exacerbate the course of both diseases.
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Affiliation(s)
- Pranay Wal
- PSIT-Pranveer Singh Institute of Technology (Pharmacy) NH 19 Agra Kanpur Bhauti, Kanpur, 209305, UP, India
| | - Pankaj Kumar
- Adesh Institute of Pharmacy and Biomedical sciences, Adesh University, NH-7, Barnala Road, Bathinda, 151001, India
| | - Harsh Bhardwaj
- Department of Pharmaceutical Chemistry, Anand College of Pharmacy (SGI) Keetham, Agra, 282007, India
| | - Komal Sharma
- Bhupal Nobles Institute of Pharmaceutical Sciences, Udaipur, Rajasthan, 313001, India
| | | | - Arpit Gupta
- PSIT-Pranveer Singh Institute of Technology (Pharmacy) NH 19 Agra Kanpur Bhauti, Kanpur, 209305, UP, India
| | - Ankita Wal
- PSIT-Pranveer Singh Institute of Technology (Pharmacy) NH 19 Agra Kanpur Bhauti, Kanpur, 209305, UP, India
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20
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Hammad H, Shaltout I, Fawzy MM, Rashed LA, Adel N, Abdelaziz TS. Brain-derived Neurotrophic Factor Level and Gene Polymorphism as Risk Factors for Depression in Patients with type 2 Diabetes Mellitus- A Case-Controlled Study. Curr Diabetes Rev 2025; 21:13-20. [PMID: 38192135 DOI: 10.2174/0115733998274778231218145449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Diabetes mellitus and depression are comorbidities that can be caused by each other. Brain-derived neurotrophic factor (BDNF) functions as a neuronal growth factor. It maintains the functional integrity of the nervous system. AIM To study the possible association between BDNF levels and gene polymorphism with depression in patients diagnosed with type 2 diabetes mellitus. METHODS The Elisa technique measured BDNF, and rs6265 gene polymorphism was detected using real-time PCR. Depression was assessed utilizing a clinical interview tool designed to establish the diagnosis of depression and differentiate it from other psychiatric diseases. RESULTS BDNF levels were significantly lower in patients with type 2 diabetes mellitus and symptoms of depression than in patients with type 2 diabetes mellitus and no symptoms of depression (82.6±16.1. vs. 122± 17.47, P< 0.001). There was a statistically significant difference in BDNF levels in patients with diabetes among the three genotypes of the BDNF gene (P-value < 0.001). Val/ Val carriers had the highest serum BDNF levels, and Met/ Met carriers had the lowest serum BDNF levels. Subgroup analysis showed statistically significant genotype-related differences in serum BDNF levels among the three subgroups in the Depression group. Val/ Val carriers had the highest serum BDNF levels, and Met/ Met carriers had the lowest serum BDNF levels. BDNF Val66Met polymorphism had no significant association with the presence of depression, yet there was a trend towards significance (p = 0.05). CONCLUSION In this pilot, Low levels of BDNF were associated with depression in patients with type 2 diabetes. Carriers of the Met/ Met allele have the lowest serum BDNF levels. Multicenter studies with more participants are required.
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Affiliation(s)
- Hany Hammad
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Inass Shaltout
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mai M Fawzy
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Laila A Rashed
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Kasr Alainy University Hospitals Cairo University, Cairo, Egypt
| | - Noha Adel
- Psychiatry Department, Faculty of Medicine, Kasr Alainy Cairo University, Cairo, Egypt
| | - Tarek S Abdelaziz
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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21
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He J, Liu F, Xu P, Xu T, Yu H, Wu B, Wang H, Chen J, Zhang K, Zhang J, Meng K, Yan X, Yang Q, Zhang X, Sun D, Chen X. Aerobic Exercise Improves the Overall Outcome of Type 2 Diabetes Mellitus Among People With Mental Disorders. Depress Anxiety 2024; 2024:6651804. [PMID: 40226688 PMCID: PMC11918971 DOI: 10.1155/da/6651804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 12/09/2024] [Indexed: 04/15/2025] Open
Abstract
The escalating global prevalence of type 2 diabetes mellitus (T2DM) and mental disorder (MD) including schizophrenia, bipolar disorder, major depressive disorder, and anxiety highlights the urgency for comprehensive therapeutic strategies. Aerobic exercise (AE) is a viable adjunct therapy, providing significant benefits for individuals dealing with both T2DM and MD. This review consolidates evidence on AE's role in alleviating the physiological and psychological effects of these comorbid conditions. It delves into the pathophysiological connections between T2DM and various MD, including depression, schizophrenia, anxiety, and bipolar disorder-emphasizing their reciprocal exacerbation. Key neurophysiological mechanisms through which AE confers benefits are explored, including neuroinflammation modulation, brain structure and neuroplasticity enhancement, growth factor expression regulation, and hypothalamic-pituitary-adrenal (HPA)/microbiota-gut-brain (MGB) axis normalization. Clinical results indicate that AE significantly improves both metabolic and psychological parameters in patients with T2DM and MD, providing a substantial argument for integrating AE into comprehensive treatment plans. Future research should aim to establish detailed, personalized exercise prescriptions and explore the long-term benefits of AE in this population. This review underscores the potential of AE to complement existing therapeutic modalities and enhance the management of patients with T2DM and MD.
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Affiliation(s)
- Jiaxuan He
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Fan Liu
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Peiye Xu
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Ting Xu
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Haiyang Yu
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Baihui Wu
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Hanbing Wang
- Department of Biotechnology, The University of Hong Kong, Hong Kong SAR 999077, China
| | - Jia Chen
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611100, China
| | - Kun Zhang
- Chongqing Municipality Clinical Research Center for Endocrinology and Metabolic Diseases, Chongqing University Three Gorges Hospital, Chongqing 404000, China
| | - Junbei Zhang
- Department of Endocrinology, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu 322000, China
| | - Kaikai Meng
- Department of Endocrinology, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu 322000, China
| | - Xiaoqing Yan
- The Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Qinsi Yang
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325000, China
| | - Xingxing Zhang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Da Sun
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
- Department of Endocrinology, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu 322000, China
| | - Xia Chen
- Department of Endocrinology, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu 322000, China
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22
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Guo T, Zou Q, Wang Q, Zhang Y, Zhong X, Lin H, Gong W, Wang Y, Xie K, Wu K, Chen F, Chen W. Association of TyG Index and TG/HDL-C Ratio with Trajectories of Depressive Symptoms: Evidence from China Health and Retirement Longitudinal Study. Nutrients 2024; 16:4300. [PMID: 39770920 PMCID: PMC11676214 DOI: 10.3390/nu16244300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2024] [Revised: 12/11/2024] [Accepted: 12/11/2024] [Indexed: 01/04/2025] Open
Abstract
OBJECTIVES To explore whether the triglyceride-glucose (TyG) index and the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio are associated with the trajectories of depressive symptoms. METHODS In this longitudinal study, 4215 participants aged 45 years and older were recruited from the China Health and Retirement Longitudinal Study from 2011 to 2018. The trajectories of depressive symptoms, measured by the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), were identified using group-based trajectory modeling. Multinomial logistic models and restricted cubic spline analysis were used to investigate the relationships between the TyG index and the TG/HDL-C ratio and the trajectories of depressive symptoms. Stratified analyses were conducted based on sex, age, place of residence, and body mass index (BMI). RESULTS Five distinct trajectories of depressive symptoms characterized by stable low, stable moderate, decreasing, increasing, and stable high were identified during a follow-up of 7 years. The associations of the TyG index and the TG/HDL-C ratio with trajectories of depressive symptoms are not entirely consistent. After adjusting for covariates, a higher TyG index at baseline was associated with lower odds of being on the decreasing trajectory of depressive symptoms (ORad = 0.61, 95% CI: 0.40-0.92) compared to the stable low trajectory, and restricted cubic spline analysis revealed a negative linear relationship between the TyG index and the likelihood of a decreasing trajectory of depressive symptoms. However, the relationship between the TG/HDL-C ratio and the decreasing trajectory of depressive symptoms was no longer statistically significant when all confounders were controlled (ORad = 0.72, 95% CI: 0.50-1.04). Additionally, this negative association between the TyG index and decreasing trajectory of depressive symptoms was observed among 45-64-year-old individuals, female participants, those living in rural areas, and those with a normal BMI. LIMITATIONS This study was conducted in a middle-aged and elderly population in China, and extrapolation to other regions and populations requires further confirmation. CONCLUSIONS Compared to the TG/HDL-C ratio, the TyG index may be a better predictor for trajectories of depressive symptoms in middle-aged and older adults. Considering that the pathology of depression progresses long term, our findings may have utility for identifying available and reliable markers for the development of depression.
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Affiliation(s)
- Tingting Guo
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Rd, Guangzhou 510080, China; (T.G.); (Q.Z.); (Q.W.); (Y.Z.); (X.Z.); (H.L.); (W.G.); (Y.W.); (K.X.); (K.W.)
| | - Qing Zou
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Rd, Guangzhou 510080, China; (T.G.); (Q.Z.); (Q.W.); (Y.Z.); (X.Z.); (H.L.); (W.G.); (Y.W.); (K.X.); (K.W.)
| | - Qi Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Rd, Guangzhou 510080, China; (T.G.); (Q.Z.); (Q.W.); (Y.Z.); (X.Z.); (H.L.); (W.G.); (Y.W.); (K.X.); (K.W.)
| | - Yi Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Rd, Guangzhou 510080, China; (T.G.); (Q.Z.); (Q.W.); (Y.Z.); (X.Z.); (H.L.); (W.G.); (Y.W.); (K.X.); (K.W.)
| | - Xinyuan Zhong
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Rd, Guangzhou 510080, China; (T.G.); (Q.Z.); (Q.W.); (Y.Z.); (X.Z.); (H.L.); (W.G.); (Y.W.); (K.X.); (K.W.)
| | - Hantong Lin
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Rd, Guangzhou 510080, China; (T.G.); (Q.Z.); (Q.W.); (Y.Z.); (X.Z.); (H.L.); (W.G.); (Y.W.); (K.X.); (K.W.)
| | - Wenxuan Gong
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Rd, Guangzhou 510080, China; (T.G.); (Q.Z.); (Q.W.); (Y.Z.); (X.Z.); (H.L.); (W.G.); (Y.W.); (K.X.); (K.W.)
| | - Yingbo Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Rd, Guangzhou 510080, China; (T.G.); (Q.Z.); (Q.W.); (Y.Z.); (X.Z.); (H.L.); (W.G.); (Y.W.); (K.X.); (K.W.)
| | - Kun Xie
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Rd, Guangzhou 510080, China; (T.G.); (Q.Z.); (Q.W.); (Y.Z.); (X.Z.); (H.L.); (W.G.); (Y.W.); (K.X.); (K.W.)
| | - Kunpeng Wu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Rd, Guangzhou 510080, China; (T.G.); (Q.Z.); (Q.W.); (Y.Z.); (X.Z.); (H.L.); (W.G.); (Y.W.); (K.X.); (K.W.)
| | - Feng Chen
- Department of Clinical Research, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Zhong Rd, Shenzhen 518033, China;
| | - Wen Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Rd, Guangzhou 510080, China; (T.G.); (Q.Z.); (Q.W.); (Y.Z.); (X.Z.); (H.L.); (W.G.); (Y.W.); (K.X.); (K.W.)
- Center for Migrant Health Policy, Sun Yat-sen University, 74 Zhongshan Second Rd, Guangzhou 510080, China
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Zhuo G, Chen W, Zhang J, Su M, Zhu X, Pu S, Liao N, Huang D, Chen X, Wu L. The impact of tea consumption on the risk of depression: A Mendelian randomization and Bayesian weighting algorithm study. Asia Pac J Clin Nutr 2024; 33:554-561. [PMID: 39209365 PMCID: PMC11389803 DOI: 10.6133/apjcn.202412_33(4).0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 06/06/2024] [Accepted: 05/28/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND AND OBJECTIVES The precise impact of tea consumption on the risk of depression remains unclear. This study aimed to explore the relationship between the consumption patterns of tea and the likelihood of depression onset, utilizing a two-sample Mendelian randomization (MR) methodology. METHODS AND STUDY DESIGN We utilized available genome-wide association study (GWAS) datasets on tea intake and depressive disorders. To investigate the causal relationship between tea consumption and depression, we employed a set of two-sample Mendelian Randomization (MR) methods. These included the inverse-variance weighted (IVW) analysis, weighted median approach, and MR-Egger regression. Additionally, we utilized MR-PRESSO and the MR-Egger intercept test for the detection of pleiotropic effects. To ensure the robustness and consistency of our findings, a sensitivity analysis was carried out, applying the 'leave-one-out' strategy. The Bayesian weighted Mendelian randomization (BWMR) was employed to conduct additional testing on the obtained results. RESULTS The study's outcomes revealed a causal association between increased tea intake and an increased risk of depression (Inverse-Variance Weighted Analysis: Odds Ratio [OR] = 1.029, 95% Confidence Interval [CI]: 1.003-1.055, p = 0.027). This was observed despite variations in instrumental variables and the nonexistence of horizontal pleiotropy. Furthermore, the robustness of our Mendelian Randomization investigation was affirmed through the implementation of the 'leave-one-out' method in our sensitivity analysis. The findings from BWMR were in line with those obtained from IVW (BWMR: OR=1.030, 95% CI: 1.003-1.057, p = 0.029). CONCLUSIONS The results from this study indicate a substantial and positive causal link between the regularity of tea drinking and the risk of depression onset.
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Affiliation(s)
- Guifeng Zhuo
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
- Department of The First Clinical College of Medicine, Guangxi University of Chinese Medicine, Nanning, China
| | - Wei Chen
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Jinzhi Zhang
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Mingyang Su
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Xiaomin Zhu
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Shanshan Pu
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Naibing Liao
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Deqing Huang
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Xiangyi Chen
- Department of School of Zhuang Medicine, Guangxi University of Chinese Medicine, Nanning, China
| | - Lin Wu
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
- Department of Graduate School, Guangxi University of Chinese Medicine, Nanning, China.
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24
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Sommer J, Borgmann SO, Gontscharuk V, Zaharia OP, Maalmi H, Herder C, Wagner R, Strassburger K, Schön M, Burkart V, Szendroedi J, Pfeiffer AFH, Bornstein S, Blüher M, Seissler J, Birkenfeld AL, Meyhöfer S, Roden M, Icks A, GDS Group. Depression symptoms, wellbeing, health-related quality of life, and diabetes-related distress in novel subtypes of recent-onset diabetes in Germany: a 5-year observational follow-up study. Lancet Diabetes Endocrinol 2024; 12:890-903. [PMID: 39491874 DOI: 10.1016/s2213-8587(24)00234-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Collaborators] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 07/22/2024] [Accepted: 07/22/2024] [Indexed: 11/05/2024]
Abstract
BACKGROUND The subjective experiences of individuals living with diabetes is commonly assessed with patient-reported outcomes (PROs; eg, depression symptoms, wellbeing, health-related quality of life [HRQOL], and diabetes-related distress). Cluster analyses have identified novel diabetes subtypes differing in phenotypic and metabolic characteristics. We aimed to investigate associations between these subtypes and PROs and whether subtype predicted PROs 5 years later. METHODS Baseline (<12 months after a diabetes diagnosis) and 5-year follow-up data were collected from German Diabetes Study (GDS) participants. Multiple regressions were applied to analyse associations between diabetes subtypes and depression symptoms (Center for Epidemiologic Studies Depression Scale), wellbeing (WHO-5), HRQOL (SF-36), and diabetes-related distress (Problem Areas in Diabetes Scale). FINDINGS Cluster analyses at baseline (n=1391) identified participants with severe autoimmune diabetes (SAID, 417 [30%]), severe insulin-deficient diabetes (SIDD, 33 [2%]), severe insulin-resistant diabetes (SIRD, 150 [11%]), mild obesity-related diabetes (MOD, 354 [25%]), and mild age-related diabetes (MARD, 437 [31%]). At baseline, multiple regression analyses showed that participants with SIRD had higher depression symptoms than participants with MARD and lower physical HRQOL than all other subtypes. Participants with SAID reported higher depression symptoms and lower mental HRQOL than participants with MARD, higher physical HRQOL than participants with MARD and MOD, and higher diabetes-related distress than most other subtypes. At the 5-year follow-up, clustering predicted no statistically significant changes in PROs after adjustment for multiple testing, whereas descriptive analyses demonstrated that individuals with SIRD were more likely to experience clinically relevant depression symptoms (16% vs 6%) and low wellbeing (31% vs 14%), respectively, than individuals with MARD. INTERPRETATION Diabetes subtypes already differ in PROs at diabetes diagnosis. Our analyses had limited predictive power during follow-up. However, our findings suggest that clustering could predict future changes in depression symptoms. FUNDING The GDS was initiated and financed by the German Diabetes Center, which is funded by the German Federal Ministry of Health, the Ministry of Culture and Science of the state of North Rhine-Westphalia, and by the German Federal Ministry of Education and Research to the German Center for Diabetes Research. TRANSLATION For the German translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Jana Sommer
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
| | - Sandra Olivia Borgmann
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Veronika Gontscharuk
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Oana Patricia Zaharia
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Haifa Maalmi
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Robert Wagner
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Klaus Strassburger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Martin Schön
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Volker Burkart
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Julia Szendroedi
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Department of Endocrinology, Diabetology, Metabolism and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas F H Pfeiffer
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Department of Endocrinology and Metabolic Medicine, Campus Benjamin Franklin, Charité University Medicine, Berlin, Germany
| | - Stefan Bornstein
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Department of Internal Medicine III, Technical University Dresden, Dresden, Germany
| | - Matthias Blüher
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Jochen Seissler
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Diabetes Center, Medical Clinic and Policlinic IV, University Hospital, LMU Munich, Munich, Germany
| | - Andreas L Birkenfeld
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Department of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, University of Tübingen, Tübingen Germany
| | - Svenja Meyhöfer
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Department of Internal Medicine 1, Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
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Collaborators
Hadi Al-Hasani, Bengt-Frederik Belgardt, Gidon Bönhof, Gerd Geerling, Christian Herder, Andrea Icks, Karin Jandeleit-Dahm, Jörg Kotzka, Oliver Kuss, Eckhard Lammert, Wolfgang Rathmann, Michael Roden, Sabrina Schlesinger, Vera Schrauwen-Hinderling, Julia Szendroedi, Sandra Trenkamp, Robert Wagner,
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Wang YZ, Xue C, Ma C, Liu AB. Associations of the Charlson comorbidity index with depression and mortality among the U.S. adults. Front Public Health 2024; 12:1404270. [PMID: 39664531 PMCID: PMC11632622 DOI: 10.3389/fpubh.2024.1404270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 10/18/2024] [Indexed: 12/13/2024] Open
Abstract
BACKGROUND Chronic comorbidities are often associated with higher risks of depression and mortality. This study aims to explore the relationships between the Charlson Comorbidity Index (CCI) and depression, and their combined effect on mortality. METHODS This study made use of data gathered in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, including a collective of 23,927 adult participants. According to CCI score distribution, CCI was categorized into three groups (T1 with CCI = 0; T2 with CCI = 1; T3 with CCI ≥ 2). In the CCI ≥ 2 group, patients may have two or more chronic diseases. Multivariable logistic regression models were employed to explore the relationship between CCI and depression. The study utilized the Cox proportional hazards model to investigate the association between CCI, the combination of CCI and depression, and all-cause mortality. RESULTS Our analysis revealed that after adjusting for potential confounders, a positive association was found between CCI and depression (OR = 1.25, 95% CI: 1.21, 1.29). Moreover, a greater CCI was found to be closely linked to higher mortality in individuals with depression (HR = 1.14, 95% CI 1.11, 1.18). Stratifying CCI into tertiles, higher tertiles of CCI (T2, T3 vs T1) also showed positive associations with depression and all-cause mortality. For patients with CCI ≥2 (T3) combined with depression, the risk of mortality was significantly elevated compared to those with CCI = 0 (T1) and non-depressed participants (HR = 2.01, 95% CI: 1.60, 2.52). CONCLUSION The study findings demonstrate a positive correlation between CCI and the risk of depression, along with an association with increased all-cause mortality among depression patients. Hence, it is important to prioritize the clinical care of patients with a high CCI (≥2) and depression in order to lower the chances of mortality.
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Affiliation(s)
- Ying-Zhao Wang
- Department of Neurology, Qianwei Hospital of Jilin Province, Changchun, China
| | - Chun Xue
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Chao Ma
- Department of Thoracic Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - An-Bang Liu
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
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Fan H, Shi Y, Liu H, Zuo X, Yang Y, Yin H, Li Y, Wang X, Liu L, Wang F, Han H, Wu Q, Yang N, Tang Y, Lu G. Inhalation of H 2/O 2 (66.7 %/33.3 %) mitigates depression-like behaviors in diabetes mellitus complicated with depression mice via suppressing inflammation and preventing hippocampal damage. Biomed Pharmacother 2024; 180:117559. [PMID: 39405908 DOI: 10.1016/j.biopha.2024.117559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 09/16/2024] [Accepted: 10/08/2024] [Indexed: 11/14/2024] Open
Abstract
Diabetes mellitus complicated with depression (DD) is a prevalent psychosomatic disorder. It is characterized by severe cognitive impairment, and associated with high rates of disability and mortality. Although conventional treatment options are available, the efficacy of these regimens in managing DD remains limited. Molecular hydrogen (H2), a selective hydroxyl radical scavenger, has shown therapeutic potential in the treatment of various systemic diseases. This study aims to investigate the therapeutic effects of H2 on DD. A DD mouse model was established through intraperitoneal injection of streptozotocin (STZ, 150 mg/kg) and lipopolysaccharide (LPS, 0.5 mg/kg). Following the induction of DD, the mice were treated with H2/O2 (66.7 %/33.3 %)inhalation for 7 days. Behavioral assessments were conducted by standard behavioral tests, and the levels of inflammatory cytokines in peripheral blood serum and hippocampal tissue were measured using enzyme-linked immunosorbent assay (ELISA). Furthermore, magnetic resonance imaging (MRI) scans and immunofluorescence staining of the hippocampus were performed to evaluate hippocampal structural integrity. The results demonstrated that inhalation of H2/O2 (66.7 %/33.3 %) significantly ameliorated depressive behaviors and symptoms in DD mice, reversed hippocampal volume reduction, decreased inflammatory cytokine levels in peripheral blood serum and hippocampal tissue, and inhibited the activation of A1 astrocytes in the hippocampus. Our study suggests that H2/O2 (66.7 %/33.3 %) inhalation therapy may offer a promising treatment strategy for DD and its associated symptoms.
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Affiliation(s)
- Huaju Fan
- Medical Laboratory Animal Center, School of Psychology, Shandong Second Medical University, Weifang, Shandong 261053, China; Sichuan Second Veterans Hospital, Chengdu, Sichuan 611230, China
| | - Yanhua Shi
- Medical Laboratory Animal Center, School of Bioscience and Technology, Shandong Second Medical University, Weifang, Shandong 261053, China
| | - Haiqiang Liu
- Weifang People's Hospital Weifang, Shandong 261000, China
| | - Xiaofei Zuo
- Medical Laboratory Animal Center, School of Bioscience and Technology, Shandong Second Medical University, Weifang, Shandong 261053, China
| | - Yanmei Yang
- Medical Laboratory Animal Center, School of Bioscience and Technology, Shandong Second Medical University, Weifang, Shandong 261053, China
| | - Hao Yin
- Medical Laboratory Animal Center, School of Bioscience and Technology, Shandong Second Medical University, Weifang, Shandong 261053, China
| | - Yanyan Li
- Medical Laboratory Animal Center, School of Bioscience and Technology, Shandong Second Medical University, Weifang, Shandong 261053, China
| | - Xianghui Wang
- Medical Laboratory Animal Center, School of Bioscience and Technology, Shandong Second Medical University, Weifang, Shandong 261053, China
| | - Li Liu
- Medical Laboratory Animal Center, School of Bioscience and Technology, Shandong Second Medical University, Weifang, Shandong 261053, China
| | - Fengjiao Wang
- Medical Laboratory Animal Center, School of Public Health, Shandong Second Medical University, Weifang, Shandong 261053, China
| | - Huifang Han
- Medical Laboratory Animal Center, School of Bioscience and Technology, Shandong Second Medical University, Weifang, Shandong 261053, China
| | - Qianying Wu
- Medical Laboratory Animal Center, School of Bioscience and Technology, Shandong Second Medical University, Weifang, Shandong 261053, China
| | - Nana Yang
- Medical Laboratory Animal Center, School of Bioscience and Technology, Shandong Second Medical University, Weifang, Shandong 261053, China.
| | - Yaohui Tang
- School of Biomedical Engineering and Affiliated Sixth People's Hospital, Shanghai JiaoTong University, 1954 Hua Shan Rd., Shanghai 200030, China.
| | - Guohua Lu
- Medical Laboratory Animal Center, School of Psychology, Shandong Second Medical University, Weifang, Shandong 261053, China.
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Yatagan Sevim G, Alkan E, Taporoski TP, Krieger JE, Pereira AC, Evans SL. Effects of glycaemic control on memory performance, hippocampal volumes and depressive symptomology. Diabetol Metab Syndr 2024; 16:219. [PMID: 39261923 PMCID: PMC11389280 DOI: 10.1186/s13098-024-01429-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/24/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Diabetes and poor glycaemic control have been shown to negatively impact cognitive abilities, while also raising risk of both mood disorders and brain structural atrophy. Sites of atrophy include the hippocampus, which has been implicated in both memory performance and depression. The current study set out to better characterise the associations between poor glycaemic control, memory performance, and depression symptoms, and investigate whether loss of hippocampal volume could represent a neuropathological mechanism underlying these. METHODS 1331 participants (60.9% female, age range 18-88 (Mean = 44.02), 6.5% with likely diabetes) provided HbA1c data (as an index of glycaemic control), completed a word list learning task, and a validated depression scale. A subsample of 392 participants underwent structural MRI; hippocampal volumes were extracted using FreeSurfer. RESULTS Partial correlation analyses (controlling for age, gender, and education) showed that, in the full sample, poorer glycaemic control was related to lower word list memory performance. In the MRI sub-sample, poorer glycaemic control was related to higher depressive symptoms, and lower hippocampal volumes. Total hippocampus volume partially mediated the association between HbA1c levels and depressive symptoms. CONCLUSIONS Results emphasise the impact of glycaemic control on memory, depression and hippocampal volume and suggest hippocampal volume loss could be a pathophysiological mechanism underlying the link between HbA1c and depression risk; inflammatory and stress-hormone related processes might have a role in this.
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Affiliation(s)
- Gulin Yatagan Sevim
- Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Erkan Alkan
- Faculty of Health, Science, Social Care and Education, Kingston University, London, UK
| | - Tamara P Taporoski
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts, USA
| | - Jose E Krieger
- University of São Paulo School of Medicine, São Paulo, Brazil
| | - Alex C Pereira
- University of São Paulo School of Medicine, São Paulo, Brazil
| | - Simon L Evans
- Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
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Migchelbrink MM, Kremers SHM, den Braver NR, Groeneveld L, Elders PJM, Blom MT, Beulens JW, Rutters F. The cross-sectional association between dietary total, animal, and plant-based protein intake and the prevalence and severity of depressive symptoms in Dutch adults with type 2 diabetes: The Hoorn Diabetes Care System cohort. Prev Med 2024; 186:108065. [PMID: 39047954 DOI: 10.1016/j.ypmed.2024.108065] [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: 03/30/2024] [Revised: 06/27/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE This study aimed to investigate cross-sectional associations of total, animal, and plant-based protein intake and depressive symptoms in Dutch adults with type 2 diabetes (T2D). METHODS We included 1137 individuals with T2D (aged 68.6 ± 9.0) from the Hoorn Diabetes Care System cohort. Energy-adjusted protein intake was assessed using a validated Food Frequency Questionnaire. The nine-item Patient Health Questionnaire (PHQ-9) was used to assess the prevalence of depressive symptoms (PHQ-9 ≥ 10 and/or anti-depressant use) and the severity of depressive symptoms (continuous PHQ-9 score). Associations between total, animal, and plant-based protein (quartiles) with depressive symptoms were assessed using multiple logistic and linear regression. RESULTS Highest intake of total, animal, and plant-based protein was not associated with the prevalence of depressive symptoms, compared to lowest intake (e.g., total protein, ORQ4vsQ1:0.75, 95%CI 0.42;1.32). For the severity of depressive symptoms, highest total protein intake was significantly associated with lower PHQ-9 scores (ORQ4vsQ1:0.87, 95%CI 0.75;1.00), compared to lowest intake. Animal protein was not associated with the severity of depressive symptoms (β ∼ 1), while the association for plant-based protein was marginally non-significant (βQ4vsQ1:0.88, 95%CI 0.76;1.02). CONCLUSION In individuals with T2D, higher total protein intake was associated with reduced severity of depressive symptoms, but not with the prevalence of depressive symptoms. Further prospective research with a larger sample size is needed to confirm these associations.
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Affiliation(s)
- Maaike M Migchelbrink
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Sanne H M Kremers
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Nicolette R den Braver
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Lenka Groeneveld
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Petra J M Elders
- Amsterdam Public Health research institute, Amsterdam, the Netherlands; General Practice, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marieke T Blom
- Amsterdam Public Health research institute, Amsterdam, the Netherlands; General Practice, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Joline W Beulens
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health research institute, Amsterdam, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Femke Rutters
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health research institute, Amsterdam, the Netherlands
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Anita NZ, Herrmann N, Ryoo SW, Major-Orfao C, Lin WZ, Kwan F, Noor S, Rabin JS, Marzolini S, Nestor S, Ruthirakuhan MT, MacIntosh BJ, Goubran M, Yang P, Cogo-Moreira H, Rapoport M, Gallagher D, Black SE, Goldstein BI, Lanctôt KL, Oh PI, Taha AY, Swardfager W. Cytochrome P450-soluble epoxide hydrolase oxylipins, depression and cognition in type 2 diabetes. J Diabetes Complications 2024; 38:108826. [PMID: 39059187 DOI: 10.1016/j.jdiacomp.2024.108826] [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: 05/14/2024] [Revised: 07/11/2024] [Accepted: 07/21/2024] [Indexed: 07/28/2024]
Abstract
AIMS This study examined serum cytochrome P450-soluble epoxide hydrolase (CYP450-sEH) oxylipins and depressive symptoms together in relation to cognitive performance in individuals with type 2 diabetes mellitus (T2DM). METHODS Clinically cognitively normal T2DM individuals were recruited (NCT04455867). Depressive symptom severity was assessed using the Beck Depression Inventory-II (BDI-II; total scores ≤13 indicated minimal depressive symptoms and ≥ 14 indicated significant depressive symptoms). Executive function and verbal memory were assessed. Fasting serum oxylipins were quantified by ultra-high-performance liquid chromatography tandem mass-spectrometry. RESULTS The study included 85 participants with minimal depressive symptoms and 27 with significant symptoms (mean age: 63.3 ± 9.8 years, 49 % women). In all participants, higher concentrations of linoleic acid derived sEH (12,13-dihydroxyoctadecamonoenoic acid; DiHOME) and CYP450 (12(13)-epoxyoctadecamonoenoic acid; EpOME) metabolites were associated with poorer executive function (F1,101 = 6.094, p = 0.015 and F1,101 = 5.598, p = 0.020, respectively). Concentrations of multiple sEH substrates interacted with depressive symptoms to predict 1) poorer executive function, including 9(10)-EpOME (F1,100 = 12.137, p < 0.001), 5(6)-epoxyeicosatrienoic acid (5(6)-EpETrE; F1,100 = 6.481, p = 0.012) and 11(12)-EpETrE (F1,100 = 4.409, p = 0.038), and 2) verbal memory, including 9(10)-EpOME (F1,100 = 4.286, p = 0.041), 5(6)-EpETrE (F1,100 = 6.845, p = 0.010), 11(12)-EpETrE (F1,100 = 3.981, p = 0.049) and 14(15)-EpETrE (F1,100 = 5.019, p = 0.027). CONCLUSIONS Associations of CYP450-sEH metabolites and depressive symptoms with cognition highlight the biomarker and therapeutic potential of the CYP450-sEH pathway in T2DM.
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Affiliation(s)
- Natasha Z Anita
- Department of Pharmacology & Toxicology, Temerty Faculty of Medicine - University of Toronto, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Canada
| | - Nathan Herrmann
- Sunnybrook Research Institute, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Psychiatry - University of Toronto, Canada
| | - Si Won Ryoo
- Department of Pharmacology & Toxicology, Temerty Faculty of Medicine - University of Toronto, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Canada
| | - Chelsi Major-Orfao
- Sunnybrook Research Institute, Toronto, Ontario, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Canada
| | - William Z Lin
- Department of Pharmacology & Toxicology, Temerty Faculty of Medicine - University of Toronto, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Canada
| | - Felicia Kwan
- Department of Pharmacology & Toxicology, Temerty Faculty of Medicine - University of Toronto, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Canada
| | - Shiropa Noor
- Department of Pharmacology & Toxicology, Temerty Faculty of Medicine - University of Toronto, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Canada
| | - Jennifer S Rabin
- Sunnybrook Research Institute, Toronto, Ontario, Canada; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Canada
| | - Susan Marzolini
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Canada; Department of Exercise Sciences, Faculty of Kinesiology and Physical Education, University of Toronto, Canada
| | - Sean Nestor
- Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Psychiatry - University of Toronto, Canada
| | - Myuri T Ruthirakuhan
- Department of Pharmacology & Toxicology, Temerty Faculty of Medicine - University of Toronto, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Bradley J MacIntosh
- Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medical Biophysics - University of Toronto, Canada
| | - Maged Goubran
- Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medical Biophysics - University of Toronto, Canada
| | - Pearl Yang
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Hugo Cogo-Moreira
- Department of Education, Østfold University College, 1757 B R A Veien 4, Halden 1757, Norway
| | - Mark Rapoport
- Sunnybrook Research Institute, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Psychiatry - University of Toronto, Canada
| | - Damien Gallagher
- Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Psychiatry - University of Toronto, Canada
| | - Sandra E Black
- Sunnybrook Research Institute, Toronto, Ontario, Canada; Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Canada
| | - Benjamin I Goldstein
- Department of Pharmacology & Toxicology, Temerty Faculty of Medicine - University of Toronto, Canada; Department of Psychiatry - University of Toronto, Canada; Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Krista L Lanctôt
- Department of Pharmacology & Toxicology, Temerty Faculty of Medicine - University of Toronto, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Canada; Department of Psychiatry - University of Toronto, Canada
| | - Paul I Oh
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Canada
| | - Ameer Y Taha
- Department of Food Science and Technology, College of Agriculture and Environmental Sciences, University of California, Davis, CA, USA; West Coast Metabolomics Center, Genome Center, University of California, Davis, CA, USA; Center for Neuroscience, One Shields Avenue, University of California, Davis, CA, USA
| | - Walter Swardfager
- Department of Pharmacology & Toxicology, Temerty Faculty of Medicine - University of Toronto, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Canada.
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Wang Y, Xu T, Zhang Y, He Y, Fang J, Xu Y, Jin L. Interaction between depression and non-essential heavy metals (Cd, Pb, and Hg) on metabolic diseases. J Trace Elem Med Biol 2024; 85:127484. [PMID: 38924924 DOI: 10.1016/j.jtemb.2024.127484] [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: 02/01/2024] [Revised: 05/19/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES Metal exposure and depression have each been associated with adverse metabolic diseases, but no study has examined the potential interaction between them. We examined the interaction of depression on the association between metals and metabolic diseases among adults. STUDY DESIGN The interaction of depression in the relationship between metal and metabolic disease in adults was investigated using NHANES, a cross-sectional survey design. METHODS By employing data from the NHANES database spanning the years 2007-2018, regression models were employed to investigate the independent impacts of heavy metals (cadmium, lead, and mercury) and depression on metabolic diseases (type 2 diabetes, hypertension, hyperlipidemia, metabolic syndrome). Subsequently, the association between metals and metabolic diseases was explored stratified by depression, and the interaction between heavy metals and depression was explored. Because of the complex NHANES design, statistical evaluations were adjusted through weighting to represent the populace of the United States. RESULTS We found log transformed-urinary lead was significantly associated with type 2 diabetes (OR: 2.33; 95 % CI: 1.23, 4.41) in adults with depression. Log transformed-urinary lead was not associated with type 2 diabetes (OR: 0.84; 95 % CI: 0.56, 1.27) in adults without depression. The interaction between Pb and depression in type 2 diabetes was significant (P for interaction = 0.033). Log transformed-urinary lead * depression was significantly associated with type 2 diabetes (OR: 1.82; 95 % CI: 1.01, 3.34) in adults. There was no significant interaction between cadmium and mercury exposure and depression in patients with type 2 diabetes, hypertension, hyperlipidemia, and metabolic syndrome (P for interaction > 0.05). CONCLUSIONS The presence of depression positively modified the adverse associations between urinary lead and type 2 diabetes.
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Affiliation(s)
- Yanfang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China
| | - Tong Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China
| | - Yuan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China
| | - Yue He
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China
| | - Jiaxin Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China
| | - Yan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
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de Galan BE. Diabetes and brain disorders, a new role for insulin? Neurosci Biobehav Rev 2024; 163:105775. [PMID: 38901787 DOI: 10.1016/j.neubiorev.2024.105775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/10/2024] [Accepted: 06/17/2024] [Indexed: 06/22/2024]
Affiliation(s)
- Bastiaan E de Galan
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
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Lai Q, Li W, He X, Wang H, He Q, Hao C, Deng Z. Leisure-time physical activity is associated with depressive symptoms in cancer patients: Data from the NHANES 2007-2018. J Affect Disord 2024; 358:35-41. [PMID: 38705529 DOI: 10.1016/j.jad.2024.05.023] [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: 02/14/2024] [Revised: 04/08/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Cancer patients have a higher risk of depression and are associated with severe adverse prognosis. The relationship between leisure-time physical activity (LTPA) and depressive symptoms in cancer patients is currently unclear. Therefore, our study mainly explores the potential association between LTPA and the weekly cumulative time of LTPA with depressive symptoms in cancer patients. METHODS We included and analyzed 3368 cancer patients (aged >20 years) from the National Health and Nutrition Examination Survey (NHANES) of the United States from 1999 to 2018. The LTPA score was evaluated through a self-report questionnaire, while depressive symptoms were evaluated through the Health Questionnaire-9 (PHQ-9). Multiple logistic regression analysis was used to explore the relationship between LTPA duration and the occurrence of cancer-related depressiive symptoms. Linear correlation was studied using the restricted cubic spline method. RESULTS According to a fully adjusted multivariate logistic regression model with confounding variables, the odds ratio (OR) between LTPA and depressive symptoms in cancer patients in this study was 0.59 (95 % confidence interval = 0.39, 0.92; P = 0.02). When the LTPA level was ≥300 min/week, the incidence of depressive symptoms was reduced by 59 % (OR = 0.41, 95 % CI = 0.21, 0.83). In addition, the cubic spline method was used to obtain a linear negative correlation between LTPA duration and tumor depressive symptoms. CONCLUSION LTPA was negatively correlated with cancer-related depressive symptoms, and the cumulative time of LTPA/week was linearly correlated with depressive symptoms. The slope of the benefit curve changed significantly when the cumulative time of LTPA reached 600 min per week, suggesting that appropriately increasing LTPA had significant benefits on mental health of cancer patients.
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Affiliation(s)
- Qun Lai
- Department of Hematology and Oncology, Third People's Hospital of Zigong, Zigong, Sichuan 643000, China
| | - Wenqiang Li
- Department of Pulmonary and Critical Care Medicine, First People's Hospital of Zigong, 42 Shangyihao Yizhi Street, Zigong, Sichuan 643000, China
| | - Xiaoyu He
- Department of Pulmonary and Critical Care Medicine, First People's Hospital of Zigong, 42 Shangyihao Yizhi Street, Zigong, Sichuan 643000, China; North Sichuan Medical College, Nanchong, Sichuan 637100, China
| | - Hongping Wang
- Department of Neurosurgery, Fourth People's Hospital of Zigong, Zigong, Sichuan 643000, China
| | - Qian He
- Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Chengluo Hao
- Department of Hematology and Oncology, Third People's Hospital of Zigong, Zigong, Sichuan 643000, China.
| | - Zhiping Deng
- Department of Pulmonary and Critical Care Medicine, First People's Hospital of Zigong, 42 Shangyihao Yizhi Street, Zigong, Sichuan 643000, China.
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Zeng N, Li C, Mei H, Wu S, Liu C, Wang X, Bao Y. Temporal Relationship between HbA1c and Depressive Symptom Trajectories in a Longitudinal Cohort Study: The Mediating Role of Healthy Lifestyles. Brain Sci 2024; 14:780. [PMID: 39199473 PMCID: PMC11353008 DOI: 10.3390/brainsci14080780] [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: 06/13/2024] [Revised: 07/24/2024] [Accepted: 07/27/2024] [Indexed: 09/01/2024] Open
Abstract
This study analyzed China Health and Retirement Longitudinal Study data to explore the HbA1c-depression link, including depressive trajectories, while considering the mitigating impact of healthy lifestyles. Cross-lagged panel models and group-based trajectory modeling were performed to investigate the temporal relationship between HbA1c levels and depressive symptoms, as well as the depressive trajectories. Structural equation models were used to assess the mediating effects of healthy lifestyles. The mean age of the participants was 57.66 ± 9.04 years, with 53.68% being female. Analyzing 8826 participants across three waves, we observed a significant prediction of subsequent depressive symptoms by the preceding HbA1c levels (β = 0.296; p < 0.001). Four distinct trajectories of depressive symptoms were distinguished: stable low, stable moderate, increasing, and stable high. Elevated HbA1c levels were associated with a higher risk of developing stable high (OR 1.12 and 95% CI 1.02-1.23), increasing (OR 1.21 and 95% CI 1.11-1.32), and stable moderate depressive symptoms (OR 1.07 and 95% CI 1.01-1.13). Engaging in two healthy life behaviors reduced stable high and increasing depressive pattern risks by 32% and 30%, respectively. Adherence to a healthy lifestyle lessened 7.2% of the impact of high HbA1c levels on the subsequent depressive symptoms. These findings highlight the potential benefits of incorporating adequate sleep and light physical activities, which might reduce the adverse impact of elevated HbA1c levels on depressive symptoms.
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Affiliation(s)
- Na Zeng
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Chao Li
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
| | - Huan Mei
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Shuilin Wu
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Chang Liu
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Xiaokun Wang
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Yanping Bao
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
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Al-Jabi SW. Emerging global interest: Unraveling the link between diabetes mellitus and depression. World J Psychiatry 2024; 14:1127-1139. [PMID: 39050204 PMCID: PMC11262933 DOI: 10.5498/wjp.v14.i7.1127] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 06/03/2024] [Accepted: 06/19/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Studies have shown a strong bidirectional association between diabetes and depression, with diabetes increasing the risk of developing depression and vice versa. Depression among patients with diabetes is associated with poor glycemic control, complications, and poor self-care. AIM To explore the present state of research globally concerning diabetes and depression, to aid understanding the current research landscape and identify potential future areas of research. METHODS A bibliometric approach was used, utilizing the Scopus database to gather pertinent research articles released from 2004 to 2023. Analyses encompassed publication patterns, significant contributors, research focal points, prevalent themes, and the most influential articles, aimed at discerning emerging research subjects. RESULTS A total of 3229 publications that met the search criteria were identified. A significant increase in the number of publications related to diabetes and depression has been observed in the past two decades. The most productive nation was the USA (n = 1015; 31.43%), followed by China (n = 325; 10.07%), the UK (n = 236; 7.31%), and Germany (n = 218; 6.75%). Three principal themes in research on depression and diabetes were delineated by the analysis. First, the exploration of the elevated prevalence and etiology of this comorbidity; second, the focus on interventions, particularly randomized controlled trials, aimed at enhancing diabetes management among individuals with depression; and finally, the investigation of the involved risk factors and biological mechanisms underlying this bidirectional relationship. CONCLUSION There has been a recent surge of interest in the relationship between diabetes and depression. This could aid researchers to identify areas lacking in the literature and shape future research.
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Affiliation(s)
- Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
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Kristensen CB, Chilcot J, Jackson SE, Steptoe A, Hackett RA. The impact of a diabetes diagnosis on health and well-being: Findings from the English Longitudinal Study of Ageing. J Diabetes 2024; 16:e13518. [PMID: 38112231 PMCID: PMC11212344 DOI: 10.1111/1753-0407.13518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/27/2023] [Accepted: 11/23/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Poorer health and well-being are associated with diabetes risk. However, little is known about the trajectory of health and well-being from before to after diabetes diagnosis. We compared depressive symptoms, quality of life, self-rated health, and loneliness at three time points (prediagnosis, diagnosis, 2-4 years post diagnosis) in individuals who developed diabetes and a comparison group. METHODS Health and well-being measures were self-reported by 3474 participants from the English Longitudinal Study of Ageing. Repeated measures analysis of variance and generalized estimating equations were used to investigate differences by group, time, and group-by-time interactions. RESULTS A total of 473 (13.6%) participants developed diabetes. The diabetes group reported greater depressive symptoms (W2(1) = 20.67, p < .001) and lower quality of life (F = 1, 2535 = 10.30, p = .001) and were more likely to rate their health as fair/poor (W2(1) = 67.11, p < .001) across time points, adjusting for age, sex, and wealth. They also reported greater loneliness (F = 1, 2693 = 9.70, p = .002) in unadjusted analyses. However, this was attenuated to the null in adjusted analyses. The group-by-time interaction was significant for quality of life (F = 1.97, 5003.58 = 5.60, p = .004) and self-rated health (W2(2) = 11.69, p = .003), with a greater decline in these measures over time in the diabetes group in adjusted analyses. CONCLUSION People who received a diabetes diagnosis had greater depressive symptoms, lower quality of life, and poorer self-rated health than those who did not develop diabetes. Quality of life and self-rated health deteriorated more rapidly following a diagnosis. Screening for these factors around the time of diagnosis could allow for interventions to improve the health and well-being of those with diabetes.
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Affiliation(s)
- Camilla Böhme Kristensen
- Health Psychology Section, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Joseph Chilcot
- Health Psychology Section, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Sarah E. Jackson
- Department of Behavioural Science and Health, Institute of Epidemiology and Health CareUniversity College LondonLondonUK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology and Health CareUniversity College LondonLondonUK
| | - Ruth A. Hackett
- Health Psychology Section, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
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Saeed Alqahtani SA, Alasmre FA, Alasmre HA, Alasmre LA, Mohammed YM, Aljuaid N, Alzahrani FAR, Alghamdi SJH, Alzahrani YMM, Abanmi SN. The Relationship Between Gestational Diabetes and Postpartum Depression: A Systematic Review. Cureus 2024; 16:e64219. [PMID: 39130921 PMCID: PMC11315442 DOI: 10.7759/cureus.64219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2024] [Indexed: 08/13/2024] Open
Abstract
This study aims to examine the relationship between gestational diabetes mellitus (GDM) and the likelihood of postpartum depression (PPD) symptoms. PubMed, Scopus, Web of Science, ScienceDirect, and the Wiley Online Library were systematically searched for relevant literature. Our results included eight studies with a total of 4,209 women diagnosed with GDM and/or PPD. The prevalence of PPD in women diagnosed with GDM ranged from 6.5% to 48.4%. The included studies demonstrated that PPD was more likely to strike women with GDM. One study reported that the most severe type of GDM is more likely to occur in those with a history of depression. Perinatal depression during pregnancy can be strongly predicted by age, BMI, and a personal history of depression. The findings imply that GDM and the likelihood of depression during the postpartum phase are related. It was also found that there was a positive correlation between depression and the chance of having GDM. This emphasizes how the association between GDM and depression appears to be reciprocal. However, the association does not imply causation, and the data at hand do not allow for the establishment of causality. Subsequent studies ought to endeavor to show causative connections between GDM and depression as well as pinpoint shared underlying endocrine variables that may play a role in the genesis of both conditions. The available information that is now available is limited due to the complexity of the etiology of both GD and depression in pregnant women; nonetheless, prevention of both conditions depends on a better understanding of the link between GD and depression. The risk of bias in the included studies was moderate to high.
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Affiliation(s)
| | - Faris A Alasmre
- Department of Obstetrics and Gynecology, Abha Maternity and Children Hospital, Abha, SAU
| | - Hind A Alasmre
- College of Medicine and Surgery, King Khalid University, Abha, SAU
| | | | - Yousef M Mohammed
- Department of Obstetrics and Gynecology, Abha Maternity and Children Hospital, Abha, SAU
| | - Norah Aljuaid
- College of Medicine and Surgery, Umm Al-Qura University, Makkah, SAU
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Yoon YJ. Depressive symptom trajectory of older adults with diabetes: exploring the role of physical activities using latent growth modeling. Aging Ment Health 2024; 28:1041-1049. [PMID: 38353514 DOI: 10.1080/13607863.2024.2313722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/25/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES The literature highlights the role of physical activities in reducing depression, primarily in clinical samples and international longitudinal studies on older adults with diabetes. Based on Andersen's Behavioral Model, this study aims to describe the trajectory of depressive symptoms in this population and examine whether physical activities are associated with this trajectory. METHODS This study used a longitudinal survey design, utilizing three waves of data from the Health and Retirement Study. The respondents were adults aged 50 or older (N = 4,278) with diabetes. After conducting descriptive analyses, latent growth modeling was performed including unconditional and conditional models. RESULTS The overall trajectory of depressive symptoms in adults with diabetes decreased over a 4-year period. Physical activities were significantly associated with the variance in the intercept of the trajectory (p < .05), but not associated with the variance in the slope (p > .05). Additionally, this study identified factors significantly associated with the variance in the intercept (e.g. age, gender, race, marriage, education, income, self-reported health) or the slope (e.g. race, marriage, education, self-reported health) of the depressive symptom trajectory (p < .05). CONCLUSION The findings underscore the importance of implementing targeted interventions to encourage and promote physical activities among older adults with diabetes, recognizing the potential benefits for managing their mental health.
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Affiliation(s)
- Young Ji Yoon
- Department of Social Work, Colorado State University Pueblo, Pueblo, USA
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Byrne B, McInerney AM, Deschênes SS. A network analysis of depressive symptoms in adults with and without diabetes: findings from the Irish longitudinal study on ageing. Ir J Psychol Med 2024:1-10. [PMID: 38699795 DOI: 10.1017/ipm.2024.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
OBJECTIVES This study aimed to estimate networks of depressive symptoms among Irish adults with and without diabetes at two time points and compare between the two groups at each time point using data from the Irish Longitudinal Study on Ageing (TILDA). METHODS Participants were from Wave 1 (2009-2011) and Wave 4 (2016) of TILDA, with n = 639 participants with diabetes and n = 7,837 without diabetes at Wave 1, and n = 1,151 with diabetes and n = 4,531 without diabetes at Wave 4. Depressive symptoms were measured using the 8 items of the Center for Epidemiologic Studies Depression Scale. Network psychometric analysis was used to examine symptom centrality, symptom-level associations, and network comparisons at each time point. RESULTS Stable, strongly connected networks emerged for people with and without diabetes at both time points. The symptoms of feeling depressed, feeling like everything's an effort, not enjoying life, feeling sad, and couldn't get going were the most central nodes in all networks, which did not differ between people with and without diabetes. However, for people with diabetes, the network was more densely connected at Wave 4, when the sample was predominately people with newly diagnosed diabetes. Furthermore, the relationship between 'felt lonely' and 'couldn't get going' and between 'not enjoying life' and 'sad' was significantly stronger for people with diabetes than for those without. CONCLUSIONS This study provides a more detailed understanding of the structure of depressive symptoms at two time points in older Irish adults with and without type 1 or type 2 diabetes.
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Affiliation(s)
- Brendan Byrne
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Amy M McInerney
- School of Psychology, University College Dublin, Dublin, Ireland
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Ganz M, Schrier R, Yomtov N, Spivak M, Bulmash M, Appelbaum Y, Gejerman Y, Miller D. Investigating the Influence of Antidiabetic Medications and Psychosocial Factors. Cureus 2024; 16:e60270. [PMID: 38872673 PMCID: PMC11170669 DOI: 10.7759/cureus.60270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/15/2024] Open
Abstract
The relationship between type 2 diabetes mellitus (T2DM) and depression presents a significant area of medical concern, characterized by a higher incidence of depression among T2DM patients compared to the general population. This connection is not only evidenced in the prevalence of depressive symptoms in diabetic patients but also in the way these symptoms impact diabetes management. Furthermore, the influence of antidiabetic medications, especially sodium-glucose cotransporter-2 (SGLT2) inhibitors, on depression risk is a topic of ongoing research, with contrasting findings regarding the effects of drugs like metformin and pioglitazone. The aim of this study is to provide a comprehensive analysis of the relationship between T2DM and depression, focusing on the prevalence of depressive symptoms among diabetic patients, and the role of antidiabetic medications in modulating depression risk. Methods Utilizing data from the National Health and Nutrition Examination Survey (NHANES), we focused on individuals with T2DM. Depression status was assessed using the nine-item Patient Health Questionnaire (PHQ-9), a validated tool for evaluating depressive symptoms. Participants' depression status was categorized based on PHQ-9 composite scores. The analysis included demographic variables and the use of antidiabetic medications, with a focus on SGLT2 inhibitors. Logistic regression models adjusted for age, race/ethnicity, and BMI were employed. Results Our study involved 23,575 participants, of which 7,862 had T2DM. A significant difference in age and BMI was observed between diabetic and non-diabetic groups. Logistic regression analysis indicated that non-diabetic individuals had a significantly lower likelihood of depression compared to diabetic patients not on SGLT2 inhibitors. However, no statistically significant difference in depression levels was found between diabetic patients on SGLT2 inhibitors and those not on these medications. Conclusion These findings highlight the complex relationship between diabetes, antidiabetic medication, and depression. Notably, we found no significant impact of SGLT2 inhibitors on depression in diabetic patients, challenging previous assumptions about the role of specific antidiabetic drugs in mental health. We also revealed that older diabetic individuals reported fewer depressive symptoms, suggesting the influence of psychosocial factors and the need for age-specific depression management strategies. This research underscores the necessity of further studies to explore the nuanced effects of different antidiabetic medications on mental health outcomes, guiding toward more personalized treatment approaches for the mental health challenges in T2DM.
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Affiliation(s)
- Marc Ganz
- Public Health Sciences, State University of New York Downstate Health Sciences University, Brooklyn, USA
| | - Rena Schrier
- Internal Medicine, State University of New York Downstate Health Sciences University, Brooklyn, USA
| | - Netanel Yomtov
- Internal Medicine, State University of New York Downstate Health Sciences University, Brooklyn, USA
| | - Mark Spivak
- Internal Medicine, State University of New York Downstate Health Sciences University, Brooklyn, USA
| | | | - Yisroel Appelbaum
- Internal Medicine, Touro College of Osteopathic Medicine, New York, USA
| | | | - Daniel Miller
- Internal Medicine, Icahn School of Medicine at Mount Sinai, NYC Health + Hospitals/Queens, New York, USA
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Woo J, Lehrer HM, Tabibi D, Cebulske L, Tanaka H, Steinhardt M. The Association of Multidimensional Sleep Health With HbA1c and Depressive Symptoms in African American Adults With Type 2 Diabetes. Psychosom Med 2024; 86:307-314. [PMID: 38724038 PMCID: PMC11090412 DOI: 10.1097/psy.0000000000001298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2024]
Abstract
OBJECTIVE Sleep is important for diabetes-related health outcomes. Using a multidimensional sleep health framework, we examined the association of individual sleep health dimensions and a composite sleep health score with hemoglobin A1c (HbA1c) and depressive symptoms among African American adults with type 2 diabetes. METHODS Participants (N = 257; mean age = 62.5 years) were recruited through local churches. Wrist-worn actigraphy and sleep questionnaire data assessed multidimensional sleep health using the RuSATED framework (regularity, satisfaction, alertness, timing, efficiency, duration). Individual sleep dimensions were dichotomized into poor or good sleep health and summed into a composite score. HbA1c was assessed using the DCA Vantage™ Analyzer or A1CNow® Self Check. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Regression models examined the association of individual sleep dimensions and composite sleep health with HbA1c and depressive symptoms. RESULTS Higher composite sleep health scores were associated with a lower likelihood of having greater than minimal depressive symptoms (PHQ-9 ≥ 5) (odds ratio [OR] = 0.578, 95% confidence interval [CI] = 0.461-0.725). Several individual sleep dimensions, including irregularity (OR = 1.013, CI = 1.005-1.021), poor satisfaction (OR = 3.130, CI = 2.095-4.678), and lower alertness (OR = 1.866, CI = 1.230-2.833) were associated with a greater likelihood of having depressive symptoms. Neither composite sleep health scores nor individual sleep dimensions were associated with HbA1c. CONCLUSIONS Better multidimensional sleep health is associated with lower depressive symptoms among African American adults with type 2 diabetes. Longitudinal research is needed to determine the causal association between multidimensional sleep health and depressive symptoms in this population. TRIAL REGISTRY ClinicalTrials.gov identifier NCT04282395.
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Affiliation(s)
- Jihun Woo
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX
| | | | - Doonya Tabibi
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX
| | - Lauren Cebulske
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX
| | - Hirofumi Tanaka
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX
| | - Mary Steinhardt
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX
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Horsbøl TA, Hoffmann SH, Thorsted AB, Rosenkilde S, Lehn SF, Kofoed-Enevoldsen A, Santos M, Iversen PB, Thygesen LC. Diabetic complications and risk of depression and anxiety among adults with type 2 diabetes. Diabet Med 2024; 41:e15272. [PMID: 38157285 DOI: 10.1111/dme.15272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 01/03/2024]
Abstract
AIMS To investigate if diabetic complications increase the risk of depression and/or anxiety among adults with type 2 diabetes. METHODS This register-based, prospective study included 265,799 adult individuals diagnosed with type 2 diabetes between 1997 and 2017 without a recent history of depression or anxiety. Diabetic complications included cardiovascular disease, amputation of lower extremities, neuropathy, nephropathy and retinopathy. Both diabetic complications and depression and anxiety were defined by hospital contacts and prescription-based medication. All individuals were followed from the date of type 2 diabetes diagnosis until the date of incident depression or anxiety, emigration, death or 31 December 2018, whichever occurred first. RESULTS The total risk time was 1,915,390 person-years. The incidence rate of depression and/or anxiety was 3368 per 100,000 person-years among individuals with diabetic complications and 1929 per 100,000 person-years among those without. Having or developing any diabetic complication was associated with an increased risk of depression and/or anxiety (HR 1.77, 95% CI 1.73-1.80). The risk for depression and/or anxiety was increased for all types of diabetic complications. The strongest association was found for amputation of lower extremities (HR 2.16, 95% CI 2.01-2.31) and the weakest for retinopathy (HR 1.13, 95% CI 1.09-1.17). CONCLUSION Individuals with type 2 diabetes and diabetic complications are at increased risk of depression and anxiety. This points towards the importance of an increased clinical focus on mental well-being among individuals with type 2 diabetes and complications.
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Affiliation(s)
| | - Sofie Have Hoffmann
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anne Bonde Thorsted
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Siri Rosenkilde
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Sara Fokdal Lehn
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Steno Diabetes Center Sjaelland, Holbaek, Denmark
| | - Allan Kofoed-Enevoldsen
- Steno Diabetes Center Sjaelland, Holbaek, Denmark
- Department of Endocrinology, Nykøbing Falster Hospital, Nykøbing Falster, Denmark
| | | | | | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Lau D, Gamble JM. Suicidality among users of glucagon-like peptide-1 receptor agonists: An emerging signal? Diabetes Obes Metab 2024; 26:1150-1156. [PMID: 38229461 DOI: 10.1111/dom.15459] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/18/2024]
Affiliation(s)
- Darren Lau
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - John-Michael Gamble
- School of Pharmacy, Faculty of Science, University of Waterloo, Kitchener, Ontario, Canada
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Taheri Kondar R, Hassani L, Ghanbarnejad A. The effect of educational intervention based on social support theory on the perceived stress caused by the covid-19 pandemic in patients with diabetes in hormozgan (2020-2021). BMC Public Health 2024; 24:691. [PMID: 38438887 PMCID: PMC10913277 DOI: 10.1186/s12889-024-18180-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND People with diabetes are more at risk of covid-19. Perceived social support plays an important role in maintaining people's health and reducing the negative effects of stress caused by the environment and society. The present study was designed and implemented with the purpose of determining the effect of educational intervention based on social support theory in reducing stress caused by the covid-19 pandemic in people with diabetes. METHODS The current investigation was an interventional and semi-experimental study conducted on 212 patients diagnosed with type 2 diabetes. Eligible participants were diabetic individuals capable of utilizing virtual platforms and not afflicted with COVID-19. Exclusion criteria encompassed unwillingness to continue study participation, absence from multiple training sessions, and development of a specific illness during the study period. Random allocation placed patients into either the control or intervention group. The intervention group received educational materials via WhatsApp, while the control group did not receive any intervention. The researcher administered a questionnaire to collect demographic information and assess perceived social support among the patients. Data analysis involved the use of chi-square tests, independent and paired t-tests, as well as ANCOVA. RESULTS This study revealed that the mean age of patients in the control and intervention groups was 46.35 ± 14.15 and 51.72 ± 11.57, respectively. Most of the diabetic patients in both groups were female, married, had a diploma, were housekeepers, and had an income between 2 and 5 million Tomans. According to the results obtained in all subscales of social support theory as well as the perceived stress score due to the corona pandemic after the educational intervention, a statistically significant difference was observed between the two groups (P < 0.05), so that the score of all subscales of social support theory in the intervention group was higher than the control group. But the perceived stress score caused by Corona in the intervention group was significantly lower than the control group. CONCLUSION The results of this study illustrate the noteworthy influence of social support training in lessening perceived stress among patients with diabetes during the COVID-19 pandemic. Consequently, healthcare providers are encouraged to integrate social support education programs into comprehensive care initiatives for diabetic patients, particularly during periods of heightened stress like the current coronavirus pandemic.
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Affiliation(s)
- Reihaneh Taheri Kondar
- MSc of Health Education and Promotion HUMS, Hormozgan University of Medical Sciences (HUMS), BandarAbbas, Iran
| | - Laleh Hassani
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, BandarAbbas, Iran.
| | - Amin Ghanbarnejad
- Department of community medicine, research institute for health, Hormozgan University of medical sciences, BandarAbbas, Iran
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Huber H, Schieren A, Holst JJ, Simon MC. Dietary impact on fasting and stimulated GLP-1 secretion in different metabolic conditions - a narrative review. Am J Clin Nutr 2024; 119:599-627. [PMID: 38218319 PMCID: PMC10972717 DOI: 10.1016/j.ajcnut.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/15/2024] Open
Abstract
Glucagon-like peptide 1 (GLP-1), a gastrointestinal peptide and central mediator of glucose metabolism, is secreted by L cells in the intestine in response to food intake. Postprandial secretion of GLP-1 is triggered by nutrient-sensing via transporters and G-protein-coupled receptors (GPCRs). GLP-1 secretion may be lower in adults with obesity/overweight (OW) or type 2 diabetes mellitus (T2DM) than in those with normal glucose tolerance (NGT), but these findings are inconsistent. Because of the actions of GLP-1 on stimulating insulin secretion and promoting weight loss, GLP-1 and its analogs are used in pharmacologic preparations for the treatment of T2DM. However, physiologically stimulated GLP-1 secretion through the diet might be a preventive or synergistic method for improving glucose metabolism in individuals who are OW, or have impaired glucose tolerance (IGT) or T2DM. This narrative review focuses on fasting and postprandial GLP-1 secretion in individuals with different metabolic conditions and degrees of glucose intolerance. Further, the influence of relevant diet-related factors (e.g., specific diets, meal composition, and size, phytochemical content, and gut microbiome) that could affect fasting and postprandial GLP-1 secretion are discussed. Some studies showed diminished glucose- or meal-stimulated GLP-1 response in participants with T2DM, IGT, or OW compared with those with NGT, whereas other studies have reported an elevated or unchanged GLP-1 response in T2DM or IGT. Meal composition, especially the relationship between macronutrients and interventions targeting the microbiome can impact postprandial GLP-1 secretion, although it is not clear which macronutrients are strong stimulants of GLP-1. Moreover, glucose tolerance, antidiabetic treatment, grade of overweight/obesity, and sex were important factors influencing GLP-1 secretion. The results presented in this review highlight the potential of nutritional and physiologic stimulation of GLP-1 secretion. Further research on fasting and postprandial GLP-1 concentrations and the resulting metabolic consequences under different metabolic conditions is needed.
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Affiliation(s)
- Hanna Huber
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Institute of Neuroscience and Physiology, Mölndal, Sweden; Department Nutrition and Microbiota, University of Bonn, Institute of Nutrition and Food Science, Bonn, Germany
| | - Alina Schieren
- Department Nutrition and Microbiota, University of Bonn, Institute of Nutrition and Food Science, Bonn, Germany
| | - Jens Juul Holst
- Department of Biomedical Sciences, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Marie-Christine Simon
- Department Nutrition and Microbiota, University of Bonn, Institute of Nutrition and Food Science, Bonn, Germany.
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Bernhardsen GP, Thomas O, Mäntyselkä P, Niskanen L, Vanhala M, Koponen H, Lehto SM. Metabolites and depressive symptoms: Network- and longitudinal analyses from the Finnish Depression and Metabolic Syndrome in Adults (FDMSA) Study. J Affect Disord 2024; 347:199-209. [PMID: 38000471 DOI: 10.1016/j.jad.2023.11.070] [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: 03/16/2023] [Revised: 10/20/2023] [Accepted: 11/18/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Depression is associated with metabolic abnormalities linked to metabolic syndrome and tissue inflammation, but the interplay between metabolic markers and their association with subsequent depression is unknown. Therefore, we aimed to describe the network of metabolites and their prospective association with depressive symptoms. METHODS The Finnish Depression and Metabolic Syndrome in Adults (FDMSA) cohort, originally a prospective case-control study, comprised a group with Beck Depression Inventory (BDI)-I scores ≥10 at baseline, and controls (n = 319, BDI-I < 10); mean (sd) follow-up time: 7.4 (0.7) years. Serum metabolic biomarkers were determined by proton nuclear magnetic resonance (NMR), and depressive symptoms sum-score by using the BDI-I. We examined the prospective associations between metabolites at baseline and BDI score at follow-up utilizing multivariate linear regression, parsimonious predictions models and network analysis. RESULTS Some metabolites tended to be either negatively (e.g. histidine) or positively associated (e.g. glycoprotein acetylation, creatinine and triglycerides in very large high density lipoproteins [XL-HDL-TG]) with depressive symptoms. None of the associations were significant after correction for multiple testing. The network analysis suggested high correlation among the metabolites, but that none of the metabolites directly influenced subsequent depressive symptoms. LIMITATIONS Although the sample size may be considered satisfactory in a prospective context, we cannot exclude the possibility that our study was underpowered. CONCLUSIONS Our results suggest that the investigated metabolic biomarkers are not a driving force in the development of depressive symptoms. These findings should be confirmed in studies with larger samples and studies that account for the heterogeneity of depressive disorders.
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Affiliation(s)
- Guro Pauck Bernhardsen
- Department of Research and Development, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.
| | - Owen Thomas
- Division of Research and Innovation, Akershus University Hospital, Lørenskog, Norway
| | - Pekka Mäntyselkä
- Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Kuopio, Finland; Clinical Research and Trials Centre, Kuopio University Hospital, Wellbeing Services County of North Savo, Kuopio, Finland
| | - Leo Niskanen
- Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Kuopio, Finland; Departments of Internal Medicine, Endocrinology/Diabetology, Päijät-Häme Central Hospital, Lahti, Finland; Eira Medical Center and Hospital, Helsinki, Finland
| | - Mauno Vanhala
- Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Kuopio, Finland
| | - Hannu Koponen
- Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Soili M Lehto
- Department of Research and Development, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry, University of Helsinki, Helsinki, Finland
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Wicaksana AL, Apriliyasari RW, Tsai PS. Effect of self-help interventions on psychological, glycemic, and behavioral outcomes in patients with diabetes: A meta-analysis of randomized controlled trials. Int J Nurs Stud 2024; 149:104626. [PMID: 37979371 DOI: 10.1016/j.ijnurstu.2023.104626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 10/06/2023] [Accepted: 10/19/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Self-help interventions are beneficial for patients with diabetes; however, related studies have reported conflicting results. To date, no review has examined the effect of self-help interventions on diabetes outcomes. OBJECTIVES To systematically evaluate the effects of self-help interventions on psychological, glycemic, and behavioral outcomes in patients with diabetes. DESIGN A systematic review and meta-analysis of randomized controlled trials. METHODS Five databases-PubMed, CINAHL, Embase, PsycINFO, and ClinicalTrials.gov-were searched from 1996, 1937, 1947, 1887, and 2000, respectively, to 2 June 2023. Studies that employed a randomized controlled trial design, enrolled adults with diabetes, implemented a self-help intervention as the main or an additional intervention, and reported the outcomes of interest were included. Studies providing self-help interventions to patients with gestational diabetes or pregnant women were excluded. The primary outcomes were diabetes distress, depression, and anxiety, and the secondary outcomes were glycemic and behavioral outcomes (self-management behavior, self-efficacy, and quality of life). Hedges' g and the associated 95 % confidence interval (CI) were calculated using a random-effects model to obtain the pooled estimates of short-, mid-, and long-term effects of self-help interventions. Heterogeneity was explored using I2 and Q statistics, and moderator analysis was performed to identify the sources of heterogeneity. RESULTS Of 17 eligible studies, 16 provided data for meta-analysis. We included 3083 patients with diabetes; the majority were women (61.95 %), and their average age was 55.13 years. Self-help interventions exerted significant short-term effects on diabetes distress (g = -0.363; 95 % CI = -0.554, -0.173), depression (g = -0.465; 95 % CI = -0.773, -0.156), anxiety (g = -0.295; 95 % CI = -0.523, -0.068), glycosylated hemoglobin level (g = -0.497; 95 % CI = -0.791, -0.167), self-efficacy (g = 0.629; 95 % CI = 0.060, 1.197), and quality of life (g = 0.413; 95 % CI = 0.104, 0.721; g = 0.182; 95 % CI = 0.031, 0.333; and g = 0.469; 95 % CI = 0.156, 0.783 for overall, physical, and mental domains, respectively). We also noted significant mid-term effects of self-help interventions on diabetes distress (g = -0.195; 95 % CI = -0.374, -0.016), self-management behavior (g = 0.305; 95 % CI = 0.155, 0.454), and overall quality of life (g = 0.562; 95 % CI = 0.315, 0.810). The certainty of evidence ranged from high to very low certainty for the measured outcomes. CONCLUSIONS Self-help interventions may have some positive effects on diabetes distress, anxiety, self-management behavior, and quality of life. REGISTRATION This review was registered in PROSPERO (CRD42022329905). TWEETABLE ABSTRACT This meta-analysis demonstrated that self-help interventions might improve psychological and behavioral outcomes in patients with diabetes.
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Affiliation(s)
- Anggi Lukman Wicaksana
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Medical Surgical Nursing, Universitas Gadjah Mada, Indonesia; The Sleman Health and Demographic Surveillance System, Universitas Gadjah Mada, Indonesia
| | - Renny Wulan Apriliyasari
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Institut Teknologi Kesehatan Cendekia Utama Kudus, Kudus, Indonesia
| | - Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing and Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
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Deng MG, Liu F, Wang K, Zhang MJ, Feng Q, Liu J. Association between dietary flavonoid intake and depressive symptoms: A cross-sectional research. Gen Hosp Psychiatry 2024; 86:75-84. [PMID: 38134552 DOI: 10.1016/j.genhosppsych.2023.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE To investigate the relationship between dietary flavonoid intake and depression symptoms in American adults. METHODS Data sets were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007-2008, 2009-2010, and 2017-2018 survey cycles. Both males and females aged 18 years and older with complete information about dietary flavonoid intake (isoflavones, anthocyanidins, flavan-3-ols, flavanones, flavones, and flavonols), depression symptoms, and covariates were included. Logistic regression models were conducted to calculate the odds ratio (OR) of single dietary flavonoid subclass intake on depression, and the restricted cubic spline (RCS) models were utilized to explore the corresponding dose-response relationships. Additionally, we implemented the weighted quantile sum (WQS) regression and quantile g-computation (qgcomp) models to estimate the mixed effects of six flavonoid subclasses and identify the predominant types. RESULTS After multivariable adjustments, people with higher consumption of flavanones (OR: 0.68, 95% CI: 0.52-0.90, p = 0.008), flavones (OR: 0.63, 95% CI: 0.46-0.87, p = 0.007), flavonols (OR: 0.66, 95% CI: 0.49-0.89, p = 0.008), and total flavonoids (OR: 0.69, 95% CI: 0.50-0.95, p = 0.024) had lower odds of depression symptoms. Meanwhile, significant dose-response relationships were supported by the RCS models. However, no obvious associations between isoflavones, anthocyanidins, flavan-3-ols, and the odds of suffering from depression symptoms were found by the logistic regression models and RCS models. As for the mixed effect, the WQS and qgcomp models both demonstrated that the mixture of six flavonoid subclasses was inversely related to the odds ratios of depression symptoms, and flavones, flavanones, and anthocyanidins were the top 3 contributors. CONCLUSION Our study implied dietary flavonoid intake was associated with the decreased probability of depression symptoms in U.S. adults, among which flavones, flavanones, and anthocyanidins may occupy the predominant roles.
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Affiliation(s)
- Ming-Gang Deng
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan 430012, Hubei, China; Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan 430012, Hubei, China.
| | - Fang Liu
- School of Public Health, Wuhan University, Wuhan 430071, Hubei, China
| | - Kai Wang
- Department of Public Health, Wuhan Fourth Hospital, Wuhan 430033, Hubei, China
| | - Min-Jie Zhang
- School of Public Health, Wuhan University, Wuhan 430071, Hubei, China
| | - Qianqian Feng
- School of Public Health, Wuhan University, Wuhan 430071, Hubei, China
| | - Jiewei Liu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan 430012, Hubei, China; Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan 430012, Hubei, China.
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Yamamoto N, Sakazaki M, Nagai Y, Shoji M, Kawashima R. The effects of palatinose on attention and cerebral blood flow in healthy adults: A randomized double-blind placebo-controlled crossover study. Brain Res 2023; 1820:148553. [PMID: 37633356 DOI: 10.1016/j.brainres.2023.148553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/09/2023] [Accepted: 08/23/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVE The primary energy source for the brain is glucose, and a continuous supply is required for the brain to work longer. This study aimed to verify the effects of palatinose on attention and cerebral blood flow in healthy adults. METHODS This randomized, double-blind, placebo-controlled crossover study included 64 healthy Japanese adults. Participants performed the Digit Vigilance Task (DVT) 60 min pre-ingestion (14:00) and 0 (15:00), 60 (16:00), 120 (17:00), and 180 (18:00) min after ingestion of 10 g of either palatinose or glucose. Cerebral blood flow was measured using a wearable 2CH functional near-infrared spectrometer (fNIRS) during each DVT. The participants underwent the Uchida-Kraepelin (UK) test between each DVT to control for fatigue. RESULTS DVT reaction times with palatinose intake were significantly shorter than those with glucose intake at 16:00, 17:00, and 18:00 (p = 0.0015, p < 0.001, and p < 0.001, respectively). The change in cerebral blood flow as a function of total hemoglobin level was significantly higher in the palatinose group than in the glucose group (p = 0.018). Regarding the post-UK mood questionnaire, "physically fatigued" and "annoyed" were significantly lower in the palatinose intake group compared to the glucose intake group at 17:00 (p = 0.0445 and p = 0.0318, respectively). Furthermore, "physically fatigued" was significantly lower, and "seriously" was higher in the palatinose intake compared to the glucose intake group at 18:00 (p = 0.00652 and p < 0.001, respectively). CONCLUSION These findings suggest that 10 g of palatinose has favorable effects on attention and cerebral blood flow. TRIAL REGISTRATION UMIN000046182.
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Affiliation(s)
- Natsumi Yamamoto
- Mitsui DM Sugar Co., Ltd., 2-28-7, Kamiochiai, Shinjuku-ku, Tokyo 161-0034, Japan.
| | - Miki Sakazaki
- Mitsui DM Sugar Co., Ltd., 2-28-7, Kamiochiai, Shinjuku-ku, Tokyo 161-0034, Japan
| | - Yukie Nagai
- Mitsui DM Sugar Co., Ltd., 2-28-7, Kamiochiai, Shinjuku-ku, Tokyo 161-0034, Japan
| | | | - Ryuta Kawashima
- NeU Corporation, Chiyoda-ku, Tokyo 101-0048, Japan; Institute of Development, Aging and Cancer (IDAC), Tohoku University, Aoba-ku, Sendai 980-0872, Japan
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Carr KD, Weiner SP, Vasquez C, Schmidt AM. Involvement of the Receptor for Advanced Glycation End Products (RAGE) in high fat-high sugar diet-induced anhedonia in rats. Physiol Behav 2023; 271:114337. [PMID: 37625475 PMCID: PMC10592025 DOI: 10.1016/j.physbeh.2023.114337] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/08/2023] [Accepted: 08/21/2023] [Indexed: 08/27/2023]
Abstract
Clinical and basic science investigation indicates a link between insulin resistance and anhedonia. Previous results of this laboratory point to impaired nucleus accumbens (NAc) insulin signaling as an underpinning of diet-induced anhedonia, based on use of a glucose lick microstructure assay. The present study evaluated whether advanced glycation end products (AGEs) and their receptor (RAGE), known to mediate obesogenic diet-induced inflammation and pathological metabolic conditions, are involved in this behavioral change. Six weeks maintenance of male and female rats on a high fat-high sugar liquid diet (chocolate Ensure) increased body weight gain, and markedly increased circulating insulin and leptin, but induced anhedonia (decreased first minute lick rate and lick burst size) in males only. In these subjects, anhedonia correlated with plasma concentrations of insulin. Although the diet did not alter plasma or NAc AGEs, or the expression of RAGE in the NAc, marginally significant correlations were seen between anhedonia and plasma content of several AGEs and NAc RAGE. Importantly, a small molecule RAGE antagonist, RAGE229, administered twice daily by oral gavage, prevented diet-induced anhedonia. This beneficial effect was associated with improved adipose function, reflected in the adiponectin/leptin ratio, and increased pCREB/total CREB in the NAc, and a shift in the pCREB correlation with pThr34-DARPP-32 from near-zero to strongly positive, such that both phospho-proteins correlated with the rescued hedonic response. This set of findings suggests that the receptor/signaling pathway and cell type underlying the RAGE229-mediated increase in pCREB may mediate anhedonia and its prevention. The possible role of adipose tissue as a locus of diet-induced RAGE signaling, and source of circulating factors that target NAc to modify hedonic reactivity are discussed.
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Affiliation(s)
- Kenneth D Carr
- Departments of Psychiatry, New York University Grossman School of Medicine, 435 East 30th Street, New York, NY 10016, United States; Departments of Biochemistry and Molecular Pharmacology, New York University Grossman School of Medicine, 435 East 30th Street, New York, NY 10016, United States.
| | - Sydney P Weiner
- Departments of Psychiatry, New York University Grossman School of Medicine, 435 East 30th Street, New York, NY 10016, United States
| | - Carolina Vasquez
- Departments of Psychiatry, New York University Grossman School of Medicine, 435 East 30th Street, New York, NY 10016, United States; Departments of Diabetes Research Program, Department of Medicine, New York University Grossman School of Medicine, 435 East 30th Street, New York, NY 10016, United States
| | - Ann Marie Schmidt
- Departments of Diabetes Research Program, Department of Medicine, New York University Grossman School of Medicine, 435 East 30th Street, New York, NY 10016, United States
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Yorke E, Boima V, Ganu V, Tetteh J, Twumasi L, Ekem‐Ferguson G, Kretchy I, Mate‐Kole CC. The mediating role of quality of life on depression and medication adherence among patients with type 2 diabetes mellitus: A cross-sectional study. Health Sci Rep 2023; 6:e1539. [PMID: 37662538 PMCID: PMC10469042 DOI: 10.1002/hsr2.1539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/27/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
Background and Aim Patients living with diabetes mellitus have a high burden of psychological distress such as depression and anxiety as well as impaired quality of life, which may negatively impact their adherence to medications, glucose control, and health-related costs.This study assessed the impact of quality of life and depression on medication adherence among patients with type 2 diabetes (type 2 diabetes mellitus [T2DM]) in a tertiary care setting in Ghana. Methods The study was a cross-sectional study involving 238 patients with diabetes aged 18 years and above. Validated tools were used to assess medication adherence, depressive symptoms, and quality of life. Structural Equation Modeling was adopted to examine the mediation effect of quality of life on the relationship between depression and medication adherence among participants. Results The mean age of the participants was 58.82 ± 13.49, and 169 (71.0%) out of a total of 238 respondents were females. Depression had a significant direct relationship with the quality of life of respondents [aβ (95% confidence interval, CI) = -0.20 (-0.03, -0.00), p < 0.05; -0.21 (-0.41, -0.01) p < 0.05, respectively] and indirect relationship with quality of life [aβ (95% CI) = -0.01 (-0.02, -0.004) p < 0.001]. Educational status and religion both showed a significant indirect relationship with quality of life [aβ (95% CI) = 0.06 (0.07, 0.12), p < 0.05; 0.18 (0.01, 0.35) p < 0.05, respectively]. The mediating effect of quality of life on the relationship between depression and medication adherence was significant (Sobel = -3.19, p < 0.001). Conclusion Depression, medication adherence, and quality of life were higher among older adults with T2DM. Depression was also found to have a strong negative association with both medication adherence and quality of life. Interventions to screen for depression and to improve the quality of life in patients living with diabetes are also recommended and this should go beyond the provision of standard treatments to explore further the mechanisms of this relationships.
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Affiliation(s)
- Ernest Yorke
- Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | - Vincent Boima
- Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | - Vincent Ganu
- Department of Medicine and Cardiothoracic UnitKorle‐Bu Teaching HospitalAccraGhana
| | - John Tetteh
- Department of Community Health, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | | | - George Ekem‐Ferguson
- Department of PsychologyUniversity of GhanaAccraGhana
- National Cardiothoracic CenterKorle Bu Teaching HospitalAccraGhana
- Department of Psychiatry, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | - Irene Kretchy
- Department of PsychologyUniversity of GhanaAccraGhana
| | - Christopher C. Mate‐Kole
- Department of PsychologyUniversity of GhanaAccraGhana
- Department of Psychiatry, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
- Center for Ageing Studies, College of HumanitiesUniversity of Ghana
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