Article

Metabolic and Inflammatory Links to Depression in Youth With Diabetes.

Department of Pediatrics, University of California, San Francisco, San Francisco, California.
Diabetes care (Impact Factor: 8.57). 10/2012; DOI: 10.2337/dc11-2329
Source: PubMed

ABSTRACT OBJECTIVE
Youth with diabetes are at increased risk for depression. The objectives of this study were to provide preliminary evidence that this at-risk status for depression is associated with metabolic and inflammatory markers and to inform future, more stringent examinations of the directionality of these associations.RESEARCH DESIGN AND METHODS
Data from SEARCH for Diabetes in Youth Study Group (SEARCH), an observational study of U.S. children diagnosed with diabetes at <20 years of age, were used for these analyses. SEARCH participants were drawn from four geographically defined populations in Ohio, Washington, South Carolina, and Colorado; health plan enrollees in Hawaii and California; and Indian Health Service beneficiaries from four Native American populations. Participants were 2,359 youth with diabetes from the 2001 prevalent and 2002-2004 incident SEARCH cohorts. Depression was measured with the Center for Epidemiologic Studies Depression scale. Eight metabolic and inflammatory markers were measured: adiponectin, leptin, C-reactive protein, serum amyloid A, apolipoprotein B (apoB), lipoprotein A, interleukin-6, and LDL.RESULTSSix of eight markers were significantly (P < 0.006) associated with depression in youth with diabetes in bivariate analyses. In general, higher levels of depression were associated with indicators of worse metabolic or inflammatory functioning. In regression models stratified by diabetes type and accounting for demographic and clinical characteristics, only higher levels of apoB remained associated with higher levels of depression in youth with type 1 diabetes.CONCLUSIONS
These data suggest that depression reported by youth with diabetes is partially associated with metabolic abnormalities and systemic inflammation.

0 Followers
 · 
86 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Type 2 diabetes (T2D) in youth is a relatively novel condition facing paediatric health care providers. Few experimental trials exist to guide clinical management in this population. Supporting and prescribing modifiable lifestyle behaviours is cornerstone in the management of T2D in adults. Clinical trials in obese adolescents suggest that intensive lifestyle interventions that include both dietary changes and increased physical activity elicit clinically meaningful reductions in weight and improve cardiovascular risk profiles. Observational studies in youth with T2D suggest that better diet quality and increased physical activity are associated with better metabolic control; however, the limited experimental data available does not support these observations. Trials evaluating lifestyle monotherapy for the treatment of hyperglycaemia in youth with T2D do not exist, and the only study evaluating combined lifestyle and pharmacologic therapy did not show additional benefit over pharmacologic treatment with metformin alone. Physiological and psychosocial differences between youth and adults with T2D likely contribute to the differences in the effectiveness of lifestyle therapy for improving glycaemic control. The current review describes these topics in detail and provides recommendations for paediatric health care providers for the promotion of lifestyle therapy for the management of hyperglycaemia and cardiovascular risk factors for youth with T2DM.
    Current Diabetes Reports 01/2015; 15(1):568. DOI:10.1007/s11892-014-0568-z · 3.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Because of the absence of data on the direct association between inflammation and depression in patients with diabetes, we examined the association between hs-CRP levels and the high prevalence of depression in adult patients with type 2 diabetes.RESEARCH DESIGN AND METHODS: Cross-sectional data were obtained from 3,573 patients with type 2 diabetes recruited from a Japanese diabetes registry. A multiple logistic regression analysis adjusted for potential confounders was used to assess independent associations between hs-CRP levels and major depression, as defined by the Patient Health Questionnaire-9.RESULTS: Mean age, BMI, and HbA1c levels were 66.0 years, 24.6 kg/m(2), and 7.4% (57.8 mmol/mol), respectively, and 122 patients (3.4%) suffered from major depression. In the age- and sex-adjusted model, the odds ratio (OR) for major depression was 1.86 (95% CI 1.01-3.42; P = 0.045) in the highest CRP quintile compared with that in the 3rd CRP quintile; however, this association disappeared after adjustment for other possible confounders (OR 1.58 [95% CI 0.85-2.94]; P = 0.148). Among patients with a BMI of ≥25 kg/m(2), a significant association was observed between the highest hs-CRP quintile and major depression (multivariable-adjusted OR 2.69 [95% CI 1.09-7.08]; P = 0.032).CONCLUSIONS: We observed a significant positive association between high hs-CRP levels and depression in patients with diabetes who had a high BMI.
    Diabetes Care 06/2014; 37(9). DOI:10.2337/dc13-2312 · 8.57 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Several studies have sought to clarify the association between adolescent obesity and psychological distress. Recently a biological link between leptin resistance and depression has been proposed. The aim of the present study was to examine changes in leptin concentrations as a potential predictor of reduced depression symptoms in obese adolescents during long-term interdisciplinary weight loss therapy. Seventy five obese adolescents (Age: 16,28 ± 2,37 years; BMI: 35,65 ± 4,64 kg/m2) engaged in a long-term interdisciplinary therapy for weight loss. They were evaluated at baseline and after one year of treatment for body composition, serum analyses and depression symptomatology. After therapy, body mass BMI, fat mass (% and Kg), waist circumference, visceral, subcutaneous and visceral/subcutaneous fat and depression symptoms decreased and lean mass (%) increased significantly. There was an improvement in inflammatory profiles with a significant reduction in leptin and increase in adiponectin. Regression analyses showed that decreased leptin predicted amelioration in depression symptoms independent of age, gender and changes in visceral fat, body mass, fat mass (%) and leptin/adiponectin ratio. These associations appear stronger in girls than boys. The attenuation of hyperleptinemia appears to play an important role in the association between weight loss and depression, particularly in obese girls.
    Peptides 01/2015; 65. DOI:10.1016/j.peptides.2014.11.010 · 2.61 Impact Factor

Full-text (2 Sources)

Download
21 Downloads
Available from
May 26, 2014