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: 8.42). 10/2012; 35(12). DOI: 10.2337/dc11-2329
Source: PubMed


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.

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Available from: Dana Dabelea, Apr 10, 2014
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    • "Moreover, the majority of studies evaluate depressive population, in contrast with the present investigation which evaluated depressive symptoms in an obese population. Hood et al. [22] showed that greater metabolic abnormalities , such as leptin, are associated with higher depressive categories in adolescents with diabetes, however, this was also a cross-sectional study and they did not test for gender differences. "
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    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 · 2.62 Impact Factor
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    • "Moreover, in several studies, hyperleptinemia and insulin resistance, which can be present in obesity, MetS, and DM2 have been also linked to endothelial dysfunction or inflammation processes [46,47], conditions also present in depression. Not only metabolic disturbances but also inflammatory markers have been recently associated with depressive symptoms in participants with diabetes from the SEARCH for Diabetes in Youth cohort study [48]. "
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    ABSTRACT: A few observational studies have found an inverse association between adherence to a Mediterranean diet and the risk of depression. Randomized trials with an intervention based on this dietary pattern could provide the most definitive answer to the findings reported by observational studies. The aim of this study was to compare in a randomized trial the effects of two Mediterranean diets versus a low-fat diet on depression risk after at least 3 years of intervention. This was a multicenter, randomized, primary prevention field trial of cardiovascular disease (Prevención con Dieta Mediterránea (PREDIMED Study)) based on community-dwelling men aged 55 to 80 years and women aged 60 to 80 years at high risk of cardiovascular disease (51% of them had type 2 diabetes; DM2) attending primary care centers affiliated with 11 Spanish teaching hospitals. Primary analyses were performed on an intention-to-treat basis. Cox regression models were used to assess the relationship between the nutritional intervention groups and the incidence of depression. We identified 224 new cases of depression during follow-up. There was an inverse association with depression for participants assigned to a Mediterranean diet supplemented with nuts (multivariate hazard ratio (HR) 0.78; 95% confidence interval (CI) 0.55 to 1.10) compared with participants assigned to the control group, although this was not significant. However, when the analysis was restricted to participants with DM2, the magnitude of the effect of the intervention with the Mediterranean diet supplemented with nuts did reach statistical significance (multivariate HR = 0.59; 95% CI 0.36 to 0.98). The result suggest that a Mediterranean diet supplemented with nuts could exert a beneficial effect on the risk of depression in patients with DM2. This trial has been registered in the Current Controlled Trials with the number ISRCTN 35739639.
    BMC Medicine 09/2013; 11(1):208. DOI:10.1186/1741-7015-11-208 · 7.25 Impact Factor
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    • "p = .01). Higher CRP levels remained 6 months after depressive episode had abated in those subjects exposed to higher levels of childhood adversity Hood et al., 2012 1. To provide preliminary evidence that the increased risk for depression in youth with diabetes is associated with metabolic and inflammatory markers 2. To inform future examinations of the directionality of these associations 2,359 youths with diabetes from the SEARCH study – an observational study of US children diagnosed with diabetes at <20 years of age. "
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    ABSTRACT: While cytokines have been implicated in the pathophysiology of depression in adults, the potential role in younger age groups such as adolescents is less clear. This article therefore reviews the literature (a) to explore the relationship between cytokines and depression in adolescents, and (b) to examine how cytokines may be related to adolescent depression in the context of other neurobiological theories of depression. A systematic review of the scientific literature on the subject was conducted in February 2013, searching the Web of Knowledge, PubMed (Medline), PsycInfo and Cochrane electronic databases. Eighteen studies were identified measuring both depression or depressive symptoms and cytokines or immune markers in adolescents. Adolescents with depression show age-specific characteristics of the immune and inflammatory system, specifically in NK cell activity and in pro-inflammatory cytokines (such as IL-1β and TNF-α). In addition, the role of cytokines in adolescent depression is influenced by neurodevelopment, hormonal changes, stress and trauma. There may be differences in the neurobiology of adolescent major depressive disorder (MDD) compared with adult MDD. Increased understanding of the role of cytokines in adolescent MDD may lead to improved outcomes in the treatment of adolescent depression.
    Journal of Child Psychology and Psychiatry 08/2013; 54(8):816-35. DOI:10.1111/jcpp.12080 · 6.46 Impact Factor
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