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1.
Acta Diabetol ; 2020 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-32277296

RESUMO

AIMS: Food addiction (FA) is conceptualized as a behavioral pattern that is similar in some ways to addictions to alcohol and other substances. This disorder has not been well studied among patients with type 2 diabetes (T2DM). We aimed to analyze if there is any relationship between FA and clinical or psychological variables among patients with T2DM. METHODS: Three hundred patients with T2DM were analyzed cross-sectionally. Participants were evaluated for the presence of FA by completing the Yale Food Addiction Scale 2.0 questionnaire. RESULTS: 29.3% of patients screened positive for FA. Patients with FA had a greater BMI (33.41 ± 7.5 vs. 31.6 ± 5.9 kg/m2; p = 0.04). HbA1c was higher among individuals with FA (7.9 ± 4.4 vs. 7.6 ± 1.4%, p = 0.008). The proportion of subjects with diabetic retinopathy, neuropathy and nephropathy was greater among patients with criteria for FA compared with patients without this condition (25% vs. 13.2%, 29.5% vs. 21.8% and 32% vs. 22.3%; p = 0.03, p = 0.05 and p = 0.05, respectively). The percentage of patients with FA with significant depressive symptoms was also greater (36.4% vs. 18.5%; p = 0.002). CONCLUSIONS: The presence of FA among T2DM patients implied a worse glycaemic control. Microvascular complications and depressive symptoms were higher among these patients.

2.
Endocrinol Diabetes Nutr ; 64(6): 338-339, 2017.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29056281
4.
Nutr Hosp ; 34(1): 81-87, 2017 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-28244776

RESUMO

INTRODUCTION: Obesity is linked to a low-grade chronic systemic inflammation that improves after weight loss. Depressive disorder has been suggested to be associated with systemic inflammation up regulation. OBJECTIVE: We aimed to explore whether, after a significant weight loss, the presence of depressive symptoms was associated with differences in terms of inflammatory markers and quality of life. METHODS: Sixty patients (78.3%♀, age 46.4 ± 9.9) who underwent bariatric surgery, with a minimum follow up of 18 months, were evaluated. For the screening of depression, the Beck Depression Inventory (BDI) was administered. RESULTS: Ten subjects (16.6%) had a positive screening for depressive disorder. The percentage of patients with weight regain was greater among subjects with symptoms of depression (70% vs. 32%; p = 0.024), although no differences were seen regarding BMI prior to surgery and current BMI. Acute phase reactants were higher among subjects with symptoms of depression: platelets (319 ± 15 x 10^12/L vs. 232 ± 47 x 10 ^ 12/L; p = 0.001), erythrocyte sedimentation rate (24.7 ± 11.3 mm vs.17 ± 10 mm; p = 0.03), fibrinogen (486 ± 107 mg/dL vs. 406 ± 66 mg/dL; p = 0.003), ferritin (106 ± 180 ng/ml vs. 34 ± 44 ng/ml; p = 0.014) and ultrasensitive C-reactive protein (0.96 ± 1.84 mg/dL vs. 0.24 ± 0.26 mg/dL; p = 0.008). All domains of quality of life were significantly lower in the depressive group. CONCLUSIONS: Despite a significant weight loss, inflammatory markers are greater and quality of life lower when associated with depressive symptoms.


Assuntos
Cirurgia Bariátrica/psicologia , Depressão/psicologia , Inflamação/sangue , Qualidade de Vida , Perda de Peso , Adulto , Biomarcadores/sangue , Depressão/epidemiologia , Depressão/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia , Obesidade/cirurgia , Obesidade Mórbida/cirurgia , Escalas de Graduação Psiquiátrica , Resultado do Tratamento
6.
Nutr. hosp ; 34(1): 81-87, ene.-feb. 2017. tab
Artigo em Inglês | IBECS | ID: ibc-161145

RESUMO

Introduction: Obesity is linked to a low-grade chronic systemic inflammation that improves after weight loss. Depressive disorder has been suggested to be associated with systemic inflammation up regulation. Objective: We aimed to explore whether, after a significant weight loss, the presence of depressive symptoms was associated with differences in terms of inflammatory markers and quality of life. Methods: Sixty patients (78.3%♀, age 46.4 ± 9.9) who underwent bariatric surgery, with a minimum follow up of 18 months, were evaluated. For the screening of depression, the Beck Depression Inventory (BDI) was administered. Results: Ten subjects (16.6%) had a positive screening for depressive disorder. The percentage of patients with weight regain was greater among subjects with symptoms of depression (70% vs. 32%; p = 0.024), although no differences were seen regarding BMI prior to surgery and current BMI. Acute phase reactants were higher among subjects with symptoms of depression: platelets (319 ± 15 x 10


Introducción: la obesidad se asocia a una inflamación crónica de bajo grado que mejora tras la pérdida de peso. El trastorno depresivo también se ha asociado a una inflamación sistémica. Objetivo: determinar si, tras una pérdida de peso significativa, la presencia de síntomas depresivos se asocia a diferencias en los marcadores inflamatorios y la calidad de vida. Métodos: sesenta pacientes (78,3% ♀, edad 46,4 ± 9.9) sometidos a cirugía bariátrica, con un seguimiento mínimo de 18 meses, fueron evaluados. Se autoadministró el test de depresión de Beck (BDI) para el screening de depresión. Resultados: diez sujetos (16,6%) tenían un screening positivo para depresión. El porcentaje de pacientes que ganaron peso fue superior en el grupo de pacientes con síntomas depresivos (70% vs. 32%; p = 0,024), aunque no se evidenciaron diferencias en cuanto al IMC antes de la cirugía ni al IMC actual. Los reactantes de fase aguda fueron mayores entre los sujetos con síntomas depresivos: plaquetas (319 ± 15 x 10


Assuntos
Humanos , Depressão/epidemiologia , Cirurgia Bariátrica/psicologia , Obesidade/psicologia , Perda de Peso , Mediadores da Inflamação/análise , Inflamação/fisiopatologia , Obesidade/cirurgia , Proteínas da Fase Aguda/análise , Qualidade de Vida
7.
Endocrinol Diabetes Nutr ; 64 Suppl 1: 15-22, 2017 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27543006
8.
Obes Surg ; 26(8): 1836-42, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-26661106

RESUMO

BACKGROUND: Specific data is needed to safely expand bariatric surgery and to preserve good surgical outcomes in response to the non-stop increase in obesity prevalence worldwide. OBJECTIVE: The aims of this study are to provide an overview of the baseline characteristics, type of surgery, and 30-day postoperative morbidity and mortality in patients undergoing bariatric surgery in Spanish public hospitals, and evaluate changes throughout the 2000-2014 period. MATERIAL AND METHODS: This is a descriptive study using data from the RICIBA, a computerized multicenter and multidisciplinary registry created by the Obesity Group of the Endocrinology and Nutrition Spanish Society. Three periods according to the date of surgery were created: January 2000 to December 2004 (G1), January 2005 to December 2009 (G2), and January 2010 to December 2014 (G3). RESULTS: Data from 3843 patients were available (44.8 ± 10.5 years, a 3:1 female-to-male ratio, 46.9 ± 8.2 kg/m(2)). Throughout the 15-year period assessed, candidate patients for bariatric surgery were progressively older and less obese, with an increase in associated comorbidities and in the prevalence of men. The global trend also showed a progressive decrease in Roux-en-Y gastric bypass, the most performed bariatric procedure (75.1 % in G1, 69.3 % in G2, and 42.6 % in G3; p < 0.001), associated with a parallel increase in sleeve gastrectomy (0.8 % in G1, 18.1 % in G2, and 39.6 % in G3; p < 0.001). An overall mortality rate of 0.3 % was reported. CONCLUSIONS: Data from Spain is similar to data observed worldwide. Information recorded in the National Registries like RICIBA is necessary in order to safely expand bariatric surgery in response to increasing demand.


Assuntos
Cirurgia Bariátrica/estatística & dados numéricos , Obesidade Mórbida/cirurgia , Cirurgia Bariátrica/métodos , Cirurgia Bariátrica/tendências , Comorbidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/mortalidade , Período Pós-Operatório , Prevalência , Sistema de Registros , Espanha/epidemiologia
11.
Eat Behav ; 18: 147-50, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26094133

RESUMO

INTRODUCTION/PURPOSE: After bariatric surgery, de novo eating patterns can develop, such as grazing. Although grazing has been associated with poorer weight loss, it has received minimal attention. We aimed to assess the influence of grazing in clinical, biochemical and psychological outcomes in a bariatric surgery sample. MATERIALS AND METHODS: Sixty patients (78.3%♀, age 46.35±9.89, months since BS 46.28±18.1) who underwent BS were evaluated cross-sectionally. Clinical, biochemical and psychological parameters were recorded. A pattern of grazing was assessed in this group of patients through interview. RESULTS: 41.7% met criteria for grazing. Mean time since BS was greater in the group with grazing (57.64±23.7months vs 38.8±26.44months; p=0.008). Although there were no differences in initial and current BMI, the percentage of patients with weight regain was greater among patients with grazing (72% vs 11.7%; p<0.0001) and the percentage of excess weight loss was lower (28.15±6.96% vs 33.35±11.9%; p=0.05). There were more difficulties in following the standardized visits according to our hospital's protocol (17.6% vs 56%; p=0.009). No significant differences were found when assessing presurgical psychiatric comorbidity among patients with a grazing pattern and individuals without this condition (68% vs 55.9%; p=0.423). When assessing quality of life only mental health was lower among patients with grazing (49.6±22.7 vs 64.2±23.3; p=0.02). CONCLUSION: Development of grazing is frequent after BS, especially when weight loss has reached a plateau. Due to its potential association with weight regain, systematic screening of grazing after BS is warranted.


Assuntos
Cirurgia Bariátrica , Comportamento Alimentar/psicologia , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Fatores de Risco , Resultado do Tratamento , Perda de Peso
12.
Acta Diabetol ; 52(6): 1037-44, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25841588

RESUMO

AIMS: Data regarding the prevalence of eating disorders (ED) and their influence on clinical outcomes among patients with type 2 diabetes (T2DM) are scarce. Our aim is to investigate the frequency of positive screening for ED, specifically binge eating disorder (BED), in a T2DM sample and analyze whether there are any differences among T2DM subjects with a positive screening for ED or BED. METHODS: Three hundred and twenty subjects with T2DM were recruited randomly. All participants were evaluated for the presence of ED by completing the "Eating Attitudes Test-26" (EAT-26). In addition, the "Questionnaire of Eating and Weight Patterns-Revised" (QEWP-R) for the screening of BED was also implemented. Sociodemographic, clinical and biochemical parameters were also recorded. RESULTS: According to EAT-26, 14 % of subjects screened positive for ED. Regarding QEWP-R, 16 % had a positive screening for ED, with BED having a frequency of 12.2 %, being the most prevalent one. There was a positive correlation between the scores obtained with the EAT-26 and the Beck Depression Inventory (p = 0.0014). Patients with BED were younger (57.5 ± 11.1 vs 63.3 ± 10.3 years; p = 0.004), with a lesser T2DM duration (8.5 ± 6.1 vs 12.1 ± 9.6 years; p = 0.002). Weight and BMI among subjects with BED were greater (89.1 ± 1.3 vs 82.4 ± 16.7 kg; p = 0.04 and 39.4 ± 10.3 vs 30.7 ± 5.5 kg/m(2); p = 0.01). The frequency of subjects with one admission related to T2DM or any other condition during the last year was higher (10 vs 3 %; p = 0.04 and 33 vs 21 %; p = 0.01). CONCLUSIONS: ED among T2DM are frequent. Due to their deleterious effect on different metabolic and psychological outcomes, they should be diagnosed promptly, especially BED.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Idoso , Atitude , Transtorno da Compulsão Alimentar/complicações , Transtorno da Compulsão Alimentar/epidemiologia , Transtorno da Compulsão Alimentar/psicologia , Estudos Transversais , Depressão/complicações , Depressão/psicologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Atenção Primária à Saúde , Escalas de Graduação Psiquiátrica , Atenção Secundária à Saúde , Fatores Socioeconômicos , Espanha/epidemiologia , Inquéritos e Questionários , Resultado do Tratamento
13.
Nutr. hosp ; 31(3): 1052-1058, mar. 2015. tab
Artigo em Inglês | IBECS | ID: ibc-134396

RESUMO

Introduction: There is an increasing awareness of the strong associations between obesity and adult attention-deficit/hyperactivity disorder (ADHD), with high rates of ADHD (26-61%) in patients seeking weight loss. Aims: To determine the frequency of ADHD in a bariatric surgery (BS) sample and investigate whether there were any differences among clinical, analytical and psychological parameters in individuals with criteria for ADHD. Methods: Sixty patients (78.3% female, age 46.3±9.8, months since BS 46.28±18.1) who underwent BS, with a minimum follow-up of 18 months, were evaluated cross-sectionally. Initial and current BMI, eating patterns, comorbidity, socio-demographic and biochemical parameters were recorded. For the screening of ADHD, ADHD self rating scale-v1.1 was administered. Results: Nineteen individuals (31.6%) had a positive screening for ADHD. This group had higher levels of HDL-cholesterol (62.8±17.3mg/dl vs 53.5±9.9mg/dl; p=0.011) and Apo-A (177.7±28.4mg/dl vs 154.9±34.7mg/ dl; p=0.015), and an increased consumption of lipids (42.2±7.1% vs 36.7±8.3%; p=0.019). Subjects with ADHD symptoms had more difficulties in following visits after BS (52.6% vs 24.3%; p= 0.011).We could not find any differences in achieved BMI, depressive symptoms or quality of life. Conclusions: Patients who met criteria for ADHD face significant difficulties with compliance in follow-up, but we could not find differences in major clinical outcomes. Surprisingly, these patients could have a protective lipid profile (AU)


Introducción: Hay una creciente concienciación de la fuerte asociación entre la obesidad y el trastorno por déficit de atención/hiperactividad del adulto (TDAH), con elevadas tasas de TDAH (26-61%) en los pacientes que consultan por pérdida ponderal. Objetivos: conocer la frecuencia del TDAH en una muestra de sujetos sometidos a cirugía bariátrica (CB) e investigar si existen diferencias clínicas, analíticas y psicológicas en estos sujetos. Métodos: Sesenta pacientes (78.3% mujeres, edad 46.3±9.8, meses desde la CB 46.28±18.1) sometidos a CB, con un seguimiento mínimo desde ésta de 18 meses, fueron evaluados transversalmente. Se recogieron y analizaron el IMC inicial y en el momento de la evaluación, patrones alimentarios, comorbilidades, y parámetros sociodemográficos y bioquímicos. Para el screening del TDAH se administró la versión española del 'ADHD self-rating scale v 1.1'. Resultados: Diecinueve individuos (31.6%) tenían un screening positivo para TDAH. Estos sujetos tenían niveles superiores de HDL colesterol (62.8±17.3mg/dl vs 53.5±9.9mg/dl; p=0.011) y Apo-A (177.7±28.4mg/dl vs 154.9±34.7mg/dl; p=0.015), y un consumo mayor de lípidos en la dieta (42.2±7.1% vs 36.7±8.3%; p=0.019). Estos sujetos tenían más dificultades en seguir las visitas protocolizadas tras la CB (52.6% vs 24.3%; p= 0.011). No se evidenciaron diferencias en el IMC alcanzado, síntomas depresivos o calidad de vida. Conclusiones: Los pacientes sometidos a CB con criterios para TDAH presentan más dificultades en la adherencia al seguimiento, pero no se evidenciaron diferencias en resultados clínicos relevantes. Curiosamente, estos sujetos podrían presentar un perfil lipídico protector (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Cirurgia Bariátrica , Obesidade/cirurgia , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Resultado do Tratamento , Depressão/epidemiologia , Cooperação do Paciente/estatística & dados numéricos , Índice de Massa Corporal , HDL-Colesterol/análise
14.
Nutr Hosp ; 31(3): 1052-8, 2014 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-25726192

RESUMO

INTRODUCTION: There is an increasing awareness of the strong associations between obesity and adult attention- deficit/hyperactivity disorder (ADHD), with high rates of ADHD (26-61%) in patients seeking weight loss. AIMS: To determine the frequency of ADHD in a bariatric surgery (BS) sample and investigate whether there were any differences among clinical, analytical and psychological parameters in individuals with criteria for ADHD. METHODS: Sixty patients (78.3% female, age 46.3±9.8, months since BS 46.28±18.1) who underwent BS, with a minimum follow-up of 18 months, were evaluated cross-sectionally. Initial and current BMI, eating patterns, comorbidity, socio-demographic and biochemical parameters were recorded. For the screening of ADHD, ADHD self rating scale-v1.1 was administered. RESULTS: Nineteen individuals (31.6%) had a positive screening for ADHD. This group had higher levels of HDL-cholesterol (62.8±17.3 mg/dl vs 53.5±9.9 mg/dl; p=0.011) and Apo-A (177.7±28.4 mg/dl vs 154.9±34.7 mg/ dl; p=0.015), and an increased consumption of lipids (42.2±7.1% vs 36.7±8.3%; p=0.019). Subjects with ADHD symptoms had more difficulties in following visits after BS (52.6% vs 24.3%; p= 0.011).We could not find any differences in achieved BMI, depressive symptoms or quality of life. CONCLUSIONS: Patients who met criteria for ADHD face significant difficulties with compliance in follow-up, but we could not find differences in major clinical outcomes. Surprisingly, these patients could have a protective lipid profile.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/complicações , Cirurgia Bariátrica , Comportamento Alimentar , Obesidade Mórbida/complicações , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/sangue , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Glicemia/análise , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Seguimentos , Homocisteína/sangue , Humanos , Hidrocortisona/sangue , Insulina/sangue , Leptina/sangue , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/sangue , Obesidade Mórbida/psicologia , Obesidade Mórbida/cirurgia , Cooperação do Paciente , Período Pós-Operatório , Avaliação de Sintomas , Vitaminas/sangue
15.
Nutr. hosp ; 29(3): 674-680, 2014. tab
Artigo em Inglês | IBECS | ID: ibc-120640

RESUMO

Background & aims: Malnutrition is very common in patients when admitted to the hospital. The aim of the present study was: a) to determine the prevalence of malnutrition at admission in a tertiary care hospital and identify risk factors for malnutrition, and b) to test the sensitivity and specificity of different screening tests for malnutrition compared to subjective global assessment (SGA). Methods: We conducted a prospective study at 24h of admission in order to assess malnutrition in 537 adult subjects (56.4% males, mean age of 61.3±17.7 years) using 4 different screening tools: mininutritional assessment short form (MNA-SF), nutritional risk screening 2002 (NRS2002), malnutrition universal screening tool (MUST), and SGA. Anthropometrics and comorbidities were registered. Results: The overall rate of undernutrition was 47.3%. Specific rates were 54.2% in patients > 65y vs.40.7% < 65y (p = 0.002) and 63.4% in medical vs.34.0% surgical department (p < 0.001). Identified risk factors of malnutrition at admission were: the presence of heart disease (OR 1.74 CI 95% 1.16-2.60 p = 0.007) for MNA-SF (AUC 0.62); liver disease (OR 4.45 CI 95% 1.9410.22 p < 0.001), > 65y (OR 2.10 CI 95% 1.19-3.93 p = 0.011), medicine department (OR 3.58 CI 95% 1.93-6.62 p < 0.001) for SGA (AUC 0.96); lung disease (OR 3.34 CI 95% 1.45-7.73 p = 0.005), medicine department (OR 2.55 CI 95%1.09-5.98 p = 0.032) for NRS 2002 (AUC 0.97). Recent unintentional weight loss was a common factor. Conclusions: Undernourishment at hospital admission is frequent. Comorbidities may contribute to the presence of undernutrition at admission. Nonetheless, SGA, NRS2002, MNA-SF or MUST can be used in our setting (AU)


Antecedentes y objetivos: La desnutrición es muy frecuente en los pacientes que ingresan en el hospital. El objetivo de nuestro estudio es a) determinar la prevalencia de desnutrición al ingreso en un hospital de tercer nivel e identificar los factores de riesgo para desnutrición. b) Estudiar la sensibilidad y especificidad de diferentes test de cribado de desnutrición comparados con las valoración global subjetiva (VGS). Material y métodos: Realizamos un estudio prospectivo a las 24 h del ingreso hospitalario a individuos (56.4% hombres con una edad media de 61,3 ± 17 años) utilizando 4 test de cribado diferentes: mininutritional assessment short form (MNA-SF), nutritional risk screening 2002 (NRS2002), malnutrition universal screening tool (MUST) y VGS. Además, se recogieron medidas antropométricas y comorbilidades. Resultados: La prevalencia global de desnutrición fue de 47.3%. Las tasas específicas fueron 54,2% para > 65 años, 40,7% en < 65 años (p = 0,002), 63,4% en las áreas médicas, 34,0% áreas quirúrgicas (p < 0,001). Los factores que influían en la presencia de desnutrición al ingreso fueron: cardiopatía (OR 1,74 IC 95% 1,16-2,60 p = 0,007) en el MNA-SF (AUC 0,62); hepatopatía (OR 4,45 IC 95% 1.9410,22 p < 0,001), > 65 años (OR 2,10 IC 95% 1,19-3,93 p = 0,011), áreas médicas (OR 3,58 IC 95% 1,93-6,62 p < 0,001) en la VGS (AUC 0,96); neumopatía (OR 3,34 IC 95% 1,45-7,73 p = 0,005), áreas médicas (OR 2,55 IC 95% 1,09-5,98 p = 0,032) en el NRS 2002 (AUC 0,97). La pérdida de peso involuntaria fue común a todos los test. Conclusiones: La desnutrición es frecuente al ingreso hospitalario. La presencia de comorbilidades puede influir en la presencia de desnutrición al ingreso, sin embargo, podemos utilizar cualquiera de los tests propuestos para su detección en nuestro hospital (AU)


Assuntos
Humanos , Desnutrição/epidemiologia , Programas de Rastreamento/métodos , Doença Crônica , Fatores de Risco , Risco Ajustado/métodos , Reprodutibilidade dos Testes , Hospitalização/estatística & dados numéricos , Comorbidade
16.
Endocrinol. nutr. (Ed. impr.) ; 60(10): 583-589, dic. 2013. tab
Artigo em Espanhol | IBECS | ID: ibc-118143

RESUMO

La diabetes tipo 2 y el trastorno depresivo son 2 enfermedades crónicas con una alta prevalencia en los países desarrollados, y con un impacto negativo sobre la calidad y la esperanza de vida. En los últimos años se ha demostrado que ambas entidades se hallan fuertemente asociadas, existiendo un mayor riesgo de desarrollar un trastorno depresivo entre la población diabética, así como de presentar alteraciones en la homeostasis de la glucosa si existe un síndrome depresivo. La coexistencia de una depresión en los pacientes diabéticos condiciona una mayor dificultad en el manejo de la enfermedad y en el control metabólico, un riesgo incrementado de desarrollar complicaciones crónicas, una disminución de la calidad de vida y un aumento del gasto sanitario. Ello ha suscitado el interés de las sociedades científicas, que ya aconsejan evaluar periódicamente el estado de ánimo. Sin embargo, la escasa experiencia a nivel clínico y los resultados contradictorios a nivel científico hacen que la elaboración de conclusiones resulte prematura (AU)


Type 2 diabetes and depressive disorder are 2 chronic diseases highly prevalent in developed countries and with a negative impact on quality of life and life expectancy. In recent years, both conditions have been shown to be strongly associated. Thus, diabetics have an increased risk of suffering depressive disorder, as well as impaired glucose homeostasis, if they experience depression. In diabetic patients, concurrent depression is associated to greater difficulties in disease management and metabolic control, increased risk of developing chronic complications, decreased quality of life, and higher healthcare expenses. As a result, the interest of diabetic scientific societies in this association has increased, and they recommend regular mood assessment in diabetic patients. However, the limited clinical experience available and the conflicting results reported to date make it difficult to draw conclusions (AU)


Assuntos
Humanos , Diabetes Mellitus Tipo 2/complicações , Transtorno Depressivo/complicações , Fatores de Risco , Hiperglicemia/prevenção & controle , Qualidade de Vida , Perfil de Impacto da Doença
17.
Diabetes Res Clin Pract ; 101(2): 148-52, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23800573

RESUMO

BACKGROUND AND OBJECTIVES: Type 2 diabetes (T2DM) almost doubles the risk of comorbid depression, with lifetime prevalence up to 29%. Recognition and treatment of depression in T2DM are important because of its association with hyperglycemia, diabetic complications and poor quality of life (QoL). However, although currently available medical therapy for depression is effective in reducing depressive symptoms, it does not consistently improve HbA1c levels. The aim of this study was to determine the effects of antidepressant therapy on depressive symptoms, health-related QoL and metabolic control in T2DM. METHODS: 48 T2DM (47.8% males, age 59.8 ± 11.1, T2DM duration 9.5 ± 6.5 years) who had a major depressive disorder diagnosed with a Beck Depression Inventory (BDI) test score greater than 16 and confirmed with a structured interview, were prescribed citalopram 20mg once daily. 10 out of 48 refused the prescription and were used as controls. BDI score, BMI, HbA1c and the Spanish version of the SF-36 Health Survey were recorded baseline and after 6 months of treatment. Sociodemographic characteristics, complications related to T2DM and comorbidities were also recorded. RESULTS: No differences in baseline characteristics were observed between the two groups. When compared with the untreated group (n=10), patients treated with citalopram (n=38) showed significant improvements in BDI score and in almost all areas of quality of life, except in general health and bodily pain. No differences in HbA1c, waist circumference or BMI were found. CONCLUSIONS: Treating depressive symptoms with medical therapy in T2DM is associated with improvements in QoL and depression, but with no improvement in metabolic control or weight.


Assuntos
Depressão/tratamento farmacológico , Diabetes Mellitus Tipo 2/patologia , Diabetes Mellitus Tipo 2/psicologia , Idoso , Antidepressivos de Segunda Geração/uso terapêutico , Citalopram/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Resultado do Tratamento
18.
Endocrinol Nutr ; 60(10): 583-9, 2013 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-23664193

RESUMO

Type 2 diabetes and depressive disorder are 2 chronic diseases highly prevalent in developed countries and with a negative impact on quality of life and life expectancy. In recent years, both conditions have been shown to be strongly associated. Thus, diabetics have an increased risk of suffering depressive disorder, as well as impaired glucose homeostasis, if they experience depression. In diabetic patients, concurrent depression is associated to greater difficulties in disease management and metabolic control, increased risk of developing chronic complications, decreased quality of life, and higher healthcare expenses. As a result, the interest of diabetic scientific societies in this association has increased, and they recommend regular mood assessment in diabetic patients. However, the limited clinical experience available and the conflicting results reported to date make it difficult to draw conclusions.


Assuntos
Transtorno Depressivo/complicações , Diabetes Mellitus Tipo 2/complicações , Transtorno Depressivo/terapia , Diabetes Mellitus Tipo 2/terapia , Previsões , Humanos
19.
Obes Surg ; 23(4): 509-14, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23090430

RESUMO

BACKGROUND: Obesity impairs quality of life, but the perception of the impairment could be different from one country to another. The purpose was to compare weight-related quality of life (QOL) between cohorts from Spain and North America. METHODS: A cross-sectional case-control study was performed between two populations. Four hundred Spanish and 400 North American obese subjects suitable for bariatric surgery closely matched for race, gender, age, and body mass index (BMI) were included. Two non-obese control groups matched for gender, age, and BMI from each population were also evaluated (n = 400 in each group). The participants completed the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire, a measure of weight-related QOL. RESULTS: Spanish morbidly obese patients showed poorer QOL than their North American counterparts in physical function, sexual life, work, and total score. By contrast, Spanish non-obese control subjects reported better QOL in all domains than their North American counterparts. Women, both in Spain and North America, reported reduced QOL compared to men on the domain of self-esteem. In addition, North American women reported reduced QOL on the sexual life domain compared to men. BMI correlated negatively with all domains of QOL except for self-esteem in both national groups. CONCLUSIONS: Spanish obese subjects suitable for bariatric surgery report poorer weight-related quality of life than their North American counterparts, and obese women, regardless of nationality, perceive a reduced quality of life compared to men.


Assuntos
Cirurgia Bariátrica , Índice de Massa Corporal , Obesidade Mórbida/psicologia , Qualidade de Vida , Autoimagem , Adulto , Cirurgia Bariátrica/psicologia , Estudos de Casos e Controles , Comparação Transcultural , Estudos Transversais , Emprego/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , América do Norte/epidemiologia , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/cirurgia , Comportamento Sexual/psicologia , Espanha/epidemiologia , Inquéritos e Questionários
20.
Invest Ophthalmol Vis Sci ; 51(9): 4416-21, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20375324

RESUMO

PURPOSE: To explore the metabolic profile of vitreous fluid of patients with proliferative diabetic retinopathy (PDR) using 1H-NMR-based metabonomic analysis. METHODS: 1H-NMR spectra were acquired from vitreous samples obtained during vitrectomy from 22 patients with type 1 diabetes with PDR and from 22 nondiabetic patients with macular hole (control group). Data analysis included a principal component analysis and partial least squares discriminant analysis (PLS-DA). In addition, 1H-(1)H and 1H-(13)C HMQC correlation spectra were acquired for the identification of metabolites. Furthermore, the main metabolites accounting for the differences in metabolic profile were assessed by current biochemical methods. RESULTS: Lactate was the most abundant metabolite, and it was present at higher levels in samples from PDR patients than from nondiabetic patients (P=0.02). Glucose was significantly higher in samples from PDR patients than nondiabetic patients (P=0.03). After removing the lactate peak at 1.35 ppm and with the use of PLS-DA, a model was obtained that was able to correctly classify 19 of 22 patients with PDR and 18 of 22 controls, resulting in a sensitivity of 86% and a specificity of 81%. The main metabolites involved in this specific pattern recognition were galactitol and ascorbic acid (AA); levels of both were significantly lower in PDR patients. CONCLUSIONS: 1H-NMR-based metabonomic analysis of vitreous fluid permits the obtainment of a metabolic signature of PDR. Apart from the higher abundance of lactate and glucose, significant deficits of galactitol and AA are the main metabolic fingerprints of vitreous fluid from PDR patients.


Assuntos
Retinopatia Diabética/diagnóstico , Retinopatia Diabética/metabolismo , Metabolômica/métodos , Ressonância Magnética Nuclear Biomolecular , Corpo Vítreo/metabolismo , Adulto , Ácido Ascórbico/metabolismo , Isótopos de Carbono , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/metabolismo , Feminino , Galactitol/metabolismo , Glucose/metabolismo , Humanos , Ácido Láctico/metabolismo , Análise dos Mínimos Quadrados , Masculino , Pessoa de Meia-Idade , Ressonância Magnética Nuclear Biomolecular/métodos , Prótons
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