Effects of cognitive-behavioral therapy on neurotrophic factors in patients with major depressive disorder

Objective: To correlate neurotrophic factors - brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and beta-nerve growth factor (beta-NGF) - and severity of depressive symptoms in patients diagnosed with major depressive disorder (MDD) undergoing cognitive-behavioral therapy (CBT). Methods: In this quasi-experimental study, participants were selected by convenience and received 16 sessions of CBT. The outcomes of interest were severity of depressive symptoms and changes in neurotrophic factor levels after CBT. The differences between variables before and after treatment (deltas) were analyzed. Results: Patients had significant changes in symptom severity after treatment. No significant associations were found between Beck Depression Inventory II (BDI-II) scores and any independent variable. No correlations were observed between BDNF or GDNF levels and BDI scores before or after treatment, although there was a trend toward significant differences in beta-NGF levels. Conclusion: BDNF, beta-NGF, and GDNF were not influenced by the effects of CBT on depressive symptoms.

Association of interleukin-10 levels with age of onset and duration of illness in patients with major depressive disorder

Objective: To investigate peripheral levels of interleukin-10 (IL-10) in patients with major depressive disorder (MDD) and bipolar disorder (BD) and evaluate the relationship between IL-10, age of disease onset, and duration of illness. Methods: Case-control study nested in a population-based cohort of 231 individuals (age 18-24 years) living in Pelotas, state of Rio Grande do Sul, Brazil. Participants were screened for psychopathology using the Mini-International Neuropsychiatric Interview (MINI) and the Structured Clinical Interview for DSM-IV (SCID-I). Serum IL-10 was measured using commercially available immunoassay kits. Results: Peripheral levels of IL-10 were not significantly different in individuals with MDD or BD as compared to controls. However, higher IL-10 levels were found in MDD patients with a later disease onset as compared with controls or early-onset patients. In addition, IL-10 levels correlated negatively with illness duration in the MDD group. In the BD group, age of onset and duration of illness did not correlate with IL-10 levels. Conclusion: Higher levels of IL-10 are correlated with late onset of MDD symptoms. Moreover, levels of this cytokine might decrease with disease progression, suggesting that an anti-inflammatory balance may be involved in the onset of depressive symptoms and disease progression in susceptible individuals.

Hypertension is the main determinant behind the association between metabolic syndrome and chronic kidney disease in subjects with different degrees of glucose tolerance / A hipertensão é o principal determinante da associação entre síndrome metabólica e doença renal crônica em indivíduos com diferentes graus de tolerância à glicose

Background: Chronic kidney disease (CKD) is a significant public health problem. It is still controversial if the metabolicsyndrome (MS) is associated with CKD.Methods: Cross-sectional study of individuals at high risk of developing diabetes at the endocrine outpatient clinic of Hospitalde Clínicas de Porto Alegre. Fasting and 2h-plasma glucose levels, A1c, insulin, cholesterol, triglycerides, creatinine, andurinary albumin excretion were measured. MS was defined as the presence of three out of five of the following factors: hypertension,low HDL-cholesterol, high triglyceride levels, elevated plasma glucose, and high waist circumference. Glomerularfiltration rate (GFR) was estimated by the Modified Diet in Renal Disease (MDRD) equation and insulin resistance wasmeasure using the Homeostasis Model of Assessment - Insulin Resistance (HOMA-IR). Correlation analyses were performedbetween each MS components and the GFR.Results: CKD was present in 20.9% of the subjects. GFR was lower in subjects with MS compared with those without MS(P =0.019). Estimated GFR decreased with the increasing number of MS criteria (mean ± SD; zero or one criterion103.09±9.5 vs. two criteria 99.14±21.2 vs. three criteria 90.9±21.1 vs. four criteria 91.0±19.4 vs. five criteria 80.9±23.5mL/min per 1.73m2; P =0.053). Only systolic arterial blood pressure was related to eGFR (r = 0.280; P =0.003).Discussion: According to our data, the previously described association between MS and decreased renal function wasconfirmed, mostly determined by the hypertension criterion.Conclusion: These data suggest that the relationship between MS and CKD is driven mostly by abnormalities in blood pressurehomeostasis.

Introdução: A Doença Renal Crônica (DRC) é um problema de saúde pública. Ainda é controversa a existência de associa-ção entre a presença de Síndrome Metabólica (SM) e DRC.Métodos: Indivíduos com risco aumentado para o desenvolvimento de diabete melito acompanhados no ambulatório deEndocrinologia do Hospital de Clínicas de Porto Alegre foram analisados em um estudo transversal. Pacientes foram submetidosao Teste de Tolerância Oral à Glicose, e hemoglobina glicada (A1c), insulina, colesterol, triglicerídeos, creatinina eexcreção urinária de albumina foram medidos. A presença de SM era baseada na presença de três entre os cinco critérios aseguir: hipertensão, níveis séricos de colesterol HDL diminuídos, níveis aumentados de triglicerídeos, hiperglicemia e circunferênciaabdominal aumentada. A taxa de filtração glomerular (TFG) foi calculada pela equação do Modified Diet in RenalDisease (MDRD) e a resistência insulínica, pelo Homeostasis Model of Assessment – Insulin Resistance (HOMA-IR).Análises de correlação foram feitas entre cada componente da SM e a TFG.Resultados: DRC esteve presente em 20,9% dos indivíduos. Níveis diminuídos de TFG foram observados em pacientescom SM comparados com aqueles sem SM (P=0,019). TFG diminuiu com o aumento no número de critérios para SM (mé-dia±DP; 0 e 1 critério 103,09±9,5; vs. 2 critérios 99,14±21,2; vs. 3 critérios 90,9±21,1; vs. 4 critérios 91,0±19,4; vs. 5 crité-rios 80,9±23,3 ml/min; P=0,053). Apenas pressão arterial sistólica mostrou-se relacionada com a TFG (r=0,280; P=0,003).Discussão: Nosso trabalho confirmou a associação entre a presença de Síndrome Metabólica e TFG diminuída descritapreviamente por outros estudos, tendo, neste presente estudo, a hipertensão como o principal determinante desta relação.Conclusão: Nossos achados sugerem que a relação existente entre a presença de SM e o desenvolvimento de DRC é determinadaprincipalmente por anormalidades na homeostase pressórica.