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What is the prevalence, and what are the clinical correlates, of insulin resistance in young people presenting for mental health care? A cross-sectional study.
Scott, Elizabeth M; Carpenter, Joanne S; Iorfino, Frank; Cross, Shane P M; Hermens, Daniel F; Gehue, Jeanne; Wilson, Chloe; White, Django; Naismith, Sharon L; Guastella, Adam J; Hickie, Ian B.
Afiliação
  • Scott EM; Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
  • Carpenter JS; School of Medicine, University of Notre Dame, Sydney, NSW, Australia.
  • Iorfino F; Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
  • Cross SPM; Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
  • Hermens DF; Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
  • Gehue J; Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
  • Wilson C; Sunshine Coast Mind and Neuroscience Thompson Institute, Birtinya, Queensland, Australia.
  • White D; Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
  • Naismith SL; Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
  • Guastella AJ; Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
  • Hickie IB; Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
BMJ Open ; 9(5): e025674, 2019 05 27.
Article em En | MEDLINE | ID: mdl-31138580
OBJECTIVES: To report the distribution and predictors of insulin resistance (IR) in young people presenting to primary care-based mental health services. DESIGN: Cross-sectional. SETTING: Headspace-linked clinics operated by the Brain and Mind Centre of the University of Sydney. PARTICIPANTS: 768 young people (66% female, mean age 19.7±3.5, range 12-30 years). MAIN OUTCOME MEASURES: IR was estimated using the updated homeostatic model assessment (HOMA2-IR). Height and weight were collected from direct measurement or self-report for body mass index (BMI). RESULTS: For BMI, 20.6% of the cohort were overweight and 10.2% were obese. However, <1% had an abnormally high fasting blood glucose (>6.9 mmol/L). By contrast, 9.9% had a HOMA2-IR score >2.0 (suggesting development of IR) and 11.7% (n=90) had a score between 1.5 and 2. Further, there was a positive correlation between BMI and HOMA2-IR (r=0.44, p<0.001). Participants in the upper third of HOMA2-IR scores are characterised by younger age, higher BMIs and depression as a primary diagnosis. HOMA2-IR was predicted by younger age (ß=0.19, p<0.001) and higher BMI (ß=0.49, p<0.001), together explaining 22% of the variance (F(2,361)=52.1, p<0.001). CONCLUSIONS: Emerging IR is evident in a significant subgroup of young people presenting to primary care-based mental health services. While the major modifiable risk factor is BMI, a large proportion of the variance is not accounted for by other demographic, clinical or treatment factors. Given the early emergence of IR, secondary prevention interventions may need to commence prior to the development of full-threshold or major mood or psychotic disorders.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Resistência à Insulina / Sobrepeso / Transtornos Mentais / Obesidade Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Female / Humans / Male País como assunto: Oceania Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Resistência à Insulina / Sobrepeso / Transtornos Mentais / Obesidade Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Female / Humans / Male País como assunto: Oceania Idioma: En Ano de publicação: 2019 Tipo de documento: Article