Yunsheng Ma

Statin therapy and the risk for diabetes among adult women: do the benefits outweigh the risk

Yunsheng Ma et al. — Fri, 18 Jan 2013 07:56:51 PST

Purpose of review: The purpose of this review was to examine statin therapy and the risk for diabetes among adult women using a selective review.

Recent findings: The literature contains reports of new-onset diabetes associated with statin use. While many studies do not report sex-specific results, there is evidence indicating the risk to benefit ratio may vary by gender. However, the absolute effects are not clear because women have historically been under-represented in clinical trials.

Summary: A review of the literature indicates that the cardiovascular benefits of statins appear to outweigh the risk for statin-related diabetes. However, the effect may depend upon baseline diabetes risk, dose, and statin potency. Rigorous, long-term studies focused on the risks and benefits of statins in women are unavailable to sort for gender-specific differences. Until this changes, individualized attention to risk assessment, and strong prevention with lifestyle changes must prevail.

Validity of self-reported height and weight and factors associated with errors in self-report

Anil Chankaramangalam Mathew et al. — Fri, 18 Jan 2013 07:56:50 PST

The aim of this investigation is to assess the validity of self-reported height and weight and to examine factors associated with errors in self-report. A cross-sectional study was conducted in Coimbatore, Tamil Nadu, South India, from June 20 to August 20, 2011. The study involved 389 men and 355 women aged 20 years and above. We found that self-reported height and weight were significantly correlated with measured height and weight for men and women [Pearson’s correlation coefficient(r) for men and women: 0.61 and 0.44 in height, 0.91 and 0.85 in weight, 0.76 and 0.64 in body mass index (BMI), respectively]. The prevalence of obesity based on self-reported height and weight were 7.9 and 15.8% for men and women, respectively, which was slightly smaller than that based on measured data 7.7 and 19.7%, respectively. Sensitivity and specificity of obesity based on self-report for both men and women were 97, 62% in men and 89, 64% in women, respectively. Participants with higher measured BMI significantly underestimated their weight compared to those with smaller BMI. It is also observed that among both men and women with measured BMI above 18.5 kg/m² were likely to underestimate their weight and BMI below 18.5 kg/m²were likely to overestimate their weight. However, the presence of diabetes, hypertension and heart disease was not associated with the difference between measured and self-reported height and weight for both men and women. Our findings indicate that self-reported weight has an acceptable agreement with measured data, but self-reported height has only a moderate agreement with measured data. There were no significant differences by presence of chronic disease and educational level between the self-reported and measured height and weight in both men and women.

Antidepressant Use, Depression, and New Onset Diabetes among Elderly Medicare Beneficiaries

Usha Sambamoorthi et al. — Fri, 18 Jan 2013 07:56:48 PST

OBJECTIVE: To examine the association between antidepressant use, diagnosed depression, and new onset diabetes among elderly Medicare beneficiaries.

MATERIALS AND METHODS: Longitudinal data from merged survey and claims from the nationally representative Medicare Current Beneficiary Survey(MCBS) from 1999-2005 were used. Diabetes incidence was extracted from claims and survey data over a 3-year period. Depression and antidepressant use data were obtained over time. Multivariable logistic regressions were used to examine association between antidepressant use, depression, and new onset diabetes, adjusted for demographic, socioeconomic, and lifestyle risk factors. Analyses accounted for complex design of MCBS.

RESULTS: Incident diabetes rate was 4.8% for those "without depression and without antidepressants" and 9.5% for those with any antidepressant use in all 3-years and diagnosed depression. Compared to Medicare beneficiaries who did not report any antidepressant use, beneficiaries reporting antidepressant use in all 3-years were 50% more likely to have new onset diabetes. However, when diagnosed depression was entered in the model, we did not observe a statistically significant association between long-term antidepressant use and new onset diabetes. Medicare beneficiaries with any depression were twice as likely as those without depression to develop diabetes(AOR = 2.04, [1.51, 2.75).

CONCLUSION: Depression could independently increase risk of developing diabetes, while there is no evidence of association between antidepressants and new onset diabetes. If replicated, these results have significant clinical implications.

THE SIGNIFICANT FINDING OF THE STUDY: We found increased diabetes risk among Medicare beneficiaries with depression.

THIS STUDY ADDS: Long-term use of antidepressants in the absence of depression increases risk of diabetes.

Clinical features of chinese coronary heart disease patients with chronic kidney disease

Yong Wang et al. — Fri, 05 Oct 2012 13:51:24 PDT

Objectives: To investigate the prevalence of chronic kidney disease (CKD) by stage in Chinese patients with coronary heart disease (CHD) and to identify the clinical features and examine control of cardiovascular risk factors.

Methods and results: Clinical data of hospitalized patients were collected by investigators in China. CKD stages were classified according to estimated glomerular filtration rate (eGFR). A total of 2509 participants with CHD were included in the final statistical analysis. The overall prevalence of CKD stage 3 and greater (eGFR of less than 60 mL/min/1.73 m(2)) in the CHD patients was 32.5%. As the CKD stage increased, fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and high-sensitivity C-reactive protein (HS-CRP) levels all worsened. As the CKD stage became more severe, CHD patients had comorbidities such as diabetes mellitus, periphery arterial disease, and ischemic stroke, and more CHD patients had triple vessel disease increased. Even when patients received treatment of CHD and risk factors, control of cardiovascular risk factors such as SBP, DBP, FBG, and low-density lipoprotein was worsened as CKD stage became more severe over a 6-week follow-up.

Conclusions: The data suggested a high prevalence of CKD in Chinese patients with CHD. Many conventional risk factors and comorbidities were correlated with high prevalence of CKD in CHD patients. Control of cardiovascular risk factors in those patients was poor.

A Novel Measure of Dietary Change in a Prostate Cancer Dietary Program Incorporating Mindfulness Training

James F. Carmody et al. — Tue, 18 Sep 2012 09:27:30 PDT

Diet may represent a modifiable prostate cancer risk factor, but a vegetable-based prostate-healthy diet is a major change for most men. We used a ratio of animal to vegetable proteins (A:V) to evaluate whether a comprehensive dietary change was self-sustaining following completion of 11 weekly dietary and cooking classes that integrated mindfulness training. Thirty-six men with recurring prostate cancer were randomized to the intervention or wait-list control. Assessments were at baseline, 3 months, and 6 months. Of 17 men randomized to the intervention, 14 completed the requirements. Nineteen were randomized to control and 17 completed requirements. Compared with controls, a significant postintervention (3 months) decrease in A:V in the intervention group (P=0.01) was self-maintained 3 months postintervention (P=0.049). At each assessment, A:V was correlated with lycopene, fiber, saturated fat, and dietary cholesterol, four dietary components linked to clinically relevant outcomes in prostate cancer. Change in A:V was also significantly correlated with changes in fiber, saturated fat, and dietary cholesterol intake. Participants reported regular mindfulness training practice, and there was a significant correlation between mindfulness training practice and changes in both initiation and maintenance of the change in A:V. These pilot results provide encouraging evidence for the feasibility of a dietary program that includes mindfulness training in supporting dietary change for men with recurrent prostate cancer and invite further study to explore the possible role of mindfulness training as a means of supporting both initiation of dietary changes and maintenance of those changes over time. All rights reserved.

Diagnostic Value of Ankle-Brachial Index in Peripheral Arterial Disease: A Meta-Analysis

Dachun Xu et al. — Tue, 18 Sep 2012 09:27:26 PDT

BACKGROUND: In a previous review, we reported that ankle brachial index (ABI)

METHODS: Quality of each study was assessed by standards for reporting diagnostic accuracy initiative and quality assessment for studies of diagnostic accuracy tool. Heterogeneity was assessed using the Cochran Q statistic, chi(2), and inconsistency index. The area under the curve and Q* were estimated using summary receiver operator curve. The pooled diagnostic odds ratio (DOR), sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of ABI

RESULTS: Four studies comprising 569 patients (922 limbs) met inclusion criteria. Significant heterogeneity among these studies was not detected in DOR but was evident in pooled sensitivity, specificity, PLR, and NLR. The area under the curve under the summary receiver operator curve is 0.87 (standard error = 0.02) and diagnostic accuracy (Q*) is 0.80 (standard error = 0.02). Additionally, DOR was 15.33 with corresponding 95% confidence intervals of 9.39-25.02. The pooled sensitivity and specificity of ABI

CONCLUSIONS: We conclude that test of ABI

Dietary intervention targeting increased fiber consumption for metabolic syndrome

Philip A. Merriam et al. — Tue, 18 Sep 2012 09:27:22 PDT

Metabolic Syndrome is highly prevalanet in the United States and is a harbinger of diabetes and cardiovascular disease. With the staggering rise in diet-related chronic diseases such as diabetes and cardiovascular disease, simple and effective dietary intervention strategies are needed. National dietary recommendations are ever-changing and complex, which can be overwhelming and confusing for individuals who are trying to prevent or manage a chronic condition. Some evidence suggests that healthy changes in one area of diet are associated with healthy changes in other untargeted areas of diet. There is an opportunity to bridge a dietetics research gap by testing a simple dietary message focusing on fiber intake to improve risk factors for metabolic syndrome.

Depression severity, diet quality, and physical activity in women with obesity and depression

Bradley M. Appelhans et al. — Tue, 18 Sep 2012 09:27:19 PDT

Major depressive disorder (MDD) is prevalent in clinical weight-loss settings and predicts poor weight-loss outcomes. It is unknown whether the severity of depressive symptoms among those with MDD is associated with diet quality or physical activity levels. This knowledge is important for improving weight-loss treatment for these patients. It was hypothesized that more severe depression is associated with poorer diet quality and lower physical activity levels among individuals with obesity and MDD. Participants were 161 women with current MDD and obesity enrolled in the baseline phase of a weight-loss trial between 2007 and 2010. Depression severity was measured with the Beck Depression Inventory II. The Alternate Healthy Eating Index was applied to data from three 24-hour diet recalls to capture overall diet quality. Daily metabolic equivalents expended per day were calculated from three 24-hour physical activity recalls. Greater depression severity was associated with poorer overall diet quality (estimate=-0.26, standard error 0.11; P=0.02), but not with physical activity (estimate=0.07, standard error 0.05; P=0.18), in linear regression models controlling for income, education, depression-related appetite change, binge eating disorder, and other potential confounds. Associations with diet quality were primarily driven by greater intake of sugar (r=0.20; P<0.01), saturated fat (r=0.21; P<0.01), and sodium (r=0.22; P<0.01). More severe depression was associated with poorer overall diet quality, but not physical activity, among treatment-seeking women with MDD and obesity. Future studies should identify mechanisms linking depression to diet quality and determine whether diet quality improves with depression treatment. All rights reserved.

Outcomes of a Latino community-based intervention for the prevention of diabetes: the Lawrence Latino Diabetes Prevention Project

Ira S. Ockene et al. — Tue, 18 Sep 2012 09:27:16 PDT

OBJECTIVES: We tested the effectiveness of a community-based, literacy-sensitive, and culturally tailored lifestyle intervention on weight loss and diabetes risk reduction among low-income, Spanish-speaking Latinos at increased diabetes risk.

METHODS: Three hundred twelve participants from Lawrence, Massachusetts, were randomly assigned to lifestyle intervention care (IC) or usual care (UC) between 2004 and 2007. The intervention was implemented by trained Spanish-speaking individuals from the community. Each participant was followed for 1 year.

RESULTS: The participants' mean age was 52 years; 59% had less than a high school education. The 1-year retention rate was 94%. Compared with the UC group, the IC group had a modest but significant weight reduction (-2.5 vs 0.63 lb; P = .04) and a clinically meaningful reduction in hemoglobin A1c (-0.10% vs -0.04%; P = .009). Likewise, insulin resistance improved significantly in the IC compared with the UC group. The IC group also had greater reductions in percentage of calories from total and saturated fat.

CONCLUSIONS: We developed an inexpensive, culturally sensitive diabetes prevention program that resulted in weight loss, improved HbA1c, and improved insulin resistance in a high-risk Latino population.

Determinants of Racial/Ethnic Disparities in Incidence of Diabetes in Postmenopausal Women in the U.S.: The Women's Health Initiative 1993-2009

Yunsheng Ma et al. — Tue, 18 Sep 2012 09:27:12 PDT

OBJECTIVE: To examine determinants of racial/ethnic differences in diabetes incidence among postmenopausal women participating in the Women's Health Initiative.

RESEARCH DESIGN AND METHODS: Data on race/ethnicity, baseline diabetes prevalence, and incident diabetes were obtained from 158,833 women recruited from 1993-1998 and followed through August 2009. The relationship between race/ethnicity, other potential risk factors, and the risk of incident diabetes was estimated using Cox proportional hazards models from which hazard ratios (HRs) and 95% CIs were computed.

RESULTS: Participants were aged 63 years on average at baseline. The racial/ethnic distribution was 84.1% non-Hispanic white, 9.2% non-Hispanic black, 4.1% Hispanic, and 2.6% Asian. After an average of 10.4 years of follow-up, compared with whites and adjusting for potential confounders, the HRs for incident diabetes were 1.55 for blacks (95% CI 1.47-1.63), 1.67 for Hispanics (1.54-1.81), and 1.86 for Asians (1.68-2.06). Whites, blacks, and Hispanics with all factors (i.e., weight, physical activity, dietary quality, and smoking) in the low-risk category had 60, 69, and 63% lower risk for incident diabetes. Although contributions of different risk factors varied slightly by race/ethnicity, most findings were similar across groups, and women who had both a healthy weight and were in the highest tertile of physical activity had less than one-third the risk of diabetes compared with obese and inactive women.

CONCLUSIONS: Despite large racial/ethnic differences in diabetes incidence, most variability could be attributed to lifestyle factors. Our findings show that the majority of diabetes cases are preventable, and risk reduction strategies can be effectively applied to all racial/ethnic groups.

Associations of Daily Eating Episodes, and Eating Away-from-home with Blood Level of Total Cholesterol

Yunsheng Ma et al. — Tue, 18 Sep 2012 09:27:09 PDT

The objective of this investigation is to describe the associations of number of eating episodes and proportion of meals eaten away from home with total serum cholesterol. Data from 499 participants, recruited from a health maintenance organization in central Massachusetts, aged 20-70, were used for this analysis. Dietary information and total blood cholesterol were obtained at five sampling points (baseline and four consecutive quarters) during the one-year follow-up. A cross-sectional study was conducted. The results from the study do not support the hypothesis that the number of eating episodes per day is associated with total blood cholesterol. However, we noted that the mean concentration of total cholesterol decreased with increasing number of eating episodes among women, although the adjusted mean among three categories of number of eating episodes per day was not statistically significant. On the other hand, the results of our study suggest that increased frequency of meals (breakfast, lunch, or dinner) eaten away from home is positively associated with mean total blood cholesterol concentration. Furthermore, meals eaten away from home, especially breakfast and dinner, were significantly higher in total calories, and percent calories from total and saturated fat, but lower in percent calories from protein and carbohydrate, and grams of fiber, than corresponding meals eaten at home. We conclude that eating out may have adverse influences on blood lipids. Further research is needed to better understand the impact of eating away from home on blood lipids.

Statin Use and Risk of Diabetes Mellitus in Postmenopausal Women in the Women's Health Initiative

Annie L. Culver et al. — Tue, 21 Feb 2012 11:10:30 PST

BACKGROUND:

This study investigates whether the incidence of new-onset diabetes mellitus (DM) is associated with statin use among postmenopausal women participating in the Women's Health Initiative (WHI).

METHODS:

The WHI recruited 161 808 postmenopausal women aged 50 to 79 years at 40 clinical centers across the United States from 1993 to 1998 with ongoing follow-up. The current analysis includes data through 2005. Statin use was captured at enrollment and year 3. Incident DM status was determined annually from enrollment. Cox proportional hazards models were used to estimate the risk of DM by statin use, with adjustments for propensity score and other potential confounding factors. Subgroup analyses by race/ethnicity, obesity status, and age group were conducted to uncover effect modification.

RESULTS:

This investigation included 153 840 women without DM and no missing data at baseline. At baseline, 7.04% reported taking statin medication. There were 10 242 incident cases of self-reported DM over 1 004 466 person-years of follow-up. Statin use at baseline was associated with an increased risk of DM (hazard ratio [HR], 1.71; 95% CI, 1.61-1.83). This association remained after adjusting for other potential confounders (multivariate-adjusted HR, 1.48; 95% CI, 1.38-1.59) and was observed for all types of statin medications. Subset analyses evaluating the association of self-reported DM with longitudinal measures of statin use in 125 575 women confirmed these findings.

CONCLUSIONS:

Statin medication use in postmenopausal women is associated with an increased risk for DM. This may be a medication class effect. Further study by statin type and dose may reveal varying risk levels for new-onset DM in this population.

Association of Post-Traumatic Stress Disorder and Obesity in a Nationally Representative Sample

Sherry L. Pagoto et al. — Fri, 11 Nov 2011 10:59:21 PST

Recent studies suggest a possible link between post-traumatic stress disorder (PTSD) and obesity risk, which would have implications for the development of obesity-related diseases in this population. The present study examined the association between PTSD and obesity and whether this association differed by sex in a representative sample of the US population. A secondary objective was to determine whether the association between PTSD and obesity was mediated by binge eating disorder (BED). Data were from the Collaborative Psychiatric Epidemiology Surveys (CPES), which comprises three nationally representative cross-sectional surveys that were conducted between 2001 and 2003. Logistic regression analyses weighted to represent the general US adult population were performed. In the total sample of 20,013 participants, rates of obesity were 24.1% for persons without a lifetime history of PTSD and 32.6% among persons with PTSD in the past year. Adjusting for socio-demographic characteristics, depression, substance and alcohol abuse/dependence, and psychotropic medication status, past year PTSD was associated with greater likelihood of obesity (odds ratio (OR) = 1.51; 95% confidence interval (CI) = 1.18, 1.95), with no differences by gender. BED did not statistically mediate the relationship between PTSD and obesity. The present study provides support for a link between PTSD and obesity. Findings further existing literature by indicating that the association is consistent across sexes and is not statistically mediated by BED.

Simple messages to improve dietary quality: A pilot investigation

Barbara C. Olendzki et al. — Fri, 11 Nov 2011 10:59:17 PST

Public health recommendations for a healthy diet often involve complex messages, requiring in-depth knowledge for understanding and compliance. The present study compared the feasibility and initial efficacy of two simple messages (a high fiber diet or a low saturated fat diet) to a combination message (high fiber and low saturated fat) on the potential to impact dietary quality and metabolic health. Conclusions: A simple dietary message appears to improve overall dietary quality and aid in weight management. Simple messages are a novel approach which could make a significant impact on the prevention and treatment of chronic disease as well as weight management. Results support the need for a larger randomized controlled trial that is powered to examine the efficacy of a simplified dietary recommendation for dietary quality and metabolic health. It would be worth exploring the impact of simple messages in a larger trial to determine their usefulness as simple public health messages as an alternative the current complex recommendations.

Citation: Olendzki B, Ma Y, Schneider K, Merriam P, Culver A, Ockene I, Pagoto S. Simple messages to improve dietary quality: A pilot investigation. American Dietetic Association Annual Meeting, October 2008, Chicago, Ill.

Pilot Testing a Novel Treatment for Inflammatory Bowel Disease

Barbara C. Olendzki et al. — Tue, 01 Nov 2011 07:29:13 PDT

Background: Inflammatory Bowel Disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), are chronic non specific inflammatory conditions. Standard IBD treatment typically employs a combination of anti-inflammatory and immune suppressive medications; however, the pharmacological approach is not by itself curative. The Anti-Inflammatory Diet for IBD (IBD-AID), which is derived and augmented from The Specific Carbohydrate Diet (SCD), is a nutritional regimen that restricts the intake of complex carbohydrates such as refined sugar, gluten-based grains, and certain starches from the diet. These carbohydrates are thought to provide a substrate for pro-inflammatory bacteria. The second component of the diet involves the ingestion of pre- and probiotics to help restore an anti inflammatory environment.

Study Objective: To assess the efficacy and feasibility of the Anti –Inflammatory Diet (IBD-AID) intervention for the treatment of IBD.

Intervention: Patients were recruited from the UMMHC gastroenterology clinic upon referral from their gastroenterologist. They received individual instruction of the diet and its restrictions through 5 individual nutrition sessions over approximately a 6-10 month period. Support materials were provided. Cooking classes were also available to the patients.

Conclusion: This case series indicates the potential for the IBD-AID to be used as an adjunctive or alternative therapy for the treatment of IBD. Notably, 9 out of 11 patients were able to be managed without anti-TNF therapy, and 100% of the patients had their symptoms reduced. To make clear recommendations for its use in clinical practice, randomized trials are needed alongside strategies to improve acceptability and compliance with the IBD-AID.

Eating Patterns in a Free-Living Healthy U. S. Adult Population

Yunsheng Ma et al. — Fri, 28 Oct 2011 11:13:09 PDT

The primary objective of this study was to describe eating patterns (e.g., breakfast, lunch, dinner, snacking, number of eating episodes, temporal patterns of eating across the 24-hour day, and the frequency of eating out) in a healthy U.S. population in order to provide a basis for future studies on the association between eating patterns and disease. Twenty-four hour dietary recalls were used to assess eating patterns, and cross-sectional analyses were conducted. Ninety-six percent of subjects usually consumed breakfast, 78% consumed lunch, 95% consumed dinner, and 60% consumed snacks. On average, participants ate 3.92 times daily (standard deviation(SD)=0.8). Caloric intake on weekend days was significantly greater than on weekdays. There was a tendency of participants to eat meals frequently outside of the home.

Design and methods for a pilot randomized clinical trial involving exercise and behavioral activation to treat comorbid type 2 diabetes and major depressive disorder

Kristin L. Schneider et al. — Tue, 20 Sep 2011 05:33:39 PDT

Background

The comorbidity of type 2 diabetes mellitus (T2DM) and depression is associated with poor glycemic control. Exercise has been shown to improve mood and glycemic control, but individuals with comorbid T2DM and depression are disproportionately sedentary compared to the general population and report more difficulty with exercise. Behavioral activation, an evidence-based depression psychotherapy, was designed to help people with depression make gradual behavior changes, and may be helpful to build exercise adherence in sedentary populations. This pilot randomized clinical trial will test the feasibility of a group exercise program enhanced with behavioral activation strategies among women with comorbid T2DM and depression.

Methods/design

Sedentary women with inadequately controlled T2DM and depression (N = 60) will be randomly assigned to one of two conditions: exercise or usual care. Participants randomized to the exercise condition will attend 38 behavioral activation-enhanced group exercise classes over 24 weeks in addition to usual care. Participants randomized to the usual care condition will receive depression treatment referrals and print information on diabetes management via diet and physical activity. Assessments will occur at baseline and 3-, 6-, and 9-months following randomization. The goals of this pilot study are to demonstrate feasibility and intervention acceptability, estimate the resources and costs required to deliver the intervention and to estimate the standard deviation of continuous outcomes (e.g., depressive symptoms and glycosylated hemoglobin) in preparation for a fully-powered randomized clinical trial.

Discussion

A novel intervention that combines exercise and behavioral activation strategies could potentially improve glycemic control and mood in women with comorbid type 2 diabetes and depression.

Trial registration: NCT01024790.

Elevated Depressive Symptoms, Antidepressant Use, and Diabetes in a Large Multiethnic National Sample of Postmenopausal Women

Yunsheng Ma et al. — Tue, 20 Sep 2011 05:33:35 PDT

OBJECTIVE To examine elevated depressive symptoms and antidepressant use in relation to diabetes incidence in the Women’s Health Initiative.

RESEARCH DESIGN AND METHODS A total of 161,808 postmenopausal women were followed for over an average of 7.6 years. Hazard ratios (HRs) estimating the effects of elevated depressive symptoms and antidepressant use on newly diagnosed incident diabetes were obtained using Cox proportional hazards models adjusted for known diabetes risk factors.

RESULTS Multivariable-adjusted HRs indicated an increased risk of incident diabetes with elevated baseline depressive symptoms (HR 1.14 [95% CI 1.08–1.21]) and antidepressant use (1.20 [1.09–1.32]). These associations persisted in year 3 data, in which respective adjusted HRs were 1.23 (1.09–1.39) and 1.31 (1.14–1.50).

CONCLUSIONS Postmenopausal women with elevated depressive symptoms and who use antidepressants have a greater risk of developing incident diabetes. In addition, longstanding elevated depressive symptoms and recent antidepressant medication use increase the risk of incident diabetes.

Association between Depression and C-Reactive Protein

Yunsheng Ma et al. — Tue, 23 Nov 2010 08:11:34 PST

Objective: Depression has been associated with increased cardiovascular disease risk, and a depression–related elevation of high sensitivity C-reactive protein (hs-CRP) has been proposed as a possible mechanism. The objective of this study was to examine association between 27 depression and high sensitivity C-reactive protein (hs-CRP).

Methods: Subjects consisted of 508 healthy adults (mean age 48.5 years; 49% women, 88% white) residing in central Massachusetts. Data were collected at baseline and at quarterly intervals over a one-year period per individual. Multivariable linear mixed models were used to assess the association for the entire sample and by gender.

Results: The mean Beck Depression Inventory score was 5.8 (standard deviation (SD) 5.4; median 4.3), and average serum hs-CRP was 1.8 mg/L (SD 1.7; median 1.2). Results from the multivariable linear mixed models show that individuals with higher depression scores have higher levels of hs-CRP. Analyses by gender show persistence of an independent association among women, but not among men. Body mass index (BMI=weight(kg)/height(m)2) appears to be a partial mediator of this relationship.

Conclusion: Depression score was correlated to hs-CRP levels in women. Further studies are required to elucidate the biological mechanisms underlying these associations and their implications.

Predictors of quality of life in Chinese patients with acute coronary syndrome

Wenlin Ma et al. — Tue, 23 Nov 2010 08:11:32 PST

Predictors of quality of life in Chinese patients with acute coronary syndrome remain unknown. Between January 2006 and March 2009, a prospective cohort study of 782 patients with acute coronary syndrome was carried out, with follow-up 7 months later. Depression and anxiety symptoms were measured using the Hospital Anxiety and Depression Scale. Quality of life was assessed using the 36-Item Short-Form Health Survey. To identify predictors of decreased quality of life, both the physical and mental component summary scores were analyzed using multiple and ordinal logistic regression. In our quality-of-life model, diabetes mellitus was an independent risk factor for a low mental component summary score. Anxiety symptoms and the baseline mental component summary score were significant independent predictors of a low mental component summary score. Acute myocardial infarction was found to be a risk factor for a low physical component summary score. Anxiety symptoms, baseline physical component summary score, and systolic blood pressure on admission were significant independent predictive factors. Among patients with acute coronary syndrome, those with acute myocardial infarction, diabetes, or a low baseline quality of life need more care and effective intervention to improve their quality of life.