RESUMO
Stress increases inflammation but whether adherence to Mediterranean diet counteracts this association and how early can these effects be observed is not well known. We tested whether (1) cortisol is associated to inflammation, (2) cortisol is associated to the adolescent Mediterranean diet score (aMDS), (3) aMDS lessens inflammation, (4) aMDS associates with cortisol levels and inflammation. Two hundred and forty-two adolescents (137 females; 12.5â»17.5 years old) provided salivary cortisol, blood and 2-day 24-h dietary recall from which aMDS was derived. Cortisol levels were associated with increased tumor necrosis factor (TNF-α B = 11.887, p = 0.001) when adjusted for age, gender, parental education and body mass index (BMI). Moreover, cortisol levels were inversely associated to adherence to the Mediterranean Diet (B = -1.023, p = 0.002). Adolescents with higher adherence to aMDS had lower levels of interleukins (IL) IL-1, IL-2, IL-6 and TNF-α, compared to those who did not adhere. The association between cortisol and TNF-α was no longer significant when aMDS was included in the model (B = 6.118, p = 0.139). In addition, comparing lower and higher aMDS groups, the association between cortisol and TNF-α was only observed in those with lower aMDS adherence. Our study suggests that adherence to the Mediterranean Diet may counteract the effect of stress on inflammatory biomarkers which may contribute to decreasing the risk of future mental health.
Assuntos
Dieta Mediterrânea , Hidrocortisona/metabolismo , Mediadores da Inflamação/metabolismo , Estresse Fisiológico/fisiologia , Estresse Psicológico/fisiopatologia , Adolescente , Biomarcadores/metabolismo , Criança , Registros de Dieta , Europa (Continente) , Feminino , Humanos , Inflamação , Masculino , Fatores de Proteção , Saliva/metabolismo , Fator de Necrose Tumoral alfa/sangueRESUMO
Depression is one of the major causes of disability worldwide, but the complete etiology of depression is not fully understood. Dehydroepiandrosterone (DHEA) and its sulphated form DHEA(S) have been associated with mood and healthy aging. Associations with mental illness over the middle to late years of life have not yet been extensively investigated in large, western community-dwelling samples. The aim of this study was to investigate whether low DHEA(S) levels are associated with the development of depressive symptoms in a large longitudinal cohort study of older men and women. We assessed data from English Longitudinal Study of Aging (ELSA) to evaluate the association of DHEA(S) levels and depressive symptoms measured by Center for Epidemiologic Studies Scale (CES-D) at baseline (n=3083) and at 4-year follow-up (n=3009). At baseline, there was an inverse association between DHEA(S) and depressive symptoms (B=-0.252, p=0.014). Adjustments for physical illnesses, impairments in cognitive function and health behaviors abolished this association (p=0.109) at baseline. Decreased DHEA(S) levels at baseline also predicted incident depression at 4-year follow-up (B=-0.332, p<0.001). In conclusion, higher DHEA(S) levels were associated with reduced risk of developing depressive symptoms in both men and women.
Assuntos
Envelhecimento/sangue , Envelhecimento/psicologia , Sulfato de Desidroepiandrosterona/sangue , Depressão/sangue , Idoso , Idoso de 80 Anos ou mais , Depressão/diagnóstico , Feminino , Humanos , Estudos Longitudinais , Masculino , Fatores de ProteçãoRESUMO
PURPOSE: To analyze the agreement between gross motor and hand function levels and clusters of functional performance in children with cerebral palsy (CP). METHOD: The sample consisted of 129 children with CP aged 4 to 13~years. Children's gross motor and hand function were classified with the gross motor classification system (GMFCS) and manual ability classification system (MACS). Their daily functioning on self-care and mobility was assessed with the Pediatric Evaluation of Disability Inventory (PEDI). Cluster analyses grouped children with similar repertoires on self-care and mobility skills using the agglomerative hierarchical technique. The associations across self-care and mobility clusters with daily living skills were tested with Chi-Square tests. The level of agreement was quantified with the Kappa coefficient. RESULTS: Four groupings of children's functional skills in self-care (R2 = 0.92) and mobility (R2 = 0.95) were identified. These groupings were associated with hand function (χ2 = 145.43; p< 0.001) and mobility levels (χ2 = 198.13; p < 0.001), respectively. The agreement between MACS and self-care skills was 61.7% (Kappa=0.47; p< 0.001) and between GMFCS and mobility skills was 64.4% (Kappa=0.54; p< 0.001). CONCLUSION: The findings support the adequacy of functional classifications and functioning repertoires. The magnitude of agreement reinforces the importance of the concomitant use of functional classification and assessments.
Assuntos
Atividades Cotidianas , Paralisia Cerebral/classificação , Avaliação da Deficiência , Destreza Motora/classificação , Adolescente , Paralisia Cerebral/diagnóstico , Paralisia Cerebral/fisiopatologia , Criança , Pré-Escolar , Análise por Conglomerados , Estudos Transversais , Feminino , Mãos/fisiopatologia , Humanos , Locomoção , Masculino , Autocuidado/classificaçãoRESUMO
BACKGROUND: Despite the old Kraepelinean concept that bipolar disorder (BD) does not evolve with cognitive decline, the presence of cognitive impairment, especially executive dysfunction has been recognized in BD patients. Brain-derived neurotrophic factor (BDNF) and pro-inflammatory molecules are important contributors to the pathophysiology of BD, and imbalance in peripheral levels of these molecules may be implicated in the cognitive decline observed in BD patients. We aimed to investigate the executive performance of BD type I euthymic patients and its relation with the plasma levels of BDNF, TNF-α and its related soluble receptors (sTNFR1 and sTNFR2). METHODS: We evaluated executive functioning through the Frontal Assessment Battery (FAB). Plasma levels of BDNF, TNF-α, sTNFR1 and sTNFR2 were measured using enzyme-linked immunosorbent assay (ELISA) in 25 euthymic type I BD patients and 25 age and gender matched healthy controls. RESULTS: BD patients had an impairment in executive functioning (p<0.006), particularly sensitivity of interference (p=0.02), inhibitory control (p=0.02), and increased BDNF plasma levels (p=0.001) in comparison with controls. Plasma levels of TNF-α were correlated with inhibitory control in BD patients (ρ=0.50, p=0.02) while motor programming was negatively correlated with sTNFR2 plasma levels (ρ=-0.47, p=0.02) in controls. Executive function correlated with age and MMSE, but not with BDNF, neither was influenced by psychiatric and clinical comorbidities nor medications in use. CONCLUSION: BDNF is altered in BD but do not correlate with executive functioning.
Assuntos
Transtorno Bipolar/sangue , Transtorno Bipolar/psicologia , Fator Neurotrófico Derivado do Encéfalo/sangue , Função Executiva , Fator de Necrose Tumoral alfa/sangue , Adulto , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Receptores Tipo I de Fatores de Necrose Tumoral/sangue , Receptores Tipo II do Fator de Necrose Tumoral/sangueRESUMO
Neurotrophic factors regulate the survival and growth of neurons, and influence synaptic efficiency and plasticity. Several studies suggest the existence of a relationship between changes in neurotrophic levels and bipolar disorder (BD). The glial cell-line derived neurotrophic factor (GDNF) influences monoaminergic neurons and glial cells, but its role in BD patients is controversial. In order to elucidate it we evaluated plasma levels of GDNF in a sample of 70 BD patients (35 in mania and 35 in euthymia) and compared with 50 healthy controls matched for age, gender and educational levels. GDNF plasma levels were measured by enzyme-linked immunosorbent assay (ELISA). Patients were assessed by a Mini-International Neuropsychiatric Interview (MINI-plus), Young Mania and Hamilton Depression Rating Scales. Plasma GDNF levels were significantly increased in BD patients in euthymia compared with BD patients in mania and healthy controls (p<0.05). GDNF plasma levels were correlated with age (ρ=0.30, p<0.05) and negatively correlated with manic symptoms in BD patients (ρ=-0.54, p<0.05). Our results provide evidence that peripheral levels of GDNF are related with different mood states in BD, reinforcing the involvement of neurotrophic factors in its physiopathology.
Assuntos
Transtorno Bipolar/sangue , Transtorno Bipolar/fisiopatologia , Fator Neurotrófico Derivado de Linhagem de Célula Glial/sangue , Adulto , Afeto/fisiologia , Feminino , Fator Neurotrófico Derivado de Linhagem de Célula Glial/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Crescimento Neural/sangue , Fatores de Crescimento Neural/fisiologia , Testes Neuropsicológicos , Índice de Gravidade de DoençaRESUMO
The secretion of melatonin has been shown as abnormal in some depressed patients, but most such studies were conducted in the northern hemisphere and with severely depressed inpatients. The aim of this study was to evaluate melatonin excretion profiles in major depressive outpatients from São Paulo, Brazil, individually matched to well-screened healthy volunteers to examine whether melatonin abnormalities are also present in patients from the southern hemisphere, and in less severely ill patients. We analyzed 32 drug-free, depressed outpatients and 32 psychiatrically healthy volunteers matched for age and gender. We also examined a set of 15 drug-free depressed outpatients and 15 healthy volunteers that were matched not only for age and gender, but also for body mass index and season, all factors known to influence melatonin excretion in humans. All patients fulfilled DSM-IV criteria for major depression. We evaluated major urinary metabolite of melatonin, 6-sulphatoxymelatonin (aMT6s), produced over 24 h and divided into four periods (06:00-12:00, 12:00-08:00, 18:00-24:00 and 24:00-06:00 h). aMT6s measurements during the 24 and 6 h intervals were similar in the 32 depressed patients and 32 healthy volunteers matched for age and gender; further matching for body mass index and season did not alter the results. Our study supports others in which depressed patients were found to have similar melatonin levels than healthy volunteers. Melatonin excretion has been considered a physiological index for noradrenergic function, which in some studies were found to be altered than depressed patients. It is conceivable that the alteration of nocturnal melatonin in depressed patients occurs only in more severe depression.