Shortened telomere length in patients with depression: A meta-analytic study

BackgroundAccelerated telomere shortening is associated with stress-related cell damage and aging. Patients with depression have been shown to have shortened life expectancy and to be associated with multiple age-related systemic diseases. Previous studies have examined leukocyte telomere length (LTL) in patients with depression, but have shown inconsistent results.MethodsWe conducted meta-analyses by pooling relevant results strictly from all eligible case–control studies for cross-sectional comparison of LTL between depressive patients and control subjects (16 studies involving 7207 subjects). The effect sizes (shown as Hedges' g) of each individual study were synthesized by using a random effects model.ResultsOur analysis revealed telomere length is significantly shorter in subjects with depression in comparison to healthy controls (Hedges' g = −0.42, p = 1 × 10⁻⁵, corresponding to r = −0.21). Significant heterogeneity among studies examining LTL in subjects with depression was found (Q = 116.07, df = 16, I² = 86.21%, p < 1 × 10⁻⁸), which can possibly be explained by methods used in measuring telomere length (Q = 18.42, df = 2, p = 1 × 10⁻⁴). There was no significant publication bias, nor moderating effect of age, female percentage, or illness duration of depression on synthesized results.ConclusionsOur results support the hypothesis that depression is associated with accelerated cell aging. Future studies are required to clarify whether the association is mediated through environmental stress, and whether effective treatment can halt cell aging.     

Accumulation of affective symptoms and midlife cognitive function: The role of inflammation

BackgroundThe aim of the present study was to test whether C-Reactive Protein (CRP), a proxy measure of inflammation, is elevated in people with higher childhood and adulthood affective symptoms and whether elevated CRP predicts midlife cognitive function.MethodsData were used from the National Child Development Study (n = 6276). Measures of memory, verbal fluency, information processing speed and accuracy were available in midlife (age 50). Affective symptoms were assessed in childhood (ages 7, 11, 16) and in adulthood (ages 23, 33, 42, 50). The level of plasma CRP was measured at age 44. Pathway models, unadjusted and fully adjusted for sex, education, childhood socioeconomic position, childhood cognitive ability and affective symptoms at age 50, were fitted to test direct associations between affective symptoms and midlife cognitive function, and indirect associations via the inflammatory pathway (CRP level).ResultsIn a fully adjusted model, there were significant indirect associations between adulthood affective symptoms and immediate memory (β = −0.01, SE = 0.003, p = .03) and delayed memory (β = −0.01, SE = 0.004, p = .03) via CRP. In addition, there were significant indirect associations between affective symptoms in childhood and immediate memory (β = −0.001, SE = 0.00, p = .03) and delayed memory (β = −0.001, SE = 0.001, p = .03), via adulthood affective symptoms and associated CRP. Independent of CRP, there was a significant direct association between adulthood affective symptoms and information processing errors (β = 0.47, SE = 0.21, p = .02). There were no direct or indirect associations between affective symptoms and verbal fluency or information processing speed.ConclusionsCRP at age 44 is elevated in people with higher affective symptoms from age 7 to 42, and elevated CRP is associated with poorer immediate and delayed memory at age 50.     

Associations of childhood adversity and adulthood trauma with C-reactive protein: A cross-sectional population-based study

Mounting evidence highlights specific forms of psychological stress as risk factors for ill health. Particularly strong evidence indicates that childhood adversity and adulthood trauma exposure increase risk for physical and psychiatric disorders, and there is emerging evidence that inflammation may play a key role in these relationships. In a population-based sample from the Health and Retirement Study (n = 11,198, mean age 69 ± 10), we examine whether childhood adversity, adulthood trauma, and the interaction between them are associated with elevated levels of the systemic inflammatory marker high sensitivity C-reactive protein (hsCRP). All models were adjusted for age, gender, race, education, and year of data collection, as well as other possible confounds in follow-up sensitivity analyses. In our sample, 67% of individuals had experienced at least one traumatic event during adulthood, and those with childhood adversity were almost three times as likely to have experienced trauma as an adult. Childhood adversities and adulthood traumas were independently associated with elevated levels of hsCRP (β = 0.03, p = 0.01 and β = 0.05, p < 0.001, respectively). Those who had experienced both types of stress had higher levels of hsCRP than those with adulthood trauma alone, Estimate = −0.06, 95% CI [−0.003, −0.12], p = 0.04, but not compared to those with childhood adversity alone, Estimate = −0.06, 95% CI [0.03, −0.16], p = 0.19. There was no interaction between childhood and adulthood trauma exposure. To our knowledge, this is the first study to examine adulthood trauma exposure and inflammation in a large population-based sample, and the first to explore the interaction of childhood adversity and adulthood trauma with inflammation. Our study demonstrates the prevalence of trauma-related inflammation in the general population and suggests that childhood adversity and adulthood trauma are independently associated with elevated inflammation.     

Physical trauma and risk of multiple sclerosis: A systematic review and meta-analysis of observational studies

BackgroundWe aimed to examine physical trauma as a risk factor for the subsequent diagnosis of MS.MethodsWe searched for observational studies that evaluated the risk for developing MS after physical trauma that occurred in childhood (≤ 20 years) or “premorbid” (> 20 years). We performed a meta-analysis using a random effects model.ResultsWe identified 1362 individual studies, of which 36 case–control studies and 4 cohort studies met the inclusion criteria for the review. In high quality case–control studies, there were statistically significant associations between those sustaining head trauma in childhood (OR = 1.27; 95% CI, 1.12–1.44; p < 0.001), premorbid head trauma (OR = 1.40; 95% CI, 1.08–1.81; p = 0.01), and other traumas during childhood (OR = 2.31; 95% CI, 1.06–5.04; p = 0.04) and the risk of being diagnosed with MS. In lesser quality studies, there was a statistical association between “other traumas” premorbid and spinal injury premorbid. No association was found between spinal injury during childhood, or fractures and burns at any age and the diagnosis of MS. The pooled OR of four cohort studies looking at premorbid head trauma was not statistically significant.ConclusionsThe result of the meta-analyses of high quality case–control studies suggests a statistically significant association between premorbid head trauma and the risk for developing MS. However, cohort studies did not. Future prospective studies that define trauma based on validated instruments, and include frequency of traumas per study participant, are needed.     

Childhood socioeconomic status,telomere length,and susceptibility to upper respiratory infection

Low socioeconomic status (SES) during childhood and adolescence has been found to predict greater susceptibility to common cold viruses in adults. Here, we test whether low childhood SES is associated with shorter leukocyte telomere length in adulthood, and whether telomere length mediates the association between childhood SES and susceptibility to acute upper respiratory disease in adulthood.At baseline, 196 healthy volunteers reported whether they currently owned their home and, for each year of their childhood, whether their parents owned the family home. Volunteers also had blood drawn for assessment of specific antibody to the challenge virus, and for CD8⁺CD28⁻ T-lymphocyte telomere length (in a subset, n = 135). They were subsequently quarantined in a hotel, exposed to a virus (rhinovirus [RV] 39) that causes a common cold and followed for infection and illness (clinical cold) over five post-exposure days.Lower childhood SES as measured by fewer years of parental home ownership was associated with shorter adult CD8⁺CD28⁻ telomere length and with an increased probability of developing infection and clinical illness when exposed to a common cold virus in adulthood. These associations were independent of adult SES, age, sex, race, body mass, neuroticism, and childhood family characteristics. Associations with infections and colds were also independent of pre-challenge viral-specific antibody and season. Further analyses do not support mediating roles for smoking, alcohol consumption or physical activity but suggest that CD8⁺CD28⁻ cell telomere length may act as a partial mediator of the associations between childhood SES and infection and childhood SES and colds.     

Effect of partial and total sleep deprivation on serum testosterone in healthy males: a systematic review and meta-analysis

BackgroundCurrently, there is no consensus on the effect of sleep deprivation on male serum testosterone. This systematic review and meta-analysis aimed to determine the association between partial/total sleep deprivation and male serum testosterone level.MethodsThe literature related to sleep deprivation and male serum testosterone in the PubMed, Embase, and Cochrane Library databases were searched from their inception to July 15, 2021. Data were pooled using the Stata 15 software. The results were presented as standard mean differences (SMDs) with their 95% confidence intervals (CIs).ResultsEighteen studies involving 252 men were included in the systematic review and meta-analysis. The findings revealed that short-term partial sleep deprivation had no significant effect on male serum testosterone (SMD = −0.22; 95% CI: −0.5, 0.06; P = 0.13), while total sleep deprivation reduced the male testosterone levels (SMD = −0.64; 95% CI: −0.87, −0.42; P < 0.001). According to the intervention duration of total sleep deprivation, subgroup analysis was conducted by a fixed-effects model. The results revealed that the serum testosterone was significantly decreased after 24 h total sleep deprivation (SMD = − 0.67; 95% CI = − 0.93, −0.42, P < 0.001), as well as 40–48 h total sleep deprivation (SMD = − 0.74; 95% CI = − 1.22, −0.26, P = 0.002).ConclusionsThis meta-analysis revealed that total sleep deprivation (more than or equal to 24 h) reduces the male testosterone levels, while short-term partial sleep deprivation has no significant effect on male serum testosterone. Sleep duration plays a pivotal role in maintaining male serum testosterone levels.     

Trait self-acceptance mediates parental childhood abuse predicting depression and anxiety symptoms in adulthood

BackgroundBiopsychosocial models posit that experiencing parental childhood abuse increases vulnerability to psychopathology in adulthood. There are a lack of studies investigating mediators of the parental childhood abuse–adulthood psychopathology relation. The current study investigated if trait self-acceptance mediated the parental childhood abuse–adulthood major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder (PD) severity relations.MethodsParticipants (n = 3294) partook in the 18-year Midlife Development in the United States (MIDUS) study at three time-points. We conducted structural equation modeling analyses to test how maternal and paternal childhood abuse at Time 1 would independently positively predict MDD, GAD, and PD severity at Time 3, and if self-acceptance at Time 2 mediated those relations while controlling for adulthood MDD, GAD, and PD severity at Time 1.ResultsSelf-acceptance notably mediated the parental childhood abuse-adulthood MDD, GAD, and PD relations. Overall, higher paternal and maternal childhood abuse was associated with lower self-acceptance. Reduced self-acceptance predicted heightened adulthood MDD, GAD, and PD.ConclusionFindings highlight the importance of understanding the parental childhood abuse–adulthood psychopathology relation and the possible mechanisms of its long-term impact.     

Childhood trauma as a correlative factor of suicidal behavior – via aggression traits. Similar results in an Italian and in a French sample

Background and objectiveChildhood trauma and aggressive traits are considered risk factors for suicidal behavior. The hypothesis we aimed to test in this study was the existence of an association between childhood trauma and aggression in two distinct samples of Italian and French suicide attempters.MethodStudy participants comprise 587 subjects with different psychiatric diagnoses according to DSM-IV-TR criteria. Three different samples were analyzed and compared: a group of French suicide attempters (N = 396; mean age 40.47 SD = 13.52; M/F: 110/286); a group of Italian suicide attempters (N = 103; mean age 38.60 SD = 12.04; M/F 27/76) and an Italian psychiatric comparison group (N = 88; mean age: 41.49 SD = 12.05; M/F; 37/51). Patients were interviewed with the Brown–Goodwin Assessment for Lifetime History of Aggression (BGLHA) and the Childhood Trauma Questionnaire (CTQ) 34-items for Italian data and 28-items for French data.ResultsWhen compared with the comparison group, Italian suicide attempters had significantly higher scores on the BGLHA scale and reported higher scores on the CTQ scores for physical abuse, sexual abuse and emotional abuse. Significant correlations between childhood trauma and aggression were found in both groups, Italian and French, of suicide attempters.ConclusionThe hypothesis tested was supported as psychiatric patients who had attempted suicide reported significantly more childhood trauma and aggression. Significant correlations were found between aggressive behavior, and childhood trauma in suicidal patients. This finding was replicated in two independently recruited samples in two countries with different prevalence of suicidal behavior.     

Childhood maltreatment and risk of intimate partner violence: A national study

ObjectivePrior research indicates that different types of childhood maltreatment frequently co-occur and confer risk for adulthood intimate partner violence (IPV). However, it is unknown whether the risk of IPV is due to specific type(s) of maltreatment or to their shared association or both. Although these competing explanations have different implications for intervention, they have never been evaluated empirically.MethodData were drawn from a nationally representative survey of 34,653 US adults, the 2004–2005 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Structural equation modeling was used to simultaneously examine the shared and specific effects of five types of childhood maltreatment (i.e., sexual abuse, physical and emotional abuse and neglect) on the risk of different IPV behaviors (i.e., perpetration, victimization and reciprocal violence). Analyses were stratified by sex and adjusted for sociodemographic characteristics (i.e., age, personal income, educational background and race/ethnicity).ResultsMost types of childhood maltreatment increased the risk of victimization, perpetration and reciprocal violence. Effects of maltreatment types on each IPV behavior were exerted mostly through a latent factor representing the shared effect across all different types of maltreatment in both sexes (CFI = 0.990, TLI = 0.990, RMSEA = 0.023), although sexual abuse had an additional effect on victimization.ConclusionsBecause childhood maltreatment types increase the risk of each intimate partner violence behavior mainly through a general maltreatment dimension, underlying biological and developmental-ecological mechanisms should be considered important targets of prevention for both victimization and perpetration of abuse in adult relationships.     

Reduced gray matter volume in psychotic disorder patients with a history of childhood sexual abuse

Childhood trauma is associated with smaller gray matter volume, similar to the pattern seen in psychotic disorders. We explored the relationship between childhood abuse, psychosis, and brain volume in a group of 60 individuals with a psychotic disorder and 26 healthy control subjects. We used voxel-based morphometry (VBM) to quantify gray and white matter volume and the Childhood Trauma Questionnaire (CTQ) to measure childhood abuse. Within the psychotic disorder group, total gray matter volume was inversely correlated with the severity of childhood sexual abuse (r = ? .34, p = .008), but not the other types of abuse. When the 24 patients with sexual abuse were compared with demographically matched samples of 23 patients without sexual abuse and 26 control subjects, only patients with a history of sexual abuse had reduced total gray matter volume (t(48) = 2.3, p = .03; Cohen's d = .63). Voxel-based analysis revealed a cluster in the prefrontal cortex where volume was negatively correlated with sexual abuse severity. Voxel based comparison of the three matched groups revealed a similar pattern of results, with widespread reductions in psychosis patients with sexual abuse relative to controls that were not found in psychosis patients without sexual abuse. These findings indicate that some of the variance of gray matter volume in psychotic disorders can be explained by a history of sexual abuse.     

The relationship of sleep quality among internship nurses with clinical learning environment and mental stress: a cross-sectional survey

BackgroundPrevious evidence has supported an association between sleep quality and psychological stress. However, the association between internship nurses' sleep status and its relevant factors is poorly understood.ObjectiveThe aim of this study was to investigate sleep quality and its related factors in clinical learning environment and mental stress.MethodsA cross-sectional survey was conducted by three instruments: Clinical Learning Environment, Supervision, and Nurse Teacher Evaluation Scale (CLES + T), Stress Rating Scale for practicing nurses (SRS) and Pittsburgh Sleep Quality Index (PSQI).ResultsA total of 508 (91.86%) of 553 students experienced poor sleep quality. The structural equation model showed a correlation of the PSQI with the CLES + T (r = −0.21, p < 0.001), a correlation of the PSQI with the SRS (r = 0.32, p < 0.001), and a correlation of the SRS with the CLES + T (r = −0.22, p < 0.001). Linear regression analysis showed that education (B = −0.56, p < 0.001), willingness to engage in nursing after graduation (B = −0.75, p < 0.001), pedagogical atmosphere in the ward (B = −0.05, p < 0.001) measured by the CLES + T, workload (B = 0.11, p = 0.01), interpersonal relationships (B = −0.12, p = 0.03), and conflicts between study and work (B = 0.12, p < 0.001) on the SRS were significant factors influencing the PSQI.ConclusionsPoor sleep quality is common among internship nurses and it's affected by clinical environment and mental stress. It's necessary to apply more tailored education programs to promote nursing development.     

Childhood abuse histories predict steeper inflammatory trajectories across time

BackgroundThe Center for Disease Control (CDC) recently named childhood abuse histories as a public health risk. Clear links between abuse histories and inflammation exist. However, it remains unknown how abuse histories impact inflammatory trajectories throughout adulthood. Accordingly, this study assessed inflammatory trajectories across three visits among healthy adults with and without abuse histories.MethodIn this secondary analysis of data from a longitudinal observational study of cancer survivors and noncancer controls, 157 noncancer controls (M_age = 55.8, range = 32–83) completed the Childhood Experiences Questionnaire (CTQ), providing data on physical, emotional, and sexual abuse prior to age 18. Cytokines interleukin-6 (IL-6), interleukin 1-beta (IL-1β), and tumor necrosis factor-alpha (TNF-α) were collected at the baseline visit and two follow-up visits approximately one (M months = 11.52, SD = 4.10) and two years (M months = 23.79, SD = 4.40) later. To represent inflammatory changes, cytokine data at each visit were combined into a composite z-score. Covariates in all analyses included age, biological sex, race, income, body mass index, menopause status, psychological diagnosis history, and medical comorbidities.ResultsCompared to their nonabused peers, those who had experienced any type of abuse in childhood demonstrated steeper rises in inflammation across time. Inflammation rose more steeply for individuals with physical and emotional abuse histories compared to those without such histories.ConclusionOverall, these data suggest that childhood abuse histories may quicken age-related increases in inflammation, contributing to accelerated aging, morbidity, and early mortality. These findings provide mechanistic insight into why child abuse is a public health risk.     

Accelerated leukocyte telomere erosion in schizophrenia: Evidence from the present study and a meta-analysis

Human telomeres consist of tandem nucleotide repeats (TTAGGG) and associated proteins, and telomere length (TL) is reduced progressively with cell division over the lifespan. Telomere erosion might be accelerated or prevented to varying degrees when exposure to serious medical illnesses. In previous studies, an association between TL decrease and schizophrenia has been extensively reported; however, the results remain largely controversial. To further investigate TL in schizophrenia patients and reconcile this controversy, we first measured leucocyte TL (LTL) in our samples (52 paranoid schizophrenia, 89 non-paranoid patients and 120 controls), and then conducted a comprehensive meta-analysis of the existing results of LTL in patients of schizophrenia compared to healthy subjects. Totally, 11 studies encompassing 1243 patients of schizophrenia and 1274 controls were included in the final meta-analysis model. In our samples, significant reduction of LTL in paranoid schizophrenia was observed compared to controls (F = 50.88, P < 0.001); whereas there was no significant difference in LTL between non-paranoid schizophrenia and controls (F = 0.842, P = 0.360). For meta-analysis, random-effects model showed significant LTL decrease in patients of schizophrenia when compared to controls (Z = 2.07, P = 0.039, SMD = −0.48, 95% CI = −0.94 to −0.03). Moreover, a marginal decrease in LTL was observed in medicated patients (Z = 1.92, P = 0.055, SMD = −0.58, 95% CI = −1.18–0.01) and those patients with poor response to antipsychotics (Z = 1.76, P = 0.078, SMD = −0.60, 95% CI = −1.27–0.07). In conclusion, we observed significant reduction of LTL in individuals with schizophrenia compared with controls. However, all the studies included in the meta-analysis were cross-sectional, and better controlled long-term studies are needed to replicate this result.     

Trauma type as a conditional risk factor for posttraumatic stress disorder in a referred clinic sample of adolescents

IntroductionTraumatic experiences that are varied in type and severity may lead to the development of Posttraumatic Stress Disorder (PTSD). Some trauma types present a higher conditional risk for PTSD owing to their nature and impact on growth and functioning. Few studies have investigated the conditional risk of PTSD in clinic referred adolescents in low- and middle-income countries. The aim of the study was to determine the conditional risk for PTSD based on various trauma types (car accidents, other serious accidents, fires, witnessing a natural disaster, witnessing a violent crime, being confronted with traumatic news, witnessing domestic violence, physical abuse and sexual abuse) and to stratify risk by gender.MethodAdolescents exposed to at least one Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) qualifying trauma were referred to a research clinic in Cape Town, South Africa (n = 216). PTSD status was assessed using a clinician administered interview. Conditional risk was determined using backwards stepwise multiple logistic regression analysis for 1) the whole sample, 2) females only and 3) males only. Gender differences in exposure to trauma types were determined using chi-square tests and cross-tabulation.ResultsThe prevalence of PTSD was 48.1% in the whole sample. Age (β = .16, p = .048, OR 1.17), fire exposure (β = 2.32, p = .036, OR 10.12) and sexual abuse (β = .93, p = .001, OR 2.54) were significant predictors of PTSD in the whole sample with the model explaining 12.4% of the variance in PTSD status. Age (β = .22, p = .041, OR 1.24) and sexual abuse (β = .87, p = .018, OR 2.39) were significant predictors of PTSD in female participants and explained 9.8% of the variance in PTSD status. Being a victim of a violent crime (β = .78 p = .100, OR 2.19) was the only remaining predictor of PTSD in male participants and showed a trend towards significance. The model explained 7% of the variance in PTSD status.ConclusionsThe findings underscore the importance of timely identification of trauma, particularly, sexual abuse and violence. Longitudinal tracking of adolescents exposed to different trauma types may identify those in need of treatment and enhance our understanding of the lasting impact of trauma.     

Self-reported sleep quality is associated with gut microbiome composition in young,healthy individuals: a pilot study

ObjectivesThe microbiota-gut-brain axis is an intricate communication network that is emerging as a key modulator of psychological and physiological wellbeing. Recent pioneering work in the field has suggested a possible link between gut microbiome composition with sleep, an evolutionarily conserved behavior demonstrated to play a critical role in health. This study is the first to address relationships between self-reported sleep habits and gut microbiome composition in young, healthy individuals.MethodsA total of 28 young, healthy subjects (17 males/11 females; 29.8 ± 10.4 years) that were free of metabolic or cardiovascular disease, and that did not take sleep medication or antibiotics within the past six months were included in the study. Relationships between self-reported sleep quality, obtained using the Pittsburgh Sleep Quality Index (PSQI), with microbial diversity (Shannon Index), the Firmicutes/Bacteroidetes (F/B) ratio, and select bacterial taxa were assessed.ResultsAlpha diversity (r = −0.50) and F/B ratio (r = −0.47) were inversely associated (P < 0.05) with the PSQI score. Ten bacterial taxa were associated (P < 0.05) with the PSQI score, including genus-level Blautia (r = −0.57), Ruminococcus (r = −0.39), and Prevotella (r = 0.39).ConclusionsIn young healthy individuals, self-reported sleep quality was positively associated with microbial diversity. We also observed a positive association between sleep quality with F/B ratio, seemingly due to a greater relative abundance of Blautia and Ruminococcus (Firmicutes) and lower proportions of Prevotella (Bacteroidetes) in individuals reporting superior sleep quality. Future studies are encouraged to evaluate mechanistic links between the gut microbiome with sleep, as well as the health implications of this relationship.     

The association between obstructive sleep apnea and shortened telomere length: a systematic review and meta-analysis

ObjectiveWe aimed to provide a more precise estimate of the relationship between telomere length and obstructive sleep apnea (OSA) by systematically reviewing evidence.MethodWe conducted a systematic electronic search in the databases of the PUBMED, PsycINFO, OVID (Medline), EMBASE and other resources (such as Google Scholar). The methodological quality of the articles was assessed according to the Newcastle Ottawa Scale. Heterogeneity was assessed using the chi-square test for Cochrane's Q statistic and I-squared. When heterogeneity was found to be reasonably high between studies, the random-effects model with the mean difference (95% confidence interval [CI]) was conducted using RevMan 5 software by using the inverse variance method (P < 0.05; chi-square test). By contrast, the fixed-effects model was carried out.ResultsEight eligible studies involving 2639 participants were included in our meta-analysis. Shortened telomere length was significantly associated with OSA with mean difference of −0.03 (95% CI: −0.06, −0.00; P = 0.003 with I-square of 85%）. The results of subgroup analysis preformed by age and sample number suggested that shorter telomere length was significantly associated with OSA, with mean difference of −0.07 (95% CI: −0.07, −0.01; P = 0.005) for adult group and −0.04 (95% CI: −0.02, −0.06; P = 0.005) for large-sample studies.ConclusionCompared to healthy people, individuals with OSA have shorter telomere lengths which implicates early intervention and timely treatment for preventing future adverse outcomes.     

Differential effects of childhood trauma subtypes on fatigue and physical functioning in chronic fatigue syndrome

ObjectiveThere is wide consensus that childhood trauma plays an important role in the aetiology of chronic fatigue syndrome (CFS). The current study examines the differential effects of childhood trauma subtypes on fatigue and physical functioning in individuals suffering from CFS.MethodsParticipants were 155 well-documented adult, predominantly female CFS patients receiving treatment at the outpatient treatment centre for CFS of the Antwerp University Hospital in Belgium. Stepwise regression analyses were conducted with outcomes of the total score of the Checklist Individual Strength (CIS) measuring fatigue and the scores on the physical functioning subscale of the Medical Outcomes Short Form 36 Health Status Survey (SF-36) as the dependent variables, and the scores on the five subscales of the Traumatic Experiences Checklist (TEC) as the independent variables.ResultsThe patients' fatigue (β = 1.38; p = 0.025) and physical functioning scores (β = − 1.79; p = 0.034) were significantly predicted by childhood sexual harassment. There were no significant effects of emotional neglect, emotional abuse, bodily threat, or sexual abuse during childhood.ConclusionOf the childhood trauma subtypes investigated, sexual harassment emerged as the most important predictor of fatigue and poor physical functioning in the CFS patients assessed. These findings have to be taken into account in further clinical research and in the assessment and treatment of individuals coping with chronic fatigue syndrome.     

DNA methylation changes at TREM2 intron 1 and TREM2 mRNA expression in patients with Alzheimer's disease

ObjectivesRecent genome-wide association studies revealed that Triggering receptor expressed on myeloid cells 2 (TREM2) was associated with Alzheimer's disease (AD) and other neurodegenerative diseases. We previously reported that TREM2 mRNA is highly expressed in leukocytes of AD patients compared to those in healthy controls. However, the mechanism of TREM2 expression change is still not known. In this study, we examined the involvement of the DNA methylation status of TREM2 in its high gene expression.Materials and methodsFifty AD subjects and age- and sex-matched control subjects were recruited (25 males, 25 females; 79.9 ± 5.27 and 79.4 ± 3.92 years old, respectively). TREM2 mRNA expression and the percentage of DNA methylation at four CpG sites in intron 1 of TREM2 were studied using their peripheral leukocytes.ResultsWe confirmed that TREM2 mRNA expression in leukocytes was significantly higher in AD patients than in controls (p = 0.007). The percentage methylation at three CpG sites in TREM2 intron 1 was significantly lower in AD subjects than in control: CpG1, 9.4 ± 3.2 vs 11.9 ± 4.0 (p = 0.001); CpG2, 15.4 ± 4.9 vs 19.1 ± 4.8 (p = 0.001); CpG3, 20.8 ± 5.5 vs 25.5 ± 5.4 (p < 0.001); and the average percentage methylation of all CpG sites: 13.5 ± 3.7 vs 16.1 ± 3.8 (p = 0.002), respectively. In addition, there were significant negative correlations between TREM2 mRNA expression and the percentage DNA methylation of each of CpG sites (CpG1, r = −0.416, p < 0.001; CpG2, r = −0.510, p < 0.001; CpG3, r = −0.504, p < 0.001; CpG4, r = −0.356, p < 0.001).ConclusionsLower DNA methylation at TREM2 intron 1 caused higher TREM2 mRNA expression in the leukocytes of AD subjects versus controls and may be a biomarker for AD.     

Cluster analysis to predict factors associated with sufficient indirect decompression immediately after single-level lateral lumbar interbody fusion

ObjectiveChanges in indirect decompression using lateral lumbar interbody fusion (LLIF) were classified into three clusters based on cluster analysis. We investigated cage variables and position to assess the effects of single-level LLIF on indirect decompression.MethodsCluster analysis was used to classify patients into three groups based on the change in the axial cross-sectional spinal canal area (ΔCSA): group 1 with slight postoperative indirect decompression (n = 35); group 2 with average indirect decompression (n = 19); and group 3 with marked indirect decompression (n = 13). Preoperative and immediately postoperative imaging data were compared between groups.ResultsPostoperative segmental lordosis, anterior, posterior, and average disc height increased significantly in each group, but the differences between groups were not significant. Cage length (p = 0.251) and cage height (p = 0.709) did not differ, but cage position differed significantly between groups (p < 0.05). ΔCSA correlated significantly with cage position for all 67 levels (r = 0.411, p < 0.01), but this association was not significant in group 2 (r =  − 0.367, p = 0.122) or group 3 (r =  − 0.005, p = 0.986). ΔCSA correlated with cage height in group 2 (r = 0.645, p < 0.01) and with cage width in group 3 (r = 0.644, p < 0.05).ConclusionsThe cluster analysis results suggest that placing the cage in the posterior position might be effective for expanding the CSA, but other factors, such as cage height or width, may also influence the sufficiency of LLIF.     

Association between night-shift work and level of melatonin: systematic review and meta-analysis

BackgroundsNight-shift workers are exposed to nocturnal light and are more prone to circadian rhythm disorders. Although night-shift work is thought to be associated with the decrease in melatonin secretion, studies have shown inconsistent results.MethodsThis systematic review and meta-analysis studied the association between night-shift work and melatonin levels. Pubmed and Embase databases were used for literature searching. The pooled standardized mean differences (SMDs) and 95% confidence intervals (CIs) were used to compare the differences between night-shift workers and the controls.ResultsThirty-three studies reported in 25 articles (1845 night-shift workers and 3414 controls, mean age 45.12 years) were included after a systematic literature review. Data of circulating melatonin levels and its metabolites, 6-sulfatoxymelatonin (aMT6s) in urine were collected for meta-analysis. The results showed that the first morning-void aMT6s level in night-shift workers was significantly lower than in day workers (SMD = −0.101, 95% CI = −0.179 to −0.022, P = 0.012). The level of mean 24-h urinary aMT6s was lower in night-shift workers than day workers (SMD: −0.264, 95% CI: −0.473 to −0.056, P = 0.013). Among fixed night-shift workers, the level of circulating melatonin, as well as first morning-void aMT6s was lower than that of day workers.ConclusionOur findings indicate that experience of night-shift work is associated with suppression of melatonin production, especially among fixed night-shift workers.