Serum anti-inflammatory markers in general population subjects with elevated depressive symptoms

Anti-inflammatory substances have previously been suggested to show compensatory elevations in depressed individuals with pronounced inflammatory changes. In order to further clarify these observations, we examined depression-related alterations in the serum levels of anti-inflammatory markers interleukin (IL)-1 receptor antagonist (RA) and IL-10 and the pro-inflammatory marker IL-6 in 416 general population participants. Depression was evaluated with the Beck Depression Inventory (BDI). Participants with elevated depressive symptoms (BDI > 14, n = 44) had increased levels of IL-1 RA and IL-6. No changes were observed in their IL-10 levels. In multivariate modeling with adjustments for age, gender, obesity, regular smoking, alcohol use, metabolic syndrome, physical exercise, sleep disturbance, and the use of non-steroidal anti-inflammatory drugs, a high level of IL-1 RA was associated with an increased likelihood of belonging to the group with elevated depressive symptoms (OR for each 1 SD increase in the serum level of IL-1 RA: 2.17, 95% CI 1.35–3.48, p = 0.001). The significance of IL-6 alterations did not persist in the same model. The pronounced secretion of anti-inflammatory marker IL-1 RA may reflect the presence of compensatory mechanisms during a depression-related inflammatory state.     

Metabolic syndrome and depression: a cross-sectional analysis

OBJECTIVE: To examine the prevalence of the metabolic syndrome in depressive outpatients and to identify its correlates in depression. METHOD: This cross-sectional analysis was performed on 121 depressive outpatients from January 2002 through January 2004 who were diagnosed at baseline with the Structured Clinical Interview for DSM-III-R. The metabolic syndrome was diagnosed at 6-year follow-up according to the modified criteria of the National Cholesterol Education Program. The severity of depressive symptoms was assessed at follow-up with the Beck Depression Inventory and the Hamilton Rating Scale for Depression, and general psychopathology was assessed with the Symptom Checklist-90. RESULTS: At 6-year follow-up, the prevalence of metabolic syndrome in the study group of depressive outpatients was 36% (N = 44). The syndrome was associated with a current diagnosis of major depression and overeating, but not with age or sex. CONCLUSION: The metabolic syndrome is highly prevalent among patients with a history of depression, especially those with current major depression. This may have implications for treatment. Furthermore, attention should be focused on the physical health of those suffering from depression.     

Analytical investigation: assay of D-lactate in diabetic plasma and urine

Objective

In this study we developed a 96-micro plate enzymatic assay for d-lactate in plasma and urine.

Methods

d-lactate was assayed enzymatically with a UV-spectrophotometer in plasma from 38 and in urine from 37 diabetics and from 42 non-diabetic controls.

Results

The within-run coefficients of variations (CV) were 2.6% for plasma and 5.7% for urine. The between run CVs were 6.8% for plasma and 6.7% for urine. The mean recovery with standard deviation (S.D.) was 107.4 ± 7.3% for plasma and 100.1% ± 6.7% for urine. The plasma d-lactate in diabetics were (mean ± S.D.) 39.6 ± 23.7 μM. We found significant difference between the urinary d-lactate in controls and diabetics (18.2 ± 12.0 vs. 35.9 ± 24.2 μM/mM creatinine, p < 0.0001).

Conclusions

The assay proved reliable with acceptable precision and recovery. Results suggest that diabetics have elevated urinary and plasma d-lactate as compared to controls.     

Persistent pain at multiple sites—Connection to glucose derangement

The aim of this study was to analyse the prevalence of prediabetes and diabetes among subjects with daily chronic widespread pain (DCWP). In the multivariate analysis, DCWP was significantly associated with prediabetes and diabetes. Persistent chronic pain at multiple sites may be an additional symptom of prediabetes and diabetes.     

Serum linoleic and total polyunsaturated fatty acids in relation to prostate and other cancers: a population-based cohort study

Dietary and serum fatty acid composition has been implicated in the pathogenesis of prostate and other cancers, but findings have been conflicting. Cohort studies reporting serum fatty acid composition are lacking. We assessed the association of fatty acid composition determined from dietary records and serum with incident cancer of the prostate and any site in a population-based cohort of 2,002 middle-aged Finnish men who were free of cancer at baseline and during the first 4 years of follow-up. During 12.6 years of follow-up, 46 men developed prostate cancer and 151 any cancer. Men with proportions of serum nonesterified [risk ratio (RR) 0.28; 95% confidence intervals (CI) 0.12-0.66] and esterified linoleic acid (RR 0.37; 95% CI = 0.16-0.86) and total polyunsaturated fatty acids (RR 0.30; 95% CI = 0.12-0.71) in the upper third were less than 1/3 as likely to develop prostate cancer during follow-up. Adjustment for possible confounders like socioeconomic status, physical activity, obesity and insulin concentrations did not attenuate the association. Similar but weaker associations with any cancer were found. Dietary linoleic acid intake also tended to be inversely associated with incident prostate cancer (age-adjusted RR for the upper vs. lower third 0.55; 95% CI = 0.26-1.14, p for the trend 0.097). Substitution of linoleic acid for saturated fat in middle-aged men consuming a high saturated-fat diet may decrease the risk of prostate and other cancers, although it is possible that some of the effect may be mediated by nutrients closely associated with vegetable fats.     

Resource use after subarachnoid hemorrhage: comparison between endovascular and surgical treatment

OBJECTIVE: The aim of this study was to compare resource use after endovascular treatment and surgical clipping of ruptured intracranial aneurysms. METHODS: The study population consisted of patients with aneurysmal subarachnoid hemorrhage who were actively treated in Kuopio University Hospital. The baseline patients' characteristics were obtained from the institution's aneurysm registry. Variables indicating resource use in the intensive care unit (ICU) were obtained from the ICU patient data management system. The Therapeutic Intervention Scoring System was used to measure the intensity of treatment in the ICU. All care days in the ICU and in the hospital and all Therapeutic Intervention Scoring System points that were accumulated during the 12-month follow-up period were calculated. Outcomes were assessed according to the Glasgow Outcome Scale. RESULTS: The study population consisted of 68 patients who underwent endovascular treatment and 103 patients who had surgery. The median lengths of stay in the ICU (1.7 versus 1.8 d) and the hospital (14.0 versus 15.0 d), as well as the accumulated Therapeutic Intervention Scoring System points (56 versus 55), among patients who underwent endovascular or surgical treatment were similar (P = NS for all). The modality of treatment did not influence the number of ICU or hospital patient days or the intensity of ICU treatment, regardless of the patient's preoperative clinical status. CONCLUSION: The modality of treatment of patients with subarachnoid hemorrhage does not seem to affect resource use. Endovascular and surgical treatment are likely to require a similar amount of ICU resources in the year after initial treatment.