Association between reduced quality of life and depression in patients with type 2 diabetes mellitus: a cohort study in a Mexican population

Isela Esther Juárez-Rojop,1 Carlos Mario Fortuny-Falconi,2 Thelma Beatriz González-Castro,3 Carlos Alfonso Tovilla-Zárate,2 Mario Villar-Soto,4 Ester Rodríguez Sanchez,4 Yazmín Hernández-Díaz,3 María Lilia López-Narvaez,5 Jorge L Ble-Castillo,1 Nonanzit Pérez-Hernández,6 José Manuel Rodríguez-Pérez6 1Multidisciplinary Academic Division of Health Sciences; Juarez Autonomous University of Tabasco, Villahermosa, Tabasco, Mexico; 2Multidisciplinary Academic Division of Comalcalco; Juarez Autonomous University of Tabasco, Comalcalco, Tabasco, Mexico; 3Multidisciplinary Academic Division of Jalpa de Méndez; Juarez Autonomous University of Tabasco, Jalpa de Méndez, Tabasco, Mexico; 4Psychiatric Care Services, Hospital of high specialty “Gustavo A. Rovirosa Pérez”, Ministry of Health, Villahermosa, Tabasco, Mexico; 5Pediatric Care Services, General Hospital of Yajalon “Dr. Manuel Velasco Suarez”, Yajalon, Chiapas, Mexico; 6Department of Molecular Biology, National Institute of Cardiology Ignacio Chávez, Mexico City, Mexico Background: Diabetes mellitus is a chronic disease that requires attention and commitment on the part of patients; improving the quality of life of these patients reduces health costs, morbidity, and mortality. We focused on investigating the factors related with the quality of life and depression symptomatology in patients with type 2 diabetes.Participants and methods: A total of 173 Mexican patients with type 2 diabetes were recruited. An interview face-to-face, a sociodemographic characteristics questionnaire, the Short Form 36 (SF-36), and the Clinical Epidemiological Studies of Depression were applied. The biochemical parameters measured were blood glucose, cholesterol, triacylglycerol levels, and glycated hemoglobin.Results: In all SF-36 subscales, female patients had lower scores in comparison with male patients; individuals ≥65 years of age showed less physical function. We observed that married patients presented a better quality of life than people who were widowed or divorced (P<0.05). Those with high rates of lipids showed decreased scores all the subscales of SF-36. Finally, we observed that depression was the major factor that decreased quality of life in patients with diabetes.Conclusion: Our results suggest that untreated and unrecognized depression can decrease the quality of life in patients with diabetes mellitus type 2. Therefore, health care professionals need to consider these findings when treating patients with diabetes. Due to the limited number of patients included in the present study, more studies are needed, studying larger samples in order to provide conclusive results. Keywords: diabetes, depression, quality of life, Mexican population&nbsp

Hypolipidemic effect and activation of Lecithin Cholesterol Acyl Transferase (LCAT) by aqueous extract of Spirulina platensis during toxicological investigation

BACKGROUND: Spirulina platensis produced in Nomayos (Cameroon) is used as a dietary supplement. S. platensis is known as a neutraceutical with many beneficial effects on humans like lipid-lowering action. This study aims to investigate the mechanism of hypolipidemic action of aqueous extract of Spirulina platensis (S. platensis) through the toxicological studies. METHODS: In this study, we included two month old Wistar rats, weighing between 180 and 200 g. Aqueous S. platensis was extracted and prepared using standard methods. The rats received a supplementation of S. platensis at 5000 mg/Kg of body weight as single dose in acute toxicity whereas different doses (250, 500, 1000 mg / kg body weight) were administered in subacute toxicity compared to control. Acute and subacute toxicities were determined according to the guidelines 420 (14 days) and 407 (28 days) of the Organization for Economic Cooperation and Development (OECD) respectively. Biochemical parameters such as urea, creatinine, total and direct bilirubin, lipid profile and transaminases; and histopathological analysis of the liver and kidneys were used to evaluate the toxicity of S. platensis on these Wistar rats. Plasmatic hydroxymethyl glutaryl coenzyme A reductase (HMG CoA reductase) and lecithine cholesterol acyl transferase (LCAT) were performed to explain the lipid-lowering action of S. platensis. Histopathological analysis of the liver and kidneys was performed. RESULTS: Our results show a decrease in total cholesterol for male rats (from 84 to 74 mg/dl) when the dose of S. platensis increased; this reduction of the total cholesterol level in male rats was significant at 500 mg/kg. There was also a significant inhibition of HMG CoA reductase in a dose dependent manner between 25 and 84.5 fold compared to the control in both male and female groups. At the dose of 250 mg/kg bw, the level of LCAT was higher compared with other groups and control, but the difference was not statistically significant. A slight inflammation in the liver and the mesangial hyperplasia of the renal glomeruli was revealed by the histopathological investigation in subacute toxicity. CONCLUSION: Spirulina platensis from Cameroon appears to have little toxic effects and may demonstrate hypolipidemic activity through the activation of LCAT