Salivary Cortisol and Binge Eating Disorder in Obese Women After Surgery for Morbid Obesity

Contains fulltext : 77127.pdf (publisher's version ) (Closed access)Background Binge eating episodes characterized by loss of control are hypothesized to be accompanied by changes in hypothalamic pituitary adrenal (HPA) axis functioning. Cortisol is an end product of this neuroendocrine stress system. Purpose The aim of this study was to examine the cortisol levels and the awakening cortisol response (ACR) in obese persons showing binge eating after surgery for morbid obesity. Method Sixteen obese women with binge eating disorder (BED) and 18 obese women without BED participated in the study. Means±SD: age 43 ± 15, body mass index 40 ± 8. Salivary cortisol, anthropometric assessments, and the eating disorder examination interview were taken. Results Women with BED showed a significantly lower waist-to-hip ratio and cortisol levels during the day than women without BED, whereas the ACR did not differ. Conclusion Our cross-sectional study in a small sample generates the hypothesis that neuroendocrine regulation differs between obese women with and without BED after obesity surgery. This finding needs replication in future studies that should also examine the causal direction of the observed association

Sex differences and heritability of two indices of heart rate dynamics: A twin study.

We investigated whether women show larger heart rate variability (HRV) than men after controlling for a large number of health-related covariates, using two indices of HRV, namely respiratory sinus arrhythmia (RSA) and approximate entropy (ApEn). In a twin design, the heritability of both indices was examined. The covariation between RSA and ApEn, a measure of heart rate dynamics derived from nonlinear dynamical systems theory, was decomposed into genetic and environmental components. Subjects were 196 male and 210 female middle-aged twins. Females showed larger HRV than men before (ApEn: p <.001; RSA: p = .052) and after adjustment for covariates (ApEn: p <.001; RSA: p = .015). This sex difference was confirmed by significant intrapair differences in the opposite-sex twin pairs for both ApEn (p <.001) and RSA (p = .03). In addition to sex, only heart period and age (both p <.001) were found to be independent predictors of ApEn, whereas RSA was also influenced by respiration rate and smoking (both p <.001). Age explained 16% and 6% of the variance in FSA and ApEn, respectively. Oral contraceptive use and menopausal status had no effect on HRV. Genetic model fitting yielded moderate heritability estimates for RSA (30%) and ApEn (40%) for both males and females. The correlation between RSA and ApEn (r = .60) could be attributed to genetic factors (48%), environmental factors (36%) and age (16%). The present study found support for a gender difference in HRV with women having greater HRV than men even after controlling for a large number of potential confounders. Indices of heart rate dynamics derived from nonlinear dynamical systems theory are moderately heritable and may be more sensitive than traditional indices of HRV to reveal subtle sex differences with important implications for health and disease

A Multivariate Genetic Analysis of Sensation Seeking

The genetic architecture of sensation seeking was analyzed in 1591 adolescent twin pairs. Individual differences in sensation seeking were best explained by a simple additive genetic model. Between 48 and 63 % of the total variance in sensation seeking subscales was attributable to genetic factors. There were no sex differences in the magnitude of the genetic and environmental effects. The different dimensions of sensation seeking were moderately correlated. The strongest correlations were between the subscales Thrill and Adventure Seeking and Experience Seeking (r = 0.4) and between Boredom Susceptibility and Disinhibition (r = 0.4 in males, r = 0.5 in females). A triangular decomposition showed that the correlations between the sensation seeking subscales were induced mainly by correlated genetic factors and, to a smaller extent, by correlated unique enviromnental factors. The genetic and environmental correlation structures differed between males and females. For females, higher genetic correlations for Experience Seeking with Boredom Susceptibility and Disinhibition and higher correlations among the unique environmental factors were found. There was no evidence that sex-specific genes influenced sensation seeking behavior in males and females. KEY WORDS: Sensation seeking; adolescent twins; multivariate genetic analysis

364 Sex Differences and Heritability of Two Indices of Heart Rate Dynamics: A Twin Study

We investigated whether women show larger heart rate variability (HRV) than men after controlling for a large number of health-related covariates, using two indices of HRV, namely respiratory sinus arrhythmia (RSA) and approximate entropy (ApEn). In a twin design, the heritability of both indices was examined. The covariation between RSA and ApEn, a measure of heart rate dynamics derived from nonlinear dynamical systems theory, was decomposed into genetic and environmental components. Subjects were 196 male and 210 female middle-aged twins. Females showed larger HRV than men before (ApEn: p &lt;.001; RSA: p =.052) and after adjustment for covariates (ApEn: p &lt;.001; RSA: p =.015). This sex difference was confirmed by significant intrapair difference

Snieder et al. Genetic Epidemiology 16:426--446 (1999) 1999 Wiley-Liss, Inc.

Genet. Epidemiol. 16:426-- 446, 1999. 1999 Wiley-Liss, Inc. Key words: heritability; twins; insulin resistance; truncated data; assay batch effects; reciprocal causation model *Correspondence to: Dr. Harold Snieder, Twin Research &amp; Genetic Epidemiology Unit, St Thomas&apos; Hospital, Lambeth Palace Road, London, UK SE1 7EH. E-mail: [email protected] Received 5 December 1997; Revised 29 July 1998; Accepted 2 October 1998 Contract grant sponsor: Netherlands Heart Foundation; Contract grant number: 90.313. INTRODUCTION Resistance to insulin-stimulated glucose uptake, also called insulin resistance or impaired insulin sensitivity, is considered a major risk factor for progression to both coronary heart disease (CHD) and non-insulin-dependent diabetes mellitus (NIDDM) [Reaven, 1988; Groop and Eriksson, 1992; Beck-Nielsen and Groop, 1994; Pierce et al., 1995]. At first, insulin-resistant individuals are able to keep a normal glucose homeostasis by developing hyperinsulinemia [Reaven,

©2006 Schattauer GmbH,Stuttgart Genetic influencesonfibrinogen, tissue plasminogen activatorantigen andvon Willebrand factorinmales andfemales

Differences ingenetic influence on death from CHD between males and females have been reported. Haemostatic factors have consistently been associated with risk for coronary heart disease (CHD), butsex differencesingenetic architecturehave not been studied.This study in middle-aged twins investigates whetherthere aresex differencesinmeans and in genetic and/ or environmental variance components of haemostatic riskfactors forCHD.Atotal of 93 monozygotic twin pairs (44 maleand 49 female) and 116dizygotic twin pairs(36 male,40 femaleand 40 opposite sex) were available for this study. Structural equation modelling was used toestimate the relative influence of genetic and environmental factors on variation in levels of fi

Does silence speak louder than words? The impact of oncologists’ emotion-oriented communication on analogue patients’ information recall and emotional stress

Objective: The impact of two types of oncologists’ emotion-oriented communication on participants’ recall of medical information was investigated, and the potential mediation by a reduction in emotional stress. Additionally, moderation effects by personal characteristics were explored. Methods: An oncologist's communication in response to a patient's emotional expressions was manipulated during a videotaped, scripted bad-news consultation. Three conditions were created: 1) standard communication, 2) emotion-oriented silence, and 3) emotion-oriented speech. Participants (N = 217) were randomly allocated to one of the three conditions. Measurements included information recall (free recall and recognition), emotional stress (self-reported and physiological), and personal characteristics. Results: Emotion-oriented silence (p =.002) and speech (p =.019) enhanced information recognition compared to standard communication. No differences in free recall were found. Emotional stress did not mediate these relations. Poorer functional health literacy predicted poorer recognition, but this was counteracted by emotion-oriented communication. Conclusions: By means of acknowledging, exploring, empathic and supportive statements, and attentive silence, the oncologist's communication resulted in better information recognition. How oncologists’ communication impacts patients’ information recall warrants further investigation, as this could not be explained by reducing emotional stress. Practice implications: These insights will help educators to validate the relevance of emotion-oriented strategies, and encourage oncologists to adopt them

Are psychophysiological arousal and self-reported emotional stress during an oncological consultation related to memory of medical information? An experimental study

Patients forget 20-80% of information provided during medical consultations. The emotional stress often experienced by patients during consultations could be one of the mechanisms that lead to limited recall. The current experimental study therefore investigated the associations between (analog) patients' psychophysiological arousal, self-reported emotional stress and their (long term) memory of information provided by the physician. One hundred and eighty one cancer-naïve individuals acted as so-called analog patients (APs), i.e. they were instructed to watch a scripted video-recoding of an oncological bad news consultation while imagining themselves being in the patient's situation. Electrodermal and cardiovascular activity (e.g. skin conductance level and heart rate) were recorded during watching. Self-reported emotional stress was assessed before and after watching, using the STAI-State and seven Visual Analog Scales. Memory, both free recall and recognition, was assessed after 24-28 h. Watching the consultation evoked significant psychophysiological and self-reported stress responses. However, investigating the associations between 24 psychophysiological arousal measures, eight self-reported stress measures and free recall and recognition of information resulted in one significant, small (partial) correlation (r = 0.19). Considering multiple testing, this significant result was probably due to chance. Alternative analytical methods yielded identical results, strengthening our conclusion that no evidence was found for relationships between variables of interest. These null-findings are highly relevant, as they may be considered to refute the long-standing, but yet untested assumption that a relationship between stress and memory exists within this context. Moreover, these findings suggest that lowering patients' stress levels during the consultation would probably not be sufficient to raise memory of information to an optimal level. Alternative explanations for these findings are discusse