Tryptophan metabolism, its relation to inflammation and stress markers and association with psychological and cognitive functioning: Tasmanian Chronic Kidney Disease pilot study

Raw Data in five data sheets including Patients relevant metadata, quantified metabolites (given at Οg/L as well as Οmol/L), psychology measures, common medication and comorbidities. (XLS 58 kb

Psychosocial factors in people with chronic kidney disease prior to renal replacement therapy

Increasing evidence implicates psychosocial factors including depression, anxiety, perceived social support and health-related quality of life in the pathophysiology of various chronic diseases. Research examining the psychosocial aspects of kidney disease has focussed predominantly on depressive disorders in dialysis patients where they are independently associated with increased risk of mortality and poor health-related quality of life. In contrast, studies examining the influence of psychosocial factors in people with chronic kidney disease (CKD) prior to the initiation of renal replacement therapy are sparse. Limited data indicate that clinical depression and depressive symptoms are common and may independently predict progression to dialysis, hospitalization and death. In contrast, the influence of anxiety disorders, lower perceived social support and impaired health-related quality of life on the clinical course of CKD have received little attention. Large-scale prospective cohort studies are needed to clarify the burden and prognostic impact of these factors in this vulnerable population. Given the escalating burden of CKD worldwide examining the role of these potentially modifiable risk factors is crucial. Identifying and implementing targeted interventions in order to prevent or delay the progression of CKD and improve quality of life will be a major challenge. Summary at a Glance This review examines the burden and prognostic role of depression, anxiety, perceived social support and health-related quality of life in adults with chronic kidney disease prior to renal replacement therapy. Further studies are required to clarify the relative influence of these factors on the disease trajectory of this population. Given the escalating economic and social burden of chronic kidney disease examining the role of potentially modifiable non-biological risk factors is crucial

Overweight and obesity in childhood and risk of mental disorder: A 20-year cohort study

Objective: Very little is known about whether overweight and obese children have long-term risk for mental health problems. This study examined the association between overweight and obesity in childhood and DSM-IV mood, anxiety, and substance use disorders in young adulthood. Method: Participants in a national Australian school survey when aged 7–15 years in 1985 were re-interviewed 20 years later as young adults aged 26–36 years (1135 women, 1108 men). Body mass index (BMI) was calculated from measured height and weight in childhood and adulthood. Children were classified as overweight or obese based on a BMI ≥85th centile for age and sex-specific height and weight. Obesity in adulthood was defined as BMI of ≥30. Twelve-month DSM-IV diagnoses of mood, anxiety and substance use disorders were obtained from the Composite International Diagnostic Interview. The relative risk (RR) for each class of mental disorder was estimated for childhood overweight/obesity versus non-overweight, and for four weight trajectories: non-overweight in childhood and non-obese in adulthood; overweight in childhood and non-obese in adulthood; non-overweight in childhood and obese in adulthood; and overweight in childhood and obese in adulthood. Results: Childhood overweight and obesity was associated with an increased risk of mood disorder in adulthood (RR = 1.54, 95%CI 1.06–2.23, p = 0.03), with a similar risk observed among girls and boys. When weight in adulthood was taken into consideration, increased risk of mood disorder was observed only among overweight girls who were obese in adulthood (adjusted RR = 2.03, 95%CI 1.22–3.66, p = 0.006), with childhood overweight or obesity in non-obese adults not associated with any mental disorder. Conclusions: Childhood overweight may increase risk for mood disorder in adulthood, especially among overweight girls who become obese women. These results suggest that prevention of childhood overweight is equally important in both sexes for reducing risk of diagnosed mood disorder in adulthood

Childhood and adolescent predictors of leisure time physical activity during the transition from adolescence to adulthood: a population based cohort study

Abstract Background Few studies have investigated factors that influence physical activity behavior during the transition from adolescence to adulthood. This study explores the associations of sociodemographic, behavioral, sociocultural, attitudinal and physical factors measured in childhood and adolescence with physical activity behavior during the transition from adolescence to adulthood. Methods Childhood and adolescent data (at ages 7-15 years) were collected as part of the 1985 Australian Health and Fitness Survey and subdivided into sociodemographics (socioeconomic status, parental education), behavioral (smoking, alcohol, sports diversity, outside school sports), sociocultural (active father, active mother, any older siblings, any younger siblings, language spoken at home), attitudinal (sports/recreational competency, self-rated health, enjoyment physical education/physical activity, not enjoying school sports) and physical (BMI, time taken to run 1.6 km, long jump) factors. Physical activity between the ages 15 and 29 years was reported retrospectively using the Historical Leisure Activity Questionnaire at follow-up in 2004-2006 by 2,048 participants in the Childhood Determinants of Adult Health Study (CDAH). Australia's physical activity recommendations for children and adults were used to categorize participants as persistently active, variably active or persistently inactive during the transition from adolescence to adulthood. Results For females, perceived sports competency in childhood and adolescence was significantly associated with being persistently active (RR = 1.88, 95% CI = 1.39, 2.55). Smoking (RR = 0.31 CI = 0.12, 0.82) and having younger siblings (RR = 0.69 CI = 0.52, 0.93) were inversely associated with being persistently active after taking physical and attitudinal factors into account. For males, playing sport outside school (RR = 1.47 CI = 1.05, 2.08), having active fathers (RR = 1.25 CI = 1.01, 1.54) and not enjoying school sport (RR = 4.07 CI = 2.31, 7.17) were associated with being persistently active into adulthood. Time taken to complete the 1.6 km run was inversely associated with being persistently active into adulthood (RR = 0.85 CI = 0.78, 0.93) after adjusting for recreational competency. Conclusions Perceived sports competency (females) and cardiorespiratory fitness, playing sport outside school and having active fathers (males) in childhood and adolescence were positively associated with being persistently active during the transition from adolescence to adulthood.</p

Physical activity and depressed mood in primary and secondary school-children

Objective: Physical activity appears effective in reducing the risk of depression in adults however associations between physical activity and depression in youth remain unclear. We have previously demonstrated physical activity domain specificity in associations between physical activity and depression in young adults participating in the Childhood Determinants of Adult Health study. The current analysis examined associations between physical activity in different domains (active commuting, school physical education, discretionary sport) and depressed mood when cohort participants were children and adolescents. Method: Participants were 6070 school-children (aged 9–15 years) participating in a national health and fitness survey in 1985. Physical activity and depressed mood were assessed via self-report. Analyses were conducted separately by gender and school-level, and prevalence ratios adjusted for scholastic level, health status, smoking, alcohol consumption, residential arrangements and familial language. Results: Associations between physical activity and depressed mood were mixed however dose–response relationships were observed whereby increasing durations of total physical activity and discretionary sport in secondary boys were associated with decreasing prevalence of depressed mood (both Ptrend < 0.001). Further, increasing durations of physical education were associated with decreasing prevalence of depressed mood in primary girls (Ptrend = 0.02). No significant associations were observed for total physical activity or discretionary sport in primary and secondary girls. Associations were not mediated by overweight/obesity in girls. Conclusions: Associations between physical activity and depressed mood varied by gender, school-level and the domain in which activity was assessed. Further research utilizing more accurate assessment of childhood physical activity and depression is required to clarify potential associations

Gender differences in the dialysis treatment of Indigenous and non‐Indigenous Australians

Abstract Objective: Access to dialysis treatment and the types of treatments employed in Australia differs by Indigenous status. We examined whether dialysis treatment utilisation in Indigenous and non‐Indigenous Australians also differs by gender. Methods: Using registry data we evaluated 21,832 incident patients (aged ≥18 years) commencing dialysis, 2001–2013. Incidence rates were calculated and multivariate regression modelling used to examine differences in dialysis treatment (modality, location and vascular access creation) by race and gender. Results: Dialysis incidence was consistently higher in Indigenous women compared to all other groups. Compared to Indigenous women, both non‐Indigenous women and men were more likely to receive peritoneal dialysis as their initial treatment (non‐Indigenous women RR=1.91, 95%CI 1.55–2.35; non‐Indigenous men RR=1.73, 1.40–2.14) and were more likely to commence initial treatment at home (non‐Indigenous women RR=2.07, 1.66–2.59; non‐Indigenous men RR=1.95, 1.56–2.45). All groups were significantly more likely than Indigenous women to receive their final treatment at home. Conclusions: Contemporary dialysis treatment in Australia continues to benefit the dominant non‐Indigenous population over the Indigenous population, with non‐Indigenous men being particularly advantaged. Implications for Public Health: Treatment guidelines that incorporate a recognition of gender‐based preferences and dialysis treatment options specific to Indigenous Australians may assist in addressing this disparity

Physical activity and depression symptom profiles in young men and women with major depression

OBJECTIVE: This study explored whether young adults with major depression who are physically active differ in their depression symptom profile from those physically inactive.  METHODS: Analyses included data from 950 (47.6%) men and 1045 women (mean [standard deviation] age = 31.5 [2.6] years) participating in a national study. Participants reported leisure physical activity (International Physical Activity Questionnaire) and ambulatory activity (pedometer steps per day). Diagnosis and symptoms of major depression were assessed using the Composite International Diagnostic Interview.  RESULTS: Prevalence of major depression was 5.5% (n = 52) for men and 11.6% (n = 121) for women. Interactions between physical activity and sex were observed for depressed mood, appetite changes, vacillating thoughts, and suicidality (all, p < .050). Among those with major depression, physically active men were significantly less likely to endorse the presence of insomnia (prevalence ratio [PR] = 0.78, 95% confidence interval [CI] = 0.63-0.96), fatigue (PR = 0.82, 95% CI = 0.69-0.99), and suicidality (PR = 0.69, 95% CI = 0.49-0.96) compared with inactive men. Physically active women were significantly less likely to endorse hypersomnia (PR = 0.50, 95% CI = 0.27-0.95), excessive/irrational guilt (PR = 0.76, 95% CI = 0.59-0.97), vacillating thoughts (PR = 0.74, 95% CI = 0.58-0.95), and suicidality (PR = 0.43, 95% CI = 0.20-0.89) compared with inactive women. Associations were adjusted for age, physical health, educational attainment, depression severity, and other depressive symptoms.  CONCLUSIONS: Among adults with major depression, those physically active seem to differ in their depression symptom profile from those physically inactive