Evaluation of Stress and Associated Biochemical Changes in Patients with Type 2 Diabetes Mellitus and Obesity

Abstract

Purpose Type 2 diabetes mellitus (T2DM), a metabolic disorder, remains associated with a physiological impairment affecting large populations worldwide. Onset of T2DM is multifactorial where obesity and abnormal basal metabolic rate are considered most critical. Of people diagnosed with T2DM, about 80% are also obese. It is also reported that obese individuals have an increased odds of developing depression, whereas T2DM is estimated to increase the incidence by two-fold. The preponderance of research data demonstrates that T2DM alters the serum level of cortisol and adiponectin which are known to be associated with neuronal physiology. The study explored, how a metabolic disorder like T2DM is linked with the altered plasma level of cortisol and adiponectin, the risk factors for stress and depression. Patients and Methods A cross-sectional population study was conducted in T2DM patients using a bimodal approach. First approach used questionnaires, (1) Patient Health Questionnaire (PHQ-9) and (2) Stress Coping Inventory Questionnaire (SCQ) to assess signs and symptoms of depression and stress, respectively, in T2DM patients. In the second approach, robust biochemical analysis was conducted for serum adiponectin and cortisol levels. Results An association of T2DM in stress and depression was evaluated in 158 subjects (105 T2DM obese patients and 53 healthy controls). A lower PHQ-9 score and adiponectin levels were seen in T2DM obese patients compared to healthy controls ( p <0.05). Further, results also depicted a lower adiponectin levels in T2DM obese patients with depression compared to T2DM obese patients without depression ( p <0.05). The study did not find a significant difference in cortisol serum levels among the T2DM and control groups. However, a higher level of serum cortisol was reported in T2DM obese patients with depression over those T2DM obese patients who lacked depression ( p <0.05). Conclusion The findings suggest that T2DM obese patients might have a higher risk of developing stress and depression. Further, biochemical parameters, adiponectin and cortisol, might be the potential biomarkers for T2DM and may help in early diagnosis of these comorbid conditions.

Serum adiponectin and cortisol levels are not affected by studied ADIPOQ gene variants: Tehran lipid and glucose study

“…In many studies, lower adiponectin levels and higher cortisol levels were reported in obesity, while our findings demonstrated a fall in cortisol level in obese people [ 24 , 25 ]. A metabolic disorder is often linked with cortisol plasma level fluctuation [ 26 ]. In Canada, the population cortisol levels were not different between BMI categories, but the level of Adiponectin was different in BMI categories, and adiponectin level was lower in obese individuals [ 27 ].…”

The contribution of type 2 diabetes mellitus to hypothalamic inflammation and depressive disorders in young patients with obesity

“…Our previous studies also showed that the incidence of depression in patients with obesity was higher than that in the normal population (6). Generally, the incidence of depressive disorder in obese people is 1.7-50% (2,18). In this study, the incidence of depression in patients with obesity was 41.14%.…”

“…Type 2 diabetes mellitus (T2DM) is one of the most common comorbidities in patients with obesity. One of the key study indicate the bidirectional associations between T2DM and obesity (2). Of the 1,389,016 eligible patients, the most common conditions in patients with T2DM included overweight/obesity in 78.2% (3).…”

Predictors Affecting Diabetes Related Distress among Diabetes Patients

“…Similarly, body fat percentage, BMI and weight had significant weak negative univariate correlation with DRD, however these were not observed in the multivariate model. Obese people with diabetics had increased risk of stress due to dysregulation of hypothalamic-pituitary-adrenal (HPA) axis and release of cortisol ( 24 ).…”