Evaluación de la funcionalidad del eje hipotálamo-hipófiso-adrenal a través del test de respuesta del cortisol al despertar en pacientes con diabetes mellitus tipo 1 con y sin depresión: Estudio Multicéntrico Argentino (EMA-1)
DOI:
https://doi.org/10.47196/diab.v54i3.454Palabras clave:
diabetes mellitus tipo 1, eje hipotálamo-hipófiso-adrenal, depresión, control glucémicoResumen
Introducción: la depresión (DP) tiene una alta prevalencia en pacientes con diabetes mellitus tipo 1 (DM1) y se asocia a repercusiones clínicas negativas como mayor morbimortalidad cardiovascular y complicaciones crónicas. Existen pocos estudios publicados sobre la funcionalidad del eje hipotálamo-hipófiso-adrenal (H-H-A) en DM1 con DP, y la relación entre la DP y el test de respuesta del cortisol al despertar (RCD) con el control glucémico (CG).
Objetivos: analizar la funcionalidad del eje H-H-A a través de la evaluación del RCD en pacientes con DM1 (PD1) con y sin DP. Como objetivos secundarios, conocer la prevalencia de DP en PD1 y ver si existe relación entre el RCD y CG y entre DP y CG.
Materiales y métodos: estudio observacional, prospectivo, de corte transversal, multicéntrico, nacional. Se incluyeron PD1 mayores de 18 años; se utilizó cuestionario Patient Health Questionnaire-9 (PHQ-9) para diagnóstico de DP. Se tomaron muestras de cortisol salival al despertar y a los 30 minutos (RCD), y se consideró RCD bloqueado si el valor de cortisol de los 30 minutos no aumentaba más del 50% del basal. Además se tomaron muestras de sangre en ayunas para medir glucemia, fructosamina y HbA1c.
Citas
I. International Diabetes Federation (2019) IDF Diabetes Atlas, 9 th edn. International Diabetes Federation, Brussels, Belgium.
II. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2018. Diabetes Care jan 2018; 41 (Suplement 1): S13-S27. doi.org/10.2337/dc18-S002.
III. Rotella F, Mannucci E. Depression as a risk factor for diabetes: meta-analysis of longitudinal studies. J Clin Psychiatry 2013: 74:31-37.
IV. Marcus M, Yasamy TM, van Ommeren M. Chisholm D, Saxena S. World Health Organization WHO Department of Mental Health and Substance Abuse. Disponible en: http://www.who.int/mental/ HYPERLINK "http://www.who.int/mental/health/management/depression/who_paper_depression_wfmh_2012.pdf?ua=1"health/management/depression/who_paper_depression_wfmh_2012.pdf?ua=1
V. International Diabetes Federation. IDF Diabetes Atlas, 6th edn. Brussels, Belgium: International Diabetes Federation, 2013. Disponible en: http://www.idf.org/diabetesatlas.
VI. Anderson RJ, Freedland KE, Clouse RE, Lutsman PJ. The prevalence of comorbid depression in adults with diabetes. Diabetes Care 2001; 24:1069-78.
VII. Lloyd CE, Roy T, Nouwen A, Chauhan AM. Epidemiology of depression in diabetes: international and cross-cultural issues. J Affect Disord 2012; 142 Suppl: S22-29.
VIII. Lloyd CE, Nouwen A, Sartorius N, Ahmed HU, Álvarez A, et al. Prevalence and correlates of depressive disorders in people with type 2 diabetes: results from International Prevalence and Treatment and Diabetes and Depression (INTERPRET-DD) study, a collaborative study carried out in 14 countries. Diabetic Med 2018. DOI: 10.1111/dme.13611.
IX. Grey M, Whittemore R, Tamborlane W. depression in type 1 diabetes in children: natural history and correlates. J Psychosom Res 2002; 53:907-11.
X. Korczak DJ, Pereira S, Koulajian K, Matejcek A, Giacca A. Type 1 diabetes mellitus and major depressive disorder: evidence for biologycal link. Diabetologia 2011; 54:2483-93.
XI. Barnard KD, Skinner TC, Peveler R. The prevalence of co-morbid depression in adults with type 1 diabetes: systematic literature review. Diabet Med 2006; 23:445-448.
XII. Simon G, Katon W, Lin E, et al. Diabetes complications and depression as predictors of health services costs. Gen Hosp Psychiatry 2005; 27:344-51.
XIII. González JS, Esbitt SA. Depression and treatment nonadherence in type 2 diabetes: assesments issues and an integrative treatment approach. Epidemiol Psichiatr Soc 2010 Apr-Jun; 19(2):110-5. Review.
XIV. Lutsman PJ, Andreson RJ, Freedland KE, de Groot M, Carney RM, Clouse RE. Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care 2000 Jul; 23(7):934-42.
XV. Badescu SV, Tataru C, Kobylinska L, Georgescu EL, Zahiu DM, Zagrean AM, Zagrean L. The association between diabetes mellitus and depression. J Med Life 2016 Apr-Jun; 9(2): 120-125.
XVI. Herder C, Schmitt A, Budden F, Reimer A, Kulzer B, Roden M, Haak T, Hermanns N. Association between pro- and anti-inflammatory cytokines and depressive symptoms in patients with diabetes-potential differences by diabetes type and depression scores. Translational Psychiatry 2017; 7:1. DOI 10.1038/s41398-017-0009-2.
XVII. Chiodini I, Adda G, Scillitani A, et al. Cortisol secretion in patients with type 2 diabetes: relationship with chronic complications. Diabetes Care 2007; 30:83-8.
XVIII. Carvalho LA, Urbanova L, Hamer M, Hackett RA, Lazzarino AI, Steptoe A. Blunted glucocorticoid andmineralocorticoid sensitivity to stress in people with diabetes. Psychoneuroendocrinology 2015; 51:209-18. DOI: 10.1016/j.psyneuen. 2014 09.023. Epub 2014 Sep 30.
XIX. Melin EO, Thunander M, Landin-Olsson M, Hillman M, Thulesius HO. Depression, smoking, physical inactivity and season independently associated with midnight salivary cortisol in type 1 diabetes. BMC Endocrine Disorders 2014; 14:75. Disponible en: http//www.biomedcentral.com/1472-6823/14/75.
XX. Wilhelm I, Born J, Kudielka BM, Schlotz W, Wust S. Is the cortisol awakening rise a response to awakening? Pshychoneuroendocrinology 2007; 32:358.366.
XXI. Lederbogen F, Hummel J, Fademrecht C, et al. Flattened circadian cortisol rhythm in type 2 diabetes. Exp Clin Endocrinol Amp Diabetes 2011; 119(9):573-575. DOI:0.055/s-0031-1275288.
XXII. Hackett RA, Steptoe A, Kumari M. Association of diurnal patterns in salivary cortisol with type 2 diabetes in the Whitehall II study. J Clin Endocrinol Metab 2014 Dec; 99(12): 4625-4631.Doi: 10.1210/jc.2014-2459.
XXIII. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Med 2001 Sep; 16(9):606-13.
XXIV. Janssen EP, Kohler S, Stethouwer CD, Schaper NC, et al. The patient health Questionnaire-9 as a screening tool for depression in individuals with type 2 diabetes mellitus: The Maastricht Study. J Am Geriatr Soc 2016 Nov; 64(11):e201-e6. PubMed PMID: 27783384.
XXV. Lloyd CE, Nouwen A, Sartorius N, Ahmed HU, Álvarez A, et al. Research: Educational and psychological aspects. Prevalence and correlates of depressive disorders in people with type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and depression (INTERPRET-DD) study, a collaborative study carried out in 14 countries. Diabetic Medicine 2018 Jun; 35(6):760-769 DOI: 10.1111/dme 13611.
XXVI. Petrak F, Baumeister HM, Skinner TC, Brown A, Holt RIG. Depression and diabetes: treatment and health-care delivery. Lancet Diabetes Endocrinol 2015; 3:472-485.
XXVII. Diez-Quevedo C, Rangil T, Sánchez-Planell L, Kroenke K, et al. Validation and utility of the patient helath questionnaire in diagnosing mental disorders in 1003 General Hospital Spanish Inpatients. Psychosom Med 2001; 63: 679-86.
XXVIII. Van Dooren FEP, Nefs G, Schram MT, Verhey FRJ, Denollet J, Pouwer F. Depression and risk of mortality in people with diabetes mellitus: a systematic review and meta-analysis. PloS ONE 2013; 8(3): e57058. DOI:10.1371/journal.pone.0057058.
XXIX. Roy T, Lloyd CE. Epidemiology of depression and diabetes: a systematic review. J Affect Disord 2012; 142(S1):S8-S21.
XXX. Ismail K, Sartorius N: Unraveling the pathogenesis of depression diabetes link. In: Depression and diabetes. Edited by Katon W, Maj M. Oxford,UK: Wiley-Blackwell; 2010; 29-62.
XXXI. Clow A, Hucklebridge F, Stalder T, Evans P, Thorn P. The cortisol awakening response: more than a measure of HPA axis function. Neuroscience & Biobehavioral Reviews 2010; 35 (1):97-103.
XXXII. Clow A, Hucklebridge F, Thorn L. The cortisol awakening response in context. Int Rev Neurobiol 2010; 93:153-75.
XXXIII. Vrshek-Schallhorn S, Doane LD, Mineka S, Zinbarg RE, Craske MG, Adam EK. The cortisol awakening response predicts major depression: predictive stability over a 4-year follow-up and effect of depression history. Psychol Med 2013; 4434(3):483-93.
XXXIV. Stroud CB, Vrshek-Shallhorn S, Norkett EM, Doane LD. The cortisol awakening response (CAR) interacts with acute interpersonal stress to prospectively predict depressive symptons among early adolescent girls. Psychoneuroendocrinology 2019; 9-18.
XXXV. Adam EK, Doane LD, Zinbarg RE, Mineka S, et al. Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence. Psychoneuroendocrinology 2010 Jul; 35(6):921-31.
XXXVI. Vreeburg SA, Hoogendijk WJ, van Pelt J, et al. Major depressive disorder and hypothalamic-pituitary-adrenal axis activity: results from a large cohort study. Arch Gen Psychiatry 2009; 66(6):617-626.
XXXVII. American Diabetes Association Glycemic Targets: Standars of Medical Care in Diabetes-2020. Diabetes Care 2020 Jan; 43 (Supplement 1): S66-S76.
XXXVIII. Kumari M, Shipley M, Stafford M, Kivimaki M. Association of diurnal patterns in salivary cortisol with all-cause and cardiovascular mortality: findings from Whitehall II study. J Clin Endocrinol Metab 2011;96:1478-1485.
XXXIX. Stagnaro JC, Cía A, Vázquez N, Vommaro H, et al. Estudio epidemiológico de salud mental en población general de la República Argentina. VERTEX Revista Arg De Psiquiat 2018; Vol.XXIX:275-299.
XL. Strandberg RB, Graue M, Wentzel-Larsen T, Peyrot M, Rokne B. Relationships of diabetes-specific emotional distress, depression, anxiety, and overall well-being with HbA1c in adults persons with type 1 diabetes. J Psychosom Res 2014 Sep;77(3):174-9.
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Dirección Nacional de Derecho de Autor, Exp. N° 5.333.129. Instituto Nacional de la Propiedad Industrial, Marca «Revista de la Sociedad Argentina de Diabetes - Asociación Civil» N° de concesión 2.605.405 y N° de disposición 1.404/13.
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