Key result
T2D is linked to ~0.7-point higher somatic depressive scores in men with stage B HF.
Why the study?
Concomitant T2DM and depressive symptoms adversely affect individuals with symptomatic HF, but their presence and association with inflammation in presymptomatic stage B HF were unclear.
Is concomitant Type II diabetes mellitus associated with greater inflammation and depressive symptoms compared to non-T2DM in men with asymptomatic stage B heart failure?
Cross-Sectional (n=349)
Measurements made by sonographers blinded to patient characteristics
Yes
Is concomitant Type II diabetes mellitus associated with greater inflammation and depressive symptoms compared to non-T2DM in men with asymptomatic stage B heart failure?
In men with asymptomatic stage B heart failure, concomitant Type II diabetes is associated with elevated inflammatory biomarkers and somatic/affective depressive symptoms, highlighting a need for early depression and biomarker screening to potentially forestall progression to symptomatic heart failure.
Answers are grounded in this paper and cite their sources.
Potential interplay between diabetes and mood in asymptomatic HF warrants exploration; leaves open whether screening alters progression.
Background The presence of concomitant Type II diabetic mellitus (T2DM) and depressive symptoms adversely affects individuals with symptomatic heart failure (HF). Hypothesis In presymptomatic stage B HF, this study hypothesized the presence of greater inflammation and depressive symptoms in T2DM as compared to non‐T2DM Stage B patients. Methods This cross‐sectional study examined clinical parameters, inflammatory biomarkers, and depressive symptoms in 349 T2DM and non‐T2DM men with asymptomatic stage B HF (mean age 66.4 years ±10.1; range 30‐91). Results Fewer diabetic HF patients had left ventricular (LV) systolic dysfunction ( P < .05) although more had LV diastolic dysfunction ( P < .001). A higher percentage of T2DM HF patients were taking ACE‐inhibitors, beta‐blockers, calcium channel blockers, statins, and diuretics ( P values < .05). T2DM HF patients had higher circulating levels of interleukin‐6 (IL‐6) ( P < .01), tumor necrosis factor‐alpha ( P < .01), and soluble ST2 (sST2) ( P < .01) and reported more somatic/affective depressive symptoms (Beck Depression Inventory II) ( P < .05) but not cognitive/affective depressive symptoms ( P = .20). Among all patients, in a multiple regression analysis predicting presence of somatic/affective depressive symptoms, sST2 ( P = .026), IL‐6 ( P = .010), B‐type natriuretic peptide ( P = .016), and sleep (Pittsburgh Sleep Quality Index [ P < .001]) were significant predictors (overall model F = 15.39, P < .001, adjusted R 2 = .207). Conclusions Somatic/affective but not cognitive/affective depressive symptoms are elevated in asymptomatic HF patients with T2DM patients. Linkages with elevated inflammatory and cardiac relevant biomarkers suggest shared pathophysiological mechanisms among T2DM HF patients with somatic depression, and these conditions are responsive to routine interventions, including behavioral.
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Mills et al. (2019) conducted a cross-sectional in Asymptomatic stage B heart failure (n=349). Type II diabetes mellitus (T2DM) vs. Non-T2DM stage B heart failure patients was evaluated on Somatic/affective depressive symptoms score (Beck Depression Inventory II) (p=0.039). Type II diabetes mellitus in men with stage B heart failure was associated with higher BDI-II somatic/affective depressive symptom scores compared to non-diabetic men.
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