Smith K.J.,McGill University |
Smith K.J.,University Institute of Mental Health |
Beland M.,University Institute of Mental Health |
Clyde M.,McGill University |
And 12 more authors.
Journal of Psychosomatic Research | Year: 2013
Objectives: Anxiety has been shown to be associated with poor outcomes in people with diabetes. However, there has been little research which has specifically examined whether diabetes mellitus is associated with an increased likelihood of co-morbid anxiety. The aim of this systematic review and meta-analysis was to determine whether people with diabetes are more likely to have anxiety disorders or elevated anxiety symptoms than people who do not have diabetes. Methods: A systematic review was performed by three independent reviewers who searched for articles that examined the association between anxiety and diabetes in adults 16 or older. Those studies that met eligibility criteria were put forward for meta-analysis using a random-effects model. Results: A total of twelve studies with data for 12,626 people with diabetes were eligible for inclusion in the systematic review and meta-analysis. Significant and positive associations were found for diabetes with both anxiety disorders, 1.20 (1.10-1.31), and elevated anxiety symptoms, 1.48 (1.02-1.93). The pooled OR for all studies that assessed anxiety was 1.25 (1.10-1.39). Conclusions: Results from this meta-analysis provide support that diabetes is associated with an increased likelihood of having anxiety disorders and elevated anxiety symptoms. © 2012.
Brazeau A.-S.,Montreal Institute for Clinical Research |
Gingras V.,Montreal Institute for Clinical Research |
Gingras V.,University of Montreal |
Leroux C.,Montreal Institute for Clinical Research |
And 13 more authors.
Applied Physiology, Nutrition and Metabolism | Year: 2014
Physical inactivity is highly common in adults with type 1 diabetes (T1D) as specific barriers (i.e., hypoglycemia) may prevent them from being active. The objective of this study was to examine the efficacy of the Physical Exercise Promotion program in type 1 diabetes (PEP-1) program, a group program of physical activity (PA) promotion (intervention) compared with an information leaflet (control), to improve total energy expenditure (TEE) in adults with T1D after 12 weeks. TEE was measured with a motion sensor over a 7-day period at inclusion, after the program (12 weeks) and 1-year after inclusion. The 12 weekly sessions of the program included a 30-min information session (glycemic control and PA) and 60 min of PA. A total of 48 adults, aged 18 to 65 years with a reported PA practice <150 min per week, were recruited (45.8% men; aged 44.6 ± 13.3 years; 8.0% ± 1.1% glycated hemoglobin (A1c)) and randomized in this pilot trial. Ninety percent of participants completed the program and 88% completed the 1-year follow-up. No change was observed for TEE and A1c in both groups. After the 12-week program, the mean peak oxygen uptake increased (14%; p = 0.003) in the intervention group; however, at the 1-year follow-up, it was no longer different from baseline. In the control group, no difference was observed for the peak oxygen uptake. These results suggest that the PEP-1 pilot program could increase cardiorespiratory fitness. However, this benefit is not sustained over a long-term period. The PEP-1 program did not increase TEE in patients with T1D and other strategies remain necessary to counteract physical inactivity in this population.
Naour N.,University Pierre and Marie Curie |
Rouault C.,University Pierre and Marie Curie |
Fellahi S.,Assistance Publique Hopitaux de Paris |
Fellahi S.,University Pierre and Marie Curie |
And 13 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2010
Context: Recent studies in humans and mice suggest the implication of the cysteine proteases cathepsins S, L, and K in vascular and metabolic complications of obesity. Objective: Our objective was to identify clinically relevant forms of cathepsin in human obesity. Design and Setting: We conducted a prospective study on two independent cohorts. Participants and Interventions: The first cohort includes 45 obese women eligible for gastric surgery (age, 39 ± 1.6 yr; body mass index, 47 ± 0.99 kg/m2) and 17 nonobese women (age, 38 ± 1.8 yr; body mass index, 21 ± 0.44kg/m2).The second cohort comprises 29 obese women (age, 57 ± 0.8 yr; body mass index, 34 ± 0.69 kg/m2) undergoing 6 months of medically supervised caloric restriction. Main Outcomes: Cathepsin S, L,and K mRNA levels were determined in surgical adipose tissue biopsies. The proteins were measured in conditioned medium of adipose tissue explants and in circulation. Results: Obese subjects had a 2-fold increase in cathepsin S mRNA in adipose tissue as compared with normal-weight subjects and an increased rate (1.5-fold) of cathepsin S release in adipose tissue explants. Cathepsin S circulating concentrations were increased with obesity (+30%) and reduced after weight reduction (P<0.05 for both). By contrast, cathepsin L was unaffected in adipose tissue and serum; cathepsin K was undetectable in circulation and unchanged in adipose tissue. Conclusion: In humans, cathepsin S is more influenced than cathepsins L and K by changes in energy balance in adipose tissue and circulation. This opens new avenues to explore whether selective inhibition of this protease could reduce cardiovascular risk and ameliorate metabolic status in obese subjects. Copyright © 2010 by The Endocrine Society.