Antipsychotics have serious metabolic side effects on blood glucose. However, the comparative influence of these drugs on blood glucose levels has not been comprehensively evaluated. We conducted a network meta-analysis to create a hierarchy of the side effects of 12 antipsychotic drugs on changes in blood glucose levels. A systematic search of the PubMed, EMBASE and Cochrane databases (last search June 2016) was conducted to identify studies that reported randomized controlled trials (RCTs) comparing changes in blood glucose levels between patients receiving one of 12 antipsychotic drugs or a placebo for the treatment of schizophrenia or related disorders. The studies we searched were limited to those published in English. Two reviewers independently extracted data. The primary outcome of interest was changes in fasting glucose levels. We included 47 studies with 114 relevant arms. Of the antipsychotic drugs, only olanzapine was associated with significantly increased glucose levels compared to a placebo (mean difference (MD) = 3.95, 95% confidence interval (CI) = 0.14 to 7.76). Moreover, olanzapine was associated with a significantly greater change in the glucose levels than ziprasidone (MD = 5.51, 95% CI = 1.62 to 9.39), lurasidone (MD = 5.58, 95% CI = 0.53 to 10.64) or risperidone (MD = 3.05, 95% CI = 0.87 to 5.22). Ziprasidone and lurasidone were associated with minimal glucose changes compared to the other antipsychotics. Olanzapine was associated with a significantly greater change in blood glucose levels than ziprasidone, lurasidone, risperidone or placebo treatment. The application of a hierarchy of glucose metabolism-related side effects may help clinicians tailor the choice of antipsychotic drug to meet the needs of individual patients.
Background: Prehypertension is a category between normotension and hypertension that is becoming increasingly common in China. However, limited data are available on the prevalence and correlates of prehypertension in northeastern China. Methods: A cross-sectional study using stratified, clustered multistage, and random sampling methods was performed on 17,584 participants. Results: The prevalence of prehypertension and hypertension was 36.0% and 30.8% in northeastern China, respectively. As age increased, the prevalence of prehypertension in males declined (p-trend < 0.001), in parallel to an increase in the prevalence of hypertension (p-trend < 0.001). The prevalence of hypertension for females increased as age increased (p-trend < 0.001). Logistic regression analysis showed that age, gender, location, drinking, Body Mass Index (BMI), abdominal obesity, hypertriglyceridemia, and hypercholesterolemia correlated with prehypertension and hypertension (p-trend < 0.05). Conclusions: This study revealed a high prevalence of prehypertension and hypertension in an adult population of northeastern China and some correlates of prehypertension and hypertension.
7 December 2022 in International Journal of Social Psychiatry
Background: The nature of the Canadian population 65+ has changed considerably over the past several decades. They comprise a larger proportion of the population, are better educated, and are wealthier than previous generations. We estimate the contributions of chronological aging, temporal periods, and birth cohort effects on the trends in the major depressive episode (MDE) prevalence among Canadian seniors from 1994/1995 to 2017/2018. Methods: Using data from two sets of national health surveys, the National Population Health Survey (NPHS) and the Canadian Community Health Survey (CCHS). Pooled data on 150,246 survey respondents aged 65+ from 16 repeated cross-sectional surveys are included. Hierarchical regression age-period-cohort models were used to visualize the linear and non-linear effects of age, period, and cohort trends in late-life depression. Results: We found that: the prevalence of MDE in later life fluctuated non-significantly during the study time period; the probability of developing MDE declined with increasing age from 65 to 80+ (β = −.32, p = .027). The significant quadratic birth cohort predictor showed a non-linear increasing association with the prevalence of MDE from the earlier to later-born cohorts (β = .01, p = .049). We also found that females 65+ were consistently more likely to be depressed than males 65+ (β = .47, p = .007). The significantly negative “age × female” interaction shows that age exerts a greater effect on females’ probability of developing MDE than males (β = −.09, p = .011). There were no consistent significant period effects but there were peaks in prevalence around 2001, 2008, and 2012 which corresponded to some recent historical events. Our moderation analysis documents that lower levels of education significantly contributed to the higher rates of depression among cohorts born earlier in the 20th century. Conclusions: Our findings show the presence of strong chronological age and cohort effects and weaker period effects on the prevalence of late-life depression in Canadian seniors.
18 July 2017 in Journal of Plastic, Reconstructive & Aesthetic Surgery
Our previous studies using the mass spectrum analysis provided evidence that fibrinopeptide A (FPA) could be a potential biomarker for schizophrenia diagnosis. We sought further to demonstrate that variants in the fibrinogen alpha chain gene (FGA) coded FPA might confer vulnerability to schizophrenia. 1,145 patients with schizophrenia and 1,016 healthy volunteers from the Han population in Northeast China were recruited. The association of three tag single nucleotide polymorphisms (SNPs) (rs2070011 in the UTR, rs2070016 in intron 4, and rs2070022 in the UTR) in FGA and schizophrenia was examined using a case-control study design. Genotypic distributions of these three SNPs were not found to be significantly different between cases and controls (rs2070011: , ; rs2070016: , ; rs2070022: , ). There were also no significant differences in SNP allelic frequencies between cases and controls (all ). Additionally, the frequency of haplotypes consisting of alleles of these three SNPs was not significantly different between cases and healthy control subjects (global , ). Our study did not show a significant association of FGA SNPs with schizophrenia. Future studies may need to test more FGA SNPs in a larger sample to identify those SNPs with a minor or moderate effect on schizophrenia.
Background: Depression is a major mental health concern among college students, and stressful events are known risk factors. However, the direction of the longitudinal association between stressful events and depression is still debated. This study aims to explore the bidirectional relations between stressful life events and depressive symptoms among college students. Methods: We constructed a three-wave longitudinal panel study between 2022 and 2024. Using a random-intercept cross-lagged panel model (RI-CLPM), we examine the bidirectional relationship between stressful life events and depression. We estimated a cross-lagged panel network (CLPN) to identify item-level pathways linking life-event exposure to depressive symptoms. Findings: This study comprised 5,247 undergraduate students. The sample was 63·2% female, with a mean age of 19·4 ± 1·8 years at baseline. The RI-CLPM results showed that stressful life events predicted subsequent depressive symptoms (β = 0·051, P = 0·030), whereas the reverse path was non-significant (β = 0·025, P = 0·259) at the within-person level. In the CLPN analysis, feelings of punishment served as a bridge node linking stressors and depression. Interpretation: These findings indicate that stressful life events prospectively increase subsequent depressive symptoms, likely through their disruptive effects on emotion regulation and cognitive functioning. Broadly, the results highlight the need for greater societal attention to college students' mental health and call for stressor-aware mental health support on campus to promote their overall well-being.