Depression/Metabolic Syndrome in Mexican-American Women.

墨西哥裔美国女性的抑郁/代谢综合症。

• 批准号: 6785947
• 负责人: MA-LI WONG
• 金额: $ 34.31万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6785947
• 关键词: Mexican Americans; antidepressants; arginine; body composition; body weight; cardiovascular disorder risk; clinical research; cortisol; diabetes mellitus; disease /disorder proneness /risk; endocrine gland /system; female; glucose clamp technique; glucose tolerance test; human subject; human therapy evaluation; hyperglycemia; hypothalamic pituitary adrenal axis; insulin sensitivity /resistance; leptin; major depression; medically underserved population; mental disorder chemotherapy; metabolic syndrome; metabolism disorder; outcomes research; photon absorptiometry

DESCRIPTION (provided by applicant): This grant application has been developed to test the hypothesis that insulin resistance and hyperglycemic trends parallel plasma cortisol levels in major depressive disorder (MDD). We will also test the more focused hypothesis that treatment of depressive symptoms ameliorates state of insulin resistance. We will approach these hypotheses by studying depressed Mexican-American women from a rigorously characterized cohort of patients who have been recruited into our NIGMS-funded project in pharmacogenomics of antidepressant treatment response (GM61394). This application builds on the enormous resource provided by that prospective study, which provides the opportunity to recruit and treat these individuals. That project is a carefully designed, prospective clinical phase IIA randomized longitudinal study, using two pharmacological agents (desipramine and fluoxetine) with demonstrated efficacy in the treatment of MDD in the Mexican-American population. Clinical status is assessed with clinical interview and ratings such as the Hamilton Ratings Scale for Depression, Beck Depression Inventory, and Hamilton Anxiety Rating Scale. These instruments have been extensively validated in Spanish. That project is a treatment study with single- and double-masking, with random assignment of treatment, and with outcomes assessed with clinical measures. All subjects will undergo comprehensive intake assessments, and will then have follow-up assessments. Treatment will be provided according to our approved protocol. We propose to conduct detailed endocrine, nutritional, and metabolic studies in normal-weight Mexican-American women, who are otherwise medically healthy and who will be extensively characterized for our pharmacogenomic study. This proposal will permit the ascertainment of degree of insulin resistance in MDD through the assessment of endocrine (HPA axis and leptin measurements), nutritional, body composition, and metabolic function (insulin sensitivity will be assessed by oral glucose tolerance test, glucose clamp and arginine stimulation test) before and after treatment. Treatment outcome data will be correlated with endocrine and metabolic endpoints. Several lines of evidence suggest diabetes mellitus is often associated with depression and that depression increases the risk of developing diabetes. This work will address this important area by the study of an population group who is markedly under represented in patient-oriented investigation.

描述(由申请人提供)：这项赠款申请是为了测试胰岛素抵抗和高血糖趋势与严重抑郁障碍(MDD)患者的血浆皮质醇水平平行的假设。我们还将测试更有针对性的假设，即治疗抑郁症状可以改善胰岛素抵抗状态。我们将通过从一组具有严格特征的患者队列中研究抑郁的墨西哥裔美国女性来探讨这些假设，这些患者已经被招募到我们的NIGMS资助的抗抑郁治疗反应的药物基因组学项目(GM61394)。这项申请建立在前瞻性研究提供的巨大资源的基础上，这项研究提供了招募和治疗这些人的机会。该项目是一项精心设计的前瞻性临床IIA期随机纵向研究，使用了两种药理学药物(地塞帕明和氟西汀)，在墨西哥裔美国人中证明了治疗MDD的有效性。临床状态通过临床访谈和评级进行评估，如汉密尔顿抑郁量表、贝克抑郁量表和汉密尔顿焦虑量表。这些工具在西班牙语中得到了广泛的验证。该项目是一项治疗研究，采用单掩蔽和双掩蔽，随机分配治疗，并用临床措施评估结果。所有受试者将接受全面的入学评估，然后进行后续评估。治疗将根据我们批准的方案提供。我们建议对体重正常的墨西哥裔美国女性进行详细的内分泌、营养和代谢研究，她们在其他方面是健康的，我们的药物基因组研究将广泛描述她们的特征。这项建议将允许在治疗前后通过内分泌(HPA轴和瘦素测量)、营养、身体成分和代谢功能(胰岛素敏感性将通过口服葡萄糖耐量试验、葡萄糖钳夹试验和精氨酸刺激试验来评估)的评估来确定MDD的胰岛素抵抗程度。治疗结果数据将与内分泌和代谢终点相关。一些证据表明，糖尿病通常与抑郁症有关，抑郁症会增加患糖尿病的风险。这项工作将通过对一个在以患者为导向的调查中明显代表不足的人群的研究来解决这一重要领域。