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Int J Endocrinol. 2015;2015:210406. doi: 10.1155/2015/210406. Epub 2015 Aug 10.

Improvement in Depressive Symptoms Is Associated with Reduced Oxidative Damage and Inflammatory Response in Type 2 Diabetic Patients with Subsyndromal Depression: The Results of a Randomized Controlled Trial Comparing Psychoeducation, Physical Exercise, and Enhanced Treatment as Usual.

International journal of endocrinology

Marijana Vučić Lovrenčić, Mirjana Pibernik-Okanović, Mario Šekerija, Manja Prašek, Dea Ajduković, Jadranka Kos, Norbert Hermanns

Affiliations

  1. Department of Laboratory Medicine, Merkur University Hospital, Zaj?eva 19, 10000 Zagreb, Croatia.
  2. Vuk Vrhovac University Clinic for Diabetes, Merkur University Hospital, Zaj?eva 19, 10000 Zagreb, Croatia.
  3. Croatian Institute of Public Health, Rockefellerova 7, 10000 Zagreb, Croatia.
  4. Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Theodor Klotzbücher Strasse 12, 97980 Bad Mergentheim, Germany.

PMID: 26347775 PMCID: PMC4546977 DOI: 10.1155/2015/210406

Abstract

Aims. To examine one-year changes in oxidative damage and inflammation level in type 2 diabetic patients undergoing behavioral treatment for subsyndromal depression. Materials and Methods. A randomized controlled comparison of psychoeducation (A), physical exercise (B), and enhanced treatment as usual (C) was performed in 209 eligible subjects in a tertiary diabetes care setting. Depressive symptoms (primary outcome) and selected biomarkers of oxidative damage and inflammation (secondary outcomes) were assessed at baseline and six- and twelve-month follow-up. Results. Out of the 74, 67, and 68 patients randomised into groups A, B, and C, respectively, 201 completed the interventions, and 179 were analysed. Participants in all three groups equally improved in depressive symptoms from baseline to one-year follow-up (repeated measures ANOVA; F = 12.51, p < 0.0001, η (2) = 0.07). Urinary 8-oxo-deoxyguanosine (u-8-oxodG) decreased (F = 10.66, p < 0.0001, η (2) = 0.06), as did sialic acid and leukocytes (F = 84.57, η (2) = 0.32 and F = 12.61, η (2) = 0.07, resp.; p < 0.0001), while uric acid increased (F = 12.53, p < 0.0001, η (2) = 0.07) in all subjects during one year. Improvement of depressive symptoms at 6 months significantly predicted one-year reduction in u-8-oxodG (β = 0.15, p = 0.044). Conclusion. Simple behavioral interventions are capable not only of alleviating depressive symptoms, but also of reducing the intensity of damaging oxidative/inflammatory processes in type 2 diabetic patients with subsyndromal depression. This trial is registered with ISRCTN05673017.

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