糖尿病
医学
2型糖尿病
肥胖
2型糖尿病
共病
胰岛素抵抗
重性抑郁障碍
失调
内科学
生物信息学
病理生理学
萧条(经济学)
疾病
内分泌学
生物
宏观经济学
经济
扁桃形结构
作者
Anastasiya Slyepchenko,Michaël Maes,Rodrigo Machado‐Vieira,Geoffrey M. Anderson,Marco Solmi,Yolanda Sanz,Michael Berk,Cristiano A. Köhler,André F. Carvalho
标识
DOI:10.2174/1381612822666160922165706
摘要
The comorbid prevalence of major depressive disorder (MDD) with obesity and type II diabetes mellitus reflects the existence of a subset of individuals with a complex common pathophysiology and overlapping risk factors. Such comorbid disease presentations imply a number of difficulties, including: decreased treatment responsivity and adherence; altered glycemic control and increased risk of wider medical complications. A number of factors link MDD to metabolic-associated disorders, including: higher rates of shared risk factors such as poor diet and physical inactivity and biological elements including increased inflammation; insulin resistance; oxidative and nitrosative stress; and mitochondrial dysfunction. All of these biological factors have been extensively investigated in the pathophysiology of obesity and type 2 diabetes mellitus as well as MDD. In this review, we aim to: (1) overview the epidemiological links between MDD, obesity and type 2 diabetes mellitus; (2) discuss the role of synergistic neurotoxic effects in MDD comorbid with obesity, and type 2 diabetes mellitus; (3) review evidence of intestinal dysbiosis, leaky gut and increased bacterial translocation, in the pathophysiology of MDD, obesity and type 2 diabetes mellitus; and (4) propose a model in which the gut-brain axis could play a pivotal role in the comorbidity of these disorders.
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