Durum Anksiyetesi Oral Glukoz Tolerans Test Sonuçlarını Etkiler mi?
Yıl 2021,
Cilt: 5 Sayı: 3, 353 - 359, 25.12.2021
Emre Gezer
,
Yeliz Demirhan
,
Alev Selek
,
Zeynep Cantürk
,
Berrin Çetinaslan
,
Mehmet Sözen
,
Ayfer Peker
Öz
Amaç: Bazı deneysel çalışmalarda, durum anksiyetesinin, katekol-o-metiltransferaz geni tarafından
düzenlenen ve norepinefrin sekresyonunda artışa neden olan otonom sinir sisteminin sempatik etkisi
tarafından düzenlendiği bildirmiştir. Bu nedenle, oral glukoz tolerans testi (OGTT) öncesi olan durum
anksiyetesinin test sonuçlarına etkisini araştıran prospektif bir çalışma planladık.
Gereç ve Yöntemler: Bu prospektif çalışma için OGTT endike olan hastalara test öncesinde, Durumluk
Sürekli Kaygı Envanteri (STAI) TX-1 formu dolduruldu. OGTT’ler bu çalışma sırasında aynı hemşire
tarafından ve aynı test odasında yapıldı. STAI TX-1 formu 20 maddeden oluşmakta ve bu maddelerin
her biri 1’den 4’e kadar değişen skorlara sahipti.Bulgular: OGTT yapılan ve STAI TX-1 formunu dolduran 516 hastayı çalışmamıza dahil ettik. Durum anksiyete skoru ile OGTT sonuçları
arasında anlamlı bir ilişki bulunmadı. İkili karşılaştırmalar, evli grupta vücut kütle indeksinin ve bel çevresinin bekar gruba göre anlamlı olarak
daha yüksek olduğunu gösterdi. Benzer şekilde, evli grupta OGTT sonrası diyabet tanı yüzdesi, bekar gruptan anlamlı derecede daha
yüksekti.
Sonuç: Çalışmamız, teste bağlı durum anksiyetesinin OGTT sonuçları üzerinde bir etkisi olmadığını gösterdi. Hastaların durum
anksiyetesinin OGTT’den hemen önce değerlendirilmesi gerekmeyebilir; ancak, literatürde açıklandığı gibi, kronik anksiyetenin OGTT
sonuçlarını etkileyebileceğini hatırlamakta fayda vardır. Kronik anksiyetenin OGTT’den önce değerlendirilmesinin gerekli olup olmadığını
belirlemeye yardımcı olmak için randomize prospektif çalışmalara ihtiyaç vardır.
Kaynakça
- 1. James SL, Abate D, Abate KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018 Nov;392(10159):1789–858.
- 2. Scott KM, Lim C, Al-Hamzawi A, et al. Association of Mental Disorders With Subsequent Chronic Physical Conditions: World Mental Health Surveys From 17 Countries. JAMA Psychiatry. 2016 Feb;73(2):150–8.
- 3. Tang F, Wang G, Lian Y. Association between anxiety and metabolic syndrome: A systematic review and meta-analysis of epidemiological studies. Vol. 77, Psychoneuroendocrinology. Elsevier Ltd; 2017. p. 112–21.
- 4. Lemche A V., Chaban OS, Lemche E. Trait anxiety but not state anxiety level associates with biomarkers for hypertension in the metabolic syndrome. Psychophysiology. 2016;53(6):914–20.
- 5. Jaremka LM, Pacanowski CR. Social anxiety symptoms moderate the link between obesity and metabolic function. Psychoneuroendocrinology. 2019 Dec;110:104425.
- 6. Batelaan NM, Seldenrijk A, Bot M, Van Balkom AJLM, Penninx BWJH. Anxiety and new onset of cardiovascular disease: Critical review and meta-analysis. Vol. 208, British Journal of Psychiatry. Royal College of Psychiatrists; 2016. p. 223–31.
- 7. Li C, Barker L, Ford ES, Zhang X, Strine TW, Mokdad AH. Diabetes and anxiety in US adults: Findings from the 2006 behavioral risk factor surveillance system. Diabet Med. 2008 Jul;25(7):878–81.
- 8. Lambert E, Dawood T, Straznicky N, et al. Association between the sympathetic firing pattern and anxiety level in patients with the metabolic syndrome and elevated blood pressure. J Hypertens. 2010 Mar;28(3):543–50.
- 9. Ziegler MG, Elayan H, Milic M, Sun P, Gharaibeh M. Epinephrine and the metabolic syndrome. Curr Hypertens Rep. 2012 Feb;14(1):1–7.
- 10. Fossum E, Høieggen A, Reims HM, et al. High screening blood pressure in related to sympathetic nervous system activity and insulin resistance in healthy young men. Blood Press. 2004;13(2):89–94.
- 11. Głowinska A, Zielona-Jenek M, Pawelczyk A, Banaszewska BE. Determinants of emotional problems and mood disorders in women with polycystic ovary syndrome. Ginekol Pol. 2016;87(6):405–10.
- 12. Powers SI, Laurent HK, Gunlicks-Stoessel M, Balaban S, Bent E. Depression and anxiety predict sex-specific cortisol responses to interpersonal stress. Psychoneuroendocrinology. 2016 Jul;69:172–9.
- 13. Prpić-Križevac I, Canecki-Varžić S, Bilić-Ćurèić I. Hyperactivity of the hypothalamic-pituitary- A drenal axis in patients with type 2 diabetes and relations with insulin resistance and chronic complications. Wien Klin Wochenschr. 2012 Jun;124(11–12):403–11.
- 14. Liukkonen T, Räsänen P, Jokelainen J, et al. The association between anxiety and C-reactive protein (CRP) levels: Results from the Northern Finland 1966 Birth Cohort Study. Eur Psychiatry. 2011 Sep;26(6):363–9.
- 15. Brunner EJ, Hemingway H, Walker BR, et al. Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: Nested case-control study. Circulation. 2002 Nov;106(21):2659–65.
- 16. Pouwer F. Should we screen for emotional distress in type 2 diabetes mellitus? Vol. 5, Nature Reviews Endocrinology. Nature Publishing Group; 2009. p. 665–71.
- 17. Bickett A, Tapp H. Anxiety and diabetes: Innovative approaches to management in primary care. Exp Biol Med. 2016 Sep;241(15):1724–31.
- 18. Hajian-Tilaki K, Heidari B. Is waist circumference a better predictor of diabetes than body mass index or waist-to-height ratio in Iranian adults? Int J Prev Med. 2015;2015-Janua.
- 19. Jawad F, Kalra S. Marriage and diabetes. Prim Care Diabetes. 2019;69(6):6–8.
- 20. Liu H, Waite L, Shen S. Diabetes Risk and Disease Management in Later Life: A National Longitudinal Study of the Role of Marital Quality. Journals Gerontol - Ser B Psychol Sci Soc Sci. 2016;71(6):1070–80.
Does State Anxiety Affect the Outcome of an Oral Glucose Tolerance Test?
Yıl 2021,
Cilt: 5 Sayı: 3, 353 - 359, 25.12.2021
Emre Gezer
,
Yeliz Demirhan
,
Alev Selek
,
Zeynep Cantürk
,
Berrin Çetinaslan
,
Mehmet Sözen
,
Ayfer Peker
Öz
Aim: Some experimental studies reported that state anxiety is mediated by sympathetic effect of
autonomic nervous system with an increase in norepinephrine secretion regulated by the catechol-omethyltransferase
gene. We conducted a prospective study investigating the effect of state anxiety of
the subjects prior to oral glucose tolerance test (OGTT) on the test outcomes.
Material and Methods: State-Trait Anxiety Inventory (STAI) TX-1 form was given to the patients whom
OGTT was indicated for this prospective study. OGTTs were performed by the same nurse and in
the same test room during this study. STAI TX-1 form consisted 20 items and each one of them had
weighted scores from 1 to 4.
Results: We included 516 patients to whom OGTT was performed and who completed STAI TX-1
form. No significant association between state anxiety score and OGTT outcomes was found. Pairwise
comparisons showed BMI and waist circumference in the group of married were significantly higher than
those in the group of single. Similarly, the percentage of DM diagnosis following OGTT in the group of
married was significantly higher than that in the group of single.
Conclusion: Our study demonstrated that test-dependent state anxiety had no impact on OGTT
outcomes. Evaluating state anxiety of the patients right before OGTT may not be required; however,
as described in the literature, it is worthwhile to remember chronic anxiety could affect the outcomes of
OGTT and a randomized prospective study is necessary to help determine if evaluating trait anxiety is
required prior to OGTT.
Kaynakça
- 1. James SL, Abate D, Abate KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018 Nov;392(10159):1789–858.
- 2. Scott KM, Lim C, Al-Hamzawi A, et al. Association of Mental Disorders With Subsequent Chronic Physical Conditions: World Mental Health Surveys From 17 Countries. JAMA Psychiatry. 2016 Feb;73(2):150–8.
- 3. Tang F, Wang G, Lian Y. Association between anxiety and metabolic syndrome: A systematic review and meta-analysis of epidemiological studies. Vol. 77, Psychoneuroendocrinology. Elsevier Ltd; 2017. p. 112–21.
- 4. Lemche A V., Chaban OS, Lemche E. Trait anxiety but not state anxiety level associates with biomarkers for hypertension in the metabolic syndrome. Psychophysiology. 2016;53(6):914–20.
- 5. Jaremka LM, Pacanowski CR. Social anxiety symptoms moderate the link between obesity and metabolic function. Psychoneuroendocrinology. 2019 Dec;110:104425.
- 6. Batelaan NM, Seldenrijk A, Bot M, Van Balkom AJLM, Penninx BWJH. Anxiety and new onset of cardiovascular disease: Critical review and meta-analysis. Vol. 208, British Journal of Psychiatry. Royal College of Psychiatrists; 2016. p. 223–31.
- 7. Li C, Barker L, Ford ES, Zhang X, Strine TW, Mokdad AH. Diabetes and anxiety in US adults: Findings from the 2006 behavioral risk factor surveillance system. Diabet Med. 2008 Jul;25(7):878–81.
- 8. Lambert E, Dawood T, Straznicky N, et al. Association between the sympathetic firing pattern and anxiety level in patients with the metabolic syndrome and elevated blood pressure. J Hypertens. 2010 Mar;28(3):543–50.
- 9. Ziegler MG, Elayan H, Milic M, Sun P, Gharaibeh M. Epinephrine and the metabolic syndrome. Curr Hypertens Rep. 2012 Feb;14(1):1–7.
- 10. Fossum E, Høieggen A, Reims HM, et al. High screening blood pressure in related to sympathetic nervous system activity and insulin resistance in healthy young men. Blood Press. 2004;13(2):89–94.
- 11. Głowinska A, Zielona-Jenek M, Pawelczyk A, Banaszewska BE. Determinants of emotional problems and mood disorders in women with polycystic ovary syndrome. Ginekol Pol. 2016;87(6):405–10.
- 12. Powers SI, Laurent HK, Gunlicks-Stoessel M, Balaban S, Bent E. Depression and anxiety predict sex-specific cortisol responses to interpersonal stress. Psychoneuroendocrinology. 2016 Jul;69:172–9.
- 13. Prpić-Križevac I, Canecki-Varžić S, Bilić-Ćurèić I. Hyperactivity of the hypothalamic-pituitary- A drenal axis in patients with type 2 diabetes and relations with insulin resistance and chronic complications. Wien Klin Wochenschr. 2012 Jun;124(11–12):403–11.
- 14. Liukkonen T, Räsänen P, Jokelainen J, et al. The association between anxiety and C-reactive protein (CRP) levels: Results from the Northern Finland 1966 Birth Cohort Study. Eur Psychiatry. 2011 Sep;26(6):363–9.
- 15. Brunner EJ, Hemingway H, Walker BR, et al. Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: Nested case-control study. Circulation. 2002 Nov;106(21):2659–65.
- 16. Pouwer F. Should we screen for emotional distress in type 2 diabetes mellitus? Vol. 5, Nature Reviews Endocrinology. Nature Publishing Group; 2009. p. 665–71.
- 17. Bickett A, Tapp H. Anxiety and diabetes: Innovative approaches to management in primary care. Exp Biol Med. 2016 Sep;241(15):1724–31.
- 18. Hajian-Tilaki K, Heidari B. Is waist circumference a better predictor of diabetes than body mass index or waist-to-height ratio in Iranian adults? Int J Prev Med. 2015;2015-Janua.
- 19. Jawad F, Kalra S. Marriage and diabetes. Prim Care Diabetes. 2019;69(6):6–8.
- 20. Liu H, Waite L, Shen S. Diabetes Risk and Disease Management in Later Life: A National Longitudinal Study of the Role of Marital Quality. Journals Gerontol - Ser B Psychol Sci Soc Sci. 2016;71(6):1070–80.