Interelation of psychosocial and clinical-pathogenetic changes in obese patients

Victoria Tkachenko, Taisiia Bagro

Keywords: abdominal obesity, anxiety, depression, sleep quality, sleepiness, eating behavior, serotonin, leptin, primary care

Background:

The problem of obesity in the world plays a significant role in the progression of non-communicable diseases.

Research questions:

To determine the interrelation between psychosocial and clinical-pathogenetic changes in obese patients.

Method:

75 patients with obesity (39.03±0.93 years) and 75 healthy (36.84±0.96 years) were examined with measurements of body surface area (BSA), waist/hip ratio (WHR), conicity index (ConI), a body shape index (ABSI), abdominal volume index (AVI), blood levels of glucose, insulin, HOMA index, cholesterol, lipidogram, serotonin and leptin, scores of HADScale, Beck Scale, Hamilton Scale, Dutch Eating Behavior Questionnaire, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Questionnaire, SF-36. Statistical analysis used IBM SPSS, Excel 2010.

Results:

Study group, in contrast to control group, had significantly higher levels of BMI, WHR, BSA, indices ConI, ABSI and AVI, HOMA, glucose, insulin, cholesterol, lipidogram, leptin, lower serotonin level. It was accompanied with clinically expressed anxiety or depression, changes in eating behavior (tendency to "eat emotionally", overeat, eating without restrictions), sleep disturbances (excessive daytime sleepiness, poor sleep quality) and reduced quality of life. A positive correlation between obesity indices, glucose levels, lipidogram, atherogenicity index, HOMA index, leptin, scores of depression and anxiety, and negative correlation with ABSI index, HDL, serotonin were found. In addition, positive correlation was observed between leptin and scores of depression, anxiety, eating behavior, sleepiness, and negative correlation of these indicators with the level of serotonin.

Conclusions:

A strong interrelation between abdominal obesity, psychoemotional, metabolic, sleeping and eating disorders, leptin and serotonin levels was determined. It is important to consider in patient-centered care of obesity.

Points for discussion:

What is pathogenetic mechanism of these changes?

Which other diagnostics can be needed?

What GP can prescribe to improve the patient-centred care for such patients?