JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENT
JAMA NEWS RELEASES
(Embargoed for Release: 3:00 p.m. CT, Tuesday, June 17, 2008)
JAMA NEWS RELEASES
TREATED DIABETES ASSOCIATED WITH INCREASED RISK FOR DEPRESSION
RADIATION TREATMENT FOR CANCER RECURRENCE AFTER RADICAL PROSTATECTOMY ASSOCIATED WITH INCREASED SURVIVAL
STUDY FINDS LINK BETWEEN PRESENCE OF ANTIBODIES FROM A CERTAIN TYPE OF HERPES VIRUS AND AN ATYPICAL FORM OF DIABETES IN SUB-SAHARAN AFRICANS
JAMA REPORT (VIDEO SCRIPT)
VIDEO: Windows Media | Quicktime
STUDY FINDS ASSOCIATION BETWEEN DIABETES AND DEPRESSION
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Embargoed for Release: 3:00 p.m. CT, Tuesday, June 17, 2008
Media Advisory: To contact Sherita Hill Golden, M.D., M.H.S., call Christen Brownlee at 410-955-7832.
TREATED DIABETES ASSOCIATED WITH INCREASED RISK FOR DEPRESSION
CHICAGO—Persons with treated type 2 diabetes are at increased risk for developing depression, while a more modest association was found between persons with depression and the risk of diabetes, according to a study in the June 18 issue of JAMA.
The prevalence of clinical depression and the presence of elevated depressive symptoms are higher among persons with diabetes compared with the general population. These associations may be related to increased risk of depressive symptoms in individuals with diabetes, increased risk of type 2 diabetes in individuals with depressive symptoms, or both. It is unclear whether type 2 diabetes is a risk factor for increased symptoms of depression. “A diagnosis of diabetes or the burden of dealing with its complications might also lead to symptoms of depression,” the authors write.
Sherita Hill Golden, M.D., M.H.S., of Johns Hopkins University, Baltimore, and colleagues used measures of fasting blood glucose and depressive symptoms to test whether elevated depressive symptoms predicted incident type 2 diabetes and whether participants with type 2 diabetes at the beginning of the study were more likely to develop increased symptoms of depression than participants without diabetes. The study included men and women age 45 to 84 years who enrolled in 2000-2002 and were followed up until 2004-2005. Elevated depressive symptoms were defined by high scores on the Center for Epidemiologic Studies Depression Scale (CES-D; a questionnaire given to participants), use of anti-depressant medications, or both. Participants were categorized as having normal fasting glucose, impaired fasting glucose or type 2 diabetes.
Analysis 1 included 5,201 participants without type 2 diabetes at baseline and estimated the relative risk of incident type 2 diabetes over 3.2 years for those with and without depressive symptoms. Analysis 2 included 4,847 participants without elevated depressive symptoms at baseline and calculated the relative odds of developing depressive symptoms over 3.1 years for those with and without type 2 diabetes.
The researchers found that treated type 2 diabetes was associated with a 52 percent higher risk of developing elevated depressive symptoms. Individuals with untreated type 2 diabetes were not at increased risk.
In examining the development of type 2 diabetes among individuals with and without elevated depressive symptoms, the incidence of type 2 diabetes over 3.2 years was 22.0 per 1,000-person years for those with elevated depressive symptoms and 16.6 for those without elevated depressive symptoms. Thus, there was a significant association between higher levels of symptoms of depression and incident diabetes; however, the association was no longer statistically significant following adjustment for lifestyle factors.
“Our findings of an association in participants with treated but not untreated type 2 diabetes suggests that the psychological stress associated with diabetes management may lead to elevated depressive symptoms,” the authors write. Regarding the link between depression and the development of diabetes, “depressive symptoms are associated with several metabolic and behavioral risk factors for type 2 diabetes. … depressed individuals are less likely to comply with dietary and weight loss recommendations and more likely to be physically inactive, contributing to obesity, a strong risk factor.”
“...the present study contributes to a growing body of literature indicating a bidirectional association between these 2 serious long-term diseases. Future studies should determine whether interventions aimed at modifying behavioral factors associated with depression will complement current type 2 diabetes prevention strategies. Finally, these findings suggest that clinicians should be aware of increased risk of elevated depressive symptoms in individuals with treated type 2 diabetes and consider routine screening for depressive symptoms among these patients,” the authors conclude.
(JAMA. 2008;299[23]:2751-2759. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, June 17, 2008
Media Advisory: To contact Bruce J. Trock, Ph.D., call Vanessa Wasta at 410-614-2916.
RADIATION TREATMENT FOR CANCER RECURRENCE AFTER RADICAL PROSTATECTOMY ASSOCIATED WITH INCREASED SURVIVAL
CHICAGO—Preliminary findings indicate that for men who underwent radical prostatectomy, radiation treatment after prostate cancer recurrence was associated with an increase in prostate cancer-related survival, according to a study in the June 18 issue of JAMA.
“Nearly 60,000 men (27 percent of newly diagnosed cases) will have undergone radical prostatectomy in 2007. Although surgery provides excellent cancer control, approximately 15 percent to 40 percent of these men will experience cancer recurrence within 5 years, usually manifested only by elevated prostate-specific antigen (PSA) level,” the authors write. For such men it is unknown whether salvage radiotherapy (radiation treatment given after recurrence of cancer) offers a survival benefit compared with observation alone.
Bruce J. Trock, Ph.D., of the Johns Hopkins University School of Medicine, Baltimore, and colleagues conducted a study to determine the association between salvage radiotherapy and prostate cancer–specific survival. The study included 635 men who underwent radical prostatectomy from 1982-2004, were followed up through December 2007, and who experienced biochemical recurrence (increased PSA levels) and/or local cancer recurrence and received either no salvage treatment (n = 397), salvage radiotherapy alone (n = 160), or salvage radiotherapy combined with hormonal therapy (n = 78).
With a median (midpoint) follow-up of 6 years after recurrence and 9 years after prostatectomy, 116 men (18 percent) died from prostate cancer, including 89 (22 percent) who received no salvage treatment, 18 (11 percent) who received salvage radiotherapy alone, and 9 (12 percent) who received salvage radiotherapy and hormonal therapy. The researchers found that salvage radiotherapy, regardless of whether given alone or with hormonal therapy, was associated with a statistically significant decrease in the risk of death of nearly 60 percent and a 3-fold increase in prostate cancer–specific survival relative to those who received no salvage treatment. Salvage radiotherapy was also associated with a significant increase in overall survival.
The increase in prostate cancer–specific survival associated with salvage radiotherapy was limited to men with PSA doubling time (a measurement of how aggressive the disease is) of less than 6 months. Among 166 men (26 percent) with PSA doubling time of less than 6 months, salvage radiotherapy alone and salvage therapy with hormonal treatment were associated with a reduction in risk of prostate cancer–specific death by more than 75 percent. Salvage radiotherapy was associated with an increase in survival only if given sooner than 2 years after recurrence.
Men whose PSA level never became undetectable after salvage radiotherapy did not experience a significant increase in prostate cancer–specific survival.
“This study provides provocative evidence that even men with adverse prognostic features such as rapid PSA doubling time or high Gleason score [a grading system for prostate cancer] may benefit from salvage radiotherapy,” the authors write.
“...our data provide the first evidence (albeit retrospective and hence, provisional) that early salvage radiotherapy is associated with improved prostate cancer–specific survival, and the magnitude of the survival benefit is similar to that observed in adjuvant [supplemental] radiotherapy trials. These data suggest that men for whom salvage radiotherapy is most beneficial are those with a PSA doubling time of less than 6 months, who also undergo treatment within 2 years of an increase in PSA level. If validated in other settings, these results could motivate a clinical trial comparing adjuvant with salvage radiotherapy, with prostate cancer–specific survival and overall survival as the primary end points.”
(JAMA. 2008;299[23]:2760-2769. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, June 17, 2008
Media Advisory: To contact corresponding author Jean-Francois Gautier, M.D., Ph.D., email: jean-francois.gautier{at}sls.aphp.fr.
STUDY FINDS LINK BETWEEN PRESENCE OF ANTIBODIES FROM A CERTAIN TYPE OF HERPES VIRUS AND AN ATYPICAL FORM OF DIABETES IN SUB-SAHARAN AFRICANS
CHICAGO—Researchers have found an association between the presence of antibodies for the virus human herpesvirus 8 (HHV-8) and an atypical form of type 2 diabetes in persons from sub-Saharan Africa, according to a preliminary study in the June 18 issue of JAMA.
Since 1987, an atypical type of diabetes has emerged as one of the most frequent forms of diabetes in populations of African origin, ketosis-prone type 2 diabetes mellitus (DM-2). Ketosis is the condition of having ketone bodies (byproducts of fat metabolism) build up in body tissues and fluids. This type of diabetes is characterized by sudden onset, suggesting there may be triggering factors, according to background information in the article.
“In this study, we hypothesized that ketosis-prone DM-2 may be associated with a viral infection, which may also be the acute and reversible precipitating phenomenon. Indeed, viruses may induce both insulin resistance and insulin secretory defect,” the authors write. “Because of the acute onset of ketosis-prone DM-2 and the high prevalence of ketosis-prone DM-2 in populations of African origin, we searched for a virus that is commonly found in this population.” HHV-8 is endemic in sub-Saharan Africa with 30 percent to 60 percent of adults having markers of HHV-8 infection.
Eugéne Sobngwi, M.D., Ph.D., of Hôpital Saint-Louis, Paris, and colleagues tested the hypothesis that HHV-8 infection is associated with ketosis-prone DM-2. The study was conducted at Saint-Louis University Hospital in Paris from January 2004 to July 2005. All participants were black and of African origin: 187 were diabetic patients of whom 81 had ketosis-prone DM-2 and 106 had non-ketotic DM-2, and an additional 90 individuals were non-diabetic control participants who were matched for age and sex. The presence of HHV-8 in genomic DNA was investigated in 22 of the participants at clinical onset of diabetes.
HHV-8 antibodies were found in 71 patients (87.7 percent) with ketosis-prone DM-2 vs. 16 patients (15.1 percent) with non-ketotic DM-2, and 36 of the control participants (40.0 percent). HHV-8 in genomic DNA was present in 6 of 13 patients with ketosis-prone DM-2 tested at acute onset and in 0 of 9 patients with non-ketotic DM-2.
“Our preliminary study shows a strong link between ketosis-prone DM-2 phenotype and markers of HHV-8 infection. Patients with ketosis-prone DM-2 have a very high prevalence of HHV-8 infection, whereas patients with non-ketotic DM-2 have a much lower prevalence of HHV-8 infection when compared with the background population. Thus, the prevalence of HHV-8 seropositivity is almost 6-fold higher in patients with ketosis-prone DM-2 compared with non-ketotic DM-2 patients,” the authors write.
“These results need to be replicated in other populations and longitudinal studies are required to understand the clinical significance of these findings.”
(JAMA. 2008;299[23]:2770-2776. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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JAMA REPORTS
VIDEO: Windows Media | Quicktime
STUDY FINDS ASSOCIATION BETWEEN DIABETES AND DEPRESSION
INTRO:
Diabetes and depression are two serious health conditions affecting millions of people each year. A recent study offers new evidence that there is a bi-directional association between the two diseases and developing one disease may make you more likely to develop the other. Jennifer Mitchell explains in this week’s JAMA Report.
VIDEO:
B-ROLL
patient walking
checking blood sugar level
checking insulin level
AUDIO:
ROSALYN TERBORG-PENN (tear-borg) HAS BEEN BATTLING DIABETES FOR YEARS. MONITORING HER BLOOD SUGAR LEVELS AND ADMINISTERING INSULIN ARE A TWENTY-FOUR SEVEN JOB.
VIDEO:
SOT/FULL
Super @: 11
Rosalyn Terborg-Penn
Diabetes Patient
Runs: 06
AUDIO:
“Sometimes I’m overwhelmed to the point where I just have to go to bed and take a break.”
VIDEO:
B-ROLL
Doctor walking
Taking patient’s blood pressure
AUDIO:
DR. SHERITA GOLDEN IS AN ENDOCRINOLOGIST AND EPIDEMIOLOGIST WITH JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE. SHE LED A TEAM OF RESEARCHERS WHO ANALYZED WHETHER THERE IS AN ASSOCIATION BETWEEN DIABETES AND SYMPTOMS OF DEPRESSION.
VIDEO:
SOT/FULL
Super @:30
Sherita Golden, M.D., M.H.S.
Johns Hopkins University School of Medicine
Runs: 06
AUDIO:
“Even with sort of symptoms of depression below a clinical threshold there’s still a risk of developing type two diabetes.”
VIDEO:
B-ROLL
GRAPHIC;
Diabetes & Depression Study (title)
About 5,000 men & women
Ages 45 to 84
Followed 3 years
Symptoms of depression
People walking
AUDIO:
RESEARCHERS COMPARED ABOUT FIVE THOUSAND MEN AND WOMEN AGES FORTY-FIVE TO EIGHTY-FOUR AND FOLLOWED THEM OVER A THREE YEAR PERIOD. THEY FOUND PARTICIPANTS WHO HAD SYMPTOMS OF DEPRESSION INCLUDING FEELINGS OF HOPELESSNESS, POOR SLEEP AND LOSS OF APPETITE, WERE MORE LIKELY THAN THOSE WITHOUT SUCH SYMPTOMS TO DEVELOP DIABETES.
VIDEO:
SOT/FULL
Sherita Golden, M.D., M.H.S.
Johns Hopkins University School of Medicine
Runs: 05
AUDIO:
“They were about had a forty-two percent increased risk of developing type two diabetes over follow up of three years.”
VIDEO:
B-ROLL
GRAPHIC;
“Those treated for type two diabetes”
“52% increased risk”
“Developing depression”
AUDIO:
RESEARCHERS ALSO FOUND THAT THOSE WHO ALREADY HAD TYPE TWO DIABETES AT THE BEGINNING OF THE STUDY AND WERE BEING TREATED FOR THE DISEASE HAD A FIFTY-TWO PERCENT HIGHER RISK OF DEVELOPING SYMPTOMS OF DEPRESSION.
VIDEO:
SOT/FULL
Sherita Golden, M.D., M.H.S.
Johns Hopkins University School of Medicine
Runs: 08
AUDIO:
“We hypothesize that some of this may be related to the increased burden of monitoring in diabetes as associated with being on medical therapy.”
VIDEO:
B-ROLL
GXF/JAMA COVER
AUDIO:
THE STUDY APPEARS THIS WEEK IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.
VIDEO:
SOT/FULL
Rosalyn Terborg-Penn
Diabetes Patient
Runs: 06
AUDIO:
“I also try to say ok I know this is my job taking care of myself. But it took me a while to get to that point.”
VIDEO:
B-ROLL
Doctor and patient talking
Doctor looking at chart
Patient testing herself
AUDIO:
RESEARCHERS BELIEVE THAT CERTAIN LIFESTYLE FACTORS ASSOCIATED WITH DEPRESSION SUCH AS POOR EATING HABITS AND LACK OF EXERCISE MAY CONTRIBUTE TO THE INCREASED RISK OF DEVELOPING TYPE TWO DIABETES. JENNIFER MITCHELL THE JAMA REPORT.
TAG:
Further studies would be needed to understand biological reasons that may be causing the two conditions to be associated. Researchers say one concern is that depression may impact a patient’s ability to care for their diabetes. They say some patients may need to be treated for both diabetes and depression at the same time. For more information about this study you can log on to www.jama.com.
