Effect of Exenatide Use on Cognitive and Affective Functioning in Obese Patients with Type 2 Diabetes Mellitus: Exenatide Use Mediates Depressive Scores through Increased Perceived Stress Levels
Journal of Clinical Psychopharmacology, cilt.41, sa.4, ss.428-435, 2021 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 41 Sayı: 4
- Basım Tarihi: 2021
- Doi Numarası: 10.1097/jcp.0000000000001409
- Dergi Adı: Journal of Clinical Psychopharmacology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, EMBASE, International Pharmaceutical Abstracts, MEDLINE, Psycinfo, Veterinary Science Database
- Sayfa Sayıları: ss.428-435
- Anahtar Kelimeler: GLP-1, exenatide, reward, mood, cognition, working memory, diabetes mellitus, obesity
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose/Background Glucagon-like peptide-1 (GLP-1) is a molecule used to treat type 2 diabetes mellitus (T2DM). Given their widespread expression in the nervous system, GLP-1 receptors also play a role in regulating mood and cognitive function. Here, we aimed to compare obese patients with T2DM, with or without exenatide (a GLP-1R agonist) use on cognitive and affective functioning. Methods/Procedures A total of 43 patients with T2DM (23 on exenatide and 20 without exenatide) were evaluated with the Snaith-Hamilton Pleasure Scale, Cognitive Failures Questionnaire, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7, Childhood Trauma Questionnaire, Perceived Stress Scale (PSS), and Chronic Stress Scale, in addition to laboratory-based measures of reward learning (the probabilistic reward task) and working memory (Letter-N-Back task). Findings/Results Patients on exenatide had higher body mass index (BMI) (37.88 ± 5.44 vs 35.29 ± 6.30; P = 0.015), PHQ-9 (9.70 ± 4.92 vs 6.70 ± 4.66; P = 0.026), and PSS (29.39 ± 6.70 vs 23.35 ± 7.69; P = 0.015) scores. Other stress scales (Childhood Trauma Questionnaire and Chronic Stress Scale), Generalized Anxiety Disorder-7 scores, response bias, or discriminability as assessed by probabilistic reward task and self-report (Cognitive Failures Questionnaire) and laboratory-based (Letter-N-Back) cognitive measures were not significantly different between groups (both Ps > 0.05). Multivariate linear regression analyses adding BMI and PSS as covariates revealed that although BMI had no effect (P = 0.5), PSS significantly predicted PHQ-9 scores (P = 0.004). Mediation analysis showed that exenatide users reported higher PSS, with greater PSS associated with higher PHQ-9 levels (b = 0.236). There was no evidence on exenatide directly influencing PHQ-9 independent of PSS (c′ = 1.573; P = 0.305; 95% bootstrap confidence interval, -1.487 to 4.634). Implications/Conclusions Based on previous research and our findings, exenatide use might be mediating depression scores through disrupting stress responses.