Depressão, Diabetes Mellitus tipo 2 e biomarcadores inflamatórios: uma interface da psicoimunologia

Abstract

Psychoimmunology is a growing area of research that investigates psychological/behavioral aspects through bidirectional relationships between the immune system and the central nervous system. The present research aims to investigate the association between depressive and stress symptoms and immunoendocrine biomarkers in patients with DM2, followed up in specialized centers for chronic conditions in Juiz de Fora (MG). This is a cross-sectional study and convenience sample of 129 individuals with DM2, divided into: group 1 (n = 25) – participants with DM2 and depression; group 2 (n = 104) – participants with DM2 and without depression. For data collection, was used the Patient Health Questionnaire (PHQ-2) as a measure of depression, the Perceived Stress Scale (PPS-10) and the Diabetes Self-Efficacy Scale – Short Version (EAD-VC). Patients' recent blood tests were also consulted to identify metabolic and inflammatory biomarkers. The groups were similar in terms of age, sex, percentage of patients with controlled DM2, fasting blood glucose, HbA1c, smoking and alcohol consumption. Furthermore, no significant differences were observed between the groups in terms of leukocytes, segmented neutrophils, normal lymphocytes, monocytes, platelets and the neutrophil/lymphocyte, monocyte/lymphocyte and platelet/lymphocyte ratios. On the other hand, the time since DM2 diagnosis was longer in the group without depression. In the multivariate generalized linear model with the monocyte/lymphocyte ratio as the outcome, the presence of depression and time since diagnosis were not significant variables. The EAD-VC Score was associated with HbA1c (rho = -0.278; P = 0.002), segmented neutrophils (rho = -0.20; P = 0.023) and neutrophil/lymphocyte ratios (rho = -0.22; P = 0.011) and monocyte/lymphocyte (rho = -0.354; P < 0.001). Furthermore, a positive correlation was observed between the PHQ2 score and leukocytes (rho = 0.174; P = 0.050). The importance of a center specialized in the treatment of diabetes is highlighted, which provides greater access to self-care guidelines, which can reduce the risk of clinical complications and facilitate the management of the disease, thus being a protective factor against depression.