The synergetic effects of dietary obesity and stress induced by electrical shocks on insulin secretion from the perfused pancreas, the action of insulin on adipose tissues and glucose tolerance were studied in rats. The rat was fed either a control (C) (50% starch) or a high fat diet (F) (40% butter) for a period of 12 weeks. Half of the rats on each diet received electrical shocks, one hour per day for the last three weeks of the experiment (group C-S, F-S). The remaining rats were not given any stress sessions (group C-N, F-N). The rats on the high fat diet gained a significant amount of weight at the 8th week, and as determined by the adipocytes, were obese at the end of 12 weeks. However, the high fat diet itself did not have any effect on plasma glucose, plasma insulin and insulin release from the perfused pancreas in response to glucose. It caused glucose intolerance and the insensitivity to insulin of adipose tissue. The rats which received electrical shocks stopped gaining weight when the shock sessions began. Moreover, the size of the adipocytes in F-S group was significantly smaller than that in F-N group, but the insensitivity to insulin of adipose tissue remained. In F-S group, glucose-induced insulin release from the perfused pancreas was signiffcantly diminished in the initial phase of release, and glucose tolerance was much impaired by stress, while in C-S group insulin release increased in the late phase of release, and glucose tolerance was unaffected by stress. These findings indicate that the ability of glucose to stimulate insulin secretion is decreased by the synergetic effects of a high fat diet and stress induced by electric shock. Thus, it may be concluded that the mechanism which mediates the effects of glucose upon insulin secretion, especially in the initial response phase, is modified by such synergetic effects.
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IntroductionAnxiety and depressive symptoms are seen in patients with anxiety and mood disorders but are also common in those with organic disorders. However, since physical symptoms are predominant complaints from patients who visit nonpsychiatric outpatient clinics, anxiety and depressive symptoms are often unrecognized. It is important for physicians to be aware of these issues concurrent with the physical symptoms. We therefore examined whether a self-administered medical questionnaire could identify anxiety and depressive symptoms.Patients and methodsA total of 453 patients on their first visit to the Department of General Medicine, Chiba University Hospital, Chiba, Japan, participated in this study. They were asked to complete a medical questionnaire and the Hospital Anxiety and Depression Scale questionnaire before examination. Data on age, sex, number of complaints, symptom duration, and number of previous physicians were extracted from the medical questionnaire. These data were used as independent variables in logistic regression analysis to develop a predictive model for the presence of anxiety and depressive symptoms.ResultsData from 358 (79.0%) patients were included in the analyses. Logistic regression analysis identified the following predictors: “three or more complaints” (odds ratio [OR] 2.39; 95% confidence interval [CI] 1.48–3.88) and “four or more previous physicians” (OR 1.72; 95% CI 1.10–2.69). In the predictive model for the presence of symptoms of anxiety and depression, the likelihood ratio was 2.40 (95% CI 1.33–4.34) in patients reporting both conditions and 1.35 (95% CI 1.04–1.77) in those reporting either condition.ConclusionThe presence of anxiety and depressive symptoms can be predicted from the items of a medical questionnaire in outpatients visiting a general medicine department of a university hospital. When patients report three or more complaints or four or more previous physicians on a medical questionnaire, physicians should consider the presence of anxiety or depression or both in differential diagnosis.
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