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.

C.Y. Eren-Yazicioglu; Buket Kara; S. Sancak; S. P. Uysal; D. Yazici; N. Okuroglu; A. E. Whitton; A. V.  Rutherford; H. Yapici-Eser

doi:10.1097/JCP.0000000000001409

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.

C.Y. Eren-Yazicioglu, Buket Kara, S. Sancak, S. P. Uysal, D. Yazici, N. Okuroglu, A. E. Whitton, A. V. Rutherford, H. Yapici-Eser

School of Sport and Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English
Pages (from-to)	428-435
Number of pages	7
Journal	Journal of Clinical Psychopharmacology
Volume	41
Issue number	4
DOIs	https://doi.org/10.1097/JCP.0000000000001409
Publication status	Published - 2021

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10.1097/JCP.0000000000001409

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Eren-Yazicioglu, C. Y., Kara, B., Sancak, S., Uysal, S. P., Yazici, D., Okuroglu, N., Whitton, A. E., Rutherford, A. V., & Yapici-Eser, H. (2021). 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, 41(4), 428-435. https://doi.org/10.1097/JCP.0000000000001409

@article{4bdbd9a653c849dcb716d44d2a51afc9,

title = "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.",

abstract = "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.",

author = "C.Y. Eren-Yazicioglu and Buket Kara and S. Sancak and Uysal, {S. P.} and D. Yazici and N. Okuroglu and Whitton, {A. E.} and Rutherford, {A. V.} and H. Yapici-Eser",

year = "2021",

doi = "10.1097/JCP.0000000000001409",

language = "English",

volume = "41",

pages = "428--435",

journal = "Journal of Clinical Psychopharmacology",

issn = "0271-0749",

number = "4",

}

Eren-Yazicioglu, CY, Kara, B, Sancak, S, Uysal, SP, Yazici, D, Okuroglu, N, Whitton, AE, Rutherford, AV & Yapici-Eser, H 2021, '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, vol. 41, no. 4, pp. 428-435. https://doi.org/10.1097/JCP.0000000000001409

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. / Eren-Yazicioglu, C.Y.; Kara, Buket; Sancak, S. et al.
In: Journal of Clinical Psychopharmacology, Vol. 41, No. 4, 2021, p. 428-435.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Effect of exenatide use on cognitive and affective functioning in obese patients with type 2 diabetes mellitus

T2 - Exenatide use mediates depressive scores through increased perceived stress levels.

AU - Eren-Yazicioglu, C.Y.

AU - Kara, Buket

AU - Sancak, S.

AU - Uysal, S. P.

AU - Yazici, D.

AU - Okuroglu, N.

AU - Whitton, A. E.

AU - Rutherford, A. V.

AU - Yapici-Eser, H.

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

U2 - 10.1097/JCP.0000000000001409

DO - 10.1097/JCP.0000000000001409

M3 - Article

SN - 0271-0749

VL - 41

SP - 428

EP - 435

JO - Journal of Clinical Psychopharmacology

JF - Journal of Clinical Psychopharmacology

IS - 4

ER -

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.

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