Prevalence and risk factors for depression among Filipino adults with diabetes mellitus type 2 at the Makati Medical Center Outpatient Department

OBJECTIVE: To  determine  the  prevalence  of  depression  in  Filipino adult patients with type 2 diabetes mellitus (DM) and the risk factors associated in its development.METHODS: This  is  a  prospective  cross-sectional  study.  Adult  patients (age 19 and above) with type 2 DM being seen at the outpatient department of the Makati Medical Center from  January  to  March  2015  were  included,  taking  into account  the  following:  age,  gender,  marital  status,  body  mass index, waist circumference, blood pressure, duration of  diabetes,  presence  of  other  co-morbid  illnesses,  pill  burden,  insulin  use,  educational  attainment,  employment  status,  family  income,  and  glycemic  status.    They  were  then screened for depression using the standardized PHQ-9 questionnaire. Bivariate analyses through Chi-square Test (for categorical variables) and Analysis of Variance (for interval/ratio variables) were used to determine which among the risk factors are significant for the development of depression.  Significant  risk  factors  were  treated  for  multivariate  and  univariate analyses through ordinal logistic regression.RESULTS: A  total  of  110  adult  patients  with  type  2  DM  were  enrolled  in  this  study.  There  were  no  drop-outs.  Sixty-nine percent  of  the  patients  had  none  to  minimal  depression,  24% had mild depression, and 7% had moderate depression. None  of  the  patients  had  depression  that  warranted  anti-depressants  or  psychotherapy.   After  step-wise  analysis, increased  BMI,  elevated  diastolic  blood  pressure  and  uncontrolled blood sugar were found to be associated with higher  PHQ-9  scores  while  unemployment  was  associated with decreased PHQ-9 score.CONCLUSION: The  prevalence  of  depression  among  Filipino type  2  diabetic  patients  is  higher  than  in  non-diabetic  patients. Being obese, having an elevated diastolic blood pressure, and the presence of uncontrolled blood sugar were significant predictors and were associated with an increased likelihood  of  developing  major  depressive  disorder. Being unemployed appears to have the opposite effect.

Prevalence of elevated TSH and its association with dyslipidemia and NAFLD among Filipino adult executive check-up patients in a tertiary hospital

OBJECTIVES: The study examined the prevalence of elevated thyroid stimulating hormone (TSH) and its association with dyslipidemia and non-alcoholic fatty liver disease (NAFLD) among Filipino adults undergoing executive check-up. METHODS: Clinical characteristics such as age, vital signs, anthropometrics, FBS, lipid profile, liver function tests, TSH and hepatobiliary ultrasound were reviewed from the charts of 580 patients to determine the prevalence of elevated TSH, NAFLD, and dyslipidemia. Binary logistic regression analysis was performed to determine association between TSH levels, NAFLD, and dyslipidemia. RESULTS: The prevalence of elevated TSH was 3.10%. Patients with increased total cholesterol was approximately 4.18 times as likely (95% CI 1.20 to 14.61%, p = 0.025) to have elevated TSH. However, after adjusting for age and sex, we had insufficient evidence to demonstrate an association between NAFLD and lipid levels with elevated TSH levels. CONCLUSION: The prevalence of elevated TSH in this group of patients from a highly urbanized area was 3.1%. We had insufficient evidence to demonstrate an association between NAFLD, lipid levels, and elevated TSH levels after adjusting for age and sex.

The relationship between hypothyroidism and color vision deficiency among Filipino adults seen at the Makati Medical Center

OBJECTIVE: To determine the relationship between hypothyroidism and color vision deficiency among Filipinos ages 20-60 yearsDESIGN AND METHODS: A cross-sectional study was performed on 91 biochemically hypothyroid and euthyroid patients seen at the Makati Medical Center from July to December 2013. All subjects underwent the Ishihara color test, followed by the Farnsworth-Munsell D15 test if this was positive. The patient who tested positive in the Farnsworth-Munsell D15 test was referred to an ophthalmologist to rule out any anatomic problem, and was excluded from the study if found to have any. Fisher's exact test assessed the significant correlation between hypothyroidism and color vision deficiency. A p-value less than 0.05 was considered significant.RESULTS: Of the 91 patients that were included in the study, the average age was 42 years, majority (87%) were females, and 41% were biochemically hypothyroid. All euthyroid patients (100%) had normal color vision, while one hypothyroid patient (3.0%) tested positive for color vision deficiency (p-value 0.407).CONCLUSION: Based on this study, the hypothyroid state of the patients had no effect on their color vision, unlike those seen in rodents, probably because mature human cones are not as easily affected by changes in thyroid hormone levels.