ABSTRACT
OBJECTIVE: To investigate the association between non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease (ALD), mental symptoms (mood, anxiety disorders and distress) by sex. METHODS: This a cross-sectional study performed in working-age adults from a Health Promotion Center (primary care) in São Paulo, Brazil. Self-reported mental symptoms from rating scales (21-item Beck Anxiety Inventory, Patient Health Questionnaire-9, and K6 distress scale) were evaluated by hepatic steatosis (NAFLD and ALD). Logistic regression models estimated the association between hepatic steatosis subtypes and mental symptoms by Odds ratios (OR) adjusted by confounders in the total sample and sex stratified. RESULTS: Among 7241 participants (70.5% men, median age: 45 years), the frequency of steatosis was of 30.7% (25.1% NAFLD), being higher in men than women (70.5% vs. 29.5%, p < 0.0001), regardless of the steatosis subtype. Metabolic risk factors were similar in both subtypes of steatosis, but not mental symptoms. Overall, NAFLD was inversely associated with anxiety (OR = 0.75, 95%CI 0.63-0.90) and positively associated with depression (OR = 1.17, 95%CI 1.00-1.38). On the other hand, ALD was positively associated with anxiety (OR = 1.51; 95%CI 1.15-2.00). In sex-stratified analyses, only men presented an association of anxiety symptoms with NAFLD (OR = 0.73; 95%CI 0.60-0.89) and ALD (OR = 1.60; 95%CI 1.18-2.16). CONCLUSIONS: The complex association between different types of steatosis (NAFLD and ALD), mood and anxiety disorders indicates the need for a deeper understanding of their common causal pathways.
Subject(s)
Non-alcoholic Fatty Liver Disease , Adult , Humans , Female , Male , Middle Aged , Non-alcoholic Fatty Liver Disease/complications , Non-alcoholic Fatty Liver Disease/epidemiology , Anxiety Disorders/epidemiology , Anxiety Disorders/complications , Cross-Sectional Studies , Sex Characteristics , Brazil/epidemiologyABSTRACT
O objetivo deste estudo foi o de conhecer a devida correspondência entre os sintomas mentais considerados na homeopatia e as várias regiões e estruturas identificáveis no encéfalo dos animais. Os resultados obtidos mostraram que as sensações e emoções muito primitivas, como medos e fobias, interagem pontualmente com regiões evolutivamente também muito primitivas do cérebro (como amígdala e núcleos septais), enquanto sentimentos nobres como afeto e lealdade interagem holisticamente com várias estruturas cerebrais evolutivamente mais recentes, tais como as áreas neocorticais terciárias associativas (área pré-frontal e temporal). No primeiro caso, as manifestações orgânicas são mediadas pelo sistema nervoso autônomo com sinais fisiológicos de taquicardia, elevação da pressão arterial, vasoconstrição periférica, eriçamento de pelos, midríase e secreção de hormônios como adrenalina e cortisol (disfluência comportamental), enquanto na outra situação apontada, eventuais manifestações orgânicas são harmoniosas e serenas (fluência comportamental). O conteúdo de todo o texto do trabalho é indicativo do interesse prático dos dados obtidos para o clínico veterinário homeopata, ressaltando-se nesse contexto a validação do uso de repertórios homeopáticos humanos na clínica veterinária, evidentemente com as devidas precauções sempre balizadas pelo bom senso do profissional.
This study was motivated by the need to determine the relationship between mental symptoms considered in homeopathy and several regions and structures identified in animals brain. Obtained results showed that very primitive sensations (what it feels like) and emotions (what is put out in behavioral terms), such as fears and phobias, interact punctually with also very primitive brain regions (from the evolutionary point of view, such as amygdala and septal nuclei), while noble feelings, such as affection and loyalty, interact holistically with newer brain structures (also from the evolutionary point of view), such as the tertiary associative neocortical areas (prefrontal and temporal). In the first case, the symptoms are expressed in organic manifestations, mediated by the autonomic nervous system, with physiological signs of tachycardia, elevated blood pressure, peripheral vasoconstriction, bristling hair, mydriasis and secretion of hormones, such as adrenaline and cortisol (behavioral disfluency), while, in the second case, eventual organic manifestations are harmonious and serene (behavioral fluency). Overall results are highly suggestive about the influence of mental conditions over health and disease of the physical body, through the process of somatization. The overall content of this work is indicative of the practical interest in the results by homeopathic veterinary practitioners, and in this context emphasizes the validity of using human homeopathic repertories in veterinary clinics, obviously with suitable precaution and, always directed by good professional judgment.