Intestinal Dysbiosis, Gut Hyperpermeability and Bacterial Translocation: Missing Links Between Depression, Obesity and Type 2 Diabetes

Sep 28, 2016Current pharmaceutical design

Gut Imbalance, Leaky Intestines, and Bacteria Moving Into the Body: Possible Connections Between Depression, Obesity, and Type 2 Diabetes

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Abstract

Major depressive disorder (MDD) is frequently found alongside obesity and type II diabetes mellitus, indicating potential common underlying mechanisms.

Comorbid MDD with obesity and type II diabetes may lead to decreased treatment effectiveness and adherence.
Altered glycemic control is associated with the presence of MDD in individuals with obesity and type II diabetes.
Shared risk factors such as poor diet and physical inactivity may contribute to the link between MDD and metabolic disorders.
Biological factors like increased inflammation, insulin resistance, and oxidative stress are implicated in the relationship between MDD and obesity or diabetes.
Evidence suggests that intestinal dysbiosis and increased bacterial translocation could play a role in the pathophysiology of these comorbid conditions.
A model proposing the gut-brain axis as a crucial factor in the comorbidity of MDD, obesity, and type II diabetes is discussed.

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The comorbid prevalence of major depressive disorder (MDD) with obesity and type II diabetes mellitus reflects the existence of a subset of individuals with a complex common pathophysiology and overlapping risk factors. Such comorbid disease presentations imply a number of difficulties, including: decreased treatment responsivity and adherence; altered glycemic control and increased risk of wider medical complications. A number of factors link MDD to metabolic-associated disorders, including: higher rates of shared risk factors such as poor diet and physical inactivity and biological elements including increased inflammation; insulin resistance; oxidative and nitrosative stress; and mitochondrial dysfunction. All of these biological factors have been extensively investigated in the pathophysiology of obesity and type 2 diabetes mellitus as well as MDD. In this review, we aim to: (1) overview the epidemiological links between MDD, obesity and type 2 diabetes mellitus; (2) discuss the role of synergistic neurotoxic effects in MDD comorbid with obesity, and type 2 diabetes mellitus; (3) review evidence of intestinal dysbiosis, leaky gut and increased bacterial translocation, in the pathophysiology of MDD, obesity and type 2 diabetes mellitus; and (4) propose a model in which the gut-brain axis could play a pivotal role in the comorbidity of these disorders.

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Intestinal Dysbiosis, Gut Hyperpermeability and Bacterial Translocation: Missing Links Between Depression, Obesity and Type 2 Diabetes

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