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Original Research

Evaluation of Stress and Associated Biochemical Changes in Patients with Type 2 Diabetes Mellitus and Obesity

, ORCID Icon, , ORCID Icon & ORCID Icon
Pages 705-717 | Published online: 16 Feb 2021

Figures & data

Figure 1 The figure represents study rationale. The figure also depicts how biochemical parameters (cortisol and adiponectin) are associated with stress including both stress resilient and susceptible populations. (↑↑ – mild increment; ↑↑↑ – moderate increment; ↑↑↑↑ – high increment; ↓↓ – mild reduction; ↓↓↓ – moderate reduction; ↓↓↓↓ – high reduction; ↔ – no change).

Figure 1 The figure represents study rationale. The figure also depicts how biochemical parameters (cortisol and adiponectin) are associated with stress including both stress resilient and susceptible populations. (↑↑ – mild increment; ↑↑↑ – moderate increment; ↑↑↑↑ – high increment; ↓↓ – mild reduction; ↓↓↓ – moderate reduction; ↓↓↓↓ – high reduction; ↔ – no change).

Figure 2 The figure demonstrates investigation plan of the study.

Figure 2 The figure demonstrates investigation plan of the study.

Table 1 Demographic Characteristics

Table 2 Independent Cluster Analysis Based on Scores from PHQ-9 and SCQ Questionnaires

Table 3 K-means Cluster Analysis: Identify Two Clusters Based on Scores from PHQ-9 and SCQ Questionnaires

Figure 3 The figure demonstrates cluster similarity across study population of diabetes. (C1: diabetic/obese patients without depression; C2: diabetic/obese patients with depression). (A) Similarity of clusters based on questionnaire scores: two clusters were identified by independently using SCQ and PHQ-9 questionnaire score as variables employing K-means cluster analysis. The independent clusters (C1 and C2) identified by SCQ scores and (C1 and C2) of PHQ-9 scores were matched subject to subject for accuracy estimations. (B) Similarity of clusters based on biochemical evaluations: two clusters were identified by independently using adiponectin and cortisol levels as variables employing K-means cluster analysis. The independent clusters (C1 and C2) identified by adiponectin levels and (C1 and C2) of cortisol levels were matched subject to subject for accuracy estimations. (C) Similarity of clusters based on questionnaire scores vs biochemical evaluations: two clusters were identified by independently using (1) SCQ and PHQ-9 questionnaire score as two variables together and (2) adiponectin and cortisol levels as two variables together. The independent clusters (C1 and C2) identified by questionnaire scores and of (C1 and C2) of biochemical evaluations were matched subject to subject for accuracy estimations.

Figure 3 The figure demonstrates cluster similarity across study population of diabetes. (C1: diabetic/obese patients without depression; C2: diabetic/obese patients with depression). (A) Similarity of clusters based on questionnaire scores: two clusters were identified by independently using SCQ and PHQ-9 questionnaire score as variables employing K-means cluster analysis. The independent clusters (C1 and C2) identified by SCQ scores and (C1 and C2) of PHQ-9 scores were matched subject to subject for accuracy estimations. (B) Similarity of clusters based on biochemical evaluations: two clusters were identified by independently using adiponectin and cortisol levels as variables employing K-means cluster analysis. The independent clusters (C1 and C2) identified by adiponectin levels and (C1 and C2) of cortisol levels were matched subject to subject for accuracy estimations. (C) Similarity of clusters based on questionnaire scores vs biochemical evaluations: two clusters were identified by independently using (1) SCQ and PHQ-9 questionnaire score as two variables together and (2) adiponectin and cortisol levels as two variables together. The independent clusters (C1 and C2) identified by questionnaire scores and of (C1 and C2) of biochemical evaluations were matched subject to subject for accuracy estimations.

Table 4 Independent Cluster Analysis Based on Cortisol and Adiponectin Levels

Table 5 K-means Cluster Analysis: Identify Two Clusters Based on Cortisol and Adiponectin Levels

Table 6 Variations of Different Variables

Figure 4 Percent change from control of total diabetes populations and two identified clusters among diabetes population (C1: diabetic/obese patients without depression; C2: diabetic/obese patients with depression).

Figure 4 Percent change from control of total diabetes populations and two identified clusters among diabetes population (C1: diabetic/obese patients without depression; C2: diabetic/obese patients with depression).

Table 7 ANOVA Variance Analysis Results for Different Variables