The longitudinal association between inflammation and incident depressive symptoms in men: The effects of hs-CRP are independent of abdominal obesity and metabolic disturbances (original) (raw)
Depressive Symptoms and Metabolic Syndrome: Is Inflammation the Underlying Link
Biological Psychiatry, 2008
Background-Behavioral alterations, including depression, are frequent in individuals with the metabolic syndrome (MetS). Recent findings suggest that chronic activation of innate immunity may be involved. The objective of this study was to examine the relationship between MetS and depressive symptoms and to elucidate the involvement of inflammation in this relationship.
Low-grade inflammation predicts persistence of depressive symptoms
Psychopharmacology, 2015
Evidence suggests that depression is cross-sectionally and longitudinally associated with activation of inflammatory response system. A few studies, however, have investigated the longitudinal relationship between raised inflammatory biomarkers and persistence of depressive symptoms. We examined the temporal relationship between serum levels of inflammatory biomarkers and persistence of depressive symptoms among older participants. Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depressive symptoms at baseline and at 5-year follow-up in 656 participants (233 men, 423 women) aged >60 years of the Rotterdam Study. Markers of inflammation interleukin (IL)-6, alpha-1-antichymotrypsin (ACT) and C-reactive protein (CRP) were assessed at baseline, and all participants taking antidepressant medications were excluded from the analysis. No cross-sectional association was found between IL-6, ACT and CRP with depressive symptoms at baseline. However, higher level...
Pathways linking depression, adiposity, and inflammatory markers in healthy young adults
Brain, Behavior, and Immunity, 2003
Despite mounting evidence that depression increases risk for cardiovascular morbidity and mortality, little is known about the mechanisms responsible for this association. The current study examined the inter-relationships between depression, adiposity, and inflammatory molecules implicated in the pathogenesis of coronary heart disease. One hundred adults were enrolled. Half were clinically depressed; the others were matched controls with no history of psychiatric illness. All subjects were in excellent health, defined as having no acute infectious disease, chronic medical illness, or prescribed medication regimen. Structural equation modeling yielded support for a model in which depressive symptoms promote weight accumulation, which in turn activates an inflammatory response through two distinct pathways: expanded adipose tissue release of interleukin-6 and leptin-induced upregulation of interleukin-6 release by white blood cells (CFI ¼ .99; NNFI ¼ .99; RMSEA ¼ .05). It did not support a sickness behavior model in which the inflammatory molecules arising from expanded adipose tissue promote depressive symptoms.
Scientific Reports
Depression has been associated with increased inflammation. However, only few large-scale, prospective studies have evaluated whether inflammation leads to new cases of depression and whether this association can be found in men and women. Longitudinal data of N = 10,357 adult participants with no evidence of depression at baseline (based on Patient Health Questionnaire (PHQ-9), lifetime diagnoses, and current antidepressant medication) were evaluated for depression 5 years later. Multivariate logistic regression models were used to predict the onset of depression based on C-reactive protein (CRP) and white blood cell count (WBC). We used interaction terms and separate analyses in men and women to investigate gender-dependent associations. Based on both markers, inflammation was predictive of new cases of depression 5 years later, even when adjusting for sociodemographic, physical health, health behavior variables, and baseline depression symptoms. As established by interaction term...
Brain, behavior, and immunity, 2018
Obesity is a major public health burden associated with neuropsychiatric comorbidities leading to social and occupational impairment. Given the growing prevalence of both obesity and mental disorders worldwide, understanding the risk factors of obesity-related neuropsychiatric comorbidities is crucial to develop preventive strategies and individualized treatments. Recent findings suggest that adiposity-driven inflammation contributes to neuropsychiatric comorbidities in obesity. However, not all obese subjects afflicted with chronic inflammation develop neuropsychiatric symptoms, suggesting additional risk factors. The aim of this study was to investigate the impact of personal history of major depressive disorder (MDD) on obesity-related inflammation and neuropsychiatric symptoms, and their relationship. A case-control study was conducted comparing 66 obese patients (body mass index > 35 kg/m) and 22 healthy non-obese participants, free of any current neuropsychiatric diseases i...
Clinical depression and inflammatory risk markers for coronary heart disease
The American Journal of Cardiology, 2002
Despite mounting evidence that psychiatric depression heightens risk for cardiac morbidity and mortality, little is known about the mechanisms responsible for this association. The present study examined the relation between depression and the expression of inflammatory risk markers implicated in the pathogenesis of coronary heart disease (CHD). One hundred adults were enrolled (68% women, 48% Caucasian, 48% African-American, mean age 30 ؎ 2 years). Fifty subjects met the diagnostic criteria for clinical depression; the remaining 50 were demographically matched controls with no history of psychiatric illness. All subjects were in excellent health, defined as having no acute infectious disease, chronic medical illness, or regular medication regimen aside from oral contraceptives. The depressed subjects exhibited significantly higher levels of the inflammatory markers C-reactive protein (3.5 ؎ 0.5 vs 2.5 ؎ 5 mg/L, p ؍ 0.04) and interleukin-6 (3.0 ؎ 0.3 vs 1.9 ؎ 0.2 pg/ml, p ؍ 0.007) compared with control subjects. Mediational analyses aimed at identifying the pathways contributing to this association revealed that neither cigarette smoking nor subclinical infection with cytomegalovirus or Chlamydia pneumoniae had been responsible. However, depressed subjects exhibited greater body mass than control subjects, and analyses were consistent with adiposity accounting for a portion of the relation between clinical depression and increased expression of inflammatory markers. These findings indicate that in otherwise healthy adults, depression is associated with heightened expression of inflammatory markers implicated in the pathogenesis of CHD. Increased body mass appears to be partially, although not completely, responsible for this relation. ᮊ2002 by Excerpta Medica, Inc.
Depression and Anxiety, 2020
Background: The link between systemic inflammation and depression has been deeply investigated, but relatively few studies explored symptom-specific associations, mostly focusing on common inflammatory biomarkers like C-reactive protein (CRP) levels. : We investigated associations of low-grade inflammation with depressive symptoms assessed through a reduced version of Patient Health Questionnaire 9 (PHQ-9) in a large population-based cohort of adult Italians (N = 13 301). We built logistic regressions between each depressive symptom and composite index of systemic inflammation based on four circulating biomarkers, namely CRP, Plt, WBC, and GLR (INFLA)-score, a composite blood-based inflammation index, and with its component biomarkers, namely CRP, platelets count (Plt), white blood cells count (WBC), and granulocyte-to-lymphocyte ratio (GLR). Results: We observed a strong association of the altered appetite/eating symptom with standardized INFLA-score (OR [95% CI] = 1 .19 [1.12-1.26]; corrected p = 3.0 × 10 -7 ),
2014
The purpose of this study was to assess the association between IL-6 and CRP with depressive items and cognitive function. We included 112 outpatients with major depression from an exercise trial and 57 healthy controls. IL-6, high sensitive CRP (hsCRP), and cognitive function were assessed in all subjects. After baseline assessment, patients were randomised to either a 3 months exercise intervention or an exercise control group. Post-intervention IL-6, hsCRP, depressive symptoms, and cognitive function were reassessed in the patient group. IL-6 and hsCRP were significantly increased in depressed patients compared to healthy controls (p = 0.02 and 0.04). These differences were no longer significant after adjustment for lifestyle associated variables. We found no association between immune markers and specific depressive symptoms at baseline or as change over time. Regarding the cognitive tests, IL-6 was positively associated with Serial sevens (p = 0.008) and hsCRP was inversely associated with Trail making A (p = 0.02) and design fluency (p = 0.001) at baseline. At 3 months follow-up IL-6 and hsCRP levels did not significantly change from baseline and did not differ between the two patient groups. Depression scores was lower compared to baseline but did not differ between groups. Combining the two groups, a decrease in IL-6 was associated to decreased verbal fluency (p = 0.02), and a decrease in hsCRP was associated with improvement in Trail making A (p = 0.005). In conclusion, the level of IL-6 and hsCRP was increased in depressed outpatients but was not associated to specific depressive symptoms. In terms of cognitive function, we found that higher hsCRP levels were associated to lower psychomotor speed both at baseline and at follow-up.
Inflammatory markers such as cytokines represent potential biomarkers for major depressive disorder (MDD). Many, generally small studies have examined the role of single markers and found significant associations. We assessed 42 inflammatory markers, namely cytokines, in the blood of 321 control subjects and 887 MDD cases. We tested whether individual inflammatory marker levels were significantly affected by MDD case/control status, current episode, or current depression severity, co-varying for age, sex, body mass index (BMI), smoking, current antidepressant use, ethnicity, assay batch and study effects. We further used machine learning algorithms to investigate if we could use our data to blindly discriminate MDD patients, or those in a current episode. We found broad and powerful influences of confounding factors on log-protein levels. Notably, IL-6 levels were very strongly influenced by BMI (p = 1.37 × 10−43, variance explained = 18%), while Interleukin-16 was the most signific...
Psychosomatics, 2014
Background: Depression and metabolic syndrome (MeS) are prevalent in elderly people and are associated with adverse outcomes, especially cardiovascular disease. Increased C-reactive protein (CRP) levels are a risk factor for depression and chronic medical disorders, such as cardiovascular disease and MeS. Objective: The aim of this study was to evaluate the risk of MeS and CRP levels in elderly (4 60 y) patients with newly-diagnosed major depressive disorder. Methods: We enrolled 30 subjects with newly diagnosed depression and 30 age-and sex-matched controls who presented for a health examination at Asan Medical Center, Seoul, Korea. Sociodemographic, MeS components, and CRP were measured before starting treatment with antidepressants. Results: There were no significant differences in sociodemographic characteristics or lifestyle factors between depressive and healthy control patients. The newly-diagnosed depression group showed a significantly increased risk of MeS (odds ratio ¼ 4.75, 95% CI: 1.58-14.25) compared with the control group. Of the 5 MeS components examined, only waist circumference was significantly different between the 2 groups (odds ratio ¼ 4.33, 95% CI: 1.20-15.61). Elevated CRP levels were significantly associated with an increased risk for depression (odds ratio ¼ 4.57, 95% 1.45-14.39). Conclusions: The risks of MeS and elevated CRP levels are higher in elderly patients with depression than in normal subjects. Physicians need to be alert to these cardiovascular risk factors when diagnosing and prescribing antidepressants for depression in the elderly. Clinical investigators are encouraged to assess markers of inflammation and review detailed information on risk factors such as waist circumference for MeS in patients with depression. (Psychosomatics 2014; ]:]]]-]]])