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Orsolini L, Ricci L, Pompili S, Cicolini A, Volpe U. Eveningness chronotype and depressive affective temperament associated with higher high-sensitivity C-reactive protein in unipolar and bipolar depression. J Affect Disord 2023; 332:210-220. [PMID: 37054896 DOI: 10.1016/j.jad.2023.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 02/27/2023] [Accepted: 04/03/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Several studies investigated the role of inflammation in the etiopathogenesis of mood disorders. The aim of our cross-sectional study is evaluating baseline high-sensitivity C-reactive-protein (hsCRP) levels in a cohort of unipolar and bipolar depressive inpatients, in relation with psychopathological, temperamental and chronotype features. METHODS Among 313 screened inpatients, we retrospectively recruited 133 moderate-to-severe depressive patients who were assessed for hsCRP levels, chronotype with Morningness-Eveningness Questionnaire (MEQ) and affective temperament with Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS). LIMITATIONS The cross-sectional and retrospective design of the study, the small sample size, the exclusion of hypomanic, maniac and euthymic bipolar patients. RESULTS hsCRP levels were significantly higher among those with previous suicide attempt (p = 0.05), death (p = 0.018) and self-harm/self-injury thoughts (p = 0.011). Linear regression analyses, adjusted for all covariates, demonstrated that higher scores at the TEMPS-M depressive, while lower scores at the hyperthymic and irritable affective temperaments [F = 88.955, R2 = 0.710, p < 0.001] and lower MEQ scores [F = 75.456, R2 = 0.405, p < 0.001] statistically significantly predicted higher hsCRP. CONCLUSION Eveningness chronotype and a depressive affective temperament appeared to be associated with higher hsCRP levels during moderate-to-severe unipolar and bipolar depression. Further longitudinal and larger studies should better characterise patients with mood disorders by investigating the influence of chronotype and temperament.
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Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Leonardo Ricci
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Simone Pompili
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Angelica Cicolini
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy.
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Li X, Nie Y, Chang B. Lack of bidirectional association between C-reactive protein and depressive symptoms in middle-aged and older adults: Results from a nationally representative prospective cohort study. Front Psychol 2023; 14:1095150. [PMID: 36860788 PMCID: PMC9969160 DOI: 10.3389/fpsyg.2023.1095150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/25/2023] [Indexed: 02/15/2023] Open
Abstract
Depression is associated with low quality of life and increased health burdens for middle-aged and older adults in resource-limited settings. Although inflammation plays an etiological role in the development and progression of depression, the directionality of the inflammation-depression relationship is unclear, especially in non-Western populations. To examine this relationship among community-dwelling Chinese middle-aged and older adults, we obtained data from the 2011, 2013, and 2015 China Health and Retirement Longitudinal Study (CHARLS). The participants were aged 45 years or above at baseline in 2011 and completed the follow-up survey in 2013 and 2015. Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), and the C-reactive protein (CRP) level was used to measure individual inflammation levels. Cross-lagged regression analyses examined the inflammation-depression relationship. Cross-group analyses were performed to test for model invariance across the sexes. Pearson's correlations revealed no concurrent correlations between depression and CRP for both 2011 and 2015 (ps > 0.05, ranging 0.07-0.36) studies. Cross-lagged regression path analyses revealed that the paths from baseline CRP to depression in 2013 (ßstd = -0.01, p = 0.80), from baseline CRP to depression in 2015 (ßstd = 0.02, p = 0.47), from baseline depression to CRP in 2015 (ßstd = -0.02, p = 0.40), and from depression at 2013 to CRP in 2015 (ßstd = 0.03, p = 0.31) were not statistically significant. Additionally, the autoregressive model did not vary across the sexes (△χ 2 = 78.75, df = 54, p = 0.02, △ comparative fit index (CFI) <0.01). We failed to find a bidirectional association between the CRP levels and depressive symptoms in our sample.
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Affiliation(s)
- Xiaohui Li
- State Key Laboratory of Experimental Hematology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - You Nie
- State Key Laboratory of Experimental Hematology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Biru Chang
- Capital Medical University, Beijing, China,School of Preschool Education, Xi’an University, Xi’an, China,Department of Psychology, Research Institute for International and Comparative Education, Shanghai Normal University, Shanghai, China,*Correspondence: Biru Chang, ✉
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Lee C, Min SH, Niitsu K. C-Reactive Protein and Specific Depression Symptoms Among Older Adults: An Exploratory Investigation of Multi-Plane Networks Using Cross-Sectional Data From NHANES (2017-2020). Biol Res Nurs 2023; 25:14-23. [PMID: 35732288 DOI: 10.1177/10998004221110602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Studies investigating the association between C-reactive protein (CRP) and depression among older adults have yielded inconsistent results. We suspect that this may be due to varying associations between CRP and particular depression symptom criteria, and we addressed this challenge using network analysis. METHODS We used cross-sectional data from prepandemic National Health and Nutrition Examination Survey questionnaires (2017-2020) and included a sample of 1698 adults aged 65 years or older. Depression symptoms were assessed using the Patient Health Questionnaire-9. Unregularized Mixed Graphical Models were estimated using the R package mgm before and after adjusting for relevant sociodemographic, clinical, and lifestyle covariates. RESULTS In the model with no covariates, the only symptom criterion associated with CRP was "appetite problems." This association remained robust after controlling for all covariates. Although not associated with CRP, other criteria such as "fatigue" and "concentration difficulty" showed associations with important covariates for older adults such as white blood cell count or hemoglobin, respectively. DISCUSSION The CRP-related variability in the depression symptom network that we have demonstrated may help explain the reported inconsistencies. The present study stands as exploratory, and future research should focus on applying longitudinal designs and including several other inflammatory proteins and covariates that were not measured in the current network model.
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Affiliation(s)
- Chiyoung Lee
- School of Nursing and Health Studies, 52576University of Washington Bothell, Bothell, WA, USA
| | - Se Hee Min
- 15776Duke University School of Nursing, Durham, NC, USA
| | - Kosuke Niitsu
- School of Nursing and Health Studies, 52576University of Washington Bothell, Bothell, WA, USA
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Concurrent presence of high serum uric acid and inflammation is associated with increased incidence of type 2 diabetes mellitus in Korean adult population. Sci Rep 2022; 12:11000. [PMID: 35768559 PMCID: PMC9243007 DOI: 10.1038/s41598-022-15176-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 06/20/2022] [Indexed: 11/09/2022] Open
Abstract
Although serum uric acid level and systemic inflammation have been highlighted as risk factors for type 2 diabetes mellitus (T2DM), little is known about these associations in the Korean population. Thus, we examined the individual and combined associations of serum uric acid and systemic inflammation (evaluated using high-sensitivity C-reactive protein [hs-CRP] measurement) with the future risk of T2DM. A total of 4152 Korean adults aged 45–76 years without T2DM, cancer, or gout at baseline in 2007–2008 from the Korean Genome and Epidemiology Study were followed up until 2016. Cox proportional hazard models were used to estimate the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of T2DM according to sex-specific tertiles of serum uric acid and hs-CRP levels after adjustment for confounders. During the mean follow-up of 7.3 years, 548 participants developed T2DM. High serum uric acid and hs-CRP levels were independently associated with an increased incidence of T2DM. The multivariable-adjusted HRs (95% CIs) for the incidence of T2DM in the highest tertiles of serum uric acid and hs-CRP were 1.54 (1.24–1.93) and 1.90 (1.48–2.43), respectively. High levels of serum uric acid and hs-CRP in combination were associated with an increased incidence of T2DM (HR: 4.69; 95% CI: 2.81–7.84) compared to low levels of serum uric acid and hs-CRP. These findings suggest that the combination of high serum uric acid and hs-CRP levels was significantly associated with an elevated incidence of T2DM; however, their synergistic effects were not observed in middle-aged and elderly Korean adults.
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Zhou J, Zhou J, Sun Z, Feng L, Feng Y, Xiao L, Chen X, Yang J. The association of C-reactive protein with responses to escitalopram antidepressant treatment in patients with major depressive disorder. J Affect Disord 2022; 306:32-38. [PMID: 35271871 DOI: 10.1016/j.jad.2022.02.069] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 02/13/2022] [Accepted: 02/27/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The effects of escitalopram vary markedly among MDD patients, and approximately one-third of patients fail to respond. A poor antidepressant response might be associated with excessively high C-reactive protein (CRP) levels, but the impact is not clear. We hypothesized that in adults with major depressive disorder, the peripheral biomarker, CRP, was associated with the response to escitalopram (SSRI). METHODS This was a prospective follow-up study. All 71 patients were treated with escitalopram for 12 weeks. Blood samples were collected at baseline and week 12. Remission was defined as a score of 7 or less on the HAMD-17 scale at week 12. Spearman correlations and multiple linear regressions were used to explore the relationship between continuous CRP levels and the HAMD-17 scores. Logistic regression was used to determine the predictors for remission. The restricted maximum likelihood (REML)-based mixed-effect model for repeated measures (MMRM) was used to examine the change of the HAMD-17 total scores between high and low CRP groups. RESULTS Compared with the high CRP group (≥0.8 mg/l), the low baseline CRP group had a higher remission rate (22.73% vs. 48.89%, χ2 = 4.2, p = 0.0403). Logistic regression revealed that patients with lower CRPs were 3.920 times (95% CI: 1.142, 13.460) more likely to experience remission (p = 0.0300). The multiple linear regression model showed that the HAMD-17 total score reduction (baseline to week 12) was negatively correlated with the baseline CRP level (t = -2.00, p = 0.0494). CONCLUSIONS We observed a predictive role of CRP for remission and symptomatic improvement after escitalopram treatment of MDD patients based on continuous or categorical CRP levels.
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Affiliation(s)
- Jingjing Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jia Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zuoli Sun
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Lei Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuan Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Le Xiao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xu Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jian Yang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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The Potential of Polygenic Risk Scores to Predict Antidepressant Treatment Response in Major Depression: A Systematic Review. J Affect Disord 2022; 304:1-11. [PMID: 35151671 DOI: 10.1016/j.jad.2022.02.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/29/2021] [Accepted: 02/09/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Understanding the genetic underpinnings of antidepressant treatment response in unipolar major depressive disorder (MDD) can be useful in identifying patients at risk for poor treatment response or treatment resistant depression. A polygenic risk score (PRS) is a useful tool to explore genetic liability of a complex trait such as antidepressant treatment response. Here, we review studies that use PRSs to examine genetic overlap between any trait and antidepressant treatment response in unipolar MDD. METHODS A systematic search of literature was conducted in PubMed, Embase, and PsycINFO. Our search included studies examining associations between PRSs of psychiatric as well as non-psychiatric traits and antidepressant treatment response in patients with unipolar MDD. A quality assessment of the included studies was performed. RESULTS In total, eleven articles were included which contained PRSs for 30 traits. Studies varied in sample size and endpoints used for antidepressant treatment response. Overall, PRSs for attention-deficit hyperactivity disorder, the personality trait openness, coronary artery disease, obesity, and stroke have been associated with antidepressant treatment response in patients with unipolar MDD. LIMITATIONS The endpoints used by included studies differed significantly, therefore it was not possible to perform a meta-analysis. CONCLUSIONS Associations between a PRS and antidepressant treatment response have been reported for a number of traits in patients with unipolar MDD. PRSs could be informative to predict antidepressant treatment response in this population, given advances in the field. Most importantly, there is a need for larger study cohorts and the use of standardized outcome measures.
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C-Reactive Protein as a Biomarker for Major Depressive Disorder? Int J Mol Sci 2022; 23:ijms23031616. [PMID: 35163538 PMCID: PMC8836046 DOI: 10.3390/ijms23031616] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 11/16/2022] Open
Abstract
The etiopathogenesis of depression is not entirely understood. Several studies have investigated the role of inflammation in major depressive disorder. The present work aims to review the literature on the association between C-Reactive Protein (CRP) and depression. A systematic review was performed for the topics of ‘CRP’ and ‘depression’ using the PubMed database from inception to December 2021. Fifty-six studies were identified and included in the review. Evidence suggested the presence of dysregulation in the inflammation system in individuals with depression. In most studies, higher blood CRP levels were associated with greater symptom severity, a specific pattern of depressive symptoms, and a worse response to treatment. Moreover, about one-third of depressed patients showed a low-grade inflammatory state, suggesting the presence of a different major depressive disorder (MDD) subgroup with a distinct etiopathogenesis, clinical course, treatment response, and prognosis, which could benefit from monitoring of CRP levels and might potentially respond to anti-inflammatory treatments. This work provides robust evidence about the potential role of CRP and its blood levels in depressive disorders. These findings can be relevant to developing new therapeutic strategies and better understanding if CRP may be considered a valuable biomarker for depression.
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Kang KY, Jung YE, Jang H, Kim MD, Bahk WM. Relationship between Handgrip Strength and Low-grade Inflammation in Older Adults with Depression. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:721-730. [PMID: 34690127 PMCID: PMC8553523 DOI: 10.9758/cpn.2021.19.4.721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 01/08/2023]
Abstract
Objective The relationship among physical functional decline, low-grade inflammation, and depression remains unclear. The aim of this study was to examine the association between hand grip strength (HGS) and high-sensitivity C-reactive protein (hs-CRP) in a large sample with depression. Methods This study used data obtained from a representative Korean sample of 9,402 people who participated in the seventh Korean National Health and Nutrition Examination Survey. Physical function was assessed using a digital grip strength dynamometer. Depression was identified using a cutoff of 5 on the Patient Health Questionnaire-9 (PHQ-9), and high hs-CPR level was defined as ≥ 3.0 mg/L. Results In older adults (≥ 60 years) with depression, 43.8% of those with high hs-CRP levels had low HGS, compared to 21.8% of those with hs-CRP levels < 3.0 mg/L (p = 0.002). Multivariate analysis revealed that, after adjustments for potentially confounding factors, high hs-CRP was independently associated with lower HGS (B = −2.25; 95% confidence interval = −4.49 to −0.02) in older adults with depression, but not in younger or middle-aged adults with depression. Conclusion These findings suggest a significant correlation between physical functional decline and low-grade inflammation in older adults with depression.
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Affiliation(s)
- Kwi Young Kang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Division of Rheumatology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Young-Eun Jung
- Department of Psychiatry, College of Medicine, Jeju National University, Jeju, Korea
| | - Hwan Jang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Moon-Doo Kim
- Department of Psychiatry, College of Medicine, Jeju National University, Jeju, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Kruse JL, Olmstead R, Hellemann G, Breen EC, Tye SJ, Brooks JO, Wade B, Congdon E, Espinoza R, Narr KL, Irwin MR. Interleukin-8 and lower severity of depression in females, but not males, with treatment-resistant depression. J Psychiatr Res 2021; 140:350-356. [PMID: 34139457 PMCID: PMC8319139 DOI: 10.1016/j.jpsychires.2021.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/17/2021] [Accepted: 06/04/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION In cross-sectional studies of depressed patients, relationships between depression and levels of IL-8 are inconsistent, and have not been examined in relation to sex. Given identified sex differences in longitudinal data, it is important to evaluate sex-specific cross-sectional relationships between IL-8 and depressive symptoms, which may explain some inconsistency in the extant literature. It is further unknown whether IL-8 levels may relate to specific symptom profiles among depressed patients, with or without regard to sex. METHODS Among 108 patients with treatment resistant depression (50 females), we evaluated cross-sectional relationships between IL-8 and depression severity, as measured by the Hamilton Depression Rating Scale [HAM-D] Score, and examined sex-specific relationships, as well as relationships with depressive symptom profiles. Other inflammatory markers (IL-6, IL-10, TNF-α, CRP) were also explored in relation to HAM-D. RESULTS Higher IL-8 was associated with lower total HAM-D score (standardized β = -0.19, p = 0.049). Sex-specific effects were identified (IL-8 x sex interaction: p = 0.03), in which higher IL-8 related to lower HAM-D score in females (standardized β = -0.41, p = 0.004, effect size (sr2) = 0.17), but not males (standardized β = 0.02, p = 0.91). Among a subset of 94 patients (41 females) who had individual HAM-D items available, we evaluated relationships between IL-8 and HAM-D factor subscores. Across sexes, higher IL-8 was associated with lower anxiety/hypochondriasis subscores (standardized β = -0.31, p = 0.002; sex interaction: p = 0.99). Sex differences were identified for relationships between IL-8 and two other HAM-D factor subscores. CONCLUSIONS IL-8 may be related to anxiety symptoms across sexes, but may have a sex-specific relationship with other depressive symptoms. Further evaluation of sex-specific relationships between IL-8, depression symptom profiles, treatment response, and potential neurobiological correlates, may inform mechanisms of depression pathophysiology and aid in development of precision medicine strategies.
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Affiliation(s)
- Jennifer L Kruse
- Cousins Center for Psychoneuroimmunology, United States; Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States.
| | - Richard Olmstead
- Cousins Center for Psychoneuroimmunology, United States; Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - Gerhard Hellemann
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - Elizabeth C Breen
- Cousins Center for Psychoneuroimmunology, United States; Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - Susannah J Tye
- Queensland Brain Institute, The University of Queensland, Australia; Department of Psychiatry & Psychology, Mayo Clinic, United States; Department of Psychiatry, University of Minnesota, United States
| | - John O Brooks
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - Benjamin Wade
- Department of Neurology, University of California at Los Angeles, Los Angeles, CA, United States
| | - Eliza Congdon
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - Randall Espinoza
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - Katherine L Narr
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States; Department of Neurology, University of California at Los Angeles, Los Angeles, CA, United States
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, United States; Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, United States
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Lee J, Kim HR, Jang TW, Lee DW, Lee YM, Kang MY. Occupational physical activity, not leisure-time physical activity, is associated with increased high-sensitivity C reactive protein levels. Occup Environ Med 2020; 78:86-91. [PMID: 32912859 DOI: 10.1136/oemed-2020-106753] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/25/2020] [Accepted: 08/04/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study aims to explore the association between physical activity and high-sensitivity C reactive protein, based on different types of physical activity-occupational and leisure time. METHODS Using cross-sectional data from the Korea National Health and Nutrition Examination Survey 2015-2018, we explored the association between different types of self-reported physical activity and high levels of high-sensitivity C reactive protein (>3 mg/L). We estimated the ORs for high-level high-sensitivity C reactive protein using multiple logistic regression models after adjusting for covariates from 12 970 eligible subjects (mean age 44.8). RESULTS Compared with subjects who did not engage in moderate-to-vigorous level of occupational physical activity (OPA), the group that engaged in moderate-to-vigorous level of OPA showed a significantly high OR (1.32, 95% CI (1.03 to 1.69)), whereas the group that engaged in moderate-to-vigorous level of leisure-time physical activity (LPA) yielded a low OR (0.84, 95% CI (0.69 to 1.01)). The group that engaged in moderate-to-vigorous level of OPA but not LPA showed a significantly high OR (1.76, 95% CI (1.27 to 2.45)) compared with subjects who engaged in moderate-to-vigorous level of LPA but not in OPA. CONCLUSIONS OPA is directly associated with high C reactive protein levels, suggesting that it increases the risk of inflammation.
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Affiliation(s)
- Jongin Lee
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, Seocho-gu, Seoul, Republic of Korea
| | - Hyoung-Ryoul Kim
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, Seocho-gu, Seoul, Republic of Korea.,Department of Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Tae-Won Jang
- Department of Occupational and Environmental Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Dong-Wook Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yu Min Lee
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, Seocho-gu, Seoul, Republic of Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, Seocho-gu, Seoul, Republic of Korea .,Department of Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Khan A, Leonard D, Defina L, Barlow CE, Willis B, Brown ES. Association between C reactive protein and depression in a population of healthy adults: the Cooper Center Longitudinal Study. J Investig Med 2020; 68:1019-1023. [DOI: 10.1136/jim-2019-001254] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2020] [Indexed: 12/21/2022]
Abstract
The relationship between depression and inflammation is currently a topic of much interest. Previous studies have produced mixed results regarding the association between depression and high-sensitivity C reactive protein (hs-CRP). The aim of this report was to determine the association between hs-CRP and depression in a large sample of healthy adults. This is a cross-sectional study of 26,638 healthy adults seen for preventive medical examinations between December 2000 and August 2018 at the Cooper Clinic in Dallas, Texas. Multivariable logistic regression was used to evaluate the association between hs-CRP levels and depressive symptoms as measured by the 10-item Center for Epidemiologic Studies Depression Scale. Covariates included race, age, education, smoking history, alcohol use, menopausal status, body mass index (BMI), and medication use. The Hs-CRP level demonstrated a weakly positive association with depressive symptoms (OR 1.06 per mg/L, 95% CI 1.03 to 1.09 for women; OR 1.05 per mg/L, 95% CI 1.02 to 1.09 for men) that became insignificant when controlling for BMI in women (OR 1.02 per mg/L, 95% CI 0.98 to 1.05) and men (OR 1.02 per mg/L, 95% CI 0.98 to 1.05). Adjusting for antidepressant and statin use did not affect the association between hs-CRP and depressive symptoms in women (OR 0.99 per mg/L, 95% CI 0.96 to 1.03) or men (OR 1.01 per mg/L, 95% CI 0.97 to 1.05). Levels of hs-CRP were not associated with depression independent of BMI in a predominantly white, male population of higher socioeconomic status. This finding suggests that associations between hs-CRP and depression may be explained by obesity, which warrants further investigation into shared pathways between obesity and depression.
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Jung YE, Kang KY. Elevated hs-CRP level is associated with depression in younger adults: Results from the Korean National Health and Nutrition Examination Survey (KNHANES 2016). Psychoneuroendocrinology 2019; 109:104397. [PMID: 31377557 DOI: 10.1016/j.psyneuen.2019.104397] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/24/2019] [Accepted: 07/24/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Reports on the association between the level of circulating high-sensitivity C-reactive protein (hs-CRP) and depression have been inconsistent. The aim of this study was to examine the association between hs-CRP and depression in a large sample. METHODS This study used data obtained from a representative Korean sample of 5447 people who participated in the first (2016) year of the seventh Korean National Health and Nutrition Examination Survey (KNHNES VII-1). Depression was identified using a cutoff of 5 on the Patient Health Questionnaire-9 (PHQ-9), and high hs-CPR level was defined as ≥ 3.0 mg/L. FINDINGS Participants with a high CRP levels had a significantly higher rate of depression than did those with a low hs-CRP levels (25.1% vs. 19.8%, p = 0.007). Serum hs-CRP was independently associated with the PHQ-9 total score after adjusting for potentially confounding factors (B = 0.014; 95% CI = 0.008-0.020). After controlling for body mass index (BMI), smoking, alcohol use problems, hypertension, diabetes, dyslipidemia, chronic illness related hs-CRP, and metabolic syndrome. Furthermore, elevated hs-CRP level was significantly associated with an increased risk of depression (adjusted OR = 1.44; 95% CI = 1.01-2.07) in younger adults, but no significant association was observed among older adults. CONCLUSION These findings suggest a significant correlation between high hs-CRP levels and depression in younger adults. Further studies are necessary to investigate the age-specific association and the biological mechanism involved.
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Affiliation(s)
- Young-Eun Jung
- Department of Psychiatry, School of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Kwi Young Kang
- Division of Rheumatology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56 Dongsu-ro, Bupyeong-gu, Incheon, Republic of Korea.
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The Association Between Long Working Hours and High-Sensitivity C-Reactive Protein in Older Aged Individuals: The Korea National Health and Nutrition Examination Survey (KNHANES) 2015. J Occup Environ Med 2019; 60:775-780. [PMID: 29794555 DOI: 10.1097/jom.0000000000001359] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The objective of this study was to show the association of high-sensitivity C-reactive protein (hs-CRP) level with working hours in different age groups. METHODS We used data from Korean National Health and Nutrition Survey. The odds ratios (ORs) and 95% confidence intervals (CIs) of variables for elevated hs-CRP (>3.0 mg/L) were generated with logistic regression models. Significant variables were verified with an adjusted multivariate logistic model after stratification of age groups. RESULTS Working for more than 55 hours per week was associated with elevated hs-CRP level in the old-ages group (≥ 60 years old: OR 2.18, 95% CI 1.07 to 4.45). Working for 40 to 55 hours per week was associated with decreased hs-CRP in the young-ages group (OR 0.58, 95% CI 0.37 to 0.93). CONCLUSION Working hours appear to influence the levels of hs-CRP in individuals aged older than 60 years.
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Bifidobacterium longum R0175 attenuates post-myocardial infarction depressive-like behaviour in rats. PLoS One 2019; 14:e0215101. [PMID: 31009477 PMCID: PMC6476493 DOI: 10.1371/journal.pone.0215101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/26/2019] [Indexed: 01/08/2023] Open
Abstract
Caspase-3 activation in the limbic system and depressive-like symptoms are observed after an acute myocardial infarction (MI) and studies suggest that inflammation may play a significant role. Combined treatment with the probiotic strains Bifidobacterium longum and Lactobacillus helveticus in rats has been shown to attenuate caspase-3 activation and depressive-like behaviour together with a reduction in pro-inflammatory cytokines. The present study was designed to determine the respective contribution of these two strains on caspase-3 activity in the limbic system and on depressive-like behaviour. Sprague-Dawley rats were assigned to one of four groups: Vehicle, L. helveticus R0052, B. longum R0175 and L. salivarius HA-118, administered orally for 14 days (109CFU daily) before inducing MI by occlusion of the left anterior descending artery for 40 min followed by 14 days of reperfusion. Animals were then tested for socialisation, passive avoidance and forced swim test to assess depressive-like behaviour. At day 18 the animals were sacrificed; infarct size was estimated, plasma C-reactive protein concentration and brain caspase-3 activity were measured. Results indicated that infarct size did not vary across the different treatments. Rats treated with B. longum spent more time socializing, learned more rapidly the passive avoidance test and spent less time immobile in the forced swim test compared to the vehicle groups. Caspase-3 activity and plasma C-reactive protein concentrations were reduced in the lateral and medial amygdala as well as in the dentate gyrus of B. longum-supplemented animals. The only significant effect in the two groups receiving Lactobacilli compared to vehicle was that rats receiving L. salivarius learned more rapidly in the step-down passive avoidance test. In conclusion, most of the beneficial effects that we previously reported with the combination of two probiotic strains in our experimentation regarding post-myocardial infarction depression are related to Bifidobacterium longum.
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Lee S, Oh SS, Jang SI, Park EC. Sex Difference in the Association between High-sensitivity C-reactive Protein and Depression: The 2016 Korea National Health and Nutrition Examination Survey. Sci Rep 2019; 9:1918. [PMID: 30760746 PMCID: PMC6374396 DOI: 10.1038/s41598-018-36402-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 11/20/2018] [Indexed: 01/08/2023] Open
Abstract
Elevated levels of circulating high-sensitivity C-reactive protein (hs-CRP) have been observed in depression, with the body mass index (BMI) being a major mediator of this association. However, the sex difference in the association between hs-CRP and depression remains unclear. This study aimed to investigate the sex difference in the association between hs-CRP and depression. Data from the 2016 Korea National Health and Nutritional Examination Survey were used for our study. High hs-CRP was defined as >3.0 mg/L, while depression was determined using a cut-off score of 10 in the Patient Health Questionnaire-9. The study population comprised 5,483 Korean adults. Men with high hs-CRP levels showed statistically higher prevalence of depression than those with low hs-CRP levels (8.90% vs. 3.65%, P < 0.0001). The high hs-CRP group was 1.86 times more likely to have depression after adjusting for BMI and other covariates in men (adjusted odds ratio: 1.86; 95% confidence interval: 1.07–3.25; P = 0.029). Meanwhile, no statistically significant association between hs-CRP and depression was found among women. Depression was considerably associated with hs-CRP only in men, indicating a biological difference between men and women that can independently modify the relationship between hs-CRP and depression.
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Affiliation(s)
- San Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sarah Soyeon Oh
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung-In Jang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea. .,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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16
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Horn SR, Long MM, Nelson BW, Allen NB, Fisher PA, Byrne ML. Replication and reproducibility issues in the relationship between C-reactive protein and depression: A systematic review and focused meta-analysis. Brain Behav Immun 2018; 73:85-114. [PMID: 29928963 PMCID: PMC6800199 DOI: 10.1016/j.bbi.2018.06.016] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 06/08/2018] [Accepted: 06/15/2018] [Indexed: 10/28/2022] Open
Abstract
One of the most common inflammatory markers examined in depression is C-reactive protein (CRP). However, the magnitude of the association between CRP and depression when controlling for potentially confounding factors such as age, sex, socio-economic status, body mass index, medication and other substance use, and medical illness, is unclear. Inconsistencies in other methodological practices, such as sample collection, assaying, and data cleaning and transformation, may contribute to variations in results. We aggregate studies that examined the association between CRP and depression in two ways. First, a systematic review summarizes how studies of CRP and depression have reported on methodological issues. Second, a tiered meta-analysis aggregates studies that have adhered to various levels of methodological rigor. Findings from the systematic review indicate a lack of protocol detail provided. The effect between depression and CRP was small, but highly significant across all stages of the meta-analysis (p < 0.01). The effect size in the most methodologically rigorous stage of the meta-analysis, which included studies controlling for age, sex, obesity, medical conditions and substance, medication, or psychosocial factors, was small (r = 0.05). There were also only 26 articles in this stage (13% of studies from the systematic review), suggesting that more studies that consistently account for these confounding factors are needed. Additionally, an a priori quality score of methodological rigor was a significant moderator in this stage of the meta-analysis. The effect size was strikingly attenuated (r = 0.005) and non-significant in studies with higher quality scores. We describe a set of recommended guidelines for future research to consider, including sample collection and assaying procedures, data cleaning and statistical methods, and control variables to assess.
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Affiliation(s)
- Sarah R Horn
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR 97402, United States.
| | - Madison M Long
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR 97402, United States; Leiden University, Faculty of Social and Behavioral Sciences, Pieter de la Court Building, P.O. Box 9555, 2300 RB Leiden, The Netherlands
| | - Benjamin W Nelson
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR 97402, United States
| | - Nicholas B Allen
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR 97402, United States
| | - Philip A Fisher
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR 97402, United States
| | - Michelle L Byrne
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR 97402, United States
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17
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Zhang L, Li JL, Zhang LL, Guo LL, Li H, Li D. No association between C-reactive protein and depressive symptoms among the middle-aged and elderly in China: Evidence from the China Health and Retirement Longitudinal Study. Medicine (Baltimore) 2018; 97:e12352. [PMID: 30235693 PMCID: PMC6160211 DOI: 10.1097/md.0000000000012352] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The depressive symptoms have been associated with increased disabilities, and the depressive symptoms-related elevation of high C-reactive protein (CRP) has been proposed as a possible mechanism. We examined the relations between CRP and depressive symptoms among the middle-aged and elderly in China.A longitudinal sample of the middle-aged and elderly (4404 men and 5055 women) who were interviewed in the 2011 China Health and Retirement Longitudinal Study was used. A multivariate logistic regression analysis was used to examine the effects of sociodemographic characteristics, lifestyle, activity status, physical exercise, systolic blood pressure, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, body mass index (BMI), and CRP levels on depressive symptoms.The mean age in the study was 60.26 years [standard deviation (SD) ± 9.25; 46.56% men]. The mean CPR level was 2.79 mg/L (range, 0.01-178.10; SD ± 7.80). Depression scores ranged from 0 to 30 with a mean 8.65 (SD ± 6.33). The prevalence of depressive symptoms was 38.49% in the total population, 31.04% in men and 44.99% in men. Compared with baseline CRP levels (≤1.00 mg/L), the depressive symptoms are only weakly correlated with CRP levels among women [CRP 1.01-3.00 mg/L: odds ratio (OR) = 0.85, 95% confidence interval (CI) = 0.73-0.98; CRP 3.01-10.00 mg/L: OR = 1.25, 95% CI = 1.03-1.51; CRP >10 mg/L: OR = 1.41, 95% CI = 1.06-1.88]. After adjusting for age, education, marital status, hukou, residence, cigarette smoking, alcohol drinking, eating meals, activity status, major accidental injury, diseases, health status, physical exercise, systolic blood pressure, LDL, HDL, triglycerides, and BMI, depressive symptoms were not associated with subsequent high CPR levels among the middle-aged and elderly (CRP 1.01-3.00 mg/L: OR = 0.93, 95% CI = 0.83-1.03; CRP 3.01-10.00 mg/L: OR = 0.95, 95% CI = 0.82-1.10; CRP >10 mg/l: OR = 1.11, 95% CI = 0.88-1.39).Our data do not support an association between CRP and depressive symptoms in both middle-aged and elderly men and women among china.
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Affiliation(s)
- Lin Zhang
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province
| | - Jin-long Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province
| | - Li-li Zhang
- Department of Surgery, Third Affiliated Hospital of Jinzhou Medical University
| | - Lei-lei Guo
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province
| | - Hong Li
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province
| | - Dan Li
- Experimental Center for Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province, P.R. China
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Smith KJ, Au B, Ollis L, Schmitz N. The association between C-reactive protein, Interleukin-6 and depression among older adults in the community: A systematic review and meta-analysis. Exp Gerontol 2018; 102:109-132. [DOI: 10.1016/j.exger.2017.12.005] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 10/20/2017] [Accepted: 12/05/2017] [Indexed: 10/18/2022]
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Faugere M, Micoulaud-Franchi JA, Faget-Agius C, Lançon C, Cermolacce M, Richieri R. Quality of life is associated with chronic inflammation in depression: A cross-sectional study. J Affect Disord 2018; 227:494-497. [PMID: 29156363 DOI: 10.1016/j.jad.2017.11.061] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 10/03/2017] [Accepted: 11/12/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND Inflammation may play a crucial role in the pathophysiology of depression. However, the association between chronic inflammation and health outcomes in depression remains unclear, particularly for patient-reported outcomes. METHODS The aim of this study was to investigate the relationship between quality of life (QoL) (physical and mental health, assessed by the SF-36) and chronic inflammation assessed using C-reactive protein (CRP) in patients with current major depressive disorder. RESULTS One hundred eighty-one patients with depression were enrolled in this study. After adjusting for key socio-demographic, clinical and biological confounding factors, patients with high levels of CRP (> 3.0mg/L) had worse physical health than those with normal CRP levels (OR = 0.95, 95% CI = 0.92-0.99). Significant associations were found between a higher rate of metabolic syndrome (OR = 0.10, 95% CI = 0.02-0.41) and high CRP levels. LIMITATIONS The cut-off point for high cardiovascular risk was used to define the two groups: normal CRP level and high CRP level. CRP was the sole marker of inflammation in this study and was collected at only one time point. The design of this study is cross-sectional and there are no conclusions about the directionality of the association between QoL and inflammation in depression. QoL was assessed only by SF-36 scores. CONCLUSION This study found an association between SF-36 physical health score and CRP in patients with depression, thereby showing the need to consider physical well-being in depression. This paves the way for interventions to act both on inflammation and QoL in patients with depression.
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Affiliation(s)
- M Faugere
- Department of Psychiatry, La Conception University Hospital, 13005 Marseille, France; EA 3279 - Self perceived Health Assessment Research Unit, Aix-Marseille University, 13005 Marseille, France.
| | - J-A Micoulaud-Franchi
- Department of Clinical Neurophysiology, Sleep Clinique, Pellegrin University Hospital, 33076 Bordeaux, France; Bordeaux University, USR CNRS 3413 SANPSY, Research Unit, 33000 Bordeaux, France
| | - C Faget-Agius
- Department of Psychiatry, La Conception University Hospital, 13005 Marseille, France; EA 3279 - Self perceived Health Assessment Research Unit, Aix-Marseille University, 13005 Marseille, France
| | - C Lançon
- Department of Psychiatry, La Conception University Hospital, 13005 Marseille, France; EA 3279 - Self perceived Health Assessment Research Unit, Aix-Marseille University, 13005 Marseille, France
| | - M Cermolacce
- SHU Adult Psychiatry, Sainte Marguerite University Hospital, 13274 Marseille, France
| | - R Richieri
- Department of Psychiatry, La Conception University Hospital, 13005 Marseille, France; EA 3279 - Self perceived Health Assessment Research Unit, Aix-Marseille University, 13005 Marseille, France; Department of Psychosis studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, United Kingdom
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Musinguzi K, Obuku A, Nakasujja N, Birabwa H, Nakku J, Levin J, Kinyanda E. Association between major depressive disorder and pro-inflammatory cytokines and acute phase proteins among HIV-1 positive patients in Uganda. BMC Immunol 2018; 19:1. [PMID: 29298663 PMCID: PMC5751544 DOI: 10.1186/s12865-017-0239-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 12/19/2017] [Indexed: 12/11/2022] Open
Abstract
Background Major depressive disorder (MDD) is a common psychiatric complication of HIV/AIDS. While considerable research has been undertaken to understand the psychosocial risk factors of MDD, there is a paucity of data on its biological risk factors including immunological factors. To address this we undertook a study to investigate the association between MDD and pro-inflammatory cytokines and acute phase proteins among persons living with HIV/AIDS (PLWHA) in Uganda. We collected clinical and laboratory data on 201 PLWHA attending two HIV clinics in central and southwestern Uganda. Clinical data included DSM-IV based MDD diagnosis, while laboratory data included the concentrations of IL-6, TNF-α and CRP measured using ELISA. Multiple logistic linear regression analysis was used to determine which proteins were independently significantly associated with MDD controlling for study site, sex, age and highest educational attainment. Results The prevalence of MDD was 62/201 (30.8%). Adjusting for confounders, the odds of MDD increased with increasing levels of IL-6 [each unit increase in IL-6 titres was associated with an aOR = 0.98 (95% CI, 0.97–0.99); p < 0.001]. Participants with low levels of TNF-α were at reduced risk of MDD compared to participants with no TNF-α [those with a TNF-α of 1- <50 pg/ml titres had an aOR = 0.35(95% CI,0.10–1.16)], but as the level of TNF-α increased, the risk of MDD increased, and in particular participants with high levels of TNF-α (of 500 or above) were at a significantly increased risk of MDD [e.g. those with a TNF-α of 500- < 1000 pg/ml titres had an aOR = 3.98 (95% CI,1.29–12.33)] compared to participants with no TNF-α. There was no evidence that MDD was associated with the level of CRP titres [aOR = 0.95 (0.78–1.15); p = 0.60)]. Conclusion In this study, the pro-inflammatory proteins IL-6 and TNF-α were significantly associated with MDD, while CRP was not.
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Affiliation(s)
- Kenneth Musinguzi
- MRC/UVRI, Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda
| | - Andrew Obuku
- MRC/UVRI, Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda
| | - Noeline Nakasujja
- Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda
| | - Harriet Birabwa
- Butabika National Psychiatric Referral Hospital, Kampala, Uganda
| | - Juliet Nakku
- Butabika National Psychiatric Referral Hospital, Kampala, Uganda
| | - Jonathan Levin
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Eugene Kinyanda
- MRC/UVRI, Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda. .,Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda. .,Senior Wellcome Trust Fellowship, London, UK.
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Hur NW, Kim HC, Waite L, Youm Y. Is the Relationship between Depression and C Reactive Protein Level Moderated by Social Support in Elderly?-Korean Social Life, Health, and Aging Project (KSHAP). Psychiatry Investig 2018; 15:24-33. [PMID: 29422922 PMCID: PMC5795026 DOI: 10.4306/pi.2018.15.1.24] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/23/2017] [Accepted: 03/06/2017] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To investigate the buffering effects of social support as an effects modifier in the association between depression and inflammation in the elderly. METHODS We analyzed the Korean Social Life, Health, and Aging Project (KSHAP) for questionnaire, clinical, and laboratory data of 530 older adults living in a rural community. Multivariate regression models were used to investigate the association between depressive symptoms and C-reactive protein level (CRP), a marker of inflammation, at varying levels of social support. RESULTS Social support affected the association between depressive symptoms and CRP level in both sexes. However, the direction of effects modification was different for men and women. In men, a higher CRP level was significantly associated with depressive symptoms only among those with lower support from a spouse or family members. By contrast, in women, the association was significant only among subgroups with higher spousal or family support. Social support from neighbors or friends did not affect the depression-inflammation relationship in men but modestly affected the relationship in women. CONCLUSION Our findings suggest that social support may have a buffering effect in the relationship between depression and inflammation in elderly Koreans. But the influence of social support may run in different directions for men and women.
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Affiliation(s)
- Nam Wook Hur
- Department of Sociology, Yonsei University, Seoul, Republic of Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University, Seoul, Republic of Korea
| | - Linda Waite
- Department of Sociology, The University of Chicago, Chicago, IL, USA
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul, Republic of Korea
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Kim WJ, Joo WT, Baek J, Sohn SY, Namkoong K, Youm Y, Kim HC, Park YR, Chu SH, Lee E. Factors Associated with Insomnia among the Elderly in a Korean Rural Community. Psychiatry Investig 2017; 14:400-406. [PMID: 28845165 PMCID: PMC5561396 DOI: 10.4306/pi.2017.14.4.400] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 06/12/2016] [Accepted: 06/18/2016] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Sleep disturbance is common in the elderly, which is result from multi-factorial causes encompassing socio-demographic, behavioral, and clinical factors. We aimed to identify factors associated with insomnia among the elderly in a rural community in South Korea, a country with a rapidly growing aged population. METHODS This cross-sectional study used the data from the second wave of the Korean Social life, Health and Ageing Project, which is a cohort study of individuals living in a typical rural community in South Korea. Socio-demographic, behavioral, and clinical characteristics were obtained through face-to-face interviews. Various factors suspected to be associated with insomnia were compared between elderly participants with and without insomnia, and multiple logistic regression analyses were conducted to identify independent risk factors for insomnia. RESULTS We found that 32.4% of 509 participants (72.8±7.7 years old) had insomnia. Female sex [odds ratio (OR)=2.19], low education level (OR=2.44), current smoking (OR=2.26), number of chronic diseases (OR=2.21 for 2-3 chronic diseases; OR=2.06 for 4 or more chronic diseases), and depression (OR=2.53) were independently associated with insomnia. CONCLUSION We found that sex, education, chronic disease, and depression independently increase the risk of insomnia of the elderly in a Korean rural community. To overcome the elderly's insomnia, interventions should target modifiable factors such as depression. To promote active aging, longitudinal studies of factors associated with insomnia among the elderly should be performed in different regions and communities.
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Affiliation(s)
- Woo Jung Kim
- Department of Psychiatry, Seonam University College of Medicine, Myongji Hospital, Goyang, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Won-tak Joo
- Department of Sociology, Yonsei University, Seoul, Republic of Korea
| | - Jiwon Baek
- Department of Sociology, Yonsei University, Seoul, Republic of Korea
| | - Sung Yun Sohn
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry,Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kee Namkoong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry,Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul, Republic of Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yeong-Ran Park
- Division of Silver Industry, Kangnam University, Yongin, Republic of Korea
| | - Sang Hui Chu
- Department of Clinical Nursing Science, Yonsei University, Seoul, Republic of Korea
| | - Eun Lee
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry,Yonsei University College of Medicine, Seoul, Republic of Korea
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Köhler-Forsberg O, Buttenschøn HN, Tansey KE, Maier W, Hauser J, Dernovsek MZ, Henigsberg N, Souery D, Farmer A, Rietschel M, McGuffin P, Aitchison KJ, Uher R, Mors O. Association between C-reactive protein (CRP) with depression symptom severity and specific depressive symptoms in major depression. Brain Behav Immun 2017; 62:344-350. [PMID: 28257825 DOI: 10.1016/j.bbi.2017.02.020] [Citation(s) in RCA: 184] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 02/03/2017] [Accepted: 02/27/2017] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Population-based studies have associated inflammation, particularly higher C-reactive protein (CRP), with depressive severity, but clinical trials in major depressive disorder were rather non-specific without examining the role of gender. We aimed to investigate the association between CRP and overall depression severity including specific depressive symptoms and to examine potential gender differences. METHODS We included 231 individuals with major depressive disorder from the Genome-Based Therapeutics Drugs for Depression (GENDEP) study. At baseline, we assessed high-sensitivity CRP levels and psychopathology with the Montgomery Aasberg Depression Rating Scale (MADRS). We performed linear regression analyses to investigate the association between baseline CRP levels with overall MADRS severity and specific symptoms at baseline and adjusted for age, gender, anti-inflammatory and psychotropic drug treatment, body mass index, smoking, inflammatory diseases, and recruitment center. RESULTS Higher CRP levels were significantly associated with greater overall MADRS symptom severity (p=0.02), which was significant among women (p=0.02) but not among men (p=0.68). Among women, higher CRP was associated with increased severity on observed mood, cognitive symptoms, interest-activity, and suicidality, but we found no significant associations among men. Interaction analyses showed no significant gender differences on the overall MADRS score or specific symptoms. DISCUSSION Our results support the sickness syndrome theory suggesting that chronic low-grade inflammation may be associated with a subtype of depression. The potential gender differences in psychopathology may be explained by biological and/or psychosocial factors, e.g. differential modulation of immune responses by sex hormones. Clinical studies should investigate symptom-specific and/or gender-specific treatment guided by peripheral inflammatory markers.
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Affiliation(s)
- Ole Köhler-Forsberg
- Aarhus University Hospital, Risskov, Psychosis Research Unit, Aarhus, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.
| | - Henriette N Buttenschøn
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Denmark
| | - Katherine E Tansey
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK
| | | | - Joanna Hauser
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poland
| | | | - Neven Henigsberg
- Croatian Institute for Brain Research, Medical School, University of Zagreb, Croatia
| | - Daniel Souery
- Laboratoire de Psychologie Médicale, Université Libre de Bruxelles; Psy Pluriel - Centre Européen de Psychologie Médicale, Belgium
| | - Anne Farmer
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Peter McGuffin
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK
| | - Katherine J Aitchison
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK; Departments of Psychiatry and Medical Genetics, University of Alberta, Edmonton, AB, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, N.S., Canada
| | - Ole Mors
- Aarhus University Hospital, Risskov, Psychosis Research Unit, Aarhus, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
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de Menezes ST, de Figueiredo RC, Goulart AC, Nunes MA, M Benseñor I, Viana MC, Barreto SM. Lack of association between depression and C-reactive protein level in the baseline of Longitudinal Study of Adult Health (ELSA-Brasil). J Affect Disord 2017; 208:448-454. [PMID: 27816325 DOI: 10.1016/j.jad.2016.10.046] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/17/2016] [Accepted: 10/23/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Depression has been linked to increased levels of inflammatory markers in clinical studies, but results from general population samples are inconsistent. We aimed to investigate whether depression was associated with serum CRP levels in a cross-sectional analysis of a large cohort from a middle-income country. METHODS We analyzed baseline data from 14,821 participants (35-74 years) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Current depression (last 7 days) was assessed by the Clinical Interview Schedule-Revised (CIS-R). Because individuals on antidepressants could be negative on CIS-R due to their therapeutic effect, the explanatory variable had three categories: (1) negative on CIS-R and not using antidepressant (reference); (2) negative on CIS-R but using antidepressant; (3) positive on CIS-R with/without antidepressant use. Associations with CRP were investigated by general linear model (GLM). RESULTS After adjustments for confounders, neither current depression, nor antidepressant use was statistically associated with elevated CRP levels. Additionally, analyzes stratified by gender, type and severity of depression did not change the results. LIMITATIONS The reference group in our analysis might include participants with a lifetime history of depression. Additionally, the exclusion of questions on weight fluctuation and appetite from the CIS-R applied in ELSA-Brasil may have slightly underestimated the prevalence of depression, as well as limited our ability to assess the presence of somatic symptoms. CONCLUSION This study found no association between current depression, use of antidepressants, and serum CRP levels.
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Affiliation(s)
- Sara Teles de Menezes
- Postgraduate Program in Sciences Applied to Adult Health Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Maria Angélica Nunes
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Isabela M Benseñor
- Clinical Research Center and Epidemiology, Academic Hospital, Faculty of Medicine of Universidade de São Paulo, São Paulo, Brazil
| | - Maria Carmen Viana
- Department of Social Medicine Post-Graduate Program in Public Health, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Sandhi Maria Barreto
- Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190, Belo Horizonte, MG, 30130-100, Brazil.
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Wysokiński A, Socha K, Sołtysik BK, Kłoszewska I, Sobów T, Kostka T. Levels of C-reactive protein (CRP) in elderly patients with unipolar depression - case control analysis. Nord J Psychiatry 2016; 70:503-7. [PMID: 27117065 DOI: 10.3109/08039488.2016.1174298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM C-reactive protein (CRP) is the major acute-phase plasma protein. Studies show that patients with depression have elevated levels of CRP. The aim of the study was to determine differences in CRP serum level in elderly patients with unipolar depression (DEP) compared with non-depressed elderly patients (nonDEP) using case-control analysis. METHODS Serum level of CRP was measured in 404 (DEP: n = 202, nonDEP: n = 202) Caucasian inpatients aged ≥60 (350 women, 86.7%; mean age = 76.7 years). RESULTS Mean CRP level in the study groups was: DEP 2.67 ± 2.56 mg/dL, nonDEP 2.41 ± 2.19 mg/dL, the difference was not significant (p = 0.96). The overall rate of being above the high level of CRP (set at 3.0 mg/L) was 33.2% for DEP and 29.2% for nonDEP groups (p = 0.39). It was also found that, in the whole study group, CRP level was not correlated with age (p = 0.10). CONCLUSIONS Elderly patients with depression have no increased CRP levels. A high percentage (∼30%) of all subjects had a CRP level >3 mg/L, which is the cut-off point for increased cardiovascular risk.
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Affiliation(s)
- Adam Wysokiński
- a Department of Old Age Psychiatry and Psychotic Disorders , Medical University of Lodz , Lodz , Poland
| | - Krzysztof Socha
- b Department of Geriatrics , Medical University of Lodz , Lodz , Poland
| | | | - Iwona Kłoszewska
- a Department of Old Age Psychiatry and Psychotic Disorders , Medical University of Lodz , Lodz , Poland
| | - Tomasz Sobów
- c Department of Medical Psychology , Medical University of Lodz , Lodz , Poland
| | - Tomasz Kostka
- b Department of Geriatrics , Medical University of Lodz , Lodz , Poland
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