Major Depressive Disorder, Inflammation, and Nutrition: A Tricky Pattern?

Impact of Intermittent Hypoxia Related to Obstructive Sleep Apnoea Syndrome on Low-Grade Inflammation in Hypertensive Patients: Potential Implications for Cardiovascular Risk

There is evidence for a particular relationship between low-grade inflammation (LGI) and intermittent hypoxia (IH) related to obstructive sleep apnoea syndrome (OSAS). However, despite the potential deleterious cardiovascular consequences associated with this LGI in hypertensive patients, few studies have investigated the impact of IH related to OSAS on CRP levels in this subpopulation. In total, 1404 hypertensive patients were selected retrospectively from the Sleep Laboratory database. CRP levels ≥3 mg/L but <10 mg/L were used as cut-offs to identify hypertensive patients with LGI. Logistic regressions were conducted to examine the risk of LGI associated with IH related to OSAS in hypertensive patients. LGI was frequent (33.8%) in hypertensive patients. After adjustment for confounders, multivariate logistic regressions revealed that only moderate to severe OSAS (apnoea-hypopnoea index ≥ 15/h) with high IH (oxygen desaturation index ≥ 15/h) [OR 1.51 (95% CI 1.06-2.14)] was significantly associated with LGI in hypertensive patients (p-value = 0.045). Consistent with our hypothesis, our results demonstrated the existence of a particular subtype of hypertensive patients at high cardiovascular risk characterised by the presence of LGI induced by IH hypoxia related to moderate to severe OSAS, which justifies the establishment of adequate management of this pathology to allow better cardiovascular prevention in this subpopulation.

Association between dietary sugar intake and depression in US adults: a cross-sectional study using data from the National Health and Nutrition Examination Survey 2011-2018

BACKGROUND

Studies examining whether diet sugar intake increases the risk of depression have produced inconsistent results. Therefore, we investigated this relationship, using the US' National Health and Nutrition Examination Survey (NHANES) database.

METHODS

This cross-sectional study included 18,439 adults (aged ≥ 20 years) from NHANES (2011-2018). Depressive symptoms were assessed using the nine-item version of the Patient Health Questionnaire (PHQ-9). Covariates, including age, sex, race/ethnicity, poverty-income ratio, education, marital status, hypertension, diabetes mellitus, cardiovascular disease, alcohol intake, smoking status, physical activity, and dietary energy intake, were adjusted in multivariate logistic regression models. Subgroup and threshold saturation effect analyses were performed.

RESULTS

After adjusting for potential confounders, we found that a 100 g/day increase in dietary sugar intake correlated with a 28% higher prevalence of depression (odds ratio = 1.28, 95% confidence interval = 1.17-1.40, P < 0.001).

CONCLUSION

Dietary sugar intake is positively associated with depression in US adults.

Effects of elevated emotional symptoms on metabolic disease development: a 10-year follow-up study

Background

In recent decades, the relationship between emotional disorders (i.e., depression and anxiety) and alterations in physiological functions (i.e., inflammation or metabolism) have been well supported. However, studies on a symptom-based approach have provided mixed results. Our study aims to gain insight into how subclinical statuses, featured by elevated depressive and/or anxious symptoms, may influence immunometabolic alterations in the concurrent relationship; and the development of metabolic diseases at 10-year follow-up: diabetes, hypertension and hypercholesterolemia.

Methods

Data from 758 Greek adults [394 men (aged 41 ± 10 years) and 364 women (aged 37 ± 12 years)] were used. Four groups were created according to the levels of depressive and anxiety symptoms: (1) control group (CG), (2) depressive group (DG), (3) anxiety group (AG) and (4) depressive and anxiety group (DAG). Multi-indicator multi-causes (MIMIC) modeling was used to estimate metabolic function and inflammatory response scores, on a wide selection of blood biomarkers. Finally, a binary logistic regression was carried out to study the influence of symptoms on the development of the aforementioned metabolic diseases on a 10-year follow-up.

Results

Group membership was not associated with metabolic function score. Conversely, DAG membership was related with higher inflammatory response score (B = 0.20, CI95 = 0.01, 0.40), with respect to the CG (p < 0.05). Both age and sex were significant variables in the calculation of both scores. Regarding disease at 10-year follow-up effect, risk of developing diabetes, hypertension and hypercholesterolemia was associated with age and socioeconomic status. Moreover, DG membership was significant for diabetes risk (OR = 2.08, CI95 = 1.00, 4.22) and DAG for hypercholesterolemia (OR = 1.68, CI95 = 1.16, 2.43).

Limitations

Data on anti-inflammatory drugs and psychopharmacological medication were not collected in this study.

Conclusions

Elevated symptoms of depression and anxiety accounts for inflammatory alterations at concurrent relationship and a higher risk of 10-year follow-up metabolic diseases.