Association between C Reactive Protein and Depression in a Population of Healthy Adults: The Cooper Center Longitudinal Study

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.

C-Reactive Protein as a Biomarker for Major Depressive Disorder?

“…Overall, the present systematic review reported that most studies here retrieved, found a positive association between elevated CRP levels and depression [29,51,52,54,55,61,63,64,66,67,[69][70][71][72][73]80,81,83,[90][91][92][93][94]100]. Conversely, other studies did not confirm this association [49,50,62,68,74,76,86,88,89].…”

“…Another cross-sectional study, including 9459 Chinese middle-aged and elderly participants of the China Health and Retirement Longitudinal Study, did not find any correlation between CRP levels and depressive symptoms after adjusting for confounders [76]. A recent large cross-sectional study assessing serum hs-CRP levels and depression symptoms using CESD, in 26,638 healthy adults, recruited at the Cooper Clinic in Dallas, Texas, reported an association between hs-CRP levels and depression which could be more likely explained by obesity status [62]. An observational study investigated the association between CRP levels and depression also considering shared genetic and environmental factors [75].…”

“…Based on our judgment, 40 studies were rated as "good" studies [16,45,46,48,49,[51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66]68,[71][72][73]75,76,78,81,83,[88][89][90][92][93][94][96][97][98]100] and 16 as "satisfactory" studies [47,50,67,69,70,74,77,79,80,82,[84]…”

Psychosocial and Biological Outcomes of Immersive, Mindfulness-Based Treks in Nature for Groups of Young Adults and Caregivers Affected by Cancer: Results from a Single Arm Program Evaluation from 2016–2021

“…While it may have been expected that both biomarkers rise and fall in unison (suggesting the possibility of a distinctive mechanism of concurrent inflammatory activity), given that CRP is a good indication of muscle inflammation, this slight rise (staying within normal values) may be explained by the physical activity of the treks [ 44 ]. Given known associations between symptoms of depression and anxiety and acute inflammation [ 45 , 46 ] and the secretion of pro-inflammatory cytokines [ 47 , 48 ], it is important to advance our understanding of how immersive experiences in nature might “get under the skin”. This said, the evaluation design and very small sample of these biomarker analyses place these findings at the very preliminary level of understanding, which should be considered when interpreting these results.…”

Serum Low-Density Lipoprotein Cholesterol Levels and Depressive Mood in Korean Adults: A Nationwide Population-Based Study

“…Among the commonly used biomarkers, recent studies have demonstrated that lower uric acid and higher C-reactive protein levels are independently associated with depression. 6,7) The association between serum cholesterol levels and depression has continuously been reported over the past decades, based on a possible mechanism between cholesterol and serotonin. 8,9) A recent metaanalysis, in 2016, 10) demonstrated a cross-sectional link between depression and low serum low-density lipoprotein cholesterol (LDL-C) levels, using serum LDL-C as a continuous variable.…”