Lack of association between depression and C-reactive protein level in the baseline of Longitudinal Study of Adult Health (ELSA-Brasil)

Menezes, Sara Teles de; Figueiredo, Rachel; Goulart, Alessandra Carvalho; Nunes, Maria Angélica; Viana, María Carmen; Barreto, Sandhi Maria

doi:10.1016/j.jad.2016.10.046

Cited by 22 publications

(18 citation statements)

References 47 publications

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“…Our findings are consistent with prior population-based studies that found no significant association between CRP and depression independent of BMI 12 15. Our findings also align with other studies that found no association between CRP and depression independent of other covariates related to depression, including antidepressant use and chronic illness 10 11 13 16 27…”

Section: Discussionsupporting

confidence: 92%

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

Khan

Léonard

DeFina

et al. 2020

Journal of Investigative Medicine

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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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Section: Discussionsupporting

confidence: 92%

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

Khan

Léonard

DeFina

et al. 2020

Journal of Investigative Medicine

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“…Other cross-sectional studies of sex differences in association of CRP with depression severity have reported conflicting results. While some reports have found greater depressive symptom severity with higher CRP levels in females only (Köhler-Forsberg et al, 2017), others have either reported stronger association of CRP with depressive symptoms in males as compared to females (Tayefi et al, 2017, Vetter et al, 2013, Liu et al, 2014 or no association of CRP with depressive symptoms in either sex (de Menezes et al, 2017). Hence, longitudinal studies that test association of CRP with depressive symptoms at multiple time points are necessary to better understand the sex differences in its association with depressive symptom severity.…”

Section: Introductionmentioning

confidence: 99%

Sex differences in the association of baseline c-reactive protein (CRP) and acute-phase treatment outcomes in major depressive disorder: Findings from the EMBARC study

Jha

Minhajuddin

Chin-Fatt

et al. 2019

Journal of Psychiatric Research

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Peripheral inflammation is associated with poor response to antidepressant treatments. However, whether sex differentially affects this association remains unknown. Participants of Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC) with baseline plasma samples were included in this study (n=220; male n=75, female n=145). Depression severity [Hamilton Rating Scale for Depression 17-item (HAMD-17)] was measured at baseline and weeks-1, 2, 3, 4, 6, and 8. Plasma c-reactive protein (CRP) was measured with commercially-available ELISA kits at baseline, week-1, and week-8. Sex difference in prediction of baseline-to-week-8 HAMD-17 change by baseline CRP was tested with sex-by-baseline-CRPby-time interaction in mixed model analysis. Additionally, changes in CRP from baseline-toweek-8 CRP and its association with HAMD-17 changes over that period were also evaluated. Covariates included body mass index, site, smoking status, and age. There was a significant sex difference in association of baseline-to-week-8 HAMD-17 reduction with baseline CRP (p=0.033). Higher baseline CRP was associated with lower baseline-to-week-8 HAMD-17 reduction in females (p<0.0001) but not in males (p=0.632). Additionally, CRP was significantly reduced (p=0.041, effect size=0.254) from baseline-to-week-8, but there were no sex differences in this reduction (p=0.249). Baseline-to-week-8 changes in HAMD-17 and CRP were not significantly associated either overall (p=0.348) or based on sex (p=0.370). In a large study of depressed outpatients, we replicated previous findings that elevated baseline CRP levels are associated with worse antidepressant treatment outcomes. However, this effect was limited only to females. These findings emphasize the importance of studying sex differences in biological mechanisms linking inflammation and depression.

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“…C-reactive protein (CRP) is a positive acute response protein that is related to systemic inflammation 5 . Elevated levels of circulating CRP have been observed in depression 6–9 , but the exact association between high CRP and depression is unclear 10–12 . Although CRP levels are generally only elevated in severe inflammation, the development of high-sensitivity assays (e.g., hs-CRP test) allowed for the quantification of low CRP levels in healthy individuals.…”

Section: Introductionmentioning

confidence: 99%

Sex Difference in the Association between High-sensitivity C-reactive Protein and Depression: The 2016 Korea National Health and Nutrition Examination Survey

Lee

Jang

2019

Sci Rep

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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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Lack of association between depression and C-reactive protein level in the baseline of Longitudinal Study of Adult Health (ELSA-Brasil)

Cited by 22 publications

References 47 publications

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

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

Sex differences in the association of baseline c-reactive protein (CRP) and acute-phase treatment outcomes in major depressive disorder: Findings from the EMBARC study

Sex Difference in the Association between High-sensitivity C-reactive Protein and Depression: The 2016 Korea National Health and Nutrition Examination Survey

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