Liukkonen Timo, Silvennoinen-Kassinen Sylvi, Jokelainen Jari, Räsänen Pirkko, Leinonen Maija, Meyer-Rochow V Benno, Timonen Markku
Department of Psychiatry, Savonlinna Central Hospital, Savonlinna, Finland.
Biol Psychiatry. 2006 Oct 15;60(8):825-30. doi: 10.1016/j.biopsych.2006.02.016. Epub 2006 Apr 17.
To investigate whether depressive episodes (previous, current single, and recurrent) are associated in both genders with highly sensitive C-reactive protein (hs-CRP) levels, earlier recommended for risk assessment of cardiovascular disease. The impact of the severity of current single and recurrent depressive episodes on this putative association was also investigated.
The genetically homogeneous Northern Finland 1966 Birth Cohort was followed until age 31, when, in a cross-sectional setting (n = 5269), the highly sensitive enzyme immunoassay (hs-EIA) method was used to measure CRP concentration. Depressive episodes were defined through mailed questionnaires, including Hopkins Symptom Checklist-25 (HSCL-25) and information on self-reported, doctor-diagnosed depression.
After adjusting for confounders, logistic regression analyses showed that in male subjects, elevated hs-CRP levels (> or =1.0 mg/L) increased the probability for severe current and recurrent depressive episodes 1.7-fold and 3.1-fold, respectively. Correspondingly, an hs-CRP level of >3.0 mg/L increased the probability for recurrent depression up to 4.1-fold. In female subjects, no statistically significant associations were found.
Our results support the hypothesis that an activation of systemic inflammatory processes may contribute to the pathophysiology of severe depression in men. Further investigations are needed regarding the impact of our findings on diagnostic/treatment strategies concerning severe and, especially recurrent, depression in men.
研究抑郁发作（既往发作、当前单次发作和复发）在男女两性中是否与高敏C反应蛋白（hs-CRP）水平相关，hs-CRP水平先前被推荐用于心血管疾病风险评估。还研究了当前单次发作和复发抑郁发作的严重程度对这种假定关联的影响。
对基因同质的1966年芬兰北部出生队列进行随访至31岁，在横断面研究中（n = 5269），采用高敏酶免疫测定法（hs-EIA）测量CRP浓度。通过邮寄问卷定义抑郁发作，问卷包括霍普金斯症状清单-25（HSCL-25）以及自我报告的、医生诊断的抑郁症信息。
在对混杂因素进行校正后，逻辑回归分析显示，在男性受试者中，hs-CRP水平升高（≥1.0 mg/L）使当前严重抑郁发作和复发抑郁发作的概率分别增加1.7倍和3.1倍。相应地，hs-CRP水平>3.0 mg/L使复发抑郁症的概率增加至4.1倍。在女性受试者中，未发现统计学上的显著关联。
我们的结果支持以下假设，即全身炎症过程的激活可能有助于男性严重抑郁症的病理生理学。需要进一步研究我们的发现对男性严重抑郁症尤其是复发抑郁症的诊断/治疗策略的影响。
