University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
Brain Behav Immun. 2010 Jan;24(1):96-101. doi: 10.1016/j.bbi.2009.08.005. Epub 2009 Aug 14.
To test whether depressive symptoms are related to subsequent C-reactive protein (CRP) levels and/or whether CRP levels are related to subsequent depressive symptoms in mid-life women.
Women enrolled in the Study of Women's Health Across the Nation (SWAN) were followed for 7years and had measures of CES-Depression scores and CRP seven times during the follow-up period. Women were pre- or early peri-menopausal at study entry and were of Caucasian, African American, Hispanic, Japanese, or Chinese race/ethnicity. Analyses were restricted to initially healthy women.
Longitudinal mixed linear regression models adjusting for age, race, site, time between exams, and outcome variable at year X showed that higher CES-D scores predicted higher subsequent CRP levels and vice versa over a 7-year period. Full multivariate models adjusting for body mass index, physical activity, medications, health conditions, and other covariates showed that higher CRP levels at year X predicted higher CES-D scores at year X+1, p=0.03. Higher depressive symptoms predicted higher subsequent CRP levels at marginally significant levels, p=0.10.
Higher CRP levels led to higher subsequent depressive symptoms, albeit the effect was small. The study demonstrates the importance of considering bi-directional relationships for depression and other psychosocial factors and risk for heart disease.
检验抑郁症状是否与随后的 C 反应蛋白（CRP）水平相关，或者 CRP 水平是否与中年女性随后的抑郁症状相关。
参加全国妇女健康研究（SWAN）的女性被随访 7 年，在随访期间进行了 7 次 CES-Depression 评分和 CRP 测量。女性在研究入组时处于绝经前或早期绝经，具有白种人、非裔美国人、西班牙裔、日裔或华裔种族/民族特征。分析仅限于最初健康的女性。
纵向混合线性回归模型调整了年龄、种族、地点、检查之间的时间和 X 年度的结果变量，结果显示在 7 年期间，较高的 CES-D 评分预测随后的 CRP 水平较高，反之亦然。在调整了体重指数、体育活动、药物、健康状况和其他协变量的全多变量模型中，X 年度的 CRP 水平较高预测 X+1 年度 CES-D 评分较高，p=0.03。较高的抑郁症状预测随后的 CRP 水平略有显著升高，p=0.10。
较高的 CRP 水平导致随后的抑郁症状升高，尽管影响较小。该研究表明，考虑抑郁和其他心理社会因素与心脏病风险之间的双向关系非常重要。
