Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
J Pediatr. 2013 Nov;163(5):1443-7. doi: 10.1016/j.jpeds.2013.06.046. Epub 2013 Aug 3.
To test whether children and adolescents with co-occurring asthma and depression are at risk for elevated inflammation-concurrently and at the next assessment.
Up to 6 yearly assessments per person from the prospective, population-based Great Smoky Mountains Study (N = 1420) were used, covering children in the community aged 10-16 years old. High-sensitivity C-reactive protein (CRP) was assayed from annual bloodspot collections and provided indicators of elevated inflammation at CRP > 1, CRP > 2, and CRP > 3 mg/L. Depression was assessed with the Child and Adolescent Psychiatric Assessment. Asthma was assessed using a form adapted from the Centers for Disease Control and Prevention National Health Interview Survey.
Controlling common covariates of CRP, the co-occurrence of asthma and depression predicted heightened CRP-concurrently and at the next assessment. In turn, elevated CRP was relatively stable from one assessment to the next.
The co-occurrence of asthma and depression in childhood poses a risk for substantially elevated inflammation concurrently and over time, which could contribute to pathophysiological processes involved in the development of additional chronic diseases and also to asthma--related morbidity and mortality.
检测同时患有哮喘和抑郁症的儿童和青少年是否存在炎症水平升高的风险——既包括当前,也包括下一次评估。
本研究使用了前瞻性、基于人群的大烟山研究(N=1420)中每个人最多可达 6 年的年度评估,研究对象为社区中 10-16 岁的儿童。通过每年的血斑采集检测高敏 C 反应蛋白(CRP),并提供 CRP>1、CRP>2 和 CRP>3mg/L 时炎症水平升高的指标。使用儿童和青少年精神科评估量表评估抑郁症。使用疾病预防控制中心国家健康访谈调查的适应性表格评估哮喘。
在控制 CRP 的常见协变量后,哮喘和抑郁症的同时发生预测了当前和下一次评估时 CRP 水平升高。反过来,从一次评估到下一次评估,CRP 水平相对稳定。
儿童时期哮喘和抑郁症的同时发生,同时存在当前和随着时间推移炎症水平显著升高的风险,这可能导致与其他慢性疾病发展相关的病理生理过程,也可能导致与哮喘相关的发病率和死亡率。