Franco Fábio Gazelato de Mello, Laurinavicius Antonio Gabriele, Lotufo Paulo A, Conceição Raquel D, Morita Fernando, Katz Marcelo, Wajngarten Maurício, Carvalho José Antonio Maluf, Bosworth Hayden B, Santos Raul Dias
Hospital Israelita Albert Einstein, São Paulo, SP - Brazil.
Centro de Pesquisa Clínica e Epidemiológica da Universidade de São Paulo (USP), São Paulo, SP - Brazil.
Arq Bras Cardiol. 2017 Jun 29;109(2):0. doi: 10.5935/abc.20170080.
Depressive symptoms are independently associated with an increased risk of cardiovascular disease (CVD) among individuals with non-diagnosed CVD. The mechanisms underlying this association, however, remain unclear. Inflammation has been indicated as a possible mechanistic link between depression and CVD.
This study evaluated the association between persistent depressive symptoms and the onset of low-grade inflammation.
From a database of 1,508 young (mean age: 41 years) individuals with no CVD diagnosis who underwent at least two routine health evaluations, 134 had persistent depressive symptoms (Beck Depression Inventory - BDI ≥ 10, BDI+) and 1,374 had negative symptoms at both time points (BDI-). All participants had been submitted to repeated clinical and laboratory evaluations at a regular follow-up with an average of 26 months from baseline. Low-grade inflammation was defined as plasma high-sensitivity C-Reactive Protein (CRP) concentrations > 3 mg/L. The outcome was the incidence of low-grade inflammation evaluated by the time of the second clinical evaluation.
The incidence of low-grade inflammation was more frequently observed in the BDI+ group compared to the BDI- group (20.9% vs. 11.4%; p = 0.001). After adjusting for sex, age, waist circumference, body mass index, levels of physical activity, smoking, and prevalence of metabolic syndrome, persistent depressive symptoms remained an independent predictor of low-grade inflammation onset (OR = 1.76; 95% CI: 1.03-3.02; p = 0.04).
Persistent depressive symptoms were independently associated with low-grade inflammation onset among healthy individuals.
在未被诊断患有心血管疾病（CVD）的个体中，抑郁症状与心血管疾病风险增加独立相关。然而，这种关联背后的机制仍不清楚。炎症已被指出可能是抑郁与心血管疾病之间的机制性联系。
本研究评估了持续性抑郁症状与低度炎症发作之间的关联。
从一个包含1508名未被诊断患有心血管疾病的年轻人（平均年龄：41岁）的数据库中选取研究对象，这些人至少接受了两次常规健康评估，其中134人有持续性抑郁症状（贝克抑郁量表 - BDI≥10，BDI+），1374人在两个时间点均无抑郁症状（BDI-）。所有参与者在定期随访中接受了重复的临床和实验室评估，从基线开始平均随访26个月。低度炎症定义为血浆高敏C反应蛋白（CRP）浓度>3mg/L。结局指标是在第二次临床评估时评估的低度炎症发生率。
与BDI-组相比，BDI+组更频繁地观察到低度炎症的发生（20.9%对11.4%；p = 0.001）。在调整了性别、年龄、腰围、体重指数、身体活动水平、吸烟和代谢综合征患病率后，持续性抑郁症状仍然是低度炎症发作的独立预测因素（OR = 1.76；95%CI：1.03 - 3.02；p = 0.04）。
在健康个体中，持续性抑郁症状与低度炎症发作独立相关。
