First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece.
Department of Nutrition & Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Maturitas. 2018 Mar;109:1-5. doi: 10.1016/j.maturitas.2017.12.001. Epub 2017 Dec 6.
A large body of evidence suggests that depression increases the risk of cardiovascular morbidity and mortality. The elevated risk associated with depression is not limited to clinical major depressive disorder but also extends to sub-syndromal depressive symptoms and constructs with overlapping characteristics, such as vital exhaustion. Multiple pathophysiological pathways are involved in the relationship between depressive symptoms and atherosclerosis and its clinical manifestations and progression. These underlying mechanisms are not yet fully understood and need further clarification. This review examines inflammation and endothelium dysfunction as potential biological factors involved in the relationship between depressive symptoms and atherosclerosis. It has been reported that systemic inflammation and psychological factors interact through complex pathophysiological and behavioral mechanisms and one question that has been raised concerns whether the inflammation drives depression or vice versa, or whether the association is merely coincidental. Although further investigation is needed, including well-designed prospective studies, to address this question thoroughly, it seems that there is a feedback relationship, although the biological pathways of each direction may be distinct.
大量证据表明，抑郁会增加心血管发病率和死亡率。与抑郁相关的风险不仅限于临床重度抑郁障碍，还扩展到亚临床抑郁症状和具有重叠特征的结构，如生命衰竭。多种病理生理途径参与了抑郁症状与动脉粥样硬化及其临床表现和进展之间的关系。这些潜在的机制尚未完全理解，需要进一步澄清。这篇综述检查了炎症和内皮功能障碍作为抑郁症状与动脉粥样硬化之间关系的潜在生物学因素。据报道，全身炎症和心理因素通过复杂的病理生理和行为机制相互作用，一个引起关注的问题是，炎症是否会导致抑郁，或者反之，或者这种关联仅仅是偶然的。尽管需要进一步的研究，包括精心设计的前瞻性研究，以彻底解决这个问题，但似乎存在一种反馈关系，尽管每个方向的生物学途径可能不同。
