Division of Clinical Research, National Hospital Organization Hizen Psychiatric Center, Saga 842-0192, Japan.
Department of Psychiatry, Faculty of Medicine, Saga University, Saga 849-8501, Japan.
Int J Mol Sci. 2019 Apr 17;20(8):1905. doi: 10.3390/ijms20081905.
Low-grade inflammation is implicated in the pathogenesis of atherosclerosis, metabolic syndrome, and apathy as a form of vascular depression. We analyzed the brain magnetic resonance imaging findings in 259 community-dwelling older adults (122 men and 137 women, with a mean age of 68.4 years). The serum concentrations of high-sensitivity C-reactive protein (hsCRP) were measured by a quantitative enzyme-linked immunosorbent assay. Logistic regression analysis revealed that the log hsCRP value and the presence of a metabolic syndrome were independently associated with confluent but not punctate deep white matter lesions (DWMLs). Path analysis based on structural equation modeling (SEM) indicated that the direct path from the log hsCRP to the DWMLs was significant (β = 0.119, = 0.039). The direct paths from the metabolic syndrome to the log hsCRP and to the DWMLs were also significant. The direct path from the DWMLs to apathy (β = -0.165, = 0.007) was significant, but the direct path from the log hsCRP to apathy was not significant. Inflammation (i.e., elevated serum hsCRP levels) was associated with DWMLs independent of common vascular risk factors, while DWMLs were associated with apathy. The present analysis with SEM revealed the more realistic scheme that low-grade inflammation was associated with apathy indirectly via DWMLs in community-dwelling older adults.
低度炎症与动脉粥样硬化、代谢综合征和冷漠（血管性抑郁症的一种形式）的发病机制有关。我们分析了 259 名居住在社区的老年成年人（122 名男性和 137 名女性，平均年龄 68.4 岁）的脑磁共振成像结果。通过定量酶联免疫吸附试验测量血清高敏 C 反应蛋白（hsCRP）浓度。逻辑回归分析显示，log hsCRP 值和代谢综合征的存在与弥漫性而非点状深部白质病变（DWML）独立相关。基于结构方程模型（SEM）的路径分析表明，log hsCRP 与 DWML 之间的直接路径具有统计学意义（β=0.119，=0.039）。代谢综合征到 log hsCRP 到 DWML 的直接路径也具有统计学意义。DWML 到冷漠的直接路径具有统计学意义（β=-0.165，=0.007），但 log hsCRP 到冷漠的直接路径没有统计学意义。本研究采用 SEM 分析发现，在社区居住的老年人中，炎症（即血清 hsCRP 水平升高）与 DWML 独立相关，而 DWML 与冷漠相关。该分析揭示了更为现实的方案，即低度炎症通过 DWML 间接与冷漠相关。
