全身性低度炎症与随后出现的抑郁症状：身体活动是否起中介作用？

Systemic low-grade inflammation and subsequent depressive symptoms: Is there a mediating role of physical activity?

机构信息

Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, WC1E 7HB, London, UK.

Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, SE5 8AB London, UK.

出版信息

Brain Behav Immun. 2019 Aug;80:688-696. doi: 10.1016/j.bbi.2019.05.017. Epub 2019 May 11.

DOI:10.1016/j.bbi.2019.05.017

PMID:31085217

Abstract

OBJECTIVE

Systemic low-grade inflammation has been associated with the onset of depression, but the exact mechanisms underlying this relationship remain elusive. This study examined whether physical activity (PA) explained the association between elevated serum levels of inflammatory markers and subsequent depressive symptoms.

DESIGN

Prospective cohort design.

METHOD

The sample consisted of 3809 non-depressed men and women (aged 50+) recruited from the English Longitudinal Study of Ageing (ELSA). Serum levels of inflammatory markers (C-reactive protein (CRP), fibrinogen) and covariates (age, sex, education, wealth, body mass index, smoking, cholesterol, triglycerides) were measured at baseline (wave 4, 2008/09). Self-reported weekly moderate/vigorous (high) PA versus no weekly moderate/vigorous (low) PA was examined at a four-year follow-up (wave 6, 2012/13), using a single-item question. Depressive symptoms were assessed at baseline, four years (wave 6, 2012/13) and six years post baseline (wave 7, 2014/15), using the 8-item version of the Centre for Epidemiological Studies Depression Scale (CES-D).

RESULTS

Participants with higher baseline concentrations of inflammatory markers were significantly more likely to report low PA levels four years later (CRP: OR: 1.25; 95% CI, 1.05-1.48; fibrinogen: OR: 1.18; 95% CI, 1.05-1.39). Moreover, low PA was associated with higher odds of elevated depressive symptoms at follow-up (OR: 1.59; 95% CI, 1.15-2.19). Mediation analyses revealed that low PA explained a total of 36.71% of the relationship between high CRP and elevated depressive symptoms, and 33.26% between higher levels of fibrinogen and elevated depressive symptoms six years later. No direct association was found between systemic low-grade inflammation and future depressive symptoms.

CONCLUSION

These results suggest that low PA is a significant partial mediator of the relationship between systemic low-grade inflammation and subsequent elevated depressive symptoms in a nationally representative cohort of older adults.

摘要

目的

全身性低度炎症与抑郁症的发病有关，但这种关系的确切机制仍不清楚。本研究旨在探讨体育活动（PA）是否可以解释炎症标志物血清水平升高与随后出现抑郁症状之间的关系。

设计

前瞻性队列设计。

方法

该样本由来自英国老龄化纵向研究（ELSA）的 3809 名非抑郁男性和女性（年龄在 50 岁以上）组成。在基线（第 4 波，2008/09 年）时测量炎症标志物（C 反应蛋白（CRP）、纤维蛋白原）和协变量（年龄、性别、教育、财富、体重指数、吸烟、胆固醇、甘油三酯）的血清水平。在四年后的随访（第 6 波，2012/13 年）中，使用一个单项问题来检查每周是否有中等/剧烈（高）体育活动与没有每周中等/剧烈（低）体育活动之间的关系。使用流行病学研究中心抑郁量表（CES-D）的 8 项版本在基线、四年后（第 6 波，2012/13 年）和六年后（第 7 波，2014/15 年）评估抑郁症状。

结果

基线炎症标志物浓度较高的参与者在四年后报告低水平 PA 的可能性显著更高（CRP：OR：1.25；95%CI，1.05-1.48；纤维蛋白原：OR：1.18；95%CI，1.05-1.39）。此外，低 PA 与随访时出现较高抑郁症状的几率较高相关（OR：1.59；95%CI，1.15-2.19）。中介分析显示，低 PA 共解释了 CRP 升高与六年后抑郁症状升高之间关系的 36.71%，以及纤维蛋白原水平升高与抑郁症状升高之间关系的 33.26%。在一个具有全国代表性的老年人群体中，没有发现全身性低度炎症与未来抑郁症状之间存在直接关联。