Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK; Institute of Clinical Sciences, Imperial College London, London, UK.
Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of Kinanthropology, Charles University, Prague, Czech Republic.
Compr Psychiatry. 2020 Jan;96:152143. doi: 10.1016/j.comppsych.2019.152143. Epub 2019 Oct 31.
Meta-analyses confirm increased circulating C-reactive protein (CRP) levels in depression. Longitudinal studies have linked one-off measurements of CRP at baseline with increased risk of developing depressive symptoms subsequently at follow-up, but studies with repeat CRP measures from the same individuals are scarce.
We have examined whether longitudinal patterns of inflammation, based on three CRP measurements from childhood to early-adulthood, are associated with the risk of depression in early-adulthood in the Avon Longitudinal Study of Parents and Children, a prospective birth cohort.
Using Gaussian mixture modelling of available CRP data from age 9, 15 and 18 years, we identified four population clusters/sub-groups reflecting different longitudinal patterns of CRP: persistently low (N=463, 29.5%); persistently high (N=371, 24%); decreasing (N=360, 23%); increasing (N=367, 23.5%). The increasing group showed a steep increase in CRP levels between adolescence and early-adulthood. Participants in this group had a higher risk of moderate/severe depression at age 18 years, compared with those with persistently low CRP; adjusted odds ratio (OR)=3.78 (95% Confidence Interval (CI), 1.46-9.81; p=0.006). The odds of moderate/severe depression were also increased for the persistently high CRP group, but this was not statistically significant; OR=2.54 (95% CI, 0.90-7.16).
Repeat CRP measures were available for a subset, who may not be representative of all cohort participants.
The results suggest that an increasing pattern of inflammation from adolescence to early-adulthood is associated with risk of depression in early-adulthood.
荟萃分析证实，抑郁症患者循环 C 反应蛋白（CRP）水平升高。纵向研究表明，基线时单次 CRP 测量值与随后随访时出现抑郁症状的风险增加相关，但针对同一人群进行重复 CRP 测量的研究很少。
我们研究了基于儿童期到成年早期的三次 CRP 测量，炎症的纵向模式是否与早期成年期发生抑郁的风险相关，这是一项前瞻性出生队列研究——阿冯纵向研究父母与子女。
利用年龄为 9 岁、15 岁和 18 岁的 CRP 数据的高斯混合模型，我们确定了四个反映 CRP 纵向模式不同的人群聚类/亚组：持续低值（N=463，29.5%）；持续高值（N=371，24%）；下降（N=360，23%）；升高（N=367，23.5%）。升高组在青春期到成年早期 CRP 水平急剧上升。与持续低值 CRP 组相比，该组在 18 岁时发生中度/重度抑郁的风险更高，调整后的比值比（OR）为 3.78（95%置信区间（CI），1.46-9.81；p=0.006）。持续高 CRP 组发生中度/重度抑郁的风险也有所增加，但无统计学意义；OR=2.54（95%CI，0.90-7.16）。
仅对一部分人进行了重复 CRP 测量，这些人可能无法代表所有队列参与者。
结果表明，从青春期到成年早期，炎症呈上升模式与成年早期发生抑郁的风险相关。
