Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.
University of Calgary, Calgary, ON, Canada; Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
J Affect Disord. 2020 Dec 1;277:940-948. doi: 10.1016/j.jad.2020.09.025. Epub 2020 Sep 11.
Increasing evidence suggests that youth with Major Depressive Disorder (MDD) exhibit early indicators of cardiovascular disease. A leading hypothesized mechanism of this association is via inflammatory pathways, however, results examining this direct association are mixed. Our objective was to synthesize and quantify observational studies examining the association of depression and inflammation among children and adolescents.
Electronic searches were conducted in MEDLINE, Embase, PsycINFO, and Scopus, yielding 2,757 non-duplicate records from 1946 to 2019. The included studies measured depression or depressive symptoms and examined its association with inflammation in participants younger than 18 years. All relevant articles were reviewed and data extracted by two independent coders. Estimates were examined by using random-effects meta-analysis.
Twenty-two studies (20,791 participants) were included. Significant associations were observed between concurrent depression and CRP (n = 7; r = 0.12; 95% confidence interval [CI] = 0.04 to 0.19), and IL-6 (n = 7; r = 0.17; 95% CI= 0.10 to 0.24). Longitudinal analyses revealed that depression is a significant predictor of IL-6 (n = 3; r = 0.29; 95% CI= 0.04 to 0.50) and conversely, that inflammation (measured by CRP or IL-6) predicts future depression (n = 4; r = 0.04; 95% CI= 0.00 to 0.08).
Results are limited by the small number of studies preventing examination of some moderator variables. Findings are correlational, not causal.
Depression is positively associated with concurrent and future inflammation among children and adolescents. Results suggest that bidirectional associations may exist between depression and a pro-inflammatory state.
越来越多的证据表明，患有重度抑郁症（MDD）的年轻人有心血管疾病的早期迹象。这种关联的一个主要假设机制是通过炎症途径，但目前检查这种直接关联的结果喜忧参半。我们的目的是综合和量化观察性研究，以检查儿童和青少年抑郁与炎症之间的关联。
电子检索 MEDLINE、Embase、PsycINFO 和 Scopus，从 1946 年到 2019 年共检索到 2757 篇非重复记录。纳入的研究测量了抑郁或抑郁症状，并检查了其与 18 岁以下参与者炎症之间的关系。两位独立的编码员对所有相关文章进行了审查和数据提取。使用随机效应荟萃分析检查估计值。
共纳入 22 项研究（20791 名参与者）。在同时患有抑郁症和 CRP（n=7；r=0.12；95%置信区间[CI]为 0.04 至 0.19）和 IL-6（n=7；r=0.17；95% CI 为 0.10 至 0.24）的参与者中观察到显著相关性。纵向分析显示，抑郁是 IL-6 的一个显著预测因素（n=3；r=0.29；95% CI 为 0.04 至 0.50），相反，炎症（通过 CRP 或 IL-6 测量）预测未来的抑郁（n=4；r=0.04；95% CI 为 0.00 至 0.08）。
由于研究数量较少，结果受到限制，无法检查一些调节变量。研究结果是相关性的，而不是因果关系的。
抑郁与儿童和青少年的并发和未来炎症呈正相关。结果表明，抑郁和促炎状态之间可能存在双向关联。
