Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK.
Psychol Med. 2022 Oct;52(14):3289-3296. doi: 10.1017/S0033291721000088. Epub 2021 Mar 18.
Depression and overweight are each associated with abnormal immune system activation. We sought to disentangle the extent to which depressive symptoms and overweight status contributed to increased inflammation and abnormal cortisol levels.
Participants were recruited through the Wellcome Trust NIMA Consortium. The sample of 216 participants consisted of 69 overweight patients with depression; 35 overweight controls; 55 normal-weight patients with depression and 57 normal-weight controls. Peripheral inflammation was measured as high-sensitivity C-Reactive Protein (hsCRP) in serum. Salivary cortisol was collected at multiple points throughout the day to measure cortisol awakening response and diurnal cortisol levels.
Overweight patients with depression had significantly higher hsCRP compared with overweight controls ( = 0.042), normal-weight depressed patients ( < 0.001) and normal-weight controls ( < 0.001), after controlling for age and gender. Multivariable logistic regression showed that comorbid depression and overweight significantly increased the risk of clinically elevated hsCRP levels ⩾3 mg/L (OR 2.44, 1.28-3.94). In a separate multivariable logistic regression model, overweight status contributed most to the risk of having hsCRP levels ⩾3 mg/L (OR 1.52, 0.7-2.41), while depression also contributed a significant risk (OR 1.09, 0.27-2). There were no significant differences between groups in cortisol awakening response and diurnal cortisol levels.
Comorbid depression and overweight status are associated with increased hsCRP, and the coexistence of these conditions amplified the risk of clinically elevated hsCRP levels. Overweight status contributed most to the risk of clinically elevated hsCRP levels, but depression also contributed to a significant risk. We observed no differences in cortisol levels between groups.
抑郁和超重都与免疫系统的异常激活有关。我们试图厘清抑郁症状和超重状态在多大程度上导致炎症增加和皮质醇水平异常。
参与者通过惠康信托 NIMA 联盟招募。该研究共纳入 216 名参与者，包括 69 名患有抑郁的超重患者；35 名超重对照者；55 名患有抑郁的正常体重患者和 57 名正常体重对照者。外周炎症通过血清中高敏 C 反应蛋白（hsCRP）进行测量。采集唾液皮质醇以测量皮质醇觉醒反应和日间皮质醇水平。
在控制年龄和性别后，患有抑郁的超重患者的 hsCRP 水平明显高于超重对照组（ = 0.042）、正常体重抑郁患者（ < 0.001）和正常体重对照组（ < 0.001）。多变量逻辑回归显示，合并抑郁和超重显著增加了 hsCRP 水平 ⩾3 mg/L 的临床升高风险（OR 2.44，1.28-3.94）。在单独的多变量逻辑回归模型中，超重状态对 hsCRP 水平 ⩾3 mg/L 的风险贡献最大（OR 1.52，0.7-2.41），而抑郁也具有显著的风险（OR 1.09，0.27-2）。各组之间的皮质醇觉醒反应和日间皮质醇水平没有显著差异。
合并抑郁和超重状态与 hsCRP 增加有关，这些情况的共存放大了 hsCRP 水平升高的风险。超重状态对 hsCRP 水平升高的风险贡献最大，但抑郁也有显著的风险。我们观察到各组之间的皮质醇水平没有差异。
