Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
Brain Behav Immun. 2022 Jul;103:215-222. doi: 10.1016/j.bbi.2022.04.006. Epub 2022 Apr 18.
Both low-grade elevation in peripheral inflammatory markers (e.g., white blood count (WBC) and C-reactive protein (CRP)) and physical illness (both chronic and acute) have been associated with depressive symptomology. However, it is unclear if low-grade elevation in inflammatory markers mediates relationships between physical illness and depression or if physical illness positively moderates relationships between inflammatory markers and depression.
In a well-powered, racially diverse cohort (n = 21,525) from NHANES datasets, we examined if inflammatory markers (CRP and WBC) and physical illnesses (acute and chronic) were independently associated with depression severity. We also examined if associations between physical illness and depression severity were mediated by inflammatory markers and if physical illness moderated associations between inflammatory markers and depression.
We found that both inflammatory markers and physical illness were associated with depression severity, even after considering a wide range of potential confounders (e.g., age, gender, body mass index). Inflammatory markers mediated a marginal portion (<5%; p < 0.001) of potential effects of physical illness on depression severity. In moderation analyses, associations between inflammatory markers and depression severity were significantly stronger in participants with chronic physical illness than those without. This moderating effect was not present for acute physical illness.
Inflammatory markers and physical illness appear independently linked to depression severity and, in individuals with chronic physical illness, inflammatory markers are more tightly connected to depressive symptomology. Such findings could help guide future individualized treatment research for depression based on both inflammatory marker level and physical illness burden.
外周炎症标志物（如白细胞计数（WBC）和 C 反应蛋白（CRP））的低度升高以及身体疾病（慢性和急性）都与抑郁症状有关。然而，目前尚不清楚炎症标志物的低度升高是否介导了身体疾病与抑郁之间的关系，或者身体疾病是否积极调节了炎症标志物与抑郁之间的关系。
在一项具有充分效力且种族多样化的队列（n=21525）中，我们来自 NHANES 数据集，研究了炎症标志物（CRP 和 WBC）和身体疾病（急性和慢性）是否与抑郁严重程度独立相关。我们还研究了身体疾病与抑郁严重程度之间的关联是否通过炎症标志物介导，以及身体疾病是否调节了炎症标志物与抑郁之间的关联。
我们发现，即使考虑了广泛的潜在混杂因素（如年龄、性别、体重指数），炎症标志物和身体疾病都与抑郁严重程度相关。炎症标志物介导了身体疾病对抑郁严重程度的潜在影响的一小部分（<5%；p<0.001）。在适度分析中，炎症标志物与抑郁严重程度之间的关联在患有慢性身体疾病的参与者中比在没有慢性身体疾病的参与者中更强。这种调节作用在急性身体疾病中不存在。
炎症标志物和身体疾病似乎与抑郁严重程度独立相关，在患有慢性身体疾病的个体中，炎症标志物与抑郁症状的关联更为紧密。这些发现可能有助于根据炎症标志物水平和身体疾病负担为抑郁症的个体化治疗研究提供指导。
