Charité -Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany.
Robert-Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany.
Brain Behav Immun. 2022 Jul;103:223-231. doi: 10.1016/j.bbi.2022.04.024. Epub 2022 Apr 28.
Depression and obesity often occur comorbidly, and once both are present, they further increase the risk of developing other medical comorbidities, likely due to the underlying chronic low-grade inflammation. We investigated to what extent depression and obesity are associated with levels of high-sensitivity C-reactive protein (hsCRP) in a nationally representative sample of the German adult population.
We analyzed data from the German Health Interview and Examination Survey for Adults (DEGS1, N = 7115), and its mental health module (DEGS1-MH; N = 4483). Two different depression measures were used: current depressive symptoms assessed by the self-administered German version of the Patient Health Questionnaire-9 and major depressive disorder (MDD) in the last 12 months assessed by a modified German version of the Composite International Diagnostic Interview. Obesity was defined by body mass index calculated from measured data. Associations with log(x + 1)-transformed hsCRP levels were analyzed using multivariable linear regression models.
Obese participants with depressive symptoms had significantly higher hsCRP compared to non-obese participants with depressive symptoms adjusted for sociodemographic and behavioral variables and medication use. In non-obese individuals, depressive symptoms were inversely associated with hsCRP, whereas MDD was not associated with hsCRP after adjustment for covariates. Additional analyses suggested symptom-specific associations of hsCRP as higher levels were linked to fatigue (β = 0.10, p <.001) while lower levels were linked to cognitive problems (β = -0.09, p <.001). Low SES, current smoking, lower levels of physical exercise, and the use of anti-inflammatory/anti-rheumatic medication and antidepressants were additional determinants of hsCRP in the fully adjusted models.
Our data suggest that obesity status is more strongly associated with increased inflammation than depressive symptoms or MDD. The relationship between depression and hsCRP in our population-based sample is substantially influenced by obesity status as well as other medical factors, lifestyle, and socioeconomic status. Furthermore, our findings suggest that the association between hsCRP and depression is symptom-specific rather than generalized.
抑郁症和肥胖症常并发，一旦同时存在，它们会进一步增加发生其他合并症的风险，这可能是由于潜在的慢性低度炎症所致。我们在德国成年人的全国代表性样本中研究了抑郁症和肥胖症与高敏 C 反应蛋白（hsCRP）水平之间的关联程度。
我们分析了德国健康访谈和体检调查（DEGS1，N=7115）及其心理健康模块（DEGS1-MH；N=4483）的数据。使用了两种不同的抑郁测量方法：用自我管理的德国版患者健康问卷-9 评估当前抑郁症状和过去 12 个月内用改良的德国版复合国际诊断访谈评估的重度抑郁症（MDD）。肥胖症通过测量数据计算的体重指数来定义。使用多变量线性回归模型分析与 log(x+1)-转换 hsCRP 水平的关联。
与非肥胖伴抑郁症状者相比，调整社会人口统计学和行为变量以及药物使用后，伴有抑郁症状的肥胖者 hsCRP 水平显著升高。在非肥胖个体中，抑郁症状与 hsCRP 呈负相关，而调整协变量后 MDD 与 hsCRP 无关。进一步的分析表明 hsCRP 与症状特异性相关，较高水平与疲劳相关（β=0.10，p<.001），而较低水平与认知问题相关（β=-0.09，p<.001）。低社会经济地位、当前吸烟、较低水平的体育锻炼以及使用抗炎/抗风湿药物和抗抑郁药是完全调整模型中 hsCRP 的其他决定因素。
我们的数据表明，肥胖状态与炎症增加的相关性强于抑郁症状或 MDD。我们在人群样本中观察到的抑郁与 hsCRP 之间的关系受到肥胖状态以及其他医学因素、生活方式和社会经济地位的显著影响。此外，我们的研究结果表明，hsCRP 与抑郁之间的关联是症状特异性的，而不是普遍的。
