抑郁的分层炎症表型：跨越五个独立样本和 27730 名成年人的新方法。
Hierarchical Inflammatory Phenotypes of Depression: A Novel Approach Across Five Independent Samples and 27,730 Adults.
机构信息
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California.
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California.
出版信息
Biol Psychiatry. 2023 Feb 1;93(3):253-259. doi: 10.1016/j.biopsych.2022.08.017. Epub 2022 Aug 22.
BACKGROUND
Although characterizing associations between inflammation and depression may prove critical for informing theory, research, and treatment decisions, extant research has been limited by ignoring the possibility that inflammation may be simultaneously associated with depression broadly and with a subset of symptoms. This lack of direct comparison has hampered attempts to understand inflammatory phenotypes of depression and critically fails to consider that inflammation might be uniquely associated with both depression broadly and individual symptoms.
METHODS
We used moderated nonlinear factor analysis in 5 NHANES (National Health and Nutrition Examination Survey) cohorts (N = 27,730, 51% female, mean age = 46 years).
RESULTS
C-reactive protein (CRP) is simultaneously associated with latent depression, appetite, and fatigue. Specifically, CRP was associated with latent depression in all 5 samples (rs: 0.044-0.089; ps: < .001-.002) and was associated with both appetite (significant rs: 0.031-0.049, significant ps: .001-.007) and fatigue (significant rs: 0.030-0.054, significant ps: < .001-.029) in 4 samples. These results were largely robust to covariates.
CONCLUSIONS
Methodologically, these models indicate that the Patient Health Questionnaire-9 is scalar noninvariant as a function of CRP (i.e., identical Patient Health Questionnaire-9 scores may represent different constructs in those with high vs. low CRP levels). Therefore, mean comparisons of depression total scores and CRP might be misleading without accounting for symptom-specific associations. Conceptually, these findings indicate that studies investigating inflammatory phenotypes of depression should examine how inflammation is simultaneously related both to depression broadly and to specific symptoms, and whether these relations function via different mechanisms. This has the potential to yield new theoretical insights and may lead to the development of novel therapies for reducing inflammation-related symptoms of depression.
背景
虽然描述炎症与抑郁之间的关联可能对理论、研究和治疗决策具有重要意义，但现有研究忽视了炎症可能同时与抑郁的广泛表现以及部分症状相关的可能性，这限制了研究的发展。这种缺乏直接比较的情况，阻碍了对抑郁炎症表型的理解，并且严重忽略了这样一种可能性，即炎症可能与抑郁的广泛表现以及个体症状都有独特的关联。
方法
我们使用 moderated nonlinear factor analysis 在 5 个 NHANES（国家健康与营养调查）队列（N=27730，女性占 51%，平均年龄 46 岁）中进行了分析。
结果
C 反应蛋白（CRP）与潜在的抑郁、食欲和疲劳同时相关。具体而言，CRP 在所有 5 个样本中均与潜在的抑郁相关（rs：0.044-0.089；ps：<0.001-0.002），并且与食欲（显著 rs：0.031-0.049，显著 ps：<0.001-0.007）和疲劳（显著 rs：0.030-0.054，显著 ps：<0.001-0.029）在 4 个样本中均相关。这些结果在很大程度上不受协变量的影响。
结论
从方法学角度来看，这些模型表明，作为 CRP 函数的 PHQ-9 是标量不变的（即，在 CRP 水平较高和较低的人群中，相同的 PHQ-9 得分可能代表不同的结构）。因此，如果不考虑特定症状的关联，仅仅比较抑郁总分和 CRP 可能会产生误导。从概念上讲，这些发现表明，研究抑郁炎症表型的研究应该考察炎症如何同时与抑郁的广泛表现以及特定症状相关，以及这些关系是否通过不同的机制起作用。这有可能产生新的理论见解，并可能导致开发新的治疗方法来减轻与炎症相关的抑郁症状。
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