Zhao Ningxuan, Jiang Lin, Hu Meijing, Zhang Baiyang, Lin Yidie, Yao Qiang, Hao Jingjing, Zhu Cairong
Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
Front Psychiatry. 2024 Jun 14;15:1319682. doi: 10.3389/fpsyt.2024.1319682. eCollection 2024.
Research examining the bidirectional relationship between C-reactive protein (CRP) and depressive symptoms, while accounting for cumulative effect of repeated episodes of CRP or depressive symptoms, is currently deficient in non-Western populations.
A nationally representative population-based cohort data from the Chinese Health and Retirement Longitudinal Study (CHARLS) was utilized. In bi-directional analysis, we considered both single determinations and two successive determinations of CRP or depressive symptoms. Multivariate logistic regression assessed the association between elevated CRP levels at baseline or repeated episodes of CRP elevations over two successive determinations and subsequent elevated depressive symptoms, and vice versa.
Although single determinations of CRP or depressive symptoms yielded non-significant results in both directions, full multivariate models, adjusting for baseline depressive symptoms, socio-demographic characteristics, health-related behaviors, metabolic measures, and health status, revealed a significantly positive association based on two successive determinations of CRP or depressive symptoms. This significant association was observed between cumulative effects of sustained CRP elevations over two successive determinations (2 vs. 0) and subsequent elevated depressive symptoms (OR=1.58; 95% CI: 1.15 to 2.17) and between cumulative effect of repeated episodes of depression (2 vs. 0) and later elevated CRP (OR=1.26; 95% CI: 1.02 to 1.56). Furthermore, sex-stratified analyses confirmed the robustness of these relationships.
There are bidirectional associations between depressive symptoms and CRP, driven by the cumulative effect of repeated episodes of CRP or depressive symptoms among middle-aged and older Chinese adults. These findings hold significant clinical implications, highlighting the potential of both anti-inflammatory and anti-depression approaches.
目前在非西方人群中，研究C反应蛋白（CRP）与抑郁症状之间的双向关系并考虑CRP或抑郁症状反复发作的累积效应的研究尚显不足。
利用中国健康与养老追踪调查（CHARLS）中具有全国代表性的基于人群的队列数据。在双向分析中，我们既考虑了CRP或抑郁症状的单次测定，也考虑了连续两次测定。多变量逻辑回归评估了基线时CRP水平升高或连续两次测定中CRP升高的反复发作与随后抑郁症状升高之间的关联，反之亦然。
尽管CRP或抑郁症状的单次测定在两个方向上均未得出显著结果，但在调整了基线抑郁症状、社会人口学特征、健康相关行为、代谢指标和健康状况的完整多变量模型中，基于CRP或抑郁症状的连续两次测定显示出显著的正相关。在连续两次测定中持续CRP升高的累积效应（2次与0次）与随后抑郁症状升高之间（比值比=1.58；95%置信区间：1.15至2.17）以及抑郁反复发作的累积效应（2次与0次）与随后CRP升高之间（比值比=1.26；95%置信区间：1.02至1.56）观察到了这种显著关联。此外，按性别分层的分析证实了这些关系的稳健性。
在中国中老年成年人中，抑郁症状与CRP之间存在双向关联，这是由CRP或抑郁症状反复发作的累积效应驱动的。这些发现具有重要的临床意义，突出了抗炎和抗抑郁方法的潜力。
