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[Association of markers of endothelial dysfunction with depression in middle-aged patients with cerebral
1Sechenov First Moscow State Medical University, Moscow, Russia.
Objective:
To assess the ratio of levels of peripheral markers of inflammation and biomarkers of endothelial dysfunction (ED) with the severity of depression in middle-aged patients with cerebral microangiopathy.
Material And Methods:
In an observational study of outpatients (n=262, 42.1% of men, 57.9% of women, average age 54.2±7 years), the severity of depressive disorders was assessed with HADS. Levels of peripheral markers of endothelial inflammation (C-reactive protein (CRP), monocytic chemoattractant protein-1 (MCP-1)) and ED biomarkers (endothelin-1, endothelial NO synthase, vascular endothelial growth factor, desquamated endotheliocytes, S100 protein, von Willebrand factor, fibrinogen) were determined by enzyme immunoassay. The initial sample of patients is divided into two groups: with clinical (n=146) and subclinical (n=116) depression. Based on the indicators of the ED biomarkers, a factor analysis was performed to calculate the integrative indicator of endothelial function (IIEF).
Results:
Patients with clinically defined depression compared with patients with subclinical depression had an increased level of peripheral markers of inflammation (CRP 6.11 vs 2.03 mg/L; p<0.05; MCP-1 2.02 vs 0.66 ng/ml; p<0.05). The severity of depression was directly correlated with the level of peripheral markers of inflammation (CRP, r=0.85, p<0.05; MCP-1, r=0.8, p<0.05, respectively). Patients with clinically expressed depression were characterized by a lower IIEF compared with patients with subclinical depression (0.12±0.04 vs 1.14±0.3; p<0.05, respectively). Odds ratios adjusted for age, obesity, type 2 diabetes mellitus were as follows: 1.5; 95% CI (1.3-1.8), p<0.001 for CRP; 1.67; 95% CI (0.63-2.85), p<0.001 for MCP-1; 1.21; 95% CI (1.19-1.35), p<0.001 for IIEF.
Conclusion:
Pro-inflammatory ED contributes to the development of depression in middle-aged patients with cerebral microangiopathy associated with arterial hypertension. The severity of depression depends on the degree of ED. The association between the degree of ED, the pro-inflammatory activity of the endothelium and the severity of depression is relatively independent of age, obesity, type 2 diabetes mellitus.
