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Mediation of the Association Between Vascular Risk Factors and Depressive Symptoms by C-Reactive Protein

Lina Romankiewicz1, H Lina Schaare2,3, Steffen Nestler1

  • 1Department of Psychology, University of Münster, Münster, Germany.

Biological Psychiatry Global Open Science
|October 26, 2023
PubMed

Insights

Vascular risk factors (VRFs) are linked to depressive symptoms, with C-reactive protein (CRP) partially mediating this relationship. Inflammation may contribute to depression, particularly somatic symptoms, in later life.

Area of Science:

  • Cardiovascular Health
  • Mental Health
  • Inflammation Research

Background:

  • Low-grade systemic inflammation, indicated by C-reactive protein (CRP), is increasingly recognized in various health conditions.
  • Vascular risk factors (VRFs) are common in mid- and later life and have been associated with adverse health outcomes.
  • The interplay between VRFs, inflammation, and depressive symptoms requires further investigation.

Purpose of the Study:

  • To investigate whether C-reactive protein (CRP) mediates the association between vascular risk factor (VRF) burden and depressive symptoms.
  • To quantify the direct and indirect effects of VRF burden on depressive symptoms through CRP.
  • To explore potential links to specific depressive symptom subtypes.

Main Methods:

  • Utilized prospective data from 10,470 UK Biobank participants.
  • Employed regression-based mediation models to estimate total, direct, and indirect effects.
  • Controlled for sociodemographic factors, baseline CRP, and baseline depression; sensitivity analyses addressed unmeasured confounding.

Main Results:

  • Vascular risk factors (VRFs) at baseline were associated with higher depressive symptoms at follow-up (total effect = 0.099).
  • C-reactive protein (CRP) partially mediated this association, accounting for 10.0% of the total effect (indirect effect = 0.010).
  • Exploratory analyses indicated that the effects were more pronounced for somatic depressive symptoms like tiredness and appetite changes.

Conclusions:

  • Inflammation, as indicated by CRP, may contribute to depressive symptoms in mid- and later life, linked to VRFs.
  • The CRP-mediated pathway explains a small proportion of the VRF-depression association after controlling for covariates.
  • Further longitudinal research is needed to clarify the complex, time-varying relationships between VRFs, inflammation, and specific depressive symptoms.
Abstract

Keywords:
DepressionInflammationMediationUK BiobankVascular depressionVascular risk factors

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