Bidirectional relationship between C-reactive protein and depressive symptoms considering cumulative effect among
Ningxuan Zhao1, Lin Jiang1, Meijing Hu1
1Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
Insights
Repeated episodes of elevated C-reactive protein (CRP) and depressive symptoms show a bidirectional link in older Chinese adults. Cumulative effects, not single instances, drive this association, suggesting dual anti-inflammatory and antidepressant strategies may be beneficial.
Area of Science:
- Biomedical Science
- Epidemiology
- Psychiatry
Background:
- Research on the bidirectional relationship between C-reactive protein (CRP) and depressive symptoms is limited in non-Western populations.
- The cumulative effect of repeated episodes of CRP or depressive symptoms requires further investigation.
Purpose of the Study:
- To examine the bidirectional association between CRP and depressive symptoms in Chinese adults.
- To investigate the role of cumulative effects of repeated episodes on this relationship.
Main Methods:
- Utilized data from the Chinese Health and Retirement Longitudinal Study (CHARLS).
- Employed multivariate logistic regression for bi-directional analysis, considering single and successive determinations of CRP and depressive symptoms.
- Adjusted for socio-demographic, behavioral, metabolic, and health status factors.
Main Results:
- Single determinations of CRP or depressive symptoms showed non-significant results.
- Two successive determinations revealed significant bidirectional associations.
- Cumulative CRP elevations predicted subsequent depressive symptoms (OR=1.58), and cumulative depressive episodes predicted later CRP elevation (OR=1.26).
Conclusions:
- Bidirectional associations between depressive symptoms and CRP are driven by cumulative effects in middle-aged and older Chinese adults.
- Findings suggest potential benefits of combined anti-inflammatory and antidepressant interventions.
- Sex-stratified analyses confirmed the robustness of these relationships.
Introduction:
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.
Methods:
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.
Results:
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.
Conclusion:
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.
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