Association Between Somatic Depressive Symptoms and Endothelial Dysfunction in Healthy Individuals

Depressive symptoms (DS) are associated with cardiovascular disease (CVD). Particular clusters of DS, such as the somatic depressive symptoms (SDS), are more associated with CVD than others. Endothelial dysfunction (ED), a precursor to CVD, is linked to traditional risk factors: older age, female sex, non-white ethnicity, smoking, high body weight, and mental stress. However, the association between SDS and ED in healthy nondepressed individuals remains unclear. This study aims to investigate the association between SDS and endothelial function in healthy individuals.

Cross-sectional study included 132 participants aged 18 to 60 years without CVD (31.1±11.5 y). Endothelial function was assessed by flow-mediated dilation (FMD) of the brachial artery. Depressive symptoms were evaluated with the PHQ-9, focusing on somatic symptoms (sleep, fatigue, appetite). Affective depressive symptoms (ADS)-including anhedonia, low self-esteem, and suicidality-and anxiety were analyzed as distinct psychological constructs. Linear and logistic regression models were performed to identify predictors of FMD and ED.

The cluster of SDS was the strongest predictor of lower FMD (β=-0.329, p <.001), followed by ADS (β=-0.239, p =.041) and body surface area (β=-0.209, p =.037). Logistic regression confirmed SDS as the strongest predictor of ED ( p =.001).

SDS are significantly associated with ED, surpassing the other risk factors. The assessment of the somatic cluster may allow the detection of individuals who are at a high risk of developing CVD.