Associations of low grade inflammation and endothelial dysfunction with depression: The Maastricht study

F.E.P. van Dooren, M.T. Schram, C.G. Schalkwijk, C.D. Stehouwer, R.M. Henry, P.C. Dagnelie, N.C. Schaper, C. J. van der Kallen, A. Koster, S. J. Sep, J. Denollet, F.R.J. Verhey, F. Pouwer

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Abstract

Background
The pathogenesis of depression may involve low-grade inflammation and endothelial dysfunction. We aimed to evaluate the independent associations of inflammation and endothelial dysfunction with depressive symptoms and depressive disorder, and the role of lifestyle factors in this association.
Methods
In The Maastricht Study, a population-based cohort study (n = 852, 55% men, m = 59.8 ± 8.5 years), depressive symptoms were assessed with the Patient Health Questionnaire-9 and (major and minor) depressive disorder with the Mini-International Neuropsychiatric Interview. Plasma biomarkers of inflammation (hsCRP, SAA, sICAM-1, IL-6, IL-8, TNF-α) and endothelial dysfunction (sVCAM-1, sICAM-1, sE-selectin, vWF) were measured with sandwich immunoassays and combined into two standardized sum scores.
Results
Biomarkers of inflammation (hsCRP, TNF-α, SAA, sICAM-1) and endothelial dysfunction (sICAM-1, sE-Selectin) were univariately associated with depressive symptoms and depressive disorder. The sum scores of inflammation and endothelial dysfunction were associated with depressive disorder after adjustment for age, sex, type 2 diabetes, kidney function and prior cardiovascular disease (OR 1.54, p = 0.001 and 1.40, p = 0.006). Both sum scores remained significantly associated with depressive disorder after additional adjustment for lifestyle factors smoking, alcohol consumption and body mass index. The sum score of inflammation was also independently associated with depressive symptoms, while the sum score of endothelial dysfunction was not.
Conclusions
Inflammation and endothelial dysfunction are both associated with depressive disorder, independent of lifestyle factors. Our results might suggest that inflammation and endothelial dysfunction are involved in depression.
Original languageEnglish
Pages (from-to)390–396
JournalBrain, Behavior, and Immunity: An international journal
Volume56
DOIs
Publication statusPublished - 2016

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    van Dooren, F. E. P., Schram, M. T., Schalkwijk, C. G., Stehouwer, C. D., Henry, R. M., Dagnelie, P. C., Schaper, N. C., van der Kallen, C. J., Koster, A., Sep, S. J., Denollet, J., Verhey, F. R. J., & Pouwer, F. (2016). Associations of low grade inflammation and endothelial dysfunction with depression: The Maastricht study. Brain, Behavior, and Immunity: An international journal, 56, 390–396. https://doi.org/10.1016/j.bbi.2016.03.004