Endothelial dysfunction is associated with a greater depressive symptom score in a general elderly population

The Hoorn Study

T.T. van Sloten, M.T. Schram, M.C. Adriaanse, J.M. Dekker, G. Nijpels, T. Teerlink, P.G. Scheffer, F. Pouwer, C.G. Schalkwijk, C.D.A. Stehouwer, R.M. Henry

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Endothelial dysfunction (ED), low-grade inflammation (LGI) and oxidative stress (OxS) may be involved in the pathobiology of depression. Previous studies on the association of these processes in depression have yielded contradictory results. We therefore investigated comprehensively, in a population-based cohort study, the association between ED, LGI and OxS on the one hand and depressive symptoms on the other.
We used data from the Hoorn Study and determined biomarkers of ED [flow-mediated dilatation (FMD), von Willebrand factor, soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1, soluble thrombomodulin and soluble endothelial selectin], LGI [C-reactive protein, tumour necrosis factor-α, interleukin 6, interleukin 8, serum amyloid A, myeloperoxidase (MPO) and sICAM-1] and OxS (oxidized low density lipoprotein and MPO). Depressive symptoms were quantified by the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire (n = 493; age 68 years; 49.9% female). Regression analyses were performed with the use of biomarker Z scores. Adjustments were made for age, sex and glucose metabolism status (cohort stratification variables) and prior cardiovascular disease, hypertension, waist-to-hip ratio, cholesterol levels, education level, physical activity, dietary habits, and the use of antihypertensive and/or lipid-lowering medication and/or metformin (potential confounders).
After adjustment for age, sex and glucose metabolism status, one standard deviation increase in the ED Z score was associated with a 1.9 [95% confidence interval (CI) 0.7–3.1] higher CES-D score. Additional adjustments did not materially change this result. LGI and OxS were not associated with the CES-D score.
ED, as quantified by an array of circulating biomarkers and FMD, was independently associated with depressive symptoms. This study supports the hypothesis that ED plays an important role in the pathobiology of depression.
Original languageEnglish
Pages (from-to)1403-1416
JournalPsychological Medicine
Volume44
Issue number7
DOIs
Publication statusPublished - 2014

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Depression
Intercellular Adhesion Molecule-1
Peroxidase
Dilatation
Thrombomodulin
Vascular Cell Adhesion Molecule-1
von Willebrand Factor
Interleukin-8
Interleukin-6
Tumor Necrosis Factor-alpha
Confidence Intervals
Exercise
Lipids
Education

Cite this

van Sloten, T. T., Schram, M. T., Adriaanse, M. C., Dekker, J. M., Nijpels, G., Teerlink, T., ... Henry, R. M. (2014). Endothelial dysfunction is associated with a greater depressive symptom score in a general elderly population: The Hoorn Study. Psychological Medicine, 44(7), 1403-1416. https://doi.org/10.1017/s0033291713002043
van Sloten, T.T. ; Schram, M.T. ; Adriaanse, M.C. ; Dekker, J.M. ; Nijpels, G. ; Teerlink, T. ; Scheffer, P.G. ; Pouwer, F. ; Schalkwijk, C.G. ; Stehouwer, C.D.A. ; Henry, R.M. / Endothelial dysfunction is associated with a greater depressive symptom score in a general elderly population : The Hoorn Study. In: Psychological Medicine. 2014 ; Vol. 44, No. 7. pp. 1403-1416.
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abstract = "Endothelial dysfunction (ED), low-grade inflammation (LGI) and oxidative stress (OxS) may be involved in the pathobiology of depression. Previous studies on the association of these processes in depression have yielded contradictory results. We therefore investigated comprehensively, in a population-based cohort study, the association between ED, LGI and OxS on the one hand and depressive symptoms on the other.We used data from the Hoorn Study and determined biomarkers of ED [flow-mediated dilatation (FMD), von Willebrand factor, soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1, soluble thrombomodulin and soluble endothelial selectin], LGI [C-reactive protein, tumour necrosis factor-α, interleukin 6, interleukin 8, serum amyloid A, myeloperoxidase (MPO) and sICAM-1] and OxS (oxidized low density lipoprotein and MPO). Depressive symptoms were quantified by the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire (n = 493; age 68 years; 49.9{\%} female). Regression analyses were performed with the use of biomarker Z scores. Adjustments were made for age, sex and glucose metabolism status (cohort stratification variables) and prior cardiovascular disease, hypertension, waist-to-hip ratio, cholesterol levels, education level, physical activity, dietary habits, and the use of antihypertensive and/or lipid-lowering medication and/or metformin (potential confounders).After adjustment for age, sex and glucose metabolism status, one standard deviation increase in the ED Z score was associated with a 1.9 [95{\%} confidence interval (CI) 0.7–3.1] higher CES-D score. Additional adjustments did not materially change this result. LGI and OxS were not associated with the CES-D score.ED, as quantified by an array of circulating biomarkers and FMD, was independently associated with depressive symptoms. This study supports the hypothesis that ED plays an important role in the pathobiology of depression.",
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van Sloten, TT, Schram, MT, Adriaanse, MC, Dekker, JM, Nijpels, G, Teerlink, T, Scheffer, PG, Pouwer, F, Schalkwijk, CG, Stehouwer, CDA & Henry, RM 2014, 'Endothelial dysfunction is associated with a greater depressive symptom score in a general elderly population: The Hoorn Study', Psychological Medicine, vol. 44, no. 7, pp. 1403-1416. https://doi.org/10.1017/s0033291713002043

Endothelial dysfunction is associated with a greater depressive symptom score in a general elderly population : The Hoorn Study. / van Sloten, T.T.; Schram, M.T.; Adriaanse, M.C.; Dekker, J.M.; Nijpels, G.; Teerlink, T.; Scheffer, P.G.; Pouwer, F.; Schalkwijk, C.G.; Stehouwer, C.D.A.; Henry, R.M.

In: Psychological Medicine, Vol. 44, No. 7, 2014, p. 1403-1416.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Endothelial dysfunction is associated with a greater depressive symptom score in a general elderly population

T2 - The Hoorn Study

AU - van Sloten, T.T.

AU - Schram, M.T.

AU - Adriaanse, M.C.

AU - Dekker, J.M.

AU - Nijpels, G.

AU - Teerlink, T.

AU - Scheffer, P.G.

AU - Pouwer, F.

AU - Schalkwijk, C.G.

AU - Stehouwer, C.D.A.

AU - Henry, R.M.

PY - 2014

Y1 - 2014

N2 - Endothelial dysfunction (ED), low-grade inflammation (LGI) and oxidative stress (OxS) may be involved in the pathobiology of depression. Previous studies on the association of these processes in depression have yielded contradictory results. We therefore investigated comprehensively, in a population-based cohort study, the association between ED, LGI and OxS on the one hand and depressive symptoms on the other.We used data from the Hoorn Study and determined biomarkers of ED [flow-mediated dilatation (FMD), von Willebrand factor, soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1, soluble thrombomodulin and soluble endothelial selectin], LGI [C-reactive protein, tumour necrosis factor-α, interleukin 6, interleukin 8, serum amyloid A, myeloperoxidase (MPO) and sICAM-1] and OxS (oxidized low density lipoprotein and MPO). Depressive symptoms were quantified by the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire (n = 493; age 68 years; 49.9% female). Regression analyses were performed with the use of biomarker Z scores. Adjustments were made for age, sex and glucose metabolism status (cohort stratification variables) and prior cardiovascular disease, hypertension, waist-to-hip ratio, cholesterol levels, education level, physical activity, dietary habits, and the use of antihypertensive and/or lipid-lowering medication and/or metformin (potential confounders).After adjustment for age, sex and glucose metabolism status, one standard deviation increase in the ED Z score was associated with a 1.9 [95% confidence interval (CI) 0.7–3.1] higher CES-D score. Additional adjustments did not materially change this result. LGI and OxS were not associated with the CES-D score.ED, as quantified by an array of circulating biomarkers and FMD, was independently associated with depressive symptoms. This study supports the hypothesis that ED plays an important role in the pathobiology of depression.

AB - Endothelial dysfunction (ED), low-grade inflammation (LGI) and oxidative stress (OxS) may be involved in the pathobiology of depression. Previous studies on the association of these processes in depression have yielded contradictory results. We therefore investigated comprehensively, in a population-based cohort study, the association between ED, LGI and OxS on the one hand and depressive symptoms on the other.We used data from the Hoorn Study and determined biomarkers of ED [flow-mediated dilatation (FMD), von Willebrand factor, soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1, soluble thrombomodulin and soluble endothelial selectin], LGI [C-reactive protein, tumour necrosis factor-α, interleukin 6, interleukin 8, serum amyloid A, myeloperoxidase (MPO) and sICAM-1] and OxS (oxidized low density lipoprotein and MPO). Depressive symptoms were quantified by the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire (n = 493; age 68 years; 49.9% female). Regression analyses were performed with the use of biomarker Z scores. Adjustments were made for age, sex and glucose metabolism status (cohort stratification variables) and prior cardiovascular disease, hypertension, waist-to-hip ratio, cholesterol levels, education level, physical activity, dietary habits, and the use of antihypertensive and/or lipid-lowering medication and/or metformin (potential confounders).After adjustment for age, sex and glucose metabolism status, one standard deviation increase in the ED Z score was associated with a 1.9 [95% confidence interval (CI) 0.7–3.1] higher CES-D score. Additional adjustments did not materially change this result. LGI and OxS were not associated with the CES-D score.ED, as quantified by an array of circulating biomarkers and FMD, was independently associated with depressive symptoms. This study supports the hypothesis that ED plays an important role in the pathobiology of depression.

U2 - 10.1017/s0033291713002043

DO - 10.1017/s0033291713002043

M3 - Article

VL - 44

SP - 1403

EP - 1416

JO - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

IS - 7

ER -