Depression is common in patients with cardiovascular disease (CVD) and associated with inflammation. Inflammation contributes to the development of CVD and can be modulated by diet. However, the role of inflammatory properties of diet in the relationship between depressive symptoms and CVD risk is not well understood. We hypothesized that the inflammatory properties of diet mediate the relationship between depressive symptoms and CVD risk in men and women. Cross-sectional data collected by the National Health and Nutrition Examination Survey (2007-2014) were used for the study. Depressive symptoms scores, inflammatory properties of diet, and CVD risk were measured by the Patient Health Questionnaire-9 (PHQ-9), the Dietary Inflammatory Index (DII), and the Framingham risk score (FRS), respectively. Generalized linear models were used for the mediation analysis. There were significant differences in the proportions of men and women in the depressed group (PHQ-9 ≥ 10; 5.24 ± 0.65% vs 9.36 ± 0.87%, P < .001) and high CVD risk group (FRS >20%; 16.47 ± 0.79% vs 6.03 ± 0.32%, P < .001). The DII partially mediated the relationship between depressive symptoms and CVD risk in men (indirect effect: 0.06, P = .010) but fully mediated the relationship between depressive symptoms and CVD risk in women (indirect effect: 0.10, P < .001). These findings confirmed our hypothesis that inflammatory properties of diet at least partially mediate the relationship between depressive symptoms and CVD risk in men and women. Our findings suggest that interventions designed to reduce depressive symptoms should contain strategies to reduce pro-inflammatory and increase anti-inflammatory properties of diet to decrease CVD risk.

中文翻译：

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饮食的炎症特性介导了抑郁症状对男性和女性弗雷明汉风险评分的影响：来自全国健康和营养检查调查的结果（2007-2014）

抑郁症在心血管疾病 (CVD) 患者中很常见，并且与炎症有关。炎症有助于 CVD 的发展，并且可以通过饮食进行调节。然而，饮食的炎症特性在抑郁症状和 CVD 风险之间的关系中的作用尚不清楚。我们假设饮食的炎症特性介导了男性和女性抑郁症状与 CVD 风险之间的关系。该研究使用了国家健康和营养检查调查（2007-2014）收集的横断面数据。抑郁症状评分、饮食的炎症特性和 CVD 风险分别通过患者健康问卷 9 (PHQ-9)、膳食炎症指数 (DII) 和弗雷明汉风险评分 (FRS) 进行测量。广义线性模型用于中介分析。抑郁组（PHQ-9 ≥ 10；5.24 ± 0.65% vs 9.36 ± 0.87%，P < .001）和高 CVD 风险组（FRS > 20%；16.47 ± 0.79% 与 6.03 ± 0.32%，P < .001）。DII 部分介导了男性抑郁症状与 CVD 风险之间的关系（间接影响：0.06，P = .010），但完全介导了女性抑郁症状与 CVD 风险之间的关系（间接影响：0.10，P < .001）。这些发现证实了我们的假设，即饮食的炎症特性至少部分介导了男性和女性抑郁症状与 CVD 风险之间的关系。