Introduction

Depression and obesity often occur comorbidly, and once both are present, they further increase the risk of developing other medical comorbidities, likely due to the underlying chronic low-grade inflammation. We investigated to what extent depression and obesity are associated with levels of high-sensitivity C-reactive protein (hsCRP) in a nationally representative sample of the German adult population.

Methods

We analyzed data from the German Health Interview and Examination Survey for Adults (DEGS1, N = 7115), and its mental health module (DEGS1-MH; N = 4483). Two different depression measures were used: current depressive symptoms assessed by the self-administered German version of the Patient Health Questionnaire-9 and major depressive disorder (MDD) in the last 12 months assessed by a modified German version of the Composite International Diagnostic Interview. Obesity was defined by body mass index calculated from measured data. Associations with log(x + 1)-transformed hsCRP levels were analyzed using multivariable linear regression models.

Results

Obese participants with depressive symptoms had significantly higher hsCRP compared to non-obese participants with depressive symptoms adjusted for sociodemographic and behavioral variables and medication use. In non-obese individuals, depressive symptoms were inversely associated with hsCRP, whereas MDD was not associated with hsCRP after adjustment for covariates. Additional analyses suggested symptom-specific associations of hsCRP as higher levels were linked to fatigue (β = 0.10, p <.001) while lower levels were linked to cognitive problems (β = −0.09, p <.001). Low SES, current smoking, lower levels of physical exercise, and the use of anti-inflammatory/anti-rheumatic medication and antidepressants were additional determinants of hsCRP in the fully adjusted models.

Conclusions

Our data suggest that obesity status is more strongly associated with increased inflammation than depressive symptoms or MDD. The relationship between depression and hsCRP in our population-based sample is substantially influenced by obesity status as well as other medical factors, lifestyle, and socioeconomic status. Furthermore, our findings suggest that the association between hsCRP and depression is symptom-specific rather than generalized.

中文翻译：

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德国抑郁症和肥胖症与 C 反应蛋白的关联：一项具有全国代表性的大型研究

介绍

抑郁症和肥胖症经常合并发生，一旦两者都存在，它们会进一步增加发生其他医学合并症的风险，这可能是由于潜在的慢性低度炎症。我们在具有全国代表性的德国成年人群样本中调查了抑郁症和肥胖症与高敏 C 反应蛋白 (hsCRP) 水平的相关程度。

方法

我们分析了来自德国成人健康访谈和检查调查 (DEGS1, N = 7115) 及其心理健康模块 (DEGS1-MH; N = 4483) 的数据。使用了两种不同的抑郁测量方法：通过自我管理的德国版患者健康问卷 9 评估的当前抑郁症状和过去 12 个月内通过改良的德国版综合国际诊断访谈评估的重度抑郁症 (MDD)。肥胖由根据测量数据计算的体重指数定义。使用多变量线性回归模型分析与 log(x + 1) 转换的 hsCRP 水平的关联。

结果

与具有抑郁症状的非肥胖参与者相比，具有抑郁症状的肥胖参与者具有显着更高的 hsCRP，并根据社会人口学和行为变量以及药物使用进行了调整。在非肥胖个体中，抑郁症状与 hsCRP 呈负相关，而在调整协变量后，MDD 与 hsCRP 无关。其他分析表明 hsCRP 与症状特异性相关，因为较高水平与疲劳有关（β  = 0.10，p  <.001），而较低水平与认知问题有关（β  = -0.09，p <.001)。在完全调整的模型中，低 SES、当前吸烟、较低水平的体育锻炼以及使用抗炎/抗风湿药物和抗抑郁药是 hsCRP 的额外决定因素。

结论

我们的数据表明，与抑郁症状或 MDD 相比，肥胖状态与炎症增加的相关性更强。在我们基于人群的样本中，抑郁症和 hsCRP 之间的关系在很大程度上受到肥胖状况以及其他医疗因素、生活方式和社会经济状况的影响。此外，我们的研究结果表明 hsCRP 与抑郁症之间的关联是症状特异性的，而不是普遍的。