Associations between systemic inflammation and somatic depressive symptoms: Findings from the Moli‐sani study. Issue 9 (5th July 2020)

• Record Type: Journal Article
• Authors: Gialluisi, Alessandro; Di Castelnuovo, Augusto; Bracone, Francesca; De Curtis, Amalia; Cerletti, Chiara; Donati, Maria Benedetta; de Gaetano, Giovanni; Iacoviello, Licia
• Is Part Of: Depression and anxiety. Volume 37:Issue 9(2020)
• Page Start: 935
• Page End: 943
• Publication Date: 2020-07-05
• Subjects: appetite -- atypical depression -- C‐reactive protein -- depressive symptoms -- granulocyte‐to‐lymphocyte ratio -- systemic inflammation -- tiredness -- white blood cells count; Anxiety -- Periodicals; Depression, Mental -- Periodicals; Depression -- Periodicals; Anxiety -- Periodicals; Anxiety Disorders -- Periodicals; 616.8527005
• DOI: 10.1002/da.23070
• Languages: English
• ISSNs: 1091-4269

Abstract

Abstract: Background: The link between systemic inflammation and depression has been deeply investigated, but relatively few studies explored symptom‐specific associations, mostly focusing on common inflammatory biomarkers like C‐reactive protein (CRP) levels. Methods: We investigated associations of low‐grade inflammation with depressive symptoms assessed through a reduced version of Patient Health Questionnaire 9 (PHQ‐9) in a large population‐based cohort of adult Italians ( N = 13 301). We built logistic regressions between each depressive symptom and composite index of systemic inflammation based on four circulating biomarkers, namely CRP, Plt, WBC, and GLR (INFLA)‐score, a composite blood‐based inflammation index, and with its component biomarkers, namely CRP, platelets count (Plt), white blood cells count (WBC), and granulocyte‐to‐lymphocyte ratio (GLR). Results: We observed a strong association of the altered appetite/eating symptom with standardized INFLA‐score (OR [95% CI] = 1.19 [1.12‐1.26]; corrected p = 3.0 × 10 −7 ), CRP (1.28 [1.20‐1.36]; p = 1.9 × 10 −13 ), and WBC (1.13 [1.06‐1.20]; p = 2.3 × 10 −3 ), and of tiredness/low energy with GLR (1.11 [1.05‐1.17]; p = 9.4 × 10 −3 ). These associations remained stable within nondepressed participants (PHQ‐9 < 10), and after adjustment for the use of antidepressants, main chronic conditions, and lifestyle factors; while they were notably attenuated within depressed participants (PHQ‐9 ≥ 10) and—for altered appetite only—by adjustment for obesity. Conclusions: This study provides a robust replication of the association previously reported between CRP and altered appetite in a large US population cohort, and supports a link between systemic inflammation, altered appetite, and tiredness. Moreover, it extends this evidence to inflammatory markers other than CRP and suggests new targets for the treatment of atypical depression.