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Persistent Depressive Symptoms are Independent Predictors of Low-Grade Inflammation Onset Among Healthy Individuals.

Franco FGM, Laurinavicius AG, Lotufo PA, Conceição RD, Morita F, Katz M, Wajngarten M, Carvalho JAM, Bosworth HB, Santos RD. Persistent Depressive Symptoms are Independent Predictors of Low-Grade Inflammation Onset Among Healthy Individuals. Arquivos brasileiros de cardiologia. 2017 Jun 29; 109(2):97-102,180.

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Abstract:

Background:: Depressive symptoms are independently associated with an increased risk of cardiovascular disease (CVD) among individuals with non-diagnosed CVD. The mechanisms underlying this association, however, remain unclear. Inflammation has been indicated as a possible mechanistic link between depression and CVD. Objectives:: This study evaluated the association between persistent depressive symptoms and the onset of low-grade inflammation. Methods:: From a database of 1,508 young (mean age: 41 years) individuals with no CVD diagnosis who underwent at least two routine health evaluations, 134 had persistent depressive symptoms (Beck Depression Inventory - BDI 10, BDI+) and 1,374 had negative symptoms at both time points (BDI-). All participants had been submitted to repeated clinical and laboratory evaluations at a regular follow-up with an average of 26 months from baseline. Low-grade inflammation was defined as plasma high-sensitivity C-Reactive Protein (CRP) concentrations > 3 mg/L. The outcome was the incidence of low-grade inflammation evaluated by the time of the second clinical evaluation. Results:: The incidence of low-grade inflammation was more frequently observed in the BDI+ group compared to the BDI- group (20.9% vs. 11.4%; p = 0.001). After adjusting for sex, age, waist circumference, body mass index, levels of physical activity, smoking, and prevalence of metabolic syndrome, persistent depressive symptoms remained an independent predictor of low-grade inflammation onset (OR = 1.76; 95% CI: 1.03-3.02; p = 0.04). Conclusions:: Persistent depressive symptoms were independently associated with low-grade inflammation onset among healthy individuals. Fundamento:: Sintomas depressivos est o associados de forma independente ao risco aumentado de doen a cardiovascular (DCV) em indiv duos com DCV n o diagnosticada. Os mecanismos subjacentes a essa associa o, entretanto, n o est o claros. Inflama o tem sido indicada como um poss vel elo mecanicista entre depress o e DCV. Objetivos:: Este estudo avaliou a associa o entre sintomas depressivos persistentes e o in cio de inflama o de baixo grau. M todos:: De um banco de dados de 1.508 indiv duos jovens (idade m dia: 41 anos) sem diagn stico de DCV submetidos a pelo menos duas avalia es de sa de de rotina, 134 tinham sintomas depressivos persistentes (Invent rio de Depress o de Beck - BDI 10, BDI+) e 1.374 n o apresentavam sintomas em nenhuma das ocasi es (BDI-). Todos os participantes foram submetidos a repetidas avalia es cl nicas e laboratoriais em seguimento regular, cuja m dia foi de 26 meses desde a condi o basal. Definiu-se inflama o de baixo grau como concentra o plasm tica de prote na C reativa (PCR) ultrassens vel > 3 mg/L. O desfecho foi a incid ncia de inflama o de baixo grau por ocasi o da segunda avalia o cl nica. Resultados:: A incid ncia de inflama o de baixo grau foi maior no grupo BDI+ em compara o ao grupo BDI- (20,9% vs. 11,4%; p = 0,001). Ap s ajuste para sexo, idade, circunfer ncia abdominal, ndice de massa corporal, n veis de atividade f sica, tabagismo e preval ncia de s ndrome metab lica, os sintomas depressivos persistentes continuaram sendo um preditor independente de in cio de inflama o de baixo grau (OR = 1,76; IC 95%: 1,03-3,02; p = 0,04). Conclus es:: Sintomas depressivos persistentes foram independentemente associados com in cio de inflama o de baixo grau em indiv duos saud veis.





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