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Associations between systemic inflammation and somatic depressive symptoms: Findings from the Moli‐sani study
Author(s) -
Gialluisi Alessandro,
Di Castelnuovo Augusto,
Bracone Francesca,
De Curtis Amalia,
Cerletti Chiara,
Donati Maria Benedetta,
Gaetano Giovanni,
Iacoviello Licia
Publication year - 2020
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.23070
Subject(s) - medicine , systemic inflammation , depression (economics) , atypical depression , inflammation , body mass index , c reactive protein , appetite , white blood cell , population , gastroenterology , immunology , environmental health , economics , macroeconomics
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.