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Raised CRP Levels in Obese Patients: Symptoms of Depression Have an Independent Positive Association
Author(s) -
Dixon John B.,
Hayden Melissa J.,
Lambert Gavin W.,
Dawood Tye,
Anderson Margaret L.,
Dixon Maureen E.,
O'Brien Paul E.
Publication year - 2008
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1038/oby.2008.271
Subject(s) - medicine , confounding , depression (economics) , interquartile range , obesity , insulin resistance , waist , beck depression inventory , body mass index , c reactive protein , endocrinology , psychiatry , inflammation , anxiety , economics , macroeconomics
Background: Depression and obesity, the two common ailments of modern society, are associated with increased risk of coronary artery disease and raised C‐reactive protein (CRP) levels. Are the effects of depression and obesity related or do they influence CRP levels independently? Objective: In 493 consecutive patients presenting for obesity surgery, we explored the relationship between symptoms of depression and raised CRP levels after controlling for confounding factors. Methods and Procedures: Depression was measured using the Beck Depression Inventory (BDI). Confounding variables were age, gender, BMI, waist and hip measures, smoking and alcohol habits, medications, biochemical measures of the metabolic syndrome, and indirect measures of insulin resistance. General linear regression sought variables independently associated with CRP levels. Results: These patients had a BMI range from 31 to 91 kg/m 2 , participants age ranged from 14 to 71 years, and 76% were women. The median CRP concentration was 7.7 mg/l (interquartile range: 3.9–14), 40% had an abnormally raised concentration (>10 mg/l). The mean BDI score was 17.0 ± 9.0, indicating symptoms of moderate depression. We found five independent factors associated with raised CRP levels. In order of strength of association, these were: higher BMI (β = 0.36, P < 0.001), female gender (β = −0.19, P < 0.001), estrogen therapy (β = 0.18, P < 0.001), higher BDI score (β = 0.11, P = 0.01), and insulin resistance index (β = 0.11, P = 0.01), and with a combined R 2 = 0.24, ( P < 0.001). Discussion: In obese patients, symptoms of depression were associated with raised CRP levels after controlling for confounding variables. Obese women on estrogen therapy are at risk of high CRP levels.