抑郁情绪和循环炎性标记物对欧洲健康男性冠心病的作用:心肌梗死的前瞻性流行病学研究(PRIME)

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Background-Dataon the possible association between depressive disorders and inflammatory markers are scarce and inconsistent. We investigated whether subjects with depressive mood had higher levels of a wide range of inflammatory markers involved in coronary heart disease(CHD) incidence and examined the contribution of these inflammatory markers and depressive mood to CHD outcome. Methods and Results-We built a nested case-referent study within the Prospective Epidemiological Study of Myocardial Infarction(PRIME) study of healthy middle-aged men from Belfast and France. We considered the baseline plasma sample from 335 future cases(angina pectoris, nonfatal myocardial infarction, coronary death) and 670 matched controls(2 controls per case). Depressive mood characterized men whose baseline depression score(13-item modification of the Welsh depression subscale) was in the fourth quartile(mean score, 5.75; range, 4 to 12). On average, men with depressive mood had 46% , 16% , and 10% higher C-reactive protein, interleukin- 6, and intercellular adhesion molecule- 1 levels, respectively, independently of case-control status, social characteristics, and classic cardiovascular risk factors; no statistical difference was found for fibrinogen. The odds ratios of depressive mood for CHD were 1.35(95% CI, 1.05 to 1.73) in univariate analysis and 1.50(95% CI, 1.04 to 2.15) after adjustment for social characteristics and classic cardiovascular risk factors. The latter odds ratio remained unchanged when each inflammatory marker was added separately, and in this analysis, each inflammatory marker contributed significantly to CHD event risk. Conclusions-These data support an association of depressive mood with inflammatory markers and suggest that depressive mood is related to CHD even after adjustment for these inflammatory markers. Background-Dataon the possible association between depressive disorders and inflammatory markers are scarce and inconsistent. We investigated whether with with depressive mood had higher levels of a wide range of inflammatory markers involved in coronary heart disease (CHD) incidence and examined the contribution of these inflammatory markers and depressive mood to CHD outcome. Methods and Results-We built a nested case-referent study within the Prospective Epidemiological Study of Myocardial Infarction (PRIME) study of healthy middle-aged men from Belfast and France. We considered the baseline plasma sample from Depressive motion characterized by the baseline depression score (13-item modification of the Welsh depression subscalecale) was in the fourth quartile mean average, men with depressive mood had 46%, 16%, and 10% high er C-reactive protein, interleukin-6, and intercellular adhesion molecule-1 levels, respectively, independently of case-control status, social characteristics, and classic cardiovascular risk factors; no statistical difference was found for fibrinogen. The odds ratios of depressive mood for CHD were 1.35 (95% CI, 1.05 to 1.73) in univariate analysis and 1.50 (95% CI, 1.04 to 2.15) after adjustment for social characteristics and classic cardiovascular risk factors. The latter odds ratio remained unchanged when each inflammatory marker was added separately, and in this analysis, each inflammatory marker contributed significantly to CHD event risk. Conclusions-These data support an association of depressive mood with inflammatory markers and suggest that depressive mood is related to CHD even after adjustment for these inflammatory markers.
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