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  Mediation of the association between vascular risk factors and depressive symptoms by c-reactive protein

Romankiewicz, L., Schaare, H. L., Nestler, S., Villringer, A., & Blöchl, M. (2023). Mediation of the association between vascular risk factors and depressive symptoms by c-reactive protein. Biological Psychiatry Global Open Science, 3(4), 642-650. doi:10.1016/j.bpsgos.2023.04.008.

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 Creators:
Romankiewicz, Lina1, Author
Schaare, Herma Lina2, 3, Author                 
Nestler, Steffen1, Author
Villringer, Arno4, 5, 6, Author                 
Blöchl, Maria1, 4, 7, Author                 
Affiliations:
1Department of Psychology, Münster University, Germany, ou_persistent22              
2Otto Hahn Group Cognitive Neurogenetics, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_3222264              
3Institute of Neuroscience and Medicine, Research Center Jülich, Germany, ou_persistent22              
4Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_634549              
5Clinic for Cognitive Neurology, University of Leipzig, Germany, ou_persistent22              
6Center for Stroke Research, Charité University Medicine Berlin, Germany, ou_persistent22              
7International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, MPI for Human Cognitive and Brain Sciences, Max Planck Society, Leipzig, DE, ou_2616696              

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Free keywords: Depression; Inflammation; Mediation; UK Biobank; Vascular depression; Vascular risk factors
 Abstract: Background
This study examined whether C-reactive protein (CRP), a marker of low-grade systemic inflammation, mediates the association between VRF burden and depressive symptoms.

Methods
We drew on the prospective design of the UK Biobank to include participants with longitudinal data on VRF burden, CRP, and depressive symptoms. Total, direct, and indirect effects were estimated using regression-based mediation models, while controlling for confounding by sociodemographic factors, baseline CRP, and baseline depression. Sensitivity analyses probed the robustness of results to unmeasured confounding.

Results
We analysed data from 10,470 participants from the UK Biobank (mean age = 56.75 years at baseline). Net of covariates, VRFs at baseline were associated with higher depressive symptoms at follow-up (total effect = 0.099, 95% CI [0.002; 0.163]). CRP mediated this association (indirect effect = 0.010, 95% CI [0.004; 0.017]), accounting for 10.0% (95% CI [0.3%; 30.0%]) of the total effect of VRF burden on depressive symptoms. Exploratory analyses suggested that the total and indirect effects pertained to somatic depressive symptoms (tiredness and appetite).

Conclusions
These results suggest that inflammation-promoting effects of VRFs might contribute to depressive symptoms in mid- and later life. However, the mediating pathway via CRP only explains a small part of the association between VRFs and depression after accounting for important covariates and might pertain to specific depressive symptoms. Future studies leveraging similar longitudinal designs are needed to further disentangle the time-varying effects between VRFs, inflammation, and certain depressive symptoms while addressing important confounders.

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Language(s): eng - English
 Dates: 2023-04-112023-01-132023-04-252023-05-192023-10
 Publication Status: Issued
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: -
 Identifiers: DOI: 10.1016/j.bpsgos.2023.04.008
Other: eCollection 2023
PMID: 37881535
PMC: PMC10593949
 Degree: -

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Title: Biological Psychiatry Global Open Science
Source Genre: Journal
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Publ. Info: Amsterdam : Elsevier
Pages: - Volume / Issue: 3 (4) Sequence Number: - Start / End Page: 642 - 650 Identifier: ISSN: 2667-1743
CoNE: https://pure.mpg.de/cone/journals/resource/2667-1743