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The associations of high levels of C-reactive protein with depression and myocardial infarction in 9258 women and men from the HUNT population study

Published online by Cambridge University Press:  06 May 2010

O. Bjerkeset ,
U. Romild ,
G. Davey Smith  and
K. Hveem
O. Bjerkeset*
Affiliation:
Department of Research and Development (RaD), Levanger Hospital, Health Trust Nord-Trøndelag, Norway Department of Neuroscience, Unit for Psychiatry and Behavioural Science, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
U. Romild
Affiliation:
Department of Research and Development (RaD), Levanger Hospital, Health Trust Nord-Trøndelag, Norway Swedish National Institute of Public Health, Östersund, Sweden
G. Davey Smith
Affiliation:
Department of Social Medicine, University of Bristol, UK
K. Hveem
Affiliation:
Department of Research and Development (RaD), Levanger Hospital, Health Trust Nord-Trøndelag, Norway Department of Public Health and General Practise, Norwegian University of Science and Technology, Trondheim, Norway
*
*Address for correspondence: Dr O. Bjerkeset, Department of Research and Development (RaD), Levanger Hospital, Kirkegt, 2, 7600 Levanger, Norway. (Email: [email protected])
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Abstract

Background

Elevated levels of circulating C-reactive protein (CRP) have been associated with coronary heart disease and, in some studies, depression. Most studies have been of populations selected by age and/or gender. We investigate these associations with depression, myocardial infarction (MI), or both, in a large general population sample.

Method

A cross-sectional population study of 9258 women and men aged ⩾20 years. The study included clinical examination, self-report of MI and depression and factors known to confound their associations. The Hospital Anxiety and Depression Scale was used to assess severity of depressive symptoms. Elevated high sensitive-CRP was defined as values >2.2 mg/l.

Results

The association of elevated CRP with depression was attenuated towards the null [from odds ratio (OR) 1.28, p=0.001 to OR 1.08, p=0.388] following extensive adjustment, while associations with MI (adjusted OR 1.42, p=0.032) and co-morbid MI and depression (adjusted OR 2.66, p=0.003) persisted. Confounders associated with elevated CRP levels were smoking (OR 1.66; p<0.001), chronic physical illness (OR 1.34, p<0.001), BMI ⩾30 (OR 1.13, p<0.001), employment (OR 0.70, p<0.001) and high coffee consumption (OR 0.83, p=0.017). Interaction tests indicated a lower effect of old age (OR 0.54, p<0.001) and smoking (OR 0.63, p<0.001) on elevated CRP levels in women compared with men.

Conclusions

CRP levels were raised in those with MI and co-morbid MI and depression; the positive association with depression was explained by confounding factors. We found new evidence that might help understand gender-specific patterns. Future studies should explore the neurobiological mechanisms underpinning these interrelations and their relevance for treatment of these conditions.

Keywords

AnxietyCRPdepressiongeneral populationinflammationMI
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 2 , February 2011 , pp. 345 - 352
Copyright
Copyright © Cambridge University Press 2010

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