Rational Pharmacotherapy in Cardiology

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Aim. To study the association of depression with a high-sensitivity C-reactive protein (hsCRP) level, taking into account the main risk factors and noncommunicable diseases in Russia residents.
Material and methods. The data of ESSE-RF multicenter study (a representative sample of the unorganized male and female population aged 25-64 years from 8 regions surveyed in 2012-2014) were used in the work. A total 11884 people were involved into the study including 35.9% men. The examination included a survey on the standard questionnaire containing data on disease history, etc. The level of depression was assessed by the validated in Russian Hospital Anxiety and Depression Scale (HADS, 1983). hsCRP level was determined in all patients.
Results. The continuing association between elevated levels of depression (HADS-D ≥8+) and high level of hsCRP ≥3.0 mg/l (odds ratio [OR] 1.15; 95% confidence interval [CI] 1.03-1.27; p=0.009) was found in the multivariate model, after adjustment for sex, age, education, and risk factors. Reducing of the relationship of elevated levels of depression with a high level of hsCRP (OR 1.11; 95% CI 1.00-1.24; p=0.048) was found with the additional introduction of diseases in the model. This relationship was reduced to not statistically significant level (OR 1.08; 95% CI 0.98-1.20; p=0.134) in the full model adjusted for regions.
Conclusion. The reduced association of depression with hsCRP ajusted for aggregate risk factors was found in the study. This suggests about multifactor affecting on this relationship.

About the Authors

S. E. Evstifeeva
State Research Center for Preventive Medicine, Moscow
Russian Federation

S. A. Shalnova
State Research Center for Preventive Medicine, Moscow
Russian Federation

A. D. Deev
State Research Center for Preventive Medicine, Moscow
Russian Federation

V. A. Metelskaya
State Research Center for Preventive Medicine, Moscow
Russian Federation

G. V. Artamonova
Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo
Russian Federation

O. A. Belova
Ivanovo Municipal Cardiology Hospital, Ivanovo
Russian Federation

J. V. Zhernakova
Tyumen State Medical Academy, Tyumen
Russian Federation

A. Yu. Efanov
Russian Cardiology Research and Production Complex, Moscow
Russian Federation

A. O. Konradi
North-West Federal Almazov Medical Research Centre, St. Petersburg
Russian Federation

N. V. Kulakova
State Pacific Medical University, Vladivostok
Russian Federation

O. P. Rotar
North-West Federal Almazov Medical Research Centre, St. Petersburg
Russian Federation

G. V. Tolparov
North Ossetia State Medical Academy, Vladikavkaz
Russian Federation

I. A. Trubacheva
Research Institute for Cardiology, Siberian Branch of the Russian Academy of Medical Sciences, Tomsk
Russian Federation

A. A. Shabunova
Institute of Socio-Economic Development of Territories, Russia Academy of Ssiences, Vologda
Russian Federation

S. A. Boytsov
State Research Center for Preventive Medicine, Moscow
Russian Federation


1. Results from the Global Burden of Disease Study 2010 (GBD 2010). Available at: Checked by 07.04.2016

2. Baune BT. Inflammation and neurodegenerative disorders: is there still hope for therapeutic intervention? Curr Opin Psychiatry 2015;28(2):148-54.

3. Leonard B, Maes M. Mechanistic explanations how cell-mediated immune activation, inflammation and oxidative and nitrosative stress pathways and their sequels and concomitants play a role in the pathophysiology of unipolar depression. Neurosc Biobehav Rev 2012;36(2):764-85.

4. Bakunina N, Pariante CM, Zunszain PA. Immune mechanisms linked to depression via oxidative stress and neuroprogression. Immunology 2015. doi: 10.1111/imm.12443.

5. Berk M, Williams LJ, Jacka FN, et al. So depression is an inflammatory disease, but where does the inflammation come from? BMC Med 2013;11:200.

6. Kreisel T, Frank MG, Licht T, et al. Dynamic microglial alterations underlie stress-induced depressivelike behavior and suppressed neurogenesis. Molecular Psychiatry 2014;19(6):699-709.

7. Copeland WE, Shanahan l, Worthman C, Comulative Depression Episodes Predict Later C-reactive Protein Levels: A Prospective Analysis Biol Psychiatry 2012;71:15-21.

8. Setiawan E, Wilson AA, Mizrahi R, et al. Role of Translocator Protein Density, a Marker of Neuroinflammation, in the Brain During Major Depressive Episodes. JAMA Psychiatry 2015; 72(3):268-75.

9. Kreisel T, Frank MG, Licht T, et al. Dynamic microglial alterations underlie stress-induced depressivelike behavior and suppressed neurogenesis. Mol Psychiatry 2014; 19(6): 699-709.

10. Scientific and Organizing Committee of the Russian Federation essay. The epidemiology of cardiovascular disease in different regions of Russia (ESSE-RF). Rationale and design of the study. Profilakticheskaya Meditsina 2013;6:25-34. In Russian (Научно-организационный комитет проекта ЭССЕ-РФ. Эпидемиология сердечно-сосудистых заболеваний в различных регионах России (ЭССЕ-РФ). Обоснование и дизайн исследований. Профилактическая медицина 2013;6:25-34).

11. Andryushchenko AV, Drobizhev MD, Dobrovol'skiy AV. Sravnitel'naya ocenka shkal CES-D i HADS v diagnostike depressiy obshemedicinskoy praktiki. Zhurnal nevrologii i psikhiatrii im. Korsakova

12. ;5:11-8. In Russian (Андрюшенко А.В., Дробижев М.Ю., Добровольский А.В. Сравнительная оценка шкал CES-D, BDI и HADS(d) в диагностике депрессий в общемедицинской практике. Журнал неврологии и психиатрии 2003;5:11-7).

13. Pearson T, Mensah G, Alexander R, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003;107:499-511.

14. Howren MB, Lamkin DM, Suls J. Associations of Depression With C-Reactive Protein, IL-1, and IL-6: A Meta-Analysis. Psychosomatic 2009;71(2):171-86.

15. Elovainio M, Aalto AM, Kivimäki M, et al. Depression and C-reactive protein: population-based health 2000 study. Psychosomatic 2009;71(4):423-30.

16. Ford DE, Erlinger TP. Depression and C-reactive protein in US adults: data from the Third NationalHealth and Nutrition Examination Survey. Archives of Internal Medicine 2004;164(9):1010-14.

17. Hsu-Ko K, Chung-Jen Y, Chia-Hsuin C, et al. Relation of C-reactive protein to stroke, cognitive disorders, and depression in the general population: systematic review and meta-analysis. Lancet Neurol 2005;4(6):371-80.

18. Haapakoski R., Mathieu J., Ebmeier KP. Cumulative meta-analysis of interleukins 6 and 1β, tumour necrosis factor α and C-reactive protein in patients with major depressive disorder. Brain Behavior and Immunity 2015; 49: 206-15.

19. Ma Y, Chiriboga DE, Sherry L, Association between Depression and C-Reactive Protein. Cardiol Res Pract 2010;2011:286509.

20. Raison CL, Capuron L, Miller AH. Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends in Immunology 2006;27(1):24-31.

21. Dinan T. Inflammatory markers in depression. Current Opinion in Psychiatry 2009; 22(1):32-6.

22. Miller AH, Maletic V, Raison C. Inflammation and Its Discontents: The Role of Cytokines in the Pathophysiology of Major Depression. Biological Psychiatry 2009;65(9):732-41.

23. Duivis HE, Vogelzangs N, Kupper N, et al. Differential association of somatic and cognitive symptoms of depression and anxiety with inflammation: Findings from the Netherlands Study of Depression and Anxiety (NESDA). Psychoneuroendocrinology 2013;38:1573-85.

24. Shal'nova SA, Evstifeeva SE, Deev AD, The prevalence of anxiety and depression in different regions of the Russian Federation and its association with sociodemographic factors (according to the data of the ESSE-RF study). Terapevticheskij arkhiv 2014;12:52-9. In Russian (Шальнова С.А., Евстифеева С.Е., Деев А.Д. и др. Распространенность тревоги и депрессии в различных регионах Российской Федерации и ее ассоциации с социально-демографическими факторами (по данным исследования ЭССЕ-РФ). Терапевтический архив 2014;12:52-9).

25. Evstifeeva SE, Shal'nova SA, Deev AD, The prevalence of elevated levels of C-reactive protein and its association with traditional risk factors and morbidity among residents of the Russian Federation (according to the ESSE-RF study). Rational Pharmacotherapy in Cardiology 2014;10(6):597-605. In Russian (Евстифеева С.Е., Шальнова С.А., Деев А.Д. и др. Распространенность повышенного уровня С-реактивного белка и его ассоциации с традиционными факторами риска и заболеваемостью у жителей Российской Федерации (по данным исследования ЭССЕ-РФ). Рациональная Фармакотерапия в Кардиологии 2014;10(6):597-605.

26. Academic highlights of the primary care companion. Translating evidence of depression and physical symptoms into effective clinical practice. J Clin Psychiatry 2007;9(4):295-302.

27. Zeltyn AE, Fofanova YuS, LisitsinaTA, Chronic stress and depression in patients with rheumatoid arthritis Hronicheskij stress i depressija u bol'nyh revmatoidnym artritom. Social'naja i klinicheskaja psihiatrija 2009;19:2:69-75. In Russian (Зелтынь А.Е.., Фофанова Ю.С., Лисицына Т.А. и др. Хронический стресс и депрессия у больных ревматоидным артритом. Социальная и клиническая психиатрия 2009;19:2:69-75).

28. Empana JP, Sykes DH, Luc G, Contributions of depressive mood and circulating inflammatory markers to coronary heart disease in healthy European men: The Prospective Epidemiological Study of Myocardial Infarction (PRIME). Circulation 2005;111:2299-305.


For citations:

Evstifeeva S.E., Shalnova S.A., Deev A.D., Metelskaya V.A., Artamonova G.V., Belova O.A., Zhernakova J.V., Efanov A.Yu., Konradi A.O., Kulakova N.V., Rotar O.P., Tolparov G.V., Trubacheva I.A., Shabunova A.A., Boytsov S.A. THE ASSOCIATION OF DEPRESSION WITH C-REACTIVE PROTEIN (THE DATA OF ESSE-RF EPIDEMIOLOGICAL STUDY). Rational Pharmacotherapy in Cardiology. 2016;12(2):129-137. (In Russ.)

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