Endothelial dysfunction is associated with a greater depressive symptom score in a general elderly population: the Hoorn Study

BackgroundEndothelial dysfunction (ED), low-grade inflammation (LGI) and oxidative stress (OxS) may be involved in the pathobiology of depression. Previous studies on the association of these processes in depression have yielded contradictory results. We therefore investigated comprehensively, in a population-based cohort study, the association between ED, LGI and OxS on the one hand and depressive symptoms on the other.MethodWe used data from the Hoorn Study and determined biomarkers of ED [flow-mediated dilatation (FMD), von Willebrand factor, soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1, soluble thrombomodulin and soluble endothelial selectin], LGI [C-reactive protein, tumour necrosis factor-α, interleukin 6, interleukin 8, serum amyloid A, myeloperoxidase (MPO) and sICAM-1] and OxS (oxidized low density lipoprotein and MPO). Depressive symptoms were quantified by the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire (n = 493; age 68 years; 49.9% female). Regression analyses were performed with the use of biomarker Z scores. Adjustments were made for age, sex and glucose metabolism status (cohort stratification variables) and prior cardiovascular disease, hypertension, waist-to-hip ratio, cholesterol levels, education level, physical activity, dietary habits, and the use of antihypertensive and/or lipid-lowering medication and/or metformin (potential confounders).ResultsAfter adjustment for age, sex and glucose metabolism status, one standard deviation increase in the ED Z score was associated with a 1.9 [95% confidence interval (CI) 0.7–3.1] higher CES-D score. Additional adjustments did not materially change this result. LGI and OxS were not associated with the CES-D score.ConclusionsED, as quantified by an array of circulating biomarkers and FMD, was independently associated with depressive symptoms. This study supports the hypothesis that ED plays an important role in the pathobiology of depression.

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Association of Markers of Microvascular Dysfunction With Prevalent and Incident Depressive Symptoms

Hypertension ◽

10.1161/hypertensionaha.120.15260 ◽

2020 ◽

Vol 76 (2) ◽

pp. 342-349 ◽

Cited By ~ 2

Author(s):

Anouk F.J. Geraets ◽

Marnix J.M. van Agtmaal ◽

Coen D.A. Stehouwer ◽

Ben M. Sörensen ◽

Tos T.J.M. Berendschot ◽

...

Keyword(s):

Depressive Symptoms ◽

Endothelial Dysfunction ◽

Adhesion Molecule ◽

Cox Regression ◽

Microvascular Dysfunction ◽

Intercellular Adhesion Molecule ◽

Study Cohort ◽

Late Life Depression ◽

Doppler Flowmetry ◽

Plasma Markers

The etiology of late-life depression (LLD) is still poorly understood. Microvascular dysfunction (MVD) has been suggested to play a role in the etiology of LLD, but direct evidence of this association is scarce. The aim of this study was to investigate whether direct and indirect markers of early microvascular dysfunction are associated with prevalent and incident LLD in the population-based Maastricht Study cohort. We measured microvascular dysfunction at baseline by use of flicker light-induced retinal vessel dilation response (Dynamic Vessel Analyzer), heat-induced skin hyperemic response (laser- Doppler flowmetry), and plasma markers of endothelial dysfunction (endothelial dysfunction; sICAM-1 [soluble intercellular adhesion molecule-1], sVCAM-1 [soluble vascular adhesion molecule-1], sE-selectin [soluble E-selectin], and vWF [Von Willebrand Factor]). Depressive symptoms were assessed with the 9-item Patient Health Questionnaire (PHQ-9) at baseline and annually over 4 years of follow-up (n=3029; mean age 59.6±8.2 years, 49.5% were women, n=132 and n=251 with prevalent and incident depressive symptoms [PHQ-9≥10]). We used logistic, negative binominal and Cox regression analyses, and adjusted for demographic, cardiovascular, and lifestyle factors. Retinal venular dilatation and plasma markers of endothelial dysfunction were associated with the more prevalent depressive symptoms after full adjustment (PHQ-9 score, RR, 1.05 [1.00–1.11] and RR 1.06 [1.01–1.11], respectively). Retinal venular dilatation was also associated with prevalent depressive symptoms (PHQ-9≥10; odds ratio, 1.42 [1.09–1.84]), after full adjustment. Retinal arteriolar dilatation and plasma markers of endothelial dysfunction were associated with incident depressive symptoms (PHQ-9≥10; HR, 1.23 [1.04–1.46] and HR, 1.19 [1.05–1.35]), after full adjustment. These findings support the concept that microvascular dysfunction in the retina, and plasma markers of endothelial dysfunction is involved in the etiology of LLD and might help in finding additional targets for the prevention and treatment of LLD.

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DEPRESSIVE SYMPTOMATOLOGY AMONG IN-SCHOOL ADOLESCENTS WITH IMPAIRED HEARING

Humanities & Social Sciences Reviews ◽

10.18510/hssr.2020.82103 ◽

2020 ◽

Vol 8 (2) ◽

pp. 931-940

Author(s):

Olufemi Timothy Adigun

Keyword(s):

Depressive Symptoms ◽

Psychosocial Development ◽

Depressive Symptomatology ◽

Survey Design ◽

Depression Scale ◽

Study Data ◽

Family Type ◽

Low Grade ◽

Impaired Hearing ◽

Significant Difference

Purpose of the study: This study determined incidences of depressive symptoms and associated causative contextual factors among in-school adolescents with impaired hearing in South West, Nigeria. The study determined symptoms of depression exhibited by in-school adolescents with impaired hearing vis-à-vis some associated intrapersonal causative (age, religion, gender, the onset of hearing loss, satisfaction with the home environment, and family type) variables. Methodology: Descriptive survey design was adopted for the study. Data were collected from 236 adolescents who are either prelingually (39.1%) and postlingually (60.9%) hearing impaired with the Depressive Symptomatology Questionnaire (α = .89). Data collected over a period of 10 weeks were analysed with both descriptive and inferential statistics via SPSS version 23. Main Findings: 58.8% of the participants scored higher on the depression scale, which is mostly characterized by loss of appetite and fearfulness. There is a significant difference (F = 7.61; p < 0.05) in the expression of depressive symptoms between gender and across variants in the onset of deafness (F = 3.59; p < 0.05) and family type (F = 23.14; p < 0.05). Academic stressor and lack of access to information were found to be the major source of their depression. Applications of this study: This study is of importance to counselling psychologist and mental health practitioners for the development of strategic therapeutic approach geared towards positive psychosocial development of individuals with impaired hearing Novelty/Originality of this study: The study confirms the manifestation of moderate to a high level of depressive symptoms among those in-school adolescents with impaired hearing. Academic anxiety/low grade, communication difficulties, and negative societal attitude were the major source of depression for adolescents with impaired hearing in high schools.

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Dietary proteins improve endothelial function under fasting conditions but not in the postprandial state, with no effects on markers of low-grade inflammation

British Journal Of Nutrition ◽

10.1017/s0007114515003530 ◽

2015 ◽

Vol 114 (11) ◽

pp. 1819-1828 ◽

Cited By ~ 7

Author(s):

Karianna F. M. Teunissen-Beekman ◽

Janneke Dopheide ◽

Johanna M. Geleijnse ◽

Stephan J. L. Bakker ◽

Elizabeth J. Brink ◽

...

Keyword(s):

Adhesion Molecule ◽

High Protein Diet ◽

Intercellular Adhesion Molecule ◽

Low Grade ◽

Dietary Proteins ◽

Intercellular Adhesion Molecule 1 ◽

Amyloid A ◽

Before And After ◽

Protein Milk ◽

Low Grade Inflammation

AbstractEndothelial dysfunction (ED) and low-grade inflammation (LGI) have a role in the development of CVD. The two studies reported here explored the effects of dietary proteins and carbohydrates on markers of ED and LGI in overweight/obese individuals with untreated elevated blood pressure. In the first study, fifty-two participants consumed a protein mix or maltodextrin (3×20 g/d) for 4 weeks. Fasting levels and 12 h postprandial responses of markers of ED (soluble intercellular adhesion molecule 1 (sICAM), soluble vascular cell adhesion molecule 1 (sVCAM), soluble endothelial selectin and von Willebrand factor) and markers of LGI (serum amyloid A, C-reactive protein and sICAM) were evaluated before and after intervention. Biomarkers were also combined into mean Z-scores of ED and LGI. The second study compared 4 h postprandial responses of ED and LGI markers in forty-eight participants after ingestion of 0·6 g/kg pea protein, milk protein and egg-white protein. In addition, postprandial responses after maltodextrin intake were compared with a protein mix and sucrose. The first study showed significantly lower fasting ED Z-scores and sICAM after 4 weeks on the high-protein diet (P≤0·02). The postprandial studies found no clear differences of ED and LGI between test meals. However, postprandial sVCAM decreased more after the protein mix compared with maltodextrin in both studies (P≤0·04). In conclusion, dietary protein is beneficial for fasting ED, but not for fasting LGI, after 4 weeks of supplementation. On the basis of Z-scores, postprandial ED and LGI were not differentially affected by protein sources or carbohydrates.

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Low-grade inflammation and endothelial dysfunction predict four-year risk and course of depressive symptoms: the Maastricht Study

Brain Behavior and Immunity ◽

10.1016/j.bbi.2021.06.013 ◽

2021 ◽

Author(s):

Eveline P.C.J. Janssen ◽

Sebastian Köhler ◽

Anouk F.J. Geraets ◽

Coen D.A. Stehouwer ◽

Nicolaas C. Schaper ◽

...

Keyword(s):

Depressive Symptoms ◽

Endothelial Dysfunction ◽

Low Grade ◽

Low Grade Inflammation

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Association of Prenatal Alcohol Exposure and Prenatal Maternal Depression with Offspring Low-Grade Inflammation in Early Adolescence

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157920 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7920

Author(s):

Janina Maschke ◽

Jakob Roetner ◽

Sophia Bösl ◽

Anne-Christine Plank ◽

Nicolas Rohleder ◽

...

Keyword(s):

Depressive Symptoms ◽

Maternal Depression ◽

Systemic Inflammation ◽

Prenatal Alcohol Exposure ◽

Depression Scale ◽

Alcohol Exposure ◽

Self Report ◽

Low Grade ◽

Inflammatory Status ◽

Prenatal Alcohol

(1) This longitudinal study aimed to investigate the link between prenatal alcohol exposure and prenatal maternal depression with the offspring’s low-grade inflammatory status. (2) Prenatal alcohol exposure was determined via maternal self-report during the 3rd trimester of pregnancy (self-report+: n = 29) and the meconium alcohol metabolite Ethyl Glucuronide (EtG), collected at birth (≥30 ng/g: n = 23). The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for prenatal maternal depressive symptoms during the 3rd trimester (≥10: n = 35). Fifteen years later, 122 adolescents (M = 13.32 years; 48.4% female) provided blood samples for the analysis of high sensitivity C-reactive protein (hsCRP; M = 0.91; SD = 1.28). (3) Higher hsCRP levels were found in EtG positive adolescents (p = 0.036, ηp2 = 0.04) and an inverse non-significant dose–response relation with hsCRP (r = −0.35, p = 0.113). For maternal self-reported prenatal alcohol consumption (p = 0.780, ηp2 = 0.00) and prenatal depressive symptoms (p = 0.360, ηp2 = 0.01) no differences for hsCRP levels between the affected and unaffected groups were found. (4) Adolescents with prenatal alcohol exposure are at risk for low-grade systemic inflammation. The EtG biomarker may be more accurate compared to self-reports. The findings suggest that prenatal maternal depression does not evoke low-grade systemic inflammation.

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The Inflammatory Potential of the Diet Is Associated with Depressive Symptoms in Different Subgroups of the General Population

Journal of Nutrition ◽

10.3945/jn.116.245167 ◽

2017 ◽

Vol 147 (5) ◽

pp. 879-887 ◽

Cited By ~ 24

Author(s):

Moufidath Adjibade ◽

Valentina A Andreeva ◽

Cédric Lemogne ◽

Mathilde Touvier ◽

Nitin Shivappa ◽

...

Keyword(s):

Depressive Symptoms ◽

Smoking Status ◽

Depression Scale ◽

Positive Association ◽

Continuous Variable ◽

Epidemiologic Studies ◽

Low Grade ◽

Physically Active ◽

Logistic Regression Models ◽

Inflammatory Index

AbstractBackground: Low-grade chronic inflammation, which can be modulated by diet, has been suggested as an important risk factor for depression, but few studies have investigated the association between the inflammatory potential of the diet and depression.Objective: We investigated the prospective association between the inflammatory potential of the diet, measured by the Dietary Inflammatory Index (DII), and incident depressive symptoms and tested the potential modulating effect of sex, age, physical activity, and smoking status.Methods: This study included 3523 participants (aged 35–60 y) from the SU.VI.MAX (Supplémentation en Vitamines et Minéraux Antioxydants) cohort, who were initially free of depressive symptoms. Baseline DII (1994–1996) was computed by using repeated 24-h dietary records. Incident depressive symptoms were defined by a Center for Epidemiologic Studies–Depression Scale score ≥17 for men and ≥23 for women in 2007–2009. We used multivariable logistic regression models to estimate ORs and 95% CIs, and modeled the DII as a continuous variable and as sex-specific quartiles.Results: A total of 172 cases of incident depressive symptoms were identified over a mean follow-up of 12.6 y. The DII was not associated with incident depressive symptoms in the full sample. In sex-specific models, men with a higher DII had a higher risk of incident depressive symptoms (quartile 4 compared with quartile 1—OR: 2.32; 95% CI: 1.01, 5.35), but the association was only marginally significant (P-trend = 0.06). When analyses were performed across smoking status, current and former smokers with a higher DII had a higher risk of incident depressive symptoms (quartile 4 compared with quartile 1—OR: 2.21; 95% CI: 1.08, 4.52). A positive association was also observed among less physically active participants (quartile 4 compared with quartile 1—OR: 2.07; 95% CI: 1.05, 4.07).Conclusion: The promotion of a healthy diet with anti-inflammatory properties may help to prevent depressive symptoms, particularly among men, smokers, or physically inactive individuals. This trial was registered at clinicaltrials.gov as NCT0027242.

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Effect of a plant sterol-enriched spread on biomarkers of endothelial dysfunction and low-grade inflammation in hypercholesterolaemic subjects

Journal of Nutritional Science ◽

10.1017/jns.2016.40 ◽

2016 ◽

Vol 5 ◽

Cited By ~ 6

Author(s):

R. T. Ras ◽

D. Fuchs ◽

W. P. Koppenol ◽

C. G. Schalkwijk ◽

A. Otten-Hofman ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Vascular Function ◽

Detection System ◽

Intercellular Adhesion Molecule ◽

Low Grade ◽

Double Blind ◽

Men And Women ◽

Amyloid A ◽

Low Grade Inflammation ◽

Regular Intake

AbstractPlant sterols (PS) lower LDL-cholesterol, an established risk factor for CHD. Endothelial dysfunction and low-grade inflammation are two important features in the development of atherosclerosis. Whether PS affect biomarkers of endothelial function and low-grade inflammation is not well studied. The aim of the present study was to investigate the effect of regular intake of PS on biomarkers of endothelial dysfunction and low-grade inflammation. In a double-blind, randomised, placebo-controlled, parallel-group study, which was primarily designed to investigate the effect of PS intake on vascular function (clinicaltrials.gov: NCT01803178), 240 hypercholesterolaemic but otherwise healthy men and women consumed a low-fat spread with added PS (3 g/d) or a placebo spread for 12 weeks. Endothelial dysfunction biomarkers (both vascular and intracellular adhesion molecules 1 and soluble endothelial-selectin) and low-grade inflammation biomarkers (C-reactive protein, serum amyloid A, IL-6, IL-8, TNF-α and soluble intercellular adhesion molecule-1) were measured using a multi-array detection system based on electrochemiluminescence technology. Biomarkers were combined using z-scores. Differences in changes from baseline between the PS and the placebo groups were assessed. The intake of PS did not significantly change the individual biomarkers of endothelial dysfunction and low-grade inflammation. The z-scores for endothelial dysfunction (−0·02; 95 % CI −0·15, 0·11) and low-grade inflammation (−0·04; 95 % CI −0·16, 0·07) were also not significantly changed after PS intake compared with placebo. In conclusion, biomarkers of endothelial dysfunction and low-grade inflammation were not affected by regular intake of 3 g/d PS for 12 weeks in hypercholesterolaemic men and women.

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Depression and Endothelial Dysfunction in Psoriatic Arthritis: Is There Any Possible Relationship?

Frontiers in Medicine ◽

10.3389/fmed.2021.669397 ◽

2021 ◽

Vol 8 ◽

Author(s):

Enrico De Lorenzis ◽

Angela Di Giorgio ◽

Gerlando Natalello ◽

Antonio Nesci ◽

Giacomo Tanti ◽

...

Keyword(s):

Depressive Symptoms ◽

Psoriatic Arthritis ◽

Endothelial Dysfunction ◽

Cardiovascular Events ◽

Depression Scale ◽

Serum Cytokines ◽

Exposure Response ◽

Framingham Risk ◽

Tnf Α ◽

Flow Mediated Dilatation

Background: Cardiovascular events (CVEs) are the first cause of death in patients with psoriatic arthritis (PsA). Depression is a recognized risk factor in cardiovascular events and is frequently associated with PsA. Flow-mediated dilatation (FMD) is a widely used method for assessing endothelial dysfunction, a parameter with strong prognostic implications for CVEs. The study aims to explore the relationship between FMD, depressive symptoms and serum cytokines in a cohort of patients with PsA.Patients and Methods: FMD was assessed in 50 consecutive PsA patients aged between 30 and 75 years without known cerebrovascular and coronary heart disease or diabetes. Depressive symptoms were reported using the related subscale of the Hospital Anxiety and Depression Scale (HDS). Disease features, activity indexes, and adjusted Framingham risk score (aFRS) were calculated. Serum level of IL-6, TNF-α, and IL-17A were also assessed.Results: In PsA patients (age 50.7 ± 10.2 years, male 42%, disease duration 5.9 ± 3.3 years, Disease Activity in PSoriatic Arthritis (DAPSA) score 14.0 ± 9.4) FMD inversely correlated with the severity of depressive symptoms according to HDS (ρ = −0.339, p = 0.016), age (ρ = −0.507, p = 0.001), aFRS (rs = −0.453, p < 0.001), duration of PsA (ρ = −0.507, p = 0.001), intensity of pain (ρ = −0.507, p = 0.001), and DAPSA (ρ = −0.507, p = 0.001). No statistically significant correlation was found between FMD or HDS and serum cytokines concentrations. HDS predicted FMD in a model adjusted for age, aFRS, PsA duration, and pain intensity (β = −0.271, p = 0.008), with depressive symptoms contributing directly to 6.4% of the variance.Conclusions: Depressive symptoms correlate with endothelial dysfunction with an exposure-response pattern in our cohort of PsA patients.

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Low-grade inflammation differentiates between symptoms of apathy and depression in community-dwelling older individuals

International Psychogeriatrics ◽

10.1017/s1041610214002683 ◽

2014 ◽

Vol 27 (4) ◽

pp. 639-647 ◽

Cited By ~ 16

Author(s):

Lisa S. M. Eurelings ◽

Edo Richard ◽

Piet Eikelenboom ◽

Willem A. van Gool ◽

Eric P. Moll van Charante

Keyword(s):

Depressive Symptoms ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Population Based ◽

Community Dwelling ◽

Low Grade ◽

Older Individuals ◽

Cross Sectional ◽

Low Grade Inflammation

ABSTRACTBackground:Systemic low-grade inflammation has repeatedly been associated with depression in old age, but the relationship with apathy is less clear. The present study assessed whether C-reactive protein (CRP) is differentially associated with symptoms of apathy and depression.Methods:A population-based cohort study was carried-out. At baseline and after two and four years of follow-up, CRP levels were assessed and symptoms of apathy and depression were measured using the 15-item Geriatric Depression Scale. Logistic regression analysis was used to investigate the cross-sectional and longitudinal associations of CRP with symptoms of apathy and depression.Results:Two thousand forty-seven community-dwelling participants (70–78 years) without a history of cardiovascular disease or stroke were studied. A cross-sectional association was found between CRP and apathy symptoms at three time points (odds ratio (OR) per natural log unit increase in CRP: baseline visit = 1.40, 95% CI = 1.12–1.75; two-year follow-up visit = 1.62, 95% CI = 1.17–2.25; four-year follow-up visit = 1.51, 95% CI = 1.03–2.21). This did not change after adjustment for demographics and depressive symptoms, and was slightly attenuated after adjustment for cardiovascular risk factors. No cross-sectional association was found with depressive symptoms. Baseline CRP did not predict incident apathy or depressive symptoms during four years of follow-up.Conclusions:Increased CRP levels are associated with apathy symptoms but not with depressive symptoms. This suggests a differential effect of inflammation on apathy and depression. In older persons, symptoms of apathy may be a behavioral manifestation of concurrent low-grade inflammation.

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The Inflammatory Potential of the Diet is Directly Associated with Incident Depressive Symptoms Among French Adults

Journal of Nutrition ◽

10.1093/jn/nxz045 ◽

2019 ◽

Vol 149 (7) ◽

pp. 1198-1207 ◽

Cited By ~ 3

Author(s):

Moufidath Adjibade ◽

Cédric Lemogne ◽

Mathilde Touvier ◽

Serge Hercberg ◽

Pilar Galan ◽

...

Keyword(s):

Depressive Symptoms ◽

Proportional Hazards ◽

Middle Age ◽

Scientific Evidence ◽

Depression Scale ◽

Cox Proportional Hazards ◽

Low Grade ◽

Wide Range ◽

Incident Cases

ABSTRACTBackgroundLow-grade chronic inflammation has been suggested to play a substantial role in the etiology of depression; however, studies on the prospective association between the inflammatory potential of the diet and depression are limited.ObjectiveThe aim of this study was to investigate the association between the inflammatory potential of the diet (measured using the Alternate Dietary Inflammatory Index, ADII) and incident depressive symptoms. We also tested the potential modulating effect of sex, age, BMI, and lifestyle indicators.MethodsThe study sample consisted of 26,730 participants (aged 18–86 y) from the NutriNet-Santé study. Baseline ADII was computed using repeated 24-h dietary records collected during the first 2 y of the follow-up. Incident cases of depressive symptoms were defined by a Center for Epidemiologic Studies Depression scale ≥17 for men and ≥23 for women at least once during follow-up. HR and 95% CI were estimated using multivariable Cox proportional hazards models.ResultsA total of 2221 incident cases of depressive symptoms were identified over a mean follow-up of 5.4 y. After accounting for a wide range of potential confounders, the highest quartile of the ADII was associated with a 15% (95% CI: 2, 31) increase in the risk of depressive symptoms compared with the lowest quartile. In the stratified analyses, associations were statistically significant only among women (HRquartile4 vs. quartile1: 1.19; 95% CI: 1.02, 1.37), middle-age adults (HRquartile4 vs. quartile1: 1.16; 95% CI: 1.00, 1.35), and participants with a BMI ≥25 (HRquartile4 vs. quartile1: 1.29; 95% CI: 1.04, 1.60).ConclusionsOverall, a proinflammatory diet was associated with a higher risk of depressive symptoms, especially among women, middle-age adults, and participants with overweight or obesity. These findings contribute to the increasing scientific evidence showing a detrimental role of the proinflammatory diet. The NutriNet-Santé study is registered at clinicaltrials.gov as NCT03335644.

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