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Associations Between Depressive Symptoms and Inflammatory/Hemostatic Markers in Women During the Menopausal Transition

Matthews, Karen A. PhD; Schott, Laura L. MA; Bromberger, Joyce PhD; Cyranowski, Jill PhD; Everson-Rose, Susan A. PhD; Sowers, Mary Fran PhD

doi: 10.1097/01.psy.0000256574.30389.1b
Original Articles

Objective: To test whether depressive symptoms are related to inflammatory and hemostatic markers in women approaching menopause.

Methods: A total of 3292 women enrolled in the Study of Women's Health Across the Nation (SWAN) were followed for five years and had measures of Center for Epidemiologic Studies-Depression and high sensitivity C-reactive protein, Factor VIIc, fibrinogen, plasminogen activator inhibitor Type 1(PAI-1), and tissue-type plasminogen activator antigen (tPA-ag) up to four times during the follow-up period. Women were pre- or early perimenopausal status at study entry and were of Caucasian, African American, Hispanic, Japanese, or Chinese race/ethnicity.

Results: Unadjusted longitudinal mixed regression models showed that over a 5-year period, higher depressive symptoms were related to higher fibrinogen, PAI-1, and tPA-ag levels, all p < .0001. Taking into account health history, medication use, ethnicity, aging, and menopausal status, the depressive symptoms were related to fibrinogen, p < .01, and PAI-1, p < .05. Depressive symptoms were related only to fibrinogen in models that also included body mass index, p < .05.

Conclusions: Depressive symptoms may be associated with cardiovascular risk in perimenopausal women in part through hypercoagulability. This is the first study to test the association of depressive symptoms and hemostatic and inflammatory markers across time.

CHD = coronary heart disease; PAI-1 = plasminogen activator inhibitor Type 1; hs-CRP = high sensitivity C-reactive protein; BMI = body mass index; SWAN = Study of Women's Health Across the Nation; CES-D = Center for Epidemiologic Studies-Depression; tPA-ag = tissue-type plasminogen activator antigen; IL = interleukin.

From the Department of Psychiatry (K.A.M., J.B., J.C), the Department of Epidemiology (K.A.M., J.B., L.L.S.), and the Department of Psychology (K.A.M.), University of Pittsburgh, Pittsburgh, Pennsylvania; the Department of Preventive Medicine and Behavioral Sciences (S.A.E.-R.), Rush University Medical Center, Chicago, Illinois; and the Department of Epidemiology (M.F.S.), University of Michigan, Ann Arbor, Michigan.

Address correspondence and reprint requests to Karen A. Matthews, Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213. E-mail:

Received for publication May 3, 2006; revision received October 24, 2006.

The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), Department of Health and Human Services (DHHS), through the National Institute on Aging, the National Institute of Nursing Research and the NIH Office of Research on Women's Health (Grants NR004061; AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495).

Copyright © 2007 by American Psychosomatic Society
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