Association Between Depression and Inflammation-Differences by Race and Sex

The META-Health Study

Abstract

Objective: 

To test whether the association between depression and inflammation differs by race and sex. Depressive symptoms have been associated with higher levels of C-reactive protein (CRP). However, few studies have examined this association in samples including a significant number of African Americans, or examined whether the association differs by race and sex.

Methods: 

Depressive symptoms and CRP were assessed in 512 African American and white participants, age 30 to 65 years, as part of the community-based Morehouse and Emory Team up to Eliminate Health Disparities (META-Health) Study. Depression was determined by responses to the Beck Depression Inventory II (BDI-II). Multivariable linear regression models were used to adjust for demographic and metabolic risk factors.

Results: 

African American men had higher total BDI-II scores than white men (p =.03), whereas there was no difference in women. There was a significant race-sex-depression interaction in predicting CRP levels (p =.02). White women with mild to severe depressive symptoms had higher levels of CRP compared with those with minimal to no depressive symptoms (p <.05). There were no differences in levels of CRP by severity of depressive symptoms in white men or African Americans of either sex. Higher BDI-II scores were related to higher CRP levels in white women after adjusting for age and level of education (β = 0.227, p =.006). However, the association was eliminated after further adjustment for metabolic risk factors (β = 0.077, p =.35).

Conclusions: 

Although depressive symptoms are associated with inflammation, the association varies by race and sex.

CVD = cardiovascular disease;

BDI-II = Beck Depression Inventory II;

CRP = C-reactive protein;

BMI = body mass index;

HDL-C = high-density lipoprotein cholesterol