Sustained low-grade pro-inflammatory state in unmedicated, remitted women with major depressive disorder as evidenced by elevated serum levels of the acute phase proteins C-reactive protein and serum amyloid A.
BACKGROUND
Major depressive disorder (MDD) shows increased coronary artery disease (CAD) risk of unknown mechanism(s). MDD is more common in women than men; CAD diagnosis can be difficult in women. Elevations of the inflammatory markers C-reactive protein (CRP) and serum amyloid A (SAA) predict increased CAD risk in populations; few data on these markers exist in MDD, particularly in remitted patients.


METHODS
We measured fasting am serum CRP (high sensitivity, CRP(hs)) and SAA in 18 unmedicated, remitted women with MDD (mean age 41 +/- (SD)12, body mass index (BMI) 25.2 +/- 4.1 kg/m(2)) and 18 BMI-matched healthy control subjects (age 36 +/- 10, BMI 25.3 +/- 3.8 kg/m(2)) on 2 separate occasions, > or = 6 days apart.


RESULTS
Repeat SAA and CRP(hs) measurements strongly correlated across study days (SAA: r = .83, p < .001; CRP(hs): r = .94, p < .001). Both SAA (5.30 +/- 3.39 vs. 2.84 +/- 1.87 mg/L, p < .005) and CRP(hs) (3.23 +/- 3.17 vs. 1.12 +/- 1.45 mg/L; p < .01) were significantly elevated in MDD women versus controls.


CONCLUSIONS
Elevated SAA and CRP(hs) in remitted, unmedicated women with MDD indicate a pro-inflammatory state unrelated to current depressive symptoms or pharmacotherapy. These findings suggest that inflammatory mechanisms may in part underlie findings of increased CAD risk in MDD.
Kling
Mitchel A
MA
Clinical Neuroendocrinology Branch, Division of Intramural Research Programs, National Institute of Mental Health, Bethesda, MD 20892-1284, USA. klingm@mail.nih.gov
Alesci
Salvatore
S
Csako
Gyorgy
G
Costello
Rene
R
Luckenbaugh
David A
DA
Bonne
Omer
O
Duncko
Roman
R
Drevets
Wayne C
WC
Manji
Husseini K
HK
Charney
Dennis S
DS
Gold
Philip W
PW
Neumeister
Alexander
A
D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood / Q000523:psychology; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D016555:Matched-Pair Analysis; D008875:Middle Aged; D012016:Reference Values; D012307:Risk Factors; D000685:Serum Amyloid A Protein / Q000032:analysis*; D018709:Statistics, Nonparametric
D015415:Biomarkers; D018836:Inflammation Mediators; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein