title: Raised CRP levels in obese patients: symptoms of depression have an independent positive association.
abstract: BACKGROUND
  Depression and obesity, the two common ailments of modern society, are associated with increased risk of coronary artery disease and raised C-reactive protein (CRP) levels. Are the effects of depression and obesity related or do they influence CRP levels independently?
  
  
  OBJECTIVE
  In 493 consecutive patients presenting for obesity surgery, we explored the relationship between symptoms of depression and raised CRP levels after controlling for confounding factors.
  
  
  METHODS
  Depression was measured using the Beck Depression Inventory (BDI). Confounding variables were age, gender, BMI, waist and hip measures, smoking and alcohol habits, medications, biochemical measures of the metabolic syndrome, and indirect measures of insulin resistance. General linear regression sought variables independently associated with CRP levels.
  
  
  RESULTS
  These patients had a BMI range from 31 to 91 kg/m2, participants age ranged from 14 to 71 years, and 76% were women. The median CRP concentration was 7.7mg/l (interquartile range: 3.9-14), 40% had an abnormally raised concentration (> 10mg/l). The mean BDI score was 17.0 +/- 9.0, indicating symptoms of moderate depression. We found five independent factors associated with raised CRP levels. In order of strength of association, these were: higher BMI (beta = 0.36, P < 0.001), female gender (beta = -0.19, P < 0.001), estrogen therapy (beta = 0.18, P < 0.001), higher BDI score (beta = 0.11, P = 0.01), and insulin resistance index (beta = 0.11, P = 0.01), and with a combined R2 = 0.24, (P < 0.001).
  
  
  CONCLUSIONS
  In obese patients, symptoms of depression were associated with raised CRP levels after controlling for confounding variables. Obese women on estrogen therapy are at risk of high CRP levels.
authors.affiliation: Centre for Obesity Research and Education, Monash University, Alfred Hospital, Melbourne, Victoria, Australia. john.dixon@med.monash.edu.au
authors.forename: John B
authors.initials: JB
authors.lastname: Dixon
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Hayden
authors.forename: Gavin W
authors.initials: GW
authors.lastname: Lambert
authors.forename: Tye
authors.initials: T
authors.lastname: Dawood
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Anderson
authors.forename: Maureen E
authors.initials: ME
authors.lastname: Dixon
authors.forename: Paul E
authors.initials: PE
authors.lastname: O'Brien
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D003863:Depression / Q000097:blood* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000523:psychology; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein