title: Are there bi-directional associations between depressive symptoms and C-reactive protein in mid-life women?
abstract: OBJECTIVE
  To test whether depressive symptoms are related to subsequent C-reactive protein (CRP) levels and/or whether CRP levels are related to subsequent depressive symptoms in mid-life women.
  
  
  METHODS
  Women enrolled in the Study of Women's Health Across the Nation (SWAN) were followed for 7years and had measures of CES-Depression scores and CRP seven times during the follow-up period. Women were pre- or early peri-menopausal at study entry and were of Caucasian, African American, Hispanic, Japanese, or Chinese race/ethnicity. Analyses were restricted to initially healthy women.
  
  
  RESULTS
  Longitudinal mixed linear regression models adjusting for age, race, site, time between exams, and outcome variable at year X showed that higher CES-D scores predicted higher subsequent CRP levels and vice versa over a 7-year period. Full multivariate models adjusting for body mass index, physical activity, medications, health conditions, and other covariates showed that higher CRP levels at year X predicted higher CES-D scores at year X+1, p=0.03. Higher depressive symptoms predicted higher subsequent CRP levels at marginally significant levels, p=0.10.
  
  
  CONCLUSIONS
  Higher CRP levels led to higher subsequent depressive symptoms, albeit the effect was small. The study demonstrates the importance of considering bi-directional relationships for depression and other psychosocial factors and risk for heart disease.
authors.affiliation: University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. matthewska@upmc.edu
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
authors.forename: Laura L
authors.initials: LL
authors.lastname: Schott
authors.forename: Joyce T
authors.initials: JT
authors.lastname: Bromberger
authors.forename: Jill M
authors.initials: JM
authors.lastname: Cyranowski
authors.forename: Susan A
authors.initials: SA
authors.lastname: Everson-Rose
authors.forename: MaryFran
authors.initials: M
authors.lastname: Sowers
mesh_terms: D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D003863:Depression / Q000453:epidemiology / Q000378:metabolism*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism; D014481:United States / Q000453:epidemiology
chemical_list: D002097:C-Reactive Protein
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