Effect of menopause and use of contraceptives/hormone therapy on association of C-reactive protein and depression: a population-based study.
OBJECTIVE
Unipolar depression has been found to associate with elevated C-reactive protein (CRP) levels in men, but findings among women have been conflicting. It has been hypothesized that this would be explained by a different hormonal environment (compared with men) and its changes throughout the lifecycle in women, but until now, the corresponding evidence has been lacking. We investigated the association between CRP levels and depressive symptoms in a population-based study in pre-, peri-, and postmenopausal women and, also, whether this association is affected by the use of exogenous hormones (contraceptives and postmenopausal hormone therapy).


METHODS
The entire age classes of those born in 1942, 1947, 1952, 1957, and 1962 and living in Pieksämäki, Finland, were invited (n=1294), and out of 730 women, 512 (70.1%) participated in this cross-sectional study in 1997 to 1998. Depressive symptoms were assessed by Beck's Depression Inventory-21 (BDI-21), and CRP was measured with a high-sensitivity CRP (hs-CRP) assay.


RESULTS
We found a positive correlation between hs-CRP levels and depressive symptoms in peri- and postmenopausal women not using exogenous hormones (Pearson correlation coefficient, r=.248, P<.001; and r=.343, P=.059, respectively). After multivariate adjustment, a statistically significant interaction was noted between hs-CRP levels and the exogenous hormone use on total score of BDI-21 (P=.022) among "peri- and postmenopausal women."


CONCLUSIONS
Our novel findings suggest that female hormones may have moderating effect at peri- and postmenopausal women on the association between elevated CRP levels and depressive symptoms. Further studies are, however, needed to confirm our findings.
Liukkonen
Timo
T
Department of Psychiatry, Savonlinna Central Hospital, Savonlinna, Finland; Institute of Health Sciences, University of Oulu, University of Oulu, Finland. timo.liukkonen@isshp.fi
Vanhala
Mauno
M
Jokelainen
Jari
J
Keinänen-Kiukaanniemi
Sirkka
S
Koponen
Hannu
H
Timonen
Markku
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003276:Contraceptives, Oral / Q000008:administration & dosage*; D003866:Depressive Disorder / Q000097:blood* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology; D015914:Estrogen Replacement Therapy / Q000523:psychology*; D005260:Female; D005387:Finland; D006801:Humans; D008875:Middle Aged; D047648:Perimenopause / Q000097:blood* / Q000187:drug effects / Q000523:psychology*; D010555:Personality Inventory; D017698:Postmenopause / Q000097:blood* / Q000187:drug effects / Q000523:psychology*; D017697:Premenopause / Q000097:blood* / Q000187:drug effects / Q000523:psychology*; D013223:Statistics as Topic; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D003276:Contraceptives, Oral; D014280:Triglycerides; D002097:C-Reactive Protein; D002784:Cholesterol