title: Neutrophil Gelatinase-Associated Lipocalin and depression in patients with chronic heart failure.
abstract: Depression adversely affects prognosis in heart failure (HF) patients. Inflammation is indicated as potential biological pathway in this co-morbidity. Since increased levels of the cytokine Neutrophil Gelatinase-Associated Lipocalin (NGAL) are predictive for HF prognosis, and recently indicated in patients with major depression, this study examined the association of serum NGAL levels with symptoms of depression in patients with HF. Serum NGAL levels were measured in 104 patients with HF (left ventricular ejection fraction, LVEF⩽40). Depression, evaluated using the Beck Depression Inventory (BDI; total score, somatic and cognitive component), and the Hamilton Depression Rating scale (HAMD), at baseline and 12months follow-up, was associated with NGAL levels using mixed model analysis. Analyses were adjusted for demographics measures, disease severity indicators, inflammation, comorbidity and medication. Increased serum NGAL levels were significantly associated with depression measured by HAMD (baseline: r=0.25, p<.05) and BDI (baseline: r=0.22, p<.05; 12months: r=0.37, p<.01). This association remained significant after adjustment for covariates; age, sex, time, LVEF, and creatinine (HAMD, t=2.01, p=.047; BDI, t=2.28, p=.024). NGAL was significantly associated with somatic- (p=0.004), but not cognitive depressive symptoms (p=0.32). NGAL levels were associated with the experienced HF-related functional limitations (6min walk test), rather than the severity of cardiac dysfunction (LVEF). This study indicates that depression in patients with chronic HF is associated with elevated NGAL levels, independent of clinical severity of the underlying disease.
authors.affiliation: Department of Molecular Neurobiology, University of Groningen, Groningen, The Netherlands; Department of Neurology and Alzheimer Research Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: p.j.w.naude@umcg.nl.
authors.forename: Petrus J W
authors.initials: PJ
authors.lastname: Naudé
authors.affiliation: CoRPS, Centre of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: Paula M C
authors.initials: PM
authors.lastname: Mommersteeg
authors.affiliation: CoRPS, Centre of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: Wobbe P
authors.initials: WP
authors.lastname: Zijlstra
authors.affiliation: Department of Molecular Neurobiology, University of Groningen, Groningen, The Netherlands; Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Leonie
authors.initials: L
authors.lastname: Gouweleeuw
authors.affiliation: CoRPS, Centre of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: Nina
authors.initials: N
authors.lastname: Kupper
authors.affiliation: Department of Molecular Neurobiology, University of Groningen, Groningen, The Netherlands.
authors.forename: Ulrich L M
authors.initials: UL
authors.lastname: Eisel
authors.affiliation: CoRPS, Centre of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: Willem J
authors.initials: WJ
authors.lastname: Kop
authors.affiliation: Department of Molecular Neurobiology, University of Groningen, Groningen, The Netherlands; Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Regien G
authors.initials: RG
authors.lastname: Schoemaker
mesh_terms: D000209:Acute-Phase Proteins; D000368:Aged; D002908:Chronic Disease; D003863:Depression / Q000097:blood* / Q000150:complications; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000150:complications; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000097:blood*
chemical_list: D000209:Acute-Phase Proteins; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins
keywords: Cognitive and somatic depressive symptoms; Depression; Follow-up; Heart failure; Inflammation; Lipocalin 2