title: Serum levels of inflammatory markers in depressed elderly patients with diabetes and mild cognitive impairment.
abstract: OBJECTIVE
  The aim of the study was to determine the serum levels of CRP, IL-6 and TNF-α in elderly diabetic patients with depressive syndrome alone or with coexisting mild cognitive impairment (MCI).
  
  
  METHODS
  276 diabetics elders were screened for depressive symptoms (using Geriatric Depression Scale: GDS-30) and MCI (using the Montreal Cognitive Assessment: MoCA score). Data of HbA1c, blood lipids and inflammatory markers levels were collected.
  
  
  RESULTS
  In all groups of patients levels of CRP, IL-6 and TNF-α were significantly higher as compared to controls. The highest level of inflammatory markers was detected in group with depressive mood and coexisting MCI, however IL-6 level didn't significantly differ as compared to MCI group. We founded correlations between all inflammatory markers in group of patients with depressive mood and in group of subjects with depressive symptoms and coexisting MCI. GDS-30 score was correlated with levels of inflammatory markers in group with depressive mood, and with levels of CRP and TNF-α in group with depressive mood and coexisting MCI. In the group with depressive mood and coexisting MCI we founded that MoCA score was negatively correlated with CRP and TNF-α levels; and HbA1c level was positively correlated with all inflammatory markers. The univariate logistic regression models revealed that variables which increased the likelihood of having been diagnosed with MCI in depressed patients were: higher levels of HbA1c, CRP, IL-6 and TNF-α, previous CVD or stroke, increased number of co-morbidities and microvascular complications, older age, less years of formal education. The multivariable model showed that previous CVD, higher HbA1c and IL-6 levels are significant factors.
  
  
  CONCLUSIONS
  We demonstrated that the presence of depressive syndrome is associated with higher levels of inflammatory markers in elderly patients with diabetes. The presence of MCI in these depressed subjects has additive effect on levels of inflammatory mediators.
authors: Department of Internal Medicine and Diabetology, Medical University of Lodz, Lodz, Poland.
authors: Malgorzata
authors: M
authors: Gorska-Ciebiada
authors: Department of Internal Medicine and Diabetology, Medical University of Lodz, Lodz, Poland.
authors: Malgorzata
authors: M
authors: Saryusz-Wolska
authors: Department of Internal Medicine and Diabetology, Medical University of Lodz, Lodz, Poland.
authors: Anna
authors: A
authors: Borkowska
authors: Department of General and Oncological Pneumology, Medical University of Lodz, Lodz, Poland.
authors: Maciej
authors: M
authors: Ciebiada
authors: Department of Internal Medicine and Diabetology, Medical University of Lodz, Lodz, Poland.
authors: Jerzy
authors: J
authors: Loba
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000097:blood* / Q000150:complications; D003863:Depression / Q000097:blood* / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; C517652:hemoglobin A1c protein, human