title: The relationship between high-sensitivity C-reactive protein at admission and post stroke depression: a 6-month follow-up study.
abstract: OBJECTIVE
  A large body of evidence suggests that stroke and depression are accompanied by activation of inflammatory pathways. Thus, the primary purpose of this study was to assess the high-sensitivity C-reactive protein (Hs-CRP) to the presence of post stroke depression (PSD).
  
  
  METHODS
  Two hundred and twenty-six ischemic stroke patients admitted to the hospital within the first 24 hours after stroke onset were consecutively recruited and followed up for 6 months. Clinical information was collected. Serum Hs-CRP levels were measured at baseline. Based on the symptoms, diagnoses of depression were made in accordance with DSM-IV criteria for depression at 6-month after stroke.
  
  
  RESULTS
  At 6-month, ninety-five patients (42.0%) showed depression at 6 months after admission and in 69 patients (30.5%) this depression was classified as major. In the 69 patients with major depression, our results showed significantly higher Hs-CRP levels (1.54[IQR, 0.79-2.27]mg/dL vs. 0.43[IQR, 0.31-1.27]mg/dL, P<0.0001) at admission than patients without major depression. After adjusting for NIHSS on admission and all other recorded confounders, Hs-CRP still was an independent predicator of PSD with an adjusted OR of 1.339 (95% CI, 1.231-1.456; P<0.001). Further, in our study, we found that an increased risk of PSD was associated with serum Hs-CRP levels ≥0.85mg/dL (adjusted OR 7.830, 95% CI: 4.193-14.620) after adjusting for above recorded confounders.
  
  
  CONCLUSIONS
  Elevated Hs-CRP serum levels at admission was found to be associated with depression 6-month after stroke, suggesting that these alterations might participate in the pathophysiology of depression symptoms in stroke patients.
authors.affiliation: Department of Neurology, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong province, PR China.
authors.forename: Rui-Rui
authors.initials: RR
authors.lastname: Yang
authors.affiliation: Department of Neurology, Qilu Shihua Central Hospital, Zibo, Shandong province, PR China.
authors.forename: Bo-Cheng
authors.initials: BC
authors.lastname: Lu
authors.affiliation: Department of Neurosurgery, the Zhangqiu People's Hospital of Shandong, Jinan, Shandong province, PR China.
authors.forename: Tao
authors.initials: T
authors.lastname: Li
authors.affiliation: Department of Neurology, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong province, PR China.
authors.forename: Yi-Feng
authors.initials: YF
authors.lastname: Du
authors.affiliation: Department of Neurology, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong province, PR China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Radiological Department, Jining No. 1 People's Hospital, Jining, Shandong province, PR China.
authors.forename: Yan-Xia
authors.initials: YX
authors.lastname: Jia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D003866:Depressive Disorder / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000378:metabolism* / Q000523:psychology; D013997:Time Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: depression; high-sensitivity C-reactive protein; inflammation; stroke