title: Anxiety independently contributes to elevated inflammation in humans with obesity.
abstract: Anxious and depressive states are associated with increased cardiovascular disease (CVD) risk and a proinflammatory phenotype, although the latter appears to be at least partially explained by adiposity. It was hypothesized that depression and anxiety would be associated with elevated inflammation independent of adiposity in persons with obesity at high risk of CVD.
  
  
  
  This study explored the relation between baseline anxiety as measured by the Beck Anxiety Inventory and depression as measured by the Beck Depression Inventory-II and baseline serum c-reactive protein (CRP) in a cross-sectional sample of 100 participants [mean (SD) age 57.8 (7.7) years; 64% female] with obesity [mean (SD) body mass index, BMI 37.3 (5.5) kg/m2] enrolled in a clinical trial for pharmacological weight loss.
  
  
  
  Beck Anxiety Inventory, but not Beck Depression Inventory-II, scores were significantly correlated with CRP (ρ = 0.28, P = 0.005). BMI was also highly correlated with CRP (ρ = 0.42, P < 0.0001). In multivariate models, the relation between anxiety and CRP remained significant (P = 0.038), independent of BMI, age, and sex.
  
  
  
  Anxiety, but not depression, was associated with elevated inflammation in persons with obesity beyond that attributable to higher BMI. Further study is warranted to assess whether anxiety represents a potential therapeutic target to mitigate corresponding CVD risk associated with elevated inflammation in persons with obesity.
authors.affiliation: Department of Health and Human Physiology, College of Liberal Arts and Sciences, The University of Iowa, Iowa City, Iowa, USA.|Abboud Cardiovascular Research Center, The University of Iowa, Iowa City, Iowa, USA.|Fraternal Order of Eagles Research Center, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Pierce
authors.affiliation: Department of Health and Human Physiology, College of Liberal Arts and Sciences, The University of Iowa, Iowa City, Iowa, USA.|Department of Internal Medicine, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Graziela Z
authors.initials: GZ
authors.lastname: Kalil
authors.affiliation: Department of Health and Human Physiology, College of Liberal Arts and Sciences, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Tiwaloluwa
authors.initials: T
authors.lastname: Ajibewa
authors.affiliation: Department of Health and Human Physiology, College of Liberal Arts and Sciences, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Seth W
authors.initials: SW
authors.lastname: Holwerda
authors.affiliation: Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA.|Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Persons
authors.affiliation: Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Moser
authors.affiliation: Abboud Cardiovascular Research Center, The University of Iowa, Iowa City, Iowa, USA.|Department of Internal Medicine, The University of Iowa, Iowa City, Iowa, USA.|Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA.|Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Jess G
authors.initials: JG
authors.lastname: Fiedorowicz
mesh_terms: D050154:Adiposity; D001007:Anxiety / Q000150:complications*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003863:Depression; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity; D011569:Psychiatric Status Rating Scales
chemical_list: D002097:C-Reactive Protein