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Gender differences in the relationship between symptoms of depression and high-sensitivity CRP

International Journal of Obesity volume 37, pages S38–S43 (2013)Cite this article

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Abstract

Background:

Depression has been associated with increased risk of cardiovascular disease. The inflammatory marker C-reactive protein (CRP) has also been identified as an independent predictor of short- and long-term cardiovascular disease events. Inflammation may influence the relationship between depression and cardiovascular disease.

Objective:

The objective of this study was to investigate the association between symptoms of depression and high-sensitivity CRP (hs-CRP) in an obese clinical population. We also sought to determine whether this relationship was different in men and women, given prior reports of a gender effect.

Methods:

Symptoms of depression and hs-CRP were measured in 390 participants enrolled in a weight loss intervention trial that was delivered in a primary care setting. Symptoms of depression were evaluated with the Patient Health Questionnaire-8 (PHQ-8), in which a score ⩾10 is consistent with major depression.

Results:

A total of 58 (15.2%) participants reported a PHQ-8 score ⩾10. The median (interquartile range) hs-CRP concentration was significantly higher in participants with symptoms consistent with major depression (7.7 (4.2–13) mg l−1) compared with those without depression (5.1 (3–9.7) mg l−1; P<0.01). Symptoms consistent with major depression were significantly associated with log-transformed hs-CRP concentrations in an analysis adjusted for age, gender, obesity class and other metabolic variables (P=0.04). When interaction by gender was examined, this relationship remained significant in men (P<0.01) but not in women (P=0.32).

Conclusions:

Symptoms consistent with major depression were significantly associated with hs-CRP in men only, even after adjusting for age, obesity class, metabolic variables and medications known to affect inflammation. This finding suggests that there are biologic differences between men and women that may modify the relationship between hs-CRP and depression. Further studies are needed to elucidate the biologic basis for these findings.

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Acknowledgements

This research was supported by grants from the National Heart, Lung and Blood Institute (U01-HL087072) and National Institute of Diabetes and Digestive and Kidney Diseases (K24-DK065018). We thank Jeffrey Lavenberg, MS, for his assistance with the statistical analysis.

This article is published as part of a supplement, sponsored by the Center for Weight and Eating Disorders—University of Pennsylvania.

Author information

Author notes

  1. M L Vetter, T A Wadden, C Vinnard, R H Moore, Z Khan, S Volger, D B Sarwer and L F Faulconbridge: Members are listed in the Appendix.

Authors and Affiliations

  1. Division of Endocrinology, Department of Medicine, Diabetes and Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    M L Vetter

  2. Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    M L Vetter, T A Wadden, R H Moore, Z Khan, S Volger, D B Sarwer & L F Faulconbridge

  3. Department of Psychology, Haverford College, Haverford, PA, USA

    T A Wadden

  4. Division of Infectious Diseases and HIV Medicine, Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA

    C Vinnard

  5. Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    R H Moore

  6. Department of Statistics, North Carolina State University, Raleigh, NC, USA

    R H Moore

  7. Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    D B Sarwer

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Corresponding author

Correspondence to M L Vetter.

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Competing interests

TAW serves on the advisory boards of Novo Nordisk and Orexigen Therapeutics, which are developing weight loss medications, as well as of Alere and the Cardiometabolic Support Network, both of which provide behavioral weight loss programs. TAW has also served as a consultant for Boehringer Ingelheim and has received grant support from the National Institutes of Health (NIH/NIDDK and NIH/NHLBI). DBS discloses relationships with the following companies: Allergan, BariMD, BaroNova, Enteromedics and Galderma. DBS has also received grant support from the National Institutes of Health (NIH). The other authors declare no conflict of interest.

Appendix

Appendix

POWER-UP Research Group: Investigators and Research Coordinators

Academic investigators at the Perelman School of Medicine at the University of Pennsylvania were Thomas A Wadden, PhD (principal investigator), David B Sarwer, PhD (co-principal investigator), Robert I Berkowitz, MD, Jesse Chittams, MS, Lisa Diewald, MS, RD, Shiriki Kumanyika, PhD, Renee Moore, PhD, Kathryn Schmitz, PhD, Adam G Tsai, MD, MSCE, Marion Vetter, MD and Sheri Volger, MS, RD.

Research coordinators at the University of Pennsylvania were Caroline H Moran, BA, Jeffrey Derbas, BS, Megan Dougherty, BS, Zahra Khan, BA, Jeffrey Lavenberg, MA, Eva Panigrahi, MA, Joanna Evans, BA, Ilana Schriftman, BA, Dana Tioxon, Victoria Webb, BA and Catherine Williams-Smith, BS.

POWER-UP Research Group: Participating Sites and Clinical Investigators

PennCare–Bala Cynwyd Medical Associates: Ronald Barg, MD, Nelima Kute, MD, David Lush, MD, Celeste Mruk, MD, Charles Orellana, MD and Gail Rudnitsky, MD (primary care providers); Angela Monroe (lifestyle coach); Lisa Anderson (practice administrator).

PennCare–Internal Medicine Associates of Delaware County: David E Eberly, MD, Albert H Fink Jr MD, Kathleen Malone, CRNP, Peter B Nonack, MD, Daniel Soffer, MD, John N Thurman, MD and Marc J Wertheimer, MD (primary care providers); Barbara Jean Shovlin, Lanisha Johnson (lifestyle coaches); Jill Esrey (practice administrator).

PennCare–Internal Medicine Mayfair: Jeffrey Heit, MD, Barbara C Joebstl, MD and Oana Vlad, MD (primary care providers); Rose Schneider, Tammi Brandley (lifestyle coaches); Linda Jelinski (practice administrator).

Penn Presbyterian Medical Associates: Joel Griska, MD, Karen J Nichols, MD, Edward G Reis, MD, James W Shepard, MD and Doris Davis-Whitely, PA (primary care providers); Dana Tioxon (lifestyle coach); Charin Sturgis (practice administrator).

PennCare–University City Family Medicine: Katherine Fleming, CRNP, Dana B Greenblatt, MD, Lisa Schaffer, DO, Tamara Welch, MD and Melissa Rosato, MD (primary care providers); Eugonda Butts, Marta Ortiz, Marysa Nieves and Alethea White (lifestyle coach); Cassandra Bullard (practice administrator).

PennCare–West Chester Family Practice: Jennifer DiMedio, CRNP, Melanie Ice, DO, Brandt Loev, DO, John S Potts, DO and Christine Tressel, DO (primary care providers); Iris Perez, Penny Rancy, and Dianne Rittenhouse (lifestyle coaches); Joanne Colligan (practice administrator).

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Vetter, M., Wadden, T., Vinnard, C. et al. Gender differences in the relationship between symptoms of depression and high-sensitivity CRP. Int J Obes 37 (Suppl 1), S38–S43 (2013). https://doi.org/10.1038/ijo.2013.95

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