Role of leukocytes, gender, and symptom domains in the influence of depression on hospitalization and mortality risk: Findings from the Moli-sani study
BackgroundMajor depressive disorder is a mental illness associated with chronic conditions like cardiovascular disease (CVD). Circulating inflammation has been proposed as a potential mechanism underlying this link, although the role of specific biomarkers, gender, and symptom domains is not well el...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.959171/full |
| _version_ | 1798019491256336384 |
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| author | Alessandro Gialluisi Alessandro Gialluisi Francesca Bracone Simona Costanzo Federica Santonastaso Augusto Di Castelnuovo Sabatino Orlandi Sara Magnacca Amalia De Curtis Chiara Cerletti Maria Benedetta Donati Giovanni de Gaetano Licia Iacoviello Licia Iacoviello |
| author_facet | Alessandro Gialluisi Alessandro Gialluisi Francesca Bracone Simona Costanzo Federica Santonastaso Augusto Di Castelnuovo Sabatino Orlandi Sara Magnacca Amalia De Curtis Chiara Cerletti Maria Benedetta Donati Giovanni de Gaetano Licia Iacoviello Licia Iacoviello |
| author_sort | Alessandro Gialluisi |
| collection | DOAJ |
| description | BackgroundMajor depressive disorder is a mental illness associated with chronic conditions like cardiovascular disease (CVD). Circulating inflammation has been proposed as a potential mechanism underlying this link, although the role of specific biomarkers, gender, and symptom domains is not well elucidated.MethodsWe performed multivariable Cox regressions of first hospitalization/all-cause mortality and CVD, ischemic heart (IHD), and cerebrovascular disease (CeVD) causes vs. depression severity in an Italian population cohort (N = 13,191; age ≥ 35 years; 49.3% men; 4,856 hospitalizations and 471 deaths, median follow-up 7.28 and 8.24 years, respectively). In models adjusted for age, sex, and socioeconomic status, we estimated the proportion of association explained by C-reactive protein (CRP), platelet count, granulocyte-to-lymphocyte ratio (GLR), and white blood cell count (WBC). Gender-by-depression interaction and gender-stratified analyses were performed. Associations of polychoric factors tagging somatic and cognitive symptoms with incident clinical risks were also tested, as well as the proportion explained by a composite index of circulating inflammation (INFLA score).ResultsSignificant proportions of the influence of depression on clinical risks were explained by CRP (4.8% on IHD hospitalizations), GLR (11% on all-cause mortality), and WBC (24% on IHD/CeVD hospitalizations). Gender-by-depression interaction was significantly associated only with all-cause mortality (p = 0.03), with moderate depression showing a + 60% increased risk in women, but not in men. Stable associations of somatic, but not of cognitive, symptoms with increased hospitalization risk were observed (+ 16% for all causes, + 14% for CVD causes), with INFLA score explaining small but significant proportions of these associations (2.5% for all causes, 8.6% for IHD causes).ConclusionsThese findings highlight the importance of cellular components of inflammation, gender, and somatic depressive symptoms in the link between depression and clinical (especially CVD) risks, pointing to the existence of additional pathways through which depression may play a detrimental effect on the cardiovascular system. |
| first_indexed | 2024-04-11T16:41:37Z |
| format | Article |
| id | doaj.art-71bb8b33ec5b4727916771ae8398c3f7 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-11T16:41:37Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-71bb8b33ec5b4727916771ae8398c3f72022-12-22T04:13:39ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-10-011310.3389/fpsyt.2022.959171959171Role of leukocytes, gender, and symptom domains in the influence of depression on hospitalization and mortality risk: Findings from the Moli-sani studyAlessandro Gialluisi0Alessandro Gialluisi1Francesca Bracone2Simona Costanzo3Federica Santonastaso4Augusto Di Castelnuovo5Sabatino Orlandi6Sara Magnacca7Amalia De Curtis8Chiara Cerletti9Maria Benedetta Donati10Giovanni de Gaetano11Licia Iacoviello12Licia Iacoviello13EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, ItalyDepartment of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, ItalyDepartment of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, ItalyDepartment of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, ItalyEPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, ItalyMediterranea Cardiocentro, Napoli, ItalyDepartment of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, ItalyMediterranea Cardiocentro, Napoli, ItalyDepartment of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, ItalyDepartment of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, ItalyDepartment of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, ItalyDepartment of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, ItalyEPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, ItalyDepartment of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, ItalyBackgroundMajor depressive disorder is a mental illness associated with chronic conditions like cardiovascular disease (CVD). Circulating inflammation has been proposed as a potential mechanism underlying this link, although the role of specific biomarkers, gender, and symptom domains is not well elucidated.MethodsWe performed multivariable Cox regressions of first hospitalization/all-cause mortality and CVD, ischemic heart (IHD), and cerebrovascular disease (CeVD) causes vs. depression severity in an Italian population cohort (N = 13,191; age ≥ 35 years; 49.3% men; 4,856 hospitalizations and 471 deaths, median follow-up 7.28 and 8.24 years, respectively). In models adjusted for age, sex, and socioeconomic status, we estimated the proportion of association explained by C-reactive protein (CRP), platelet count, granulocyte-to-lymphocyte ratio (GLR), and white blood cell count (WBC). Gender-by-depression interaction and gender-stratified analyses were performed. Associations of polychoric factors tagging somatic and cognitive symptoms with incident clinical risks were also tested, as well as the proportion explained by a composite index of circulating inflammation (INFLA score).ResultsSignificant proportions of the influence of depression on clinical risks were explained by CRP (4.8% on IHD hospitalizations), GLR (11% on all-cause mortality), and WBC (24% on IHD/CeVD hospitalizations). Gender-by-depression interaction was significantly associated only with all-cause mortality (p = 0.03), with moderate depression showing a + 60% increased risk in women, but not in men. Stable associations of somatic, but not of cognitive, symptoms with increased hospitalization risk were observed (+ 16% for all causes, + 14% for CVD causes), with INFLA score explaining small but significant proportions of these associations (2.5% for all causes, 8.6% for IHD causes).ConclusionsThese findings highlight the importance of cellular components of inflammation, gender, and somatic depressive symptoms in the link between depression and clinical (especially CVD) risks, pointing to the existence of additional pathways through which depression may play a detrimental effect on the cardiovascular system.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.959171/fulldepressionmortalityhospitalizationsinflammationgranulocyteslymphocytes |
| spellingShingle | Alessandro Gialluisi Alessandro Gialluisi Francesca Bracone Simona Costanzo Federica Santonastaso Augusto Di Castelnuovo Sabatino Orlandi Sara Magnacca Amalia De Curtis Chiara Cerletti Maria Benedetta Donati Giovanni de Gaetano Licia Iacoviello Licia Iacoviello Role of leukocytes, gender, and symptom domains in the influence of depression on hospitalization and mortality risk: Findings from the Moli-sani study Frontiers in Psychiatry depression mortality hospitalizations inflammation granulocytes lymphocytes |
| title | Role of leukocytes, gender, and symptom domains in the influence of depression on hospitalization and mortality risk: Findings from the Moli-sani study |
| title_full | Role of leukocytes, gender, and symptom domains in the influence of depression on hospitalization and mortality risk: Findings from the Moli-sani study |
| title_fullStr | Role of leukocytes, gender, and symptom domains in the influence of depression on hospitalization and mortality risk: Findings from the Moli-sani study |
| title_full_unstemmed | Role of leukocytes, gender, and symptom domains in the influence of depression on hospitalization and mortality risk: Findings from the Moli-sani study |
| title_short | Role of leukocytes, gender, and symptom domains in the influence of depression on hospitalization and mortality risk: Findings from the Moli-sani study |
| title_sort | role of leukocytes gender and symptom domains in the influence of depression on hospitalization and mortality risk findings from the moli sani study |
| topic | depression mortality hospitalizations inflammation granulocytes lymphocytes |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.959171/full |
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