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DOI: 10.1055/s-0037-1601630
Associations between pro- and anti-inflammatory cytokines and depressive symptoms in patients with diabetes – potential differences by diabetes type and depression screening instruments
Publication History
Publication Date:
05 May 2017 (online)
Background:
Subclinical inflammation has been implicated in the development of depression, a common comorbidity of type 1 diabetes (T1D) and type 2 diabetes (T2D). This study aimed to compare the relationships of immune mediators with depressive symptoms between patients with T1D and T2D.
Materials and methods:
Six biomarkers of inflammation were measured in serum samples of participants with elevated depressive symptoms and T1D (n = 389, diabetes duration 15 ± 11 years) or T2D (n = 204, diabetes duration 13 ± 8 years). Subclinical depression was examined using three questionnaires (Center for Epidemiologic Studies Depression [CES-D] score, Patient Health Questionnaire [PHQ9], 5-item World Health Organization Well-Being Index [WHO5]).
Results:
In T1D, levels of interleukin-1 receptor antagonist (IL-1RA) were positively associated with depression for two scores (CES-D, PHQ9), high-sensitivity C-reactive protein (hsCRP) was positively associated with depression for one score (WHO5) after adjustment for age, sex, study, BMI, diabetes duration, metabolic variables, medication and comorbidities (p = 0.008 – 0.042). In T2D, IL-18 and IL-1RA were positively associated with depression for two scores (IL-18: PHQ9, WHO5; IL-1RA: CES-D, WHO5), hsCRP for one score (PHQ9), and adiponectin showed an inverse association with depression for one score (PHQ9) after adjustment (p = 0.006 – 0.048). No associations were found for IL-6 and monocyte chemoattractant protein-1 (MCP-1/CCL2).
Conclusions:
Associations between biomarkers of inflammation and depressive symptoms in patients with diabetes were most consistent for IL-1RA and hsCRP. In T2D, there was additional evidence for associations between IL-18 and (inversely) adiponectin with depressive symptoms. The strength of the associations depended on diabetes type and the method used to assess depressive symptoms.
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No conflict of interest has been declared by the author(s).