Depression Trajectories, Inflammation, and Lifestyle Factors in Adolescence: The TRacking Adolescents' Individual Lives Survey
Depression Trajectories, Inflammation, and Lifestyle Factors in Adolescence: The TRacking Adolescents' Individual Lives Survey
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DOI：
10.1037/hea0000210
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发表时间：
2015-11-01
影响因子：
4.2
通讯作者：
de Jonge, Peter
中科院分区：
文献类型：
--
作者：
Duivis, Hester E.;Kupper, Nina;de Jonge, Peter
目的：在成人中，抑郁和炎症是双向相关的。这种关联在青少年中不太明显。此外，躯体和认知抑郁症状可能与炎症存在不同的相关性。与成人一样，生活方式因素可能在青少年中发挥重要的中介作用。在当前的研究中，我们评估了 5 年过程中青春期抑郁症状的轨迹及其与随后的高敏 C 反应蛋白 (hsCRP) 水平的关系，并检查了作为中介的生活方式因素。方法：从 2001 年到 2008 年，对跟踪青少年个人生活调查（TRAILS；N = 1166）的参与者进行了跟踪。每两年进行三次青少年抑郁症状自我报告（YSR）评估。在第 3 波中评估了人口统计、健康和生活方式因素以及 hsCRP 水平。潜在类别分析用于确定抑郁症的轨迹，并使用一般线性模型来确定抑郁症轨迹与 hsCRP 之间的关联。最后，进行中介分析来测试生活方式因素的中介作用。结果：持续中度至高度抑郁症状与较高的 hsCRP 水平相关。当我们调整人口统计和健康变量时，结果没有改变。吸烟在很大程度上介导了抑郁症状总分与 hsCRP 之间的关联。与持续低分相比，躯体和认知症状分量表持续较高的得分与较高的 hsCRP 水平相关。经过协变量调整后，这些结果变得不显着。结论：持续的抑郁症状与随后较高的 hsCRP 水平相关，躯体症状和认知症状的影响相同。这种关联是由吸烟行为介导的。这些发现表明，减少青少年抑郁和吸烟是预防炎症性疾病的重要起点。
Objective: In adults, depression and inflammation are bidirectionally related. This association is less clear in adolescents. Moreover, somatic and cognitive depressive symptoms might be differentially related to inflammation. Lifestyle factors, as in adults, may play an important mediating role in adolescents. For the current study we evaluated trajectories of depressive symptoms in adolescence over a 5-year course and their relation with subsequent high-sensitivity C-reactive protein (hsCRP) levels, and examined lifestyle factors as mediators. Method: Participants of the TRacking Adolescents' Individual Lives' Survey (TRAILS; N = 1166) were followed from 2001 until 2008. Three biennial youth self-report (YSR) assessments of depressive symptoms were taken. Demographics, health, and lifestyle factors and levels of hsCRP were assessed at Wave 3. Latent-class analysis was used to determine trajectories of depression and general linear models to determine the association between depression trajectories and hsCRP. Finally, mediation analysis was performed to test mediation of lifestyle factors. Results: Persistently moderate to high depressive symptoms were associated with higher hsCRP levels. Results were unaltered when we adjusted for demographics and health variables. Smoking mediated the association between depressive symptoms total score and hsCRP, in large part. Persistently higher scores on somatic and cognitive symptom subscales were associated with higher levels of hsCRP than persistently low scores. These results were rendered nonsignificant after covariate adjustment. Conclusion: Persistent depressive symptoms were associated with subsequent higher levels of hsCRP, with somatic and cognitive symptoms contributing equally. The association was mediated by smoking behavior. These findings suggest that reducing adolescent depression and smoking are important starting points in the prevention of inflammatory diseases.