Depression in diabetes is associated with subclinical inflammation

Professorship/Faculty: Clinical Psychology and Psychotherapy  
Authors: Hermanns, Norbert ; Schmitt, Andreas; Reimer, Andre; Haak, Thomas; Kulzer, Bernhard
Corporate Body: 76th ADA Scientific Sessions, 10 - 14 June 2016, New Orleans, Louisiana, U.S.
Publisher Information: Bamberg : OPUS
Year of publication: 2017
Pages / Size: 1 pdf-Datei (1 S.)
Source/Other editions: Ursprünglich in: Diabetes : the journal of the American Diabetes Association 65 (2016), Suppl 1, A200-A201 (781-P)
Year of first publication: 2016
Language(s): English
Licence: German Act on Copyright 
URN: urn:nbn:de:bvb:473-opus4-496821
Document Type: Other
There is evidence that in non-diabetic people depression is associated with an elevation
of circulating levels of inflammatory markers. Cross-sectionally, this study examines
if high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, IL-18, IL-1 receptor antagonist
(IL-1RA), monocyte chemotactic protein (MCP)-1 and adiponektin are associated
with depression at baseline in people with diabetes. Longitudinally, this study also
analyzes if a significantly improved depression score after a 12 month follow-up was
associated with a reduction in the systemic inflammatory markers mentioned above.
At baseline and at the 12 month follow-up 132 people with diabetes and subthreshold
depression completed a depression questionnaire (CES-D). A significant improvement
of depression was operationalized as a reduction by 9.1 points of the depression score
(reliable change index). At both measurement points blood samples for the determination
of the systemic inflammatory markers were drawn and analyzed in a central laboratory
using the same assays and plates for baseline as well as for follow-up samples.
The multivariate analysis was adjusted for age, sex, BMI, HbA1c, diabetes type, macrovascular
disease and medication intake (statins, NSAID, anti-coagulant drugs, thyroid
medication). Pre-post data were available for 132 people with diabetes (age 44.5 ±
13.7 yrs., 44.1 % female, HbA1c 8.8 ± 1.7%, 64.1% type 1 diabetes, CES-D score 23.4 ±
8.0). At baseline IL-1RA was significantly correlated with the depression score (ß=0.135,
p=0.026). Patients with a significant reduction of their depression score at the 12 month
follow-up had significant lower IL-1RA (396 ± 51 vs. 540 ± 32 pg/ml; p=0.034) and IL-18
serum levels (270 ± 29 vs. 337 ± 19 pg/ml; p=0.023). In addition, there was a significant
interaction effect between IL-1RA reduction and diabetes type (more pronounced reduction
in type-2-diabetes).In the cross-sectional as well as in the longitudinal responder
analyses, IL-1RA levels showed a significant association with elevated depression
scores as well as with the reduction of depression scores. In addition, people with a significant
reduction of their depression score had a significant lower IL-18 level at followup.
Besides lifestyle factors, adherence and glycemic control, systemic inflammatory
processes involving cytokines of the IL-1 family might present a mediating mechanism
between depression and the prognosis of diabetes.
Supported by ‘Competence Network for Diabetes mellitus’ funded by the BMBF (FKZ
Peer Reviewed: Ja
International Distribution: Ja
Release Date: 24. July 2017