Depression and Inflammation in Patients With Lung Cancer: A Comparative Analysis of Acute Phase Reactant Inflammatory Markers.
C reactive protein
acute phase reactants
albumin
cancer
depression
lung cancer
Journal
Psychosomatics
ISSN: 1545-7206
Titre abrégé: Psychosomatics
Pays: England
ID NLM: 0376506
Informations de publication
Date de publication:
Historique:
received:
21
02
2020
revised:
19
03
2020
accepted:
23
03
2020
pubmed:
26
4
2020
medline:
27
7
2021
entrez:
26
4
2020
Statut:
ppublish
Résumé
Depression and inflammation are intertwined, which is particularly relevant for patients with lung cancer who have an abundance of inflammation and experience depression. Acute phase reactants (APRs), albumin and C-reactive protein (CRP), are easily interpretable indirect markers of inflammation that have never been concomitantly compared with depression. Inflammation increases CRP (positive APR) and decreases albumin (negative APR). We hypothesize that albumin will be similarly associated with depression, thereby helping to inform the diagnosis of inflammatory depression. Compares the relationship between depression and representative positive and negative acute phase reactants in patients with metastatic lung cancer. Patients (n = 109) with metastatic lung cancer were evaluated for depression using the Hospital Anxiety and Depression Scale. Inflammation as measured by positive (CRP) and negative (albumin) APRs along with demographic and treatment variables were analyzed for associations with depression. Depression was associated with lower albumin (r = -0.35, P < 0.001), higher CRP (r = 0.47, P < 0.001), and the CRP/albumin ratio (r = 0.45, P < 0.001). Hierarchical linear regression modeling found that albumin was associated with depression when controlling for demographics, disease, and treatment types (β = -0.28, P = 0.01). When both APRs were in the model, only CRP predicted depression (β = 0.31, P = 0.01), and albumin did not moderate CRP and depression. CRP/albumin ratio did not add to understanding depression variability, but patients with both low albumin and high CRP had particularly severe depression. Albumin is associated with depression but not to a greater extent than CRP. The coupling of lower albumin and higher CRP describes more severe depression. Positive and negative APRs may form a distinct biologic signature to help identify patients with inflammatory depression in the lung cancer setting.
Sections du résumé
BACKGROUND
Depression and inflammation are intertwined, which is particularly relevant for patients with lung cancer who have an abundance of inflammation and experience depression. Acute phase reactants (APRs), albumin and C-reactive protein (CRP), are easily interpretable indirect markers of inflammation that have never been concomitantly compared with depression. Inflammation increases CRP (positive APR) and decreases albumin (negative APR). We hypothesize that albumin will be similarly associated with depression, thereby helping to inform the diagnosis of inflammatory depression.
OBJECTIVE
Compares the relationship between depression and representative positive and negative acute phase reactants in patients with metastatic lung cancer.
METHODS
Patients (n = 109) with metastatic lung cancer were evaluated for depression using the Hospital Anxiety and Depression Scale. Inflammation as measured by positive (CRP) and negative (albumin) APRs along with demographic and treatment variables were analyzed for associations with depression.
RESULTS
Depression was associated with lower albumin (r = -0.35, P < 0.001), higher CRP (r = 0.47, P < 0.001), and the CRP/albumin ratio (r = 0.45, P < 0.001). Hierarchical linear regression modeling found that albumin was associated with depression when controlling for demographics, disease, and treatment types (β = -0.28, P = 0.01). When both APRs were in the model, only CRP predicted depression (β = 0.31, P = 0.01), and albumin did not moderate CRP and depression. CRP/albumin ratio did not add to understanding depression variability, but patients with both low albumin and high CRP had particularly severe depression.
CONCLUSION
Albumin is associated with depression but not to a greater extent than CRP. The coupling of lower albumin and higher CRP describes more severe depression. Positive and negative APRs may form a distinct biologic signature to help identify patients with inflammatory depression in the lung cancer setting.
Identifiants
pubmed: 32331769
pii: S0033-3182(20)30058-X
doi: 10.1016/j.psym.2020.03.005
pmc: PMC7529727
mid: NIHMS1600261
pii:
doi:
Substances chimiques
Acute-Phase Proteins
0
Albumins
0
Biomarkers
0
Serum Albumin
0
C-Reactive Protein
9007-41-4
Types de publication
Comparative Study
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
527-537Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NCI NIH HHS
ID : T32 CA009461
Pays : United States
Informations de copyright
Copyright © 2020 Academy of Consultation-Liaison Psychiatry. Published by Elsevier Inc. All rights reserved.
Références
Clin Chem. 1997 Jan;43(1):52-8
pubmed: 8990222
Psychosom Med. 2009 Feb;71(2):171-86
pubmed: 19188531
J Clin Invest. 1987 Jun;79(6):1635-41
pubmed: 3584463
J Psychosom Res. 2002 Feb;52(2):69-77
pubmed: 11832252
Nephrol Dial Transplant. 2011 Feb;26(2):658-64
pubmed: 20631406
Cancer. 2017 Nov 1;123(21):4236-4243
pubmed: 28654189
Psychooncology. 2014 Feb;23(2):121-30
pubmed: 24105788
Psychiatry Res. 2015 Dec 15;230(2):658-63
pubmed: 26520562
J Affect Disord. 2002 Dec;72(3):237-41
pubmed: 12450640
Mol Psychiatry. 2018 Feb;23(2):335-343
pubmed: 27752078
PLoS One. 2011;6(11):e27181
pubmed: 22110613
Psychoneuroendocrinology. 2017 Apr;78:105-113
pubmed: 28187400
Mol Aspects Med. 2012 Jun;33(3):209-90
pubmed: 22230555
Arch Gen Psychiatry. 2010 Mar;67(3):220-9
pubmed: 20194822
Immunol Today. 1994 Feb;15(2):81-8
pubmed: 8155266
Front Psychiatry. 2017 Nov 23;8:250
pubmed: 29218020
J Clin Oncol. 2016 Nov 20;34(33):3984-3991
pubmed: 27996350
Int J Mol Sci. 2018 Jan 12;19(1):
pubmed: 29329256
Lancet Psychiatry. 2014 Oct;1(5):343-50
pubmed: 26360998
Brain Behav Immun. 2018 Oct;73:163-164
pubmed: 30077590
Chang Gung Med J. 2002 Aug;25(8):509-13
pubmed: 12392362
JAMA Psychiatry. 2013 Feb;70(2):176-84
pubmed: 23266538
Ann N Y Acad Sci. 1982;389:39-48
pubmed: 7046585
J Affect Disord. 2013 Sep 25;150(3):736-44
pubmed: 23870425
Vet Clin Pathol. 2018 Mar;47(1):130-137
pubmed: 29377276
Brain Behav Immun. 2017 Nov;66:89-93
pubmed: 28728805
Drug Metab Dispos. 2017 Jul;45(7):790-797
pubmed: 28411280
Psychooncology. 2006 Aug;15(8):684-93
pubmed: 16302291
Acta Psychiatr Scand. 1983 Jun;67(6):361-70
pubmed: 6880820
Prog Neuropsychopharmacol Biol Psychiatry. 2013 Dec 2;47:69-76
pubmed: 23969030
J Psychosom Res. 2017 Oct;101:38-43
pubmed: 28867422
BMJ Open. 2018 Jan 5;8(1):e017959
pubmed: 29306881
Ann Clin Biochem. 2016 Jan;53(Pt 1):112-6
pubmed: 26195486
Nat Rev Immunol. 2016 Jan;16(1):22-34
pubmed: 26711676
J Clin Invest. 2003 Jun;111(12):1805-12
pubmed: 12813013
PLoS One. 2017 Sep 8;12(9):e0184412
pubmed: 28886134
Health Psychol. 2017 Sep;36(9):852-862
pubmed: 28650200
Exp Gerontol. 2018 Feb;102:109-132
pubmed: 29237576
Eur Neuropsychopharmacol. 2015 Oct;25(10):1532-43
pubmed: 26169573
J Clin Oncol. 2000 Feb;18(4):893-903
pubmed: 10673533