Prevalence of low-grade inflammation in depression: a systematic review and meta-analysis of CRP levels

被引:555
作者
Osimo, Emanuele Felice [1 ,2 ,3 ]
Baxter, Luke James [4 ]
Lewis, Glyn [5 ]
Jones, Peter B. [1 ,2 ]
Khandaker, Golam M. [1 ,2 ]
机构
[1] Univ Cambridge, Sch Clin Med, Dept Psychiat, Cambridge, England
[2] Cambridgeshire & Peterborough NHS Fdn Trust, Cambridge, England
[3] Imperial Coll London, MRC London Inst Med Sci, Fac Med, Hammersmith Hosp Campus, London, England
[4] Univ Cambridge, Sch Clin Med, Cambridge, England
[5] UCL, Div Psychiat, London, England
基金
美国国家卫生研究院; 英国惠康基金; 英国医学研究理事会;
关键词
C-reactive protein; CRP; depression; immunopsychiatry; inflammation; low-grade inflammation; meta-analysis; mood; prevalence; review; C-REACTIVE PROTEIN; CORONARY-HEART-DISEASE; ALL-CAUSE MORTALITY; ACUTE-PHASE PROTEINS; CARDIOVASCULAR-DISEASE; MAJOR DEPRESSION; RHEUMATOID-ARTHRITIS; ELDERLY-PATIENTS; RISK-FACTORS; SERUM-LEVELS;
D O I
10.1017/S0033291719001454
中图分类号
B849 [应用心理学];
学科分类号
040203 [应用心理学];
摘要
Background Peripheral low-grade inflammation in depression is increasingly seen as a therapeutic target. We aimed to establish the prevalence of low-grade inflammation in depression, using different C-reactive protein (CRP) levels, through a systematic literature review and meta-analysis. Methods We searched the PubMed database from its inception to July 2018, and selected studies that assessed depression using a validated tool/scale, and allowed the calculation of the proportion of patients with low-grade inflammation (CRP >3 mg/L) or elevated CRP (>1 mg/L). Results After quality assessment, 37 studies comprising 13 541 depressed patients and 155 728 controls were included. Based on the meta-analysis of 30 studies, the prevalence of low-grade inflammation (CRP >3 mg/L) in depression was 27% (95% CI 21-34%); this prevalence was not associated with sample source (inpatient, outpatient or population-based), antidepressant treatment, participant age, BMI or ethnicity. Based on the meta-analysis of 17 studies of depression and matched healthy controls, the odds ratio for low-grade inflammation in depression was 1.46 (95% CI 1.22-1.75). The prevalence of elevated CRP (>1 mg/L) in depression was 58% (95% CI 47-69%), and the meta-analytic odds ratio for elevated CRP in depression compared with controls was 1.47 (95% CI 1.18-1.82). Conclusions About a quarter of patients with depression show evidence of low-grade inflammation, and over half of patients show mildly elevated CRP levels. There are significant differences in the prevalence of low-grade inflammation between patients and matched healthy controls. These findings suggest that inflammation could be relevant to a large number of patients with depression.
引用
收藏
页码:1958 / 1970
页数:13
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