Association of Systemic Inflammation with Depressive Symptoms in Individuals with COPD

• Published in: International journal of chronic obstructive pulmonary disease Vol. 16; pp. 2515 - 2522
• Main Authors: Strollo, Hilary C, Nouraie, Seyed M, Hoth, Karin F, Riley, Craig M, Karoleski, Chad, Zhang, Yingze, Hanania, Nicola A, Bowler, Russell P, Bon, Jessica, Sciurba, Frank C
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2021; Dove Medical Press Ltd; Dove; Dove Medical Press
• Subjects: Airway management; Analysis; bdi; beck depression inventory; Biomarkers; Chronic obstructive pulmonary disease; Cohort Studies; Comorbidity; copdgene; crp; depression; Depression - diagnosis; Depression - epidemiology; Depression, Mental; Diabetes; Enrollments; Female; hads; Humans; il-6; Inflammation; Inflammation - diagnosis; Inflammation - epidemiology; Lung cancer; Lung diseases; Lung diseases, Obstructive; Male; Mental depression; Mortality; Original Research; Pathogenesis; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - epidemiology; Questionnaires; Risk factors; sccor; Smoking; Spirometry; tnf-a; Tumor necrosis factor-TNF; Variables; CRP; TNF-a; BDI; SCCOR; HADS; COPDGene; depression; beck depression inventory; IL-6
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S322144

Depression is a prevalent comorbidity of chronic obstructive pulmonary disease (COPD) that, along with COPD, has been associated with inflammation. An association between inflammation and depression in COPD has not been validated in a large COPD cohort. Individuals from the University of Pittsburgh SCCOR cohort and the COPDGene cohort with tobacco use history and airway obstruction (FEV /FVC <0.7) were evaluated using the Beck Depression Inventory II (BDI-II) and the Hospital Anxiety and Depression Scale (HADS), respectively. Participants completed symptom-related questionnaires and plasma IL-6 measurements. -test, Fisher's Exact tests and logistic regression were used for statistical analysis. The SCCOR cohort included 220 obstructed participants: 44% female and 21.4% with elevated depressive symptoms. GOLD staging distribution was predominantly stage I and II. The COPDGene cohort included 745 obstructed participants: 44% female and 13.0% with elevated depressive symptoms. GOLD distribution was predominantly stage II and III. In the SCCOR cohort, correlation between IL-6 and depressive symptoms trended toward significance (p= 0.08). Multivariable modeling adjusted for FEV , age, gender and medical comorbidities showed a significant association (OR = 1.70, 95% CI = 1.08-2.69). IL-6 was significantly associated with elevated depressive symptoms in COPDGene in both univariate (p=0.001) and multivariable modeling (OR = 1.52, 95% CI =1.13-2.04). Elevated plasma IL-6 levels are associated with depressive symptoms in individuals with COPD independent of airflow limitation and comorbid risk factors for depression. Our results suggest that systemic inflammation may play a significant and possibly bidirectional role in depression associated with COPD.