What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: General pediatric population (n=1466). Intervention: Depression symptoms vs. Lower depression symptoms. Primary outcome: Log high-sensitivity C-reactive protein (hs-CRP) (β = 0.011, p=0.047).

February 10, 2020Annals of Behavioral Medicine9 citationsOpen Access

Adiposity, Depression Symptoms and Inflammation in Hispanic/Latino Youth: Results From HCHS/SOL Youth

SNSelena T. Nguyen‐RodriguezUniversity of Southern California LGLinda C. GalloCross-Cutting Cardiology CICarmen R. IsasiRutgers, The State University of New Jersey

Key Result

Depression symptoms were significantly associated with increased log hs-CRP (β = 0.011) in Hispanic/Latino youth, an association that was indirectly mediated by adiposity.

Study Design

Type

Cross-Sectional (n=1,466)

Multicenter

Yes

Structured PICO

Population

1,466 Hispanic/Latino youth aged 8 to 16 years from four U.S. metropolitan areas, assessed cross-sectionally for psychological distress, adiposity, and inflammatory markers.

Outcome

High-sensitivity C-reactive protein (hs-CRP) and plasminogen activator inhibitor-1 (PAI-1) levelssurrogate

The association between depression symptoms and inflammation in Hispanic/Latino youth appears to be indirectly mediated by adiposity, suggesting that addressing both mental health and weight may be important for primary prevention of chronic inflammation.

Main Result

Effect estimate: β = 0.011

p-value: p=0.047

Limitations

Cross-sectional design prevents determining causal direction or ruling out confounding.
Self-reported sleep data is subject to recall bias and measurement error.
Sample is only representative of the four urban communities enrolled.
Limited variability in anxiety symptom scores may have prevented detection of associations.
Cross-sectional design prevents determining causal direction
Self-reported sleep data subject to measurement error
Sample only representative of the four urban communities enrolled

Abstract

BACKGROUND: Inflammation is implicated as one of many factors related to the development of chronic disease; thus, identifying its modifiable risk factors offers potential intervention targets to reduce risk. PURPOSE: To investigate whether depression and anxiety symptoms may indirectly affect high-sensitivity C-reactive protein (hs-CRP) and plasminogen activator inhibitor-1 (PAI-1) through sleep duration and adiposity (i.e., percentage body fat and waist circumference). METHODS: Multiple regression analyses were performed on Hispanic Community Health Study/Study of Latinos Youth (ages 8-16 years) cross-sectional baseline data, which were weighted to adjust for sampling design. Data were collected at a clinical assessment, including fasting blood samples, self-report surveys, and objectively measured anthropometrics. RESULTS: Adjusting for sociodemographic covariates, depression symptoms were associated with log hs-CRP (β = .011, p = .047) but not PAI-1 (p = .285). Percentage body fat and waist circumference were positively related to depression symptoms (p = .026 and p = .028, respectively) and log hs-CRP (p < .001 for both). When including adiposity in the hs-CRP model, the associations of depression symptoms with hs-CRP were attenuated and became nonsignificant. Monte Carlo confidence intervals (CIs) showed that the indirect effects from depression symptoms to CRP through percentage body fat (95% CI: .0006, .0119) and waist circumference (95% CI: .0004, .0109) were statistically significant. CONCLUSIONS: Results indicate that the association between psychological distress and inflammation may occur indirectly through adiposity in Hispanic/Latino children. If findings are replicated in causal designs, reducing depression symptoms and adiposity among Hispanic/Latino children may be avenues for primary prevention of inflammation in later years.

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