Association Between Somatic Depressive Symptoms and Endothelial Dysfunction in Healthy Individuals

Objective: Depressive symptoms (DS) are associated with cardiovascular disease (CVD). Particular clusters of DS, such as the Somatic Depressive symptoms (SDS) are more associated with CVD than others. Endothelial dysfunction (ED), a precursor to CVD, is linked to traditional risk factors: older age, female sex, non-white ethnicity, smoking, high body weight, and mental stress. However, the association between SDS and ED in healthy non-depressed individuals remains unclear. This study aims to investigate the association between SDS and endothelial function in healthy individuals Methods: Cross-sectional study included 132 participants aged 18-60 years without CVD (31.1±11.5 y). Endothelial function was assessed by flow-mediated dilation (FMD) of the brachial artery. Depressive symptoms were evaluated with the PHQ-9, focusing on somatic symptoms (sleep, fatigue, appetite). Affective depressive symptoms (ADS)—including anhedonia, low self-esteem, and suicidality—and anxiety were analyzed as distinct psychological constructs. Linear and logistic regression models were performed to identify predictors of FMD and ED. Results: The cluster of SDS was the strongest predictor of lower FMD (β=–0.329, P <0.001), followed by ADS (β=–0.239, P =0.041) and body surface area (β=–0.209, P =0.037). Logistic regression confirmed SDS as the strongest predictor of ED ( P =0.001). Conclusions: SDS are significantly associated with ED, surpassing the other risk factors. The assessment of the somatic cluster may allow the detection of individuals who are at a high risk of developing CVD.