Elevated Levels of hs-CRP Are Associated With High Prevalence of Depression in Japanese Patients With Type 2 Diabetes: The Diabetes Distress and Care Registry at Tenri (DDCRT 6)

OBJECTIVE: Because of the absence of data on the direct association between inflammation and depression in patients with diabetes, we examined the association between hs-CRP levels and the high prevalence of depression in adult patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: Cross-sectional data were obtained from 3,573 patients with type 2 diabetes recruited from a Japanese diabetes registry. A multiple logistic regression analysis adjusted for potential confounders was used to assess independent associations between hs-CRP levels and major depression, as defined by the Patient Health Questionnaire-9. RESULTS: Mean age, BMI, and HbA1c levels were 66.0 years, 24.6 kg/m(2), and 7.4% (57.8 mmol/mol), respectively, and 122 patients (3.4%) suffered from major depression. In the age- and sex-adjusted model, the odds ratio (OR) for major depression was 1.86 (95% CI 1.01-3.42; P = 0.045) in the highest CRP quintile compared with that in the 3rd CRP quintile; however, this association disappeared after adjustment for other possible confounders (OR 1.58 [95% CI 0.85-2.94]; P = 0.148). Among patients with a BMI of ≥25 kg/m(2), a significant association was observed between the highest hs-CRP quintile and major depression (multivariable-adjusted OR 2.69 [95% CI 1.09-7.08]; P = 0.032). CONCLUSIONS: We observed a significant positive association between high hs-CRP levels and depression in patients with diabetes who had a high BMI.