What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Major Depressive Disorder (n=200). Intervention: Female sex vs. Male sex. Primary outcome: Inflammatory marker levels (IL-6 and leptin) (p=0.012).

June 16, 2017Frontiers in Psychiatry95 citationsOpen Access

Sex Differences in the Peripheral Immune System in Patients with Depression

BBBadari Birur EAEllen M. Amrock RSRichard C. Shelton

Key Result

Depressed females exhibited significantly higher levels of IL-6 and leptin compared to depressed males after controlling for BMI, indicating a sex-specific inflammatory profile in depression.

Study Design

Type

Cross-Sectional (n=200)

Multicenter

Structured PICO

Population

200 adults aged 19 to 65 years with and without major depressive disorder, free of current infectious or autoimmune diseases, evaluated in a cross-sectional study.

Comparator

Healthy controls (male and female) and depressed males

Outcome

Differences in inflammatory blood markers (IL-8, IFN-γ, leptin, IL-5, adiponectin, IL-6, etc.) between depressed females, depressed males, and healthy controlssurrogate

There is a sex-specific relationship between inflammation and depression, with depressed females exhibiting higher levels of certain inflammatory markers compared to depressed males and healthy controls.

Main Result

p-value: p=0.012

Limitations

Cross-sectional design cannot establish a cause-effect relationship.
Majority of MDD participants were taking antidepressants, which may affect inflammation.
Clinical variables like duration of the current depressive episode or total number of depressive episodes were not collected.
Cross-sectional design cannot establish cause-effect relationship
Majority of MDD participants were taking antidepressants
Did not collect clinical variables like duration of current depressive episode or total number of depressive episodes

Abstract

BACKGROUND: Females are twice as likely as males to experience depression. Recent findings indicate a relationship linking inflammation with depression. Whether the higher prevalence of depression in women is sex-specific or if inflammation contributes to a higher prevalence of depression in females is unclear. Thus, the objective was to determine whether depressed females show higher inflammation compared to males in a cross-sectional study. MATERIALS AND METHODS: Two hundred participants were enrolled. Depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS), and blood samples were collected from all participants to measure inflammatory blood markers. RESULTS: Higher rates of suicidal thoughts, pessimism, and lassitude measured by the MADRS were seen in depressed females compared with depressed males. Among all inflammatory markers measured, there were no significant differences in depressed males vs. male controls. Increased levels of interleukin (IL)-8, interferon-γ, and leptin, and decreased levels of IL-5 and adiponectin were observed in depressed females compared to female controls. Compared with depressed males, IL-6 and leptin levels were significantly elevated in depressed females after controlling for body mass index. Correlation analysis revealed that depression severity negatively correlated with IL-12 in males, and positively correlated with IL-1β and tumor necrosis factor (TNF)-α in females. IL-1β and TNF-α correlated with suicidal thoughts, lassitude, and pessimism in depressed females. CONCLUSION: Our findings indicate a sex-specific relationship between inflammation and depression, which may be important in identifying potential psychopathology and suggesting novel immunomodulatory treatments for depressed females.

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