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Direction of association between Cardiovascular risk and depressive symptoms during the first 18 years of life: A prospective birth cohort study.

Accepted version
Peer-reviewed

Type

Article

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Authors

Chaplin, Anna B 
Smith, Nick 
Jones, Peter B 
Khandaker, Golam M 

Abstract

BACKGROUND: Cardiovascular disease (CVD) and depression are bidirectionally associated in adults. However, the direction of association between CVD risk and depressive symptoms in young people and potential mechanisms are poorly understood. METHODS: Using longitudinal birth cohort data, we created a CVD risk score age at 15 using age, ethnicity, physical activity, maternal social status, maternal smoking, own smoking, BMI, systolic blood pressure, LDL, HDL and triglycerides. We used regression analysis to test: (1) association between CVD risk score at age 15 and depressive symptoms at ages 12 and 18; (2) association of IL-6 and CRP at age 9 with depressive symptoms at age 12 and CVD risk score at age 15; and (3) mediating effects of CVD risk score on associations of IL-6/CRP at age 9 with depressive symptoms at age 18. RESULTS: The risk set comprised 5007 participants. CVD risk score in mid-adolescence was associated with depressive symptoms in early-adulthood (adjusted beta=0.06; standard error (SE)=0.02; p<0.001). Depressive symptoms in childhood were not associated with CVD risk score in mid-adolescence (adjusted beta=0.03; SE=0.02; p=0.11). Childhood inflammatory markers were associated with CVD risk score in mid-adolescence. Adolescent CVD risk score mediated the associations between childhood inflammatory markers and depressive symptoms in early-adulthood. LIMITATIONS: The cohort primarily comprises White individuals, limiting generalisability. Sample attrition required imputation for missing data. CONCLUSIONS: Association between CVD risk and depression in childhood/adolescence is unidirectional, with higher CVD risk increasing the risk of depressive symptoms. Childhood inflammation may increase risk of depression by influencing adolescent CVD risk.

Description

Keywords

ALSPAC, Adolescence, Cardiovascular risk, Depressive symptoms, Inflammation, Longitudinal study, Adolescent, Adult, Cardiovascular Diseases, Child, Cohort Studies, Depression, Female, Heart Disease Risk Factors, Humans, Longitudinal Studies, Prospective Studies, Risk Factors

Journal Title

J Affect Disord

Conference Name

Journal ISSN

0165-0327
1573-2517

Volume Title

292

Publisher

Elsevier BV

Rights

All rights reserved
Sponsorship
Wellcome Trust (201486/Z/16/Z)
MQ: Transforming Mental Health (MQDS17\40)
BMA Foundation for Medical Research (Unknown)
Medical Research Council (MC_PC_17213)
Medical Research Council (MR/S037675/1)
Funding The UK Medical Research Council and Wellcome (Grant ref: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. The publication is the work of the authors who will serve as guarantors for the contents of this paper. A comprehensive list of grants funding is available on the ALSPAC website (http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf). This research was specifically funded by the National Institute of Health Research CLAHRC RCF (MRR73-1795-00000)) and the Wellcome Trust.