Associations of depression and anxiety statues with serum inflammatory biomarkers in elderly patients with chronic heart failure
10.3760/cma.j.cn115354-20200527-00412
- VernacularTitle:老年慢性心衰患者抑郁焦虑状态与血清炎症标志物的相关性
- Author:
Wenxi LI
1
;
Guoshun LIU
;
Cheng PENG
;
Huiling LOU
Author Information
1. 广州市第一人民医院老年病科 510180
- Keywords:
Chronic heart failure;
Depression;
Anxiety;
Inflammatory biomarker
- From:
Chinese Journal of Neuromedicine
2020;19(12):1228-1234
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the associations of depression and anxiety statues with serum inflammatory biomarkers in elderly patients with chronic heart failure.Methods:From January 2018 to January 2020, 225 elderly patients with chronic heart failure were enrolled from our hospital. Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS) were performed in all patients to determine if the patients were with depression and anxiety statues and evaluate the degrees of depression and anxiety. The differences in demographic and clinical data, geriatric comprehensive assessment indicators, and serum inflammatory markers were compared among patients in the control group (without depression and anxiety), depression group, anxiety group, and depression and anxiety group (with both depression and anxiety). Spearman correlation test was used to analyze the correlation between the levels of serum inflammatory markers and the degrees of depression and anxiety in patients with depression and anxiety. Binary Logistic regression analysis was used to determine the independent influencing factors for depression and anxiety.Results:(1) As compared with those in the control group, patients in the depression group, anxiety group, and depression and anxiety group had significantly increased scores of Chinese version of Tilburg Frailty Indicator, statistically decreased Mini Mental State Examination (MMSE) scores, significantly increased Minnesota Living with Heart Failure Questionnaire (MLWHFQ) scores, increased proportions of patients with 2-4 kinds of diseases and those taking 2-4 kinds of drugs, and decreased Basic Activity of Daily Living (BADL) scores ( P<0.05); as compared with those in the depression group and the anxiety group, the changes of the above indicators in the depression and anxiety group were more obvious with significant differences ( P<0.05). As compared with those in the control group, patients in the depression group, anxiety group, and depression and anxiety group had significantly increased serum interleukin (IL)-6 and C-reactive protein (CRP) levels, patients in the anxiety group and depression and anxiety group had statistically elevated serum homocysteine (Hcy) level, and patients in the depression group and depression and anxiety group had significantly increased serum tumor necrosis factor α (TNF-α) level ( P<0.05); the serum levels of CRP, Hcy and TNF-α in patients from the depression and anxiety group were significantly higher than those in depression group ( P<0.05); the levels of IL-6, CRP, Hcy and TNF-α in the depression and anxiety group were significantly higher than those in the anxiety group ( P<0.05). As compared with that in the control group, the proportion of patients with nutritional risk in the depression and anxiety group was statistically higher ( P<0.05). (2) The serum levels of IL-6, CRP and TNF-α in depression patients were positively correlated with the depression degrees ( P<0.05); the serum levels of IL-6, CRP and Hcy in anxiety patients were positively correlated with the anxiety degrees ( P<0.05). (3) Results of binary Logistic regression analysis showed that IL-6 was an independent risk factor for depression in elderly patients with chronic heart failure ( OR=1.093, 95%CI: 1.049-1.139, P=0.000); Hcy was an independent risk factor for anxiety in elderly patients with chronic heart failure ( OR=1.114, 95%CI: 1.030-1.205, P=0.007); CRP, TNF-α, IL-6 and Hcy were independent risk factors for depression and anxiety in elderly patients with chronic heart failure ( P<0.05). Conclusion:The depression and anxiety degrees and expressions of inflammatory markers in elderly patients with chronic heart failure have synergistic effects.
