Associations of Total, Cognitive/Affective, and Somatic Depressive Symptoms and Antidepressant Use with Cardiovascular Disease-Relevant Biomarkers in HIV: Veterans Aging Cohort Study
Autor: | Samir K. Gupta, Matthew S. Freiberg, Brittanny M. Polanka, Chung-Chou H. Chang, Jesse C. Stewart, Suman Kundu, Kaku So-Armah, Jessica R. White |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Oncology
Adult Male medicine.medical_specialty medicine.drug_class Serotonin reuptake inhibitor Lipopolysaccharide Receptors Tricyclic antidepressant HIV Infections Disease Cardiovascular System Article Monocytes Cohort Studies Fibrin Fibrinogen Degradation Products 03 medical and health sciences 0302 clinical medicine Cognition Risk Factors Internal medicine Medicine Humans Applied Psychology Depression (differential diagnoses) Aged Veterans chemistry.chemical_classification Inflammation business.industry Depression Interleukin-6 Confounding Middle Aged Antidepressive Agents 030227 psychiatry Psychiatry and Mental health chemistry Cardiovascular Diseases Antidepressant Female business 030217 neurology & neurosurgery Biomarkers Tricyclic Cohort study |
Zdroj: | Psychosom Med |
Popis: | Objective We sought to determine the associations of total, cognitive/affective, and somatic depressive symptoms and antidepressant use with biomarkers of processes implicated in cardiovascular disease in HIV (HIV-CVD). Methods We examined data from 1546 HIV-positive and 843 HIV-negative veterans. Depressive symptoms were assessed using the Patient Health Questionnaire-9, and past-year antidepressant use was determined from Veterans Affair pharmacy records. Monocyte (soluble CD14 [sCD14]), inflammatory (interleukin-6 [IL-6]), and coagulation (D-dimer) marker levels were determined from previously banked blood specimens. Linear regression models with multiple imputation were run to estimate the associations between depression-related factors and CVD-relevant biomarkers. Results Among HIV-positive participants, greater somatic depressive symptoms were associated with higher sCD14 (exp[b] = 1.02, 95% confidence interval [CI] = 1.00-1.03) and D-dimer (exp[b] = 1.06, 95% CI = 1.00-1.11) after adjustment for demographics and potential confounders. Further adjustment for antidepressant use and HIV factors slightly attenuated these relationships. Associations were also detected for antidepressant use, as selective serotonin reuptake inhibitor use was related to lower sCD14 (exp[b] = 0.95, 95% CI = 0.91-1.00) and IL-6 (exp[b] = 0.86, 95% CI = 0.76-0.96), and tricyclic antidepressant use was related to higher sCD14 (exp[b] = 1.07, 95% CI = 1.03-1.12) and IL-6 (exp[b] = 1.14, 95% CI = 1.02-1.28). Among HIV-negative participants, total, cognitive/affective, and somatic depressive symptoms were associated with higher IL-6, and tricyclic antidepressant use was related to higher sCD14. Conclusions Our novel findings suggest that a) monocyte activation and altered coagulation may represent two pathways through which depression increases HIV-CVD risk and that b) tricyclic antidepressants may elevate and selective serotonin reuptake inhibitors may attenuate HIV-CVD risk by influencing monocyte and inflammatory activation. |
Databáze: | OpenAIRE |
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