Abstract
BackgroundPremature shortening of leukocyte telomere length has been proposed as a novel mechanism by which depression may confer increased risk of adverse cardiovascular events. Prior studies demonstrating associations of depression and depressive symptoms with shorter leukocyte telomere length were small, included selected psychiatric outpatients, were based on convenience samples, and/or adjusted for a limited number of possible confounding factors.Methods and FindingsWe examined the associations of depressive symptoms, probable depressive disorder, and specific depressive symptom clusters, as assessed by the Center for Epidemiological Studies—Depression (CES-D) scale, with leukocyte telomere length, measured by using a real-time PCR method, in 2,225 apparently healthy participants from the 1995 Nova Scotia Health Survey population-based study. The mean age was 48.2±18.9 years; 49.9% of participants were female; and the mean CES-D score was 7.4±7.9. The mean telomere length was 5,301±587 base pairs. In an unadjusted model, depressive symptoms were significantly associated with longer leukocyte telomere length (B = 27.6 base pairs per standard deviation increase in CES-D, 95% confidence interval [CI] = 3.1–52.1, p = 0.027). This association was no longer significant after adjustment for age and sex (B = 9.5, 95% CI = −14.6–33.6, p = 0.44) or after further adjustment for body mass index, Framingham risk score and previous history of ischemic heart disease (all p's≥0.37). Neither probable depressive disorder nor specific depressive symptom clusters were independently associated with leukocyte telomere length.ConclusionsConcurrent depressive symptoms were not associated with leukocyte telomere length in a large, representative, population-based study.
Highlights
Depressive symptoms and depressive disorders are important causes of disability worldwide. [1] Depression has been found to predict incident and recurrent cardiovascular disease (CVD) events and mortality [2,3]; the pathophysiology and mechanisms underlying the association between depression and CVD events remains poorly understood
We examined the association between depression and leukocyte telomere length in 2,225 participants from the population-based 1995 Nova Scotia Health Survey study, and determined whether this association was independent of age, sex, body mass index and other cardiovascular risk factors
Given that depression is a complex phenotype [17] and that specific depressive symptom clusters may be differentially related to cardiovascular prognosis [18] and biological factors related to cardiovascular prognosis [19,20], we secondarily investigated whether specific depressive symptom clusters are differentially associated with shorter leukocyte telomere length
Summary
Depressive symptoms and depressive disorders are important causes of disability worldwide. [1] Depression has been found to predict incident and recurrent cardiovascular disease (CVD) events and mortality [2,3]; the pathophysiology and mechanisms underlying the association between depression and CVD events remains poorly understood. Accelerated cellular aging has been proposed as a novel pathogenic process associated with depression [4] and a biological mechanism by which depressive symptoms may confer increased risk of adverse cardiovascular events due to the role of vascular cellular aging in atherosclerosis development [5]. Telomere length has been proposed as a biomarker for biological aging [6], and shorter leukocyte telomere length has been associated with a variety of age-related disorders, including atherosclerosis [7], cardiovascular diseases [8,9], dementia [10], and cancer [11]. Prior studies demonstrating associations of depression and depressive symptoms with shorter leukocyte telomere length were small, included selected psychiatric outpatients, were based on convenience samples, and/or adjusted for a limited number of possible confounding factors
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