Effect of menopause and use of contraceptives/hormone therapy on association of C-reactive protein and depression: A population-based study

Abstract

Objective Unipolar depression has been found to associate with elevated C-reactive protein (CRP) levels in men, but findings among women have been conflicting. It has been hypothesized that this would be explained by a different hormonal environment (compared with men) and its changes throughout the lifecycle in women, but until now, the corresponding evidence has been lacking. We investigated the association between CRP levels and depressive symptoms in a population-based study in pre-, peri-, and postmenopausal women and, also, whether this association is affected by the use of exogenous hormones (contraceptives and postmenopausal hormone therapy). Methods The entire age classes of those born in 1942, 1947, 1952, 1957, and 1962 and living in Pieksämäki, Finland, were invited ( n=1294), and out of 730 women, 512 (70.1%) participated in this cross-sectional study in 1997 to 1998. Depressive symptoms were assessed by Beck's Depression Inventory-21 (BDI-21), and CRP was measured with a high-sensitivity CRP (hs-CRP) assay. Results We found a positive correlation between hs-CRP levels and depressive symptoms in peri- and postmenopausal women not using exogenous hormones (Pearson correlation coefficient, r=.248, P<.001; and r=.343, P=.059, respectively). After multivariate adjustment, a statistically significant interaction was noted between hs-CRP levels and the exogenous hormone use on total score of BDI-21 ( P=.022) among “peri- and postmenopausal women.” Conclusions Our novel findings suggest that female hormones may have moderating effect at peri- and postmenopausal women on the association between elevated CRP levels and depressive symptoms. Further studies are, however, needed to confirm our findings.