Investigating the effects of CRP and IL-6 Inflammatory Responses on Depression Scores with Psychosocial Covariates (Childhood Trauma & Everyday Discrimination) among Lupus Patients in Atlanta, GA Open Access
Brown, Victoria (Spring 2024)
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can result in inflammation of numerous body systems. SLE patients are at higher risk of developing depressive symptoms over the course of disease progression as compared to healthy individuals.
The relationship between such inflammation and depression has not been well-defined in the field; studies suggest a bilateral relationship between inflammation and depression. This paper investigates the relationship between known biomarkers of inflammation common to SLE disease progression— C-Reactive Protein (CRP) and Interlukin-6 (IL-6), and three depression scores (Neuro-QoL, PHQ-9, and PROMIS). In addition, this paper assesses the use of psychosocial covariates — Childhood Trauma and Everyday Discrimination that have been shown to play a role in immune activity. Hierarchal Regression is used to assess and compare the usefulness of the inclusion of Childhood Trauma Score and Everyday Discrimination in a model that contains demographics alone. Results of hierarchal regression, done by adding demographics, childhood trauma, and everyday discrimination as blocks, indicate IL-6 expression is not a significant predictor of depression scores in any of the models.
At the 5% significance level, data support PROMIS Score decreases by -0.80 (95% CI: -1.51, -0.07) for every one mg/L increase in CRP serum levels when holding demographic variables, childhood trauma score, and everyday discrimination score constant (p=0.03). Model comparisons indicate that at the 95% confidence level, the addition of Childhood Trauma Score explained approximately 1-3% additional explanation of variance of all depression scores for both CRP and IL-6 (p x=CRP,y=Neuro-QoL=0.0109, p x=CRPy=phq9=0.0009, p x=CRP y=PROMIS=0.0069; p x=IL-6,y=Neuro-QoL=0.0108, p x=IL-6 y=phq9=0.0009, p x=IL-6 y=PROMIS=0.0078). Everyday discrimination did not significantly contribute to models containing demographic/lifestyle data for Neuro-QoL and PHQ-9 score but did contribute approximately 10% additional explanation of variance to the models predicting PROMIS score (p x=IL-6 <0.001; p x=CRP <0.001).
Table of Contents
Components
1. Background & Introduction
1.1 SLE Presentation and Manifestation
1.2 Socioeconomic Impact of SLE
1.3 Depression and SLE
1.4 Psychosocial Covariates of Interest
1.4.1 Perceived Everyday Discrimination (Lewis)
1.4.2 Childhood Trauma Score (CTS)
1.5 Biomarkers of Inflammation and Depression
1.5.1 CRP
1.5.2 IL-6
1.6 Objectives, Significance, and Aims
2. Methods
2.1 Study Population
2.2 Primary Outcome Measures: Measurements of Depression
2.2.1. Neuro-QoL
2.2.2 PHQ-9
2.2.3 PROMIS
2.3 Biospecimen Collection & Analysis
2.4 Exploratory Analysis of Depression Scores, CTS, and Everyday Discrimination
3. Results
3.1 Statistical Analysis
3.1.1 Bivariate Associations
3.1.2 Test of Collinearity
3.1.3 Hierarchal Regression
3.2 Interpretation of Significant Models of CRP and IL-6 Exposure
3.2.1 CRP Model Comparisons
3.2.2 IL-6 Model Comparisons
4. Discussion & Conclusion
5. Appendix
About this Master's Thesis
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Investigating the effects of CRP and IL-6 Inflammatory Responses on Depression Scores with Psychosocial Covariates (Childhood Trauma & Everyday Discrimination) among Lupus Patients in Atlanta, GA () | 2024-01-24 17:51:44 -0500 |
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