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@ARTICLE{Romankiewicz:941224,
      author       = {Romankiewicz, Lina and Schaare, Lina and Nestler, Steffen
                      and Villringer, Arno and Blöchl, Maria},
      title        = {{M}ediation of the {A}ssociation {B}etween {V}ascular
                      {R}isk {F}actors and {D}epressive {S}ymptoms by
                      {C}-{R}eactive {P}rotein: {L}ongitudinal {E}vidence from the
                      {UK} {B}iobank},
      reportid     = {FZJ-2023-00827},
      year         = {2022},
      abstract     = {People with vascular risk factors (VRFs) are at higher risk
                      for depressive symptoms. Given recent findings implicating
                      low-grade systemic inflammation in both vascular and mental
                      health, this study examined the extent to which the
                      VRF–depressive symptom association might be mediated by
                      low-grade systemic inflammation. To this end, we analysed
                      longitudinal data of 9,034 participants from the UK Biobank
                      (mean age = 56.54 years), who took part in three consecutive
                      assessments over the course of about 8 years. Cumulative VRF
                      burden at baseline was defined as the presence of 5 VRFs
                      (hypertension, obesity, hypercholesterolemia, diabetes, and
                      smoking). Low-grade systemic inflammation was assessed using
                      serum-derived C-reactive protein (CRP) and depressive
                      symptoms were measured using the Patient Health
                      Questionnaire-9 (PHQ-9). We performed mediation models using
                      longitudinal data and a path analytic framework, while
                      controlling for age, gender, racial-ethnic background,
                      socioeconomic status, and baseline mood. VRFs at baseline
                      showed a small association with higher depressive symptoms
                      at follow-up (total effect = 0.014, $95\%$ CI [0.007;
                      0.021]). CRP mediated this association (indirect effect =
                      0.003, $95\%$ CI [0.001; 0.005]) and accounted for $20.10\%$
                      of the total effect of VRF burden on depressive symptoms.
                      Exploratory analyses taking a symptom-based approach
                      revealed that mediating pathways pertained to specific
                      depressive symptoms: tiredness and changes in appetite.
                      These results suggest that the small association between VRF
                      burden and depressive symptoms may be partly explained by
                      the inflammation-promoting effects of VRFs, which might
                      promote a specific symptom-profile of depression.},
      cin          = {INM-7},
      cid          = {I:(DE-Juel1)INM-7-20090406},
      pnm          = {5254 - Neuroscientific Data Analytics and AI (POF4-525)},
      pid          = {G:(DE-HGF)POF4-5254},
      typ          = {PUB:(DE-HGF)25},
      doi          = {10.31234/osf.io/m8zv4},
      url          = {https://juser.fz-juelich.de/record/941224},
}