Association Between Seafood Intake,Brain-derived Neurotrophic Factor,Inflammatory Factors With Coronary Heart Disease Comorbid With Depression

Objective: Evidence supports that high-fish intake have a beneficial effects on depression or coronary heart disease(CHD),but the association with comorbid depression and CHD remains unclear.Therefore,we examined the association of seafood(fish intake)with comorbid depression and CHD in Chinese adults.Methods: We conducted a cross-sectional study including 1,099 Chinese adults aged 25～95 years living in Zhejiang,China.Fish intake were assessed by using the food frequency questionnaire(FFQ),while depression status was assessed by hospital anxiety and depression scales(HADS),with HADS scores ≥ 8 indicating a prevalence of depression.Fish intake were categorized as three tertiles of ≤1 time/week,2～6 times/week and ≥7 times/week.Multivariable logistic regression models were used to compute odds ratios(ORs)and 95% confidence intervals(CIs)for the prevalence of depression comorbidity with CHD.Results: Among the included 932 participants,194(17.65%),583(53.05%)and 106(9.65%)were diagnosed with depression,CHD and comorbid depression and CHD,respectively.The multivariate-adjusted ORs were0.355(95% CI: 0.221,0.569)for depression and 0.727(95% CI: 0.471,1.123)for CHD.Participants in the highest tertiles of fish intake have significantly lower odds of comorbid depression and CHD compared with individuals in the lowest(OR= 0.355,95%CI: 0.198,0.638),with a 49% reduction in odds of comorbid depression and CHD for per one-tertiles(3times/week)increase in fish intake(OR = 0.511,95% CI:0.363,0.716,P <0.001).Conclusions: Our findings highlight that high intake of fish is associated with lower odds of comorbid depression and CHD in this Chinese population,suggesting that high intake of fish may have offered psychosomatic benefits in primary prevention.Objective: The pathophysiology mechanism of coronary heart disease(CHD)related depression has not been completely clear.In order to explore the inflammatory mechanism of coronary heart disease complicated with depression,we detected the levels of brain derived neurotrophic factor(BDNF),interleukin-1β(IL-1β),interleukin-2(IL-2),interleukin-4(IL-4),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in plasma.The present study aimed at exploring the pathophysiological mechanisms of patients with CHD combined with depression,in order to provide theoretical and strategys guidance for the prevention,diagnosis and clinical treatment of patients with CHD suffering from depression.Methods: We selected the hospitalized patients who were first diagnosed with CHD(coronary angiography with single or multiple narrowed blood vessels by more than 50%)in Wenling first people’s Hospital from January 2018 and June 2020,and all patients had no depressive-related symptoms or antidepressant treatment before the diagnosis of CHD.We choosed physical examination subjects with undiagnosed CHD or other severe physical or mental illness as blank control group.A total of 639 patients who met the inclusion criteria and the blank control group were included in the subjects.We collected all participants’ generally demographic data,included 125 patients in blank control group(group A)and 514 patients in CHD group(group B)and assessed Hospital Anxiety Depression Scale(HAD).HAD-C1 and HAD-C2 represents anxiety and depression respectively and the sum of the scores of the two factors is the global score of HAD.According to the score of HAD-2,the CHD patients were divided into no-combined depression group(group C),combined depression tendency group(group D)and combined depression group(group E),including 133 patients in group C,275 patients in group D and 106 patients in group E.We collected 5 m L of peripheral blood samples on the first day of hospitalization,Enzym-linked immunosorbents assay was used to measure the levels of BDNF、IL-1β,IL-2,IL-4,IL-6 and TNF-α in plasma of all subjects.Results:1.The analysis of patients in the CHD group(group B)and blank control group(group A).(1)The comparison of general data between the two groups showed that,the patients in the CHD group(group B)were older,male,smoking,hypertension and diabetes accounted for a higher proportion,among which the difference was statistically significant(P<0.05).(2)The biomarkers level in plasma were compared between the two groups,and the results showed that,the mean concentrations of BDNF,IL-4 and TNF-α in plasma of blank control group(group A)were higher than those of CHD group(group B),the mean concentrations of IL-1β,IL-2 and IL-6 in plasma of CHD group(group B)were higher than those of blank control group(group A),and the concentrations of BDNF,IL-1β,IL-2 and IL-6in plasma were different between the two groups,and the difference was statistically significant(P<0.05).(3)Intra-group correlation analysis in CHD group(group B)showed that,(1)HAD-C2 score was negatively correlated with plasma BDNF concentration(P <0.05);(2)HAD-C2 score was positively correlated with plasma IL-1β,IL-2 and IL-6 concentrations(P < 0.05).(4)Binary logistic regression analysis,with coronary heart disease as the dependent variable,showed that high plasma IL-2 concentration was a risk factor for coronary heart disease.the OR value and 95% confidence interval(CI)of IL-2 for coronary heart disease were 1.074(1.011 ~ 1.142).2.Statistical analysis of CHD with no-combined depression group(group C),CHD combined depression tendency group(group D)and CHD combined depression group(group E).(1)Plasma concentrations of various substances in the three groups were compared,and the results showed that,the mean plasma levels of BDNF and IL-4 in CHD with no-combined depression group(group C)were higher than those in CHD combined depression tendency group(group D)and CHD combined depression group(group E),and the plasma levels of IL-1β,IL-2 and IL-6 in CHD combined depression group(group E)were higher than those in CHD with no-combined depression group(group C)and CHD combined depression tendency group(group D).There were significant differences in plasma concentrations of BDNF,IL-1β and IL-6 among the three groups(P<0.05).(2)Ordered logistic regression analysis,CHD patients with depression as dependent variable,showed that low BDNF plasma level and high IL-6 level were risk factors for depression in patients with CHD.According to the graph of ROC,the results showed that the Area under curve(AUC)and 95% confidence interval of plasma BDNF in diagnosing depression in patients with CHD were 0.333(0.285~0.381,P<0.01).The AUC and 95%CI of plasma IL-6for diagnosing depression in patients with CHD were 0.665(95%CI: 0.616~0.713,P<0.01)under the optimal threshold,the sensitivity and specificity of BDNF were 66.9% and 69.5%,and the optimal threshold of plasma IL-6 concentration was 16.011pg/m L,and the sensitivity and specificity of IL-6 were 81.5% and 23.8%.Conclusion: The occurrence and development of depression in patients with CHD may be caused by the combination of high levels of IL-6and low BDNF.When the plasma IL-6 concentration is higher than 16.011 pg/m L and the BDNF is less than 0.028 pg/m L,the occurrence of depression can be predicted in patients with CHD in the early stage.However,it is also necessary to screen out patients with double heart disease state according to the clinical scale for early treatment.