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

Liukkonen, Timo; Vanhala, Mauno; Jokelainen, Jari; Keinänen-Kiukaanniemi, Sirkka; Koponen, Hannu; Timonen, Markku

doi:10.1016/j.jpsychores.2009.11.003

« Previous Next »Journal of Psychosomatic Research
Volume 68, Issue 6 , Pages 573-579, June 2010

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

Timo Liukkonen
- Department of Psychiatry, Savonlinna Central Hospital, Savonlinna, Finland
- Institute of Health Sciences, University of Oulu, University of Oulu, Finland
- Corresponding author. Department of Psychiatry, Savonlinna Central Hospital, Keskussairaalantie 6, FIN-57120 Savonlinna, Finland. Tel.: +358 15 581 7015; fax: +358 15 581 7016.
Mauno Vanhala
- Unit of General Practice, Centre Finland Central Hospital, Jyväskylä, Finland
- Family Practice Unit, Kuopio University and Kuopio University Hospital, Kuopio, Finland
Jari Jokelainen
- Institute of Health Sciences, University of Oulu, University of Oulu, Finland
- Unit of General Practice, Oulu University Hospital, OYS, Finland
Sirkka Keinänen-Kiukaanniemi
- Institute of Health Sciences, University of Oulu, University of Oulu, Finland
- Unit of General Practice, Oulu University Hospital, OYS, Finland
- Oulu Health Centre, City of Oulu, Finland
Hannu Koponen
- Department of Psychiatry, Kuopio University and University Hospital, Kuopio, Finland; and the Academy of Finland
Markku Timonen
- Institute of Health Sciences, University of Oulu, University of Oulu, Finland

Received 2 December 2008; received in revised form 3 November 2009; accepted 3 November 2009. published online 21 December 2009.

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.

Keywords: Contraceptives, CRP, Depression, Hormone therapy, Menopause