Longitudinal Population Subgroups of CRP and Risk of Depression in the ALSPAC birth cohort

Background
Meta-analyses confirm increased circulating C-reactive protein (CRP) levels in depression. Longitudinal studies have linked one-off measurements of CRP at baseline with increased risk of developing depressive symptoms subsequently at follow-up, but studies with repeat CRP measures from the same individuals are scarce.

Methods
We have examined whether longitudinal patterns of inflammation, based on three CRP measurements from childhood to early-adulthood, are associated with the risk of depression in early-adulthood in the Avon Longitudinal Study of Parents and Children, a prospective birth cohort.

Results
Using Gaussian mixture modelling of available CRP data from age 9, 15 and 18 years, we identified four population clusters/sub-groups reflecting different longitudinal patterns of CRP: persistently low (N = 463, 29.5%); persistently high (N = 371, 24%); decreasing (N = 360, 23%); increasing (N = 367, 23.5%). The increasing group showed a steep increase in CRP levels between adolescence and early-adulthood. Participants in this group had a higher risk of moderate/severe depression at age 18 years, compared with those with persistently low CRP; adjusted odds ratio (OR) = 3.78 (95% Confidence Interval (CI), 1.46-9.81; p = 0.006). The odds of moderate/severe depression were also increased for the persistently high CRP group, but this was not statistically significant; OR = 2.54 (95% CI, 0.90-7.16).

Limitations
Repeat CRP measures were available for a subset, who may not be representative of all cohort participants.

Conclusions
The results suggest that an increasing pattern of inflammation from adolescence to early-adulthood is associated with risk of depression in early-adulthood.