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. 2011 Jan 5;12(1):3.
doi: 10.1186/1465-9921-12-3.

Biomarkers of systemic inflammation and depression and fatigue in moderate clinically stable COPD

Khaled Al-shair  1 , Umme Kolsum, Rachel Dockry, Julie Morris, Dave Singh, Jørgen Vestbo
Affiliations

Biomarkers of systemic inflammation and depression and fatigue in moderate clinically stable COPD

Khaled Al-shair et al. Respir Res. .

Abstract

Introduction: COPD is an inflammatory disease with major co-morbidities. It has recently been suggested that depression may be the result of systemic inflammation. We aimed to explore the association between systemic inflammation and symptoms of depression and fatigue in patients with mainly moderate and clinically stable COPD using a range of inflammatory biomarkers, 2 depression and 2 fatigue scales.

Method: We assessed 120 patients with moderate COPD (FEV1% 52, men 62%, age 66). Depression was assessed using the BASDEC and CES-D scales. Fatigue was assessed using the Manchester COPD-fatigue scale (MCFS) and the Borg scale before and after 6MWT. We measured systemic TNF-α, CRP, TNF-α-R1, TNF-α-R2 and IL-6.

Results: A multivariate linear model of all biomarkers showed that TNF-α only had a positive correlation with BASDEC depression score (p = 0.007). TNF-α remained positively correlated with depression (p = 0.024) after further adjusting for TNF-α-R1, TNF-α-R2, 6MWD, FEV1%, and pack-years. Even after adding the MCFS score, body mass and body composition to the model TNF-α was still associated with the BASDEC score (p = 0.044). Furthermore, patients with higher TNF-α level (> 3 pg/ml, n = 7) had higher mean CES-D depression score than the rest of the sample (p = 0.03). Borg fatigue score at baseline were weakly correlated with TNF-α and CRP, and with TNF-α only after 6MWT. Patients with higher TNF-α had more fatigue after 6MWD (p = 0.054).

Conclusion: This study indicates a possible association between TNF-α and two frequent and major co-morbidities in COPD; i.e., depression and fatigue.

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Figures

Figure 1
Figure 1
Mean CES-D depression scores in relation to plasma TNF-α level. CES-D = Centre for Epidemiologic Studies Depression Scale, TNF-α = Tumor necrosis factor-α
See this image and copyright information in PMC

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