Table_2_C-Reactive Protein and TGF-α Predict Psychological Distress at Two Years of Follow-Up in Healthy Adolescent Boys: The Fit Futures Study.DOCX

ObjectiveThe scarcity of research on associations between inflammatory markers and symptoms of depression and anxiety during adolescence has yielded inconsistent results. Further, not all studies have controlled for potential confounders. We explored the associations between baseline inflammatory markers and psychological distress including moderators at follow-up in a Norwegian adolescent population sample.
MethodsData was derived from 373 girls and 294 boys aged 15–18 years at baseline, in the Fit Futures Study, a large-scale 2-year follow-up study on adolescent health. Baseline data was gathered from 2010 to 2011 and follow-up data from 2012 to 2013. Psychological distress was measured with Hopkins Symptom Checklist (HSCL-10). Serum levels of the following inflammatory markers were measured: C-reactive protein (CRP), Interleukin 6 (IL-6), Transforming growth factor alpha (TGF-α), Tumor necrosis factor alpha variant 1 (TRANCE), and variant 2 (TWEAK). Independent associations between baseline inflammatory markers and HSCL-10 at follow-up were explored by linear regressions, in sex-stratified analyses.
ResultsIn girls, analyses showed positive associations between all inflammatory markers and HSCL-10, except for TRANCE. However, all associations were non-significant in crude as well as in adjusted analyses. In boys, CRP (p = 0.03) and TGF-α (p < 0.01) showed significant associations with HSCL-10, that remained significant after adjustment. Additionally, moderators were found. In boys, CRP was associated with HSCL-10 in those with high body fat and those being physical inactive, and the association between TWEAK and HSCL-10 was dependent upon sleep duration.
ConclusionThere were significant prospective associations between CRP, TFG-α, and HSCL-10 in boys aged 15–18 years at baseline.

研究目的：目前针对青春期炎症标志物与抑郁、焦虑症状间关联的研究较为匮乏，且已有研究结果存在不一致性；同时，并非所有研究均对潜在混杂因素进行了控制。本研究以挪威青少年人群样本为对象，探讨基线炎症标志物与随访阶段心理困扰的关联，并分析调节变量的作用。
研究方法：本研究数据来自青少年健康大型2年随访研究《Fit Futures Study》，基线时共纳入373名女孩与294名男孩，年龄范围为15~18岁。基线数据采集于2010至2011年，随访数据采集于2012至2013年。采用霍普金斯症状量表（Hopkins Symptom Checklist, HSCL-10）评估心理困扰水平。检测血清中以下炎症标志物水平：C反应蛋白（C-reactive protein, CRP）、白细胞介素6（Interleukin 6, IL-6）、转化生长因子α（Transforming growth factor alpha, TGF-α）、肿瘤坏死因子α变体1（Tumor necrosis factor alpha variant 1, TRANCE）及变体2（TWEAK）。采用线性回归模型进行性别分层分析，以探讨基线炎症标志物与随访期HSCL-10得分间的独立关联。
研究结果：在女性群体中，除TRANCE外，其余所有炎症标志物均与HSCL-10得分呈正相关，但未校正与校正分析中所有关联均无统计学意义。在男性群体中，CRP（p=0.03）与TGF-α（p<0.01）与HSCL-10得分存在显著关联，且该关联在校正混杂因素后仍具有统计学意义。此外，本研究还发现了调节效应：在体脂水平较高及身体活动不足的男性群体中，CRP与HSCL-10得分存在关联；而TWEAK与HSCL-10得分的关联则受睡眠时长的影响。
研究结论：在基线年龄为15~18岁的男性群体中，CRP与TGF-α同HSCL-10得分存在显著的前瞻性关联。