ORIGINAL RESEARCH article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders: Autoinflammatory Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1590483
Association between the depression and cardiovascular risk in arthritis patients: a prospective cohort study from the CHARLS database
Provisionally accepted
- 1Second Affiliated Hospital of Dalian Medical University, Dalian, China
- 2Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning Province, China
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To investigate the association between depression and cardiovascular disease (CVD) risk in arthritis patients and evaluate the modifying role of systemic inflammation.Using data from the China Health and Retirement Longitudinal Study (CHARLS), we conducted a prospective cohort analysis of 2,571 arthritis patients without baseline CVD. Depression severity was assessed using the 10-item CES-D scale, with scores ≥12 defining depression. Multivariable logistic regression and restricted cubic spline (RCS) models analyzed dose-response relationships. We utilized C-reactive protein (CRP) to assess whether inflammatory status in arthritis patients modify this relationship. Sensitivity analyses included multiple imputation and complete-case approaches.Results: Each 1-point increase in CES-D score elevated CVD risk by 2.8% (OR=1.028, 95% CI 1.012-1.044). High inflammation amplified CVD risk exclusively in depressed patients (OR=1.52 vs. OR=1.32 in low-inflammation depressed group), with no significant association in non-depressed individuals. Diabetes mellitus synergistically intensified this relationship (OR=2.83 in diabetic vs. OR=1.21 in non-diabetic depressed patients, P = 0.03 for interaction). Results remained robust across sensitivity analyses.Depression linearly increases CVD risk in arthritis patients, with systemic inflammation selectively potentiating this association in depressed individuals. The diabetes-depression-CVD interaction highlights shared pathophysiological pathways. These findings underscore the imperative for integrated clinical strategies targeting both psychological health and inflammatory pathways to reduce cardiovascular morbidity in arthritis populations.
Keywords: Arthritis, Depression, CHARLS, cardiovascular disease, inflammatory status
Received: 11 Mar 2025; Accepted: 04 Aug 2025.
Copyright: © 2025 Tian, Yang, Cao, Qu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bocheng Zhang, Second Affiliated Hospital of Dalian Medical University, Dalian, China
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