Age-Related Differences in Depression Among Patients with Hypothyroidism: Associations of Irisin, Inflammatory Cytokines, and Immune Cell Ratios
Abstract
Objective: To evaluate age-related differences in depressive symptoms among patients with hypothyroidism and to assess their association with circulating irisin, inflammatory markers, immune cell ratios, and thyroid autoantibodies.
Material and Methods: This cross-sectional study included 100 patients with hypothyroidism, stratified into two age groups (25–45 years and 45–65 years). Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Serum irisin and interleukin-6 levels were measured using enzyme-linked immunosorbent assay. Systemic inflammation was evaluated using neutrophil–lymphocyte ratio, monocyte–lymphocyte ratio, platelet count, and thyroid autoantibodies. Group comparisons, correlation analyses, and multivariate regression analysis were performed.
Results: Patients aged 45–65 years showed significantly higher depression scores, increased interleukin-6 levels, neutrophil–lymphocyte ratio, monocyte–lymphocyte ratio, platelet counts, and thyroid autoantibody levels, along with significantly lower circulating irisin concentrations compared with younger patients. Irisin demonstrated a significant inverse association with depression severity, whereas inflammatory markers showed positive associations. Irisin and interleukin-6 remained independent predictors of depressive symptoms on multivariate analysis (p-value<0.05).
Conclusion: Age-related immune–metabolic alterations are significantly associated with depressive symptoms in patients with hypothyroidism. Combined assessment of irisin and simple inflammatory markers may help identify individuals at higher risk of depression, particularly in older populations.
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Taylor PN, Albrecht D, Scholz A, Gutierrez-Buey G, Lazarus JH, Dayan CM. Global epidemiology of hyperthyroidism and hypothyroidism. Lancet Diabetes Endocrinol 2021;9:484–95.
Ittermann T, Volzke H, Baumeister SE, Appel K, Grabe HJ. Association between thyroid dysfunction and depressive symptoms: a population-based study. J Clin Endocrinol Metab 2022;107:e779–89.
Kohler CA, Freitas TH, Stubbs B, Solmi F, Veronese N, Herrmann N, et al. Peripheral alterations in cytokine and chemokine levels in depression: a meta-analysis of 82 studies. Acta Psychiatr Scand 2021;143:97–109.
Kohler-Forsberg O, Cumming P, Miskowiak KW. Inflammation and depression: a review of pathophysiological mechanisms. Mol Psychiatry 2021;26:2866–80.
Effraimidis G, Wiersinga WM. Mechanisms in autoimmune thyroid disease. Eur J Endocrinol 2021;184:R1–14.
Wrann CD. FNDC5/irisin—a metabolic and neuroprotective factor. Nat Rev Endocrinol 2022;18:7–19.
Lourenco MV, Ribeiro FC, Sudo FK, Ferreira ST, De Felice FG, et al. Neuroprotective effects of irisin in neurodegenerative conditions. Nat Med 2021;27:1441–51.
Kim HJ, So B, Choi M, Kang D, Song W, et al. Irisin and inflammatory metabolism in endocrine disorders. Front Endocrinol (Lausanne) 2022;13:828090.
Panagiotou G, Mu L, Naidoo N, Kalantar-Zadeh K, et al. Circulating irisin and depressive symptoms in metabolic disease. Psychoneuroendocrinology 2023;148:105986.
Franceschi C, Garagnani P, Parini P, Giuliani C, Santoro A. Inflammaging and age-related disease mechanisms. Nat Rev Endocrinol 2022;18:595–608.
Mazza MG, Lucchi S, Tringali AGM, Rossetti A, Botti ER, et al. Inflammatory markers in mood disorders: a meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2022;113:110485.
Fountoulakis KN, Carvalho AF. Inflammatory biomarkers in depression: recent advances. J Affect Disord 2023;321:352–64.
Dowlati Y, Herrmann N, Swardfager W, Liu H, Sham L, et al. A meta-analysis of cytokines in major depression. Biol Psychiatry 2021;90:98–108.
Zuo H, Shi Z, Yuan B, Dai Y, Hu G, et al. Association between inflammatory biomarkers and depressive symptoms. Brain Behav Immun 2022;99:88–96.
Franceschi C, Campisi J. Chronic inflammation (inflammaging) and age-related diseases. J Gerontol A Biol Sci Med Sci 2022;77:1520–30.
Chen J, Liu X, Wang Y, Zhang L, et al. Association between thyroid autoimmunity and depression: a meta-analysis. Endocrine 2021;74:1–10.
Liu Y, Ho RC, Mak A. Interleukin-6 and depression: a systematic review and meta-analysis. Brain Behav Immun 2021;95:350–61.
Maes M, Carvalho AF. The immunological underpinnings of major depression. Prog Neuropsychopharmacol Biol Psychiatry 2021;111:110347.
Swardfager W, Rosenblat JD, Benlamri M, McIntyre RS. Inflammation and depression: a review of biomarkers. Curr Psychiatry Rep 2022;24:235–47.
Khandaker GM, Dantzer R. Is inflammation a cause of depression? World Psychiatry 2021;20:25–35.
Lopresti AL. Inflammation and depression: a review of cytokine markers. Brain Behav Immun Health 2022;20:100420.
Strawbridge R, Arnone D, Danese A. Inflammation and depression: evidence and therapeutic implications. Curr Opin Psychiatry 2022;35:1–7.
Liu CS, Adibfar A, Herrmann N, Gallagher D, Lanctot KL. Inflammation and antidepressant response. J Psychiatr Res 2021;137:437–45.
Kiecolt-Glaser JK, Derry HM, Fagundes CP. Inflammation and depression: mechanisms and treatment. Neurosci Biobehav Rev 2021;126:88–98.
Miller AH, Raison CL. The role of inflammation in depression: from evolutionary adaptation to modern pathology. Nat Rev Immunol 2021;21:316–28.
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