{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T18:18:02Z","timestamp":1787595482107,"version":"build-2736575974"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005047","name":"Natural Science Foundation of Liaoning Province","doi-asserted-by":"publisher","award":["2024-BS-186"],"award-info":[{"award-number":["2024-BS-186"]}],"id":[{"id":"10.13039\/501100005047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the association between depression and cardiovascular disease (CVD) risk in arthritis patients and evaluate the modifying role of systemic inflammation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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 \u226512 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Each 1-point increase in CES-D score elevated CVD risk by 2.8% (OR=1.028, 95% CI 1.012\u20131.044). 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1590483","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T05:20:37Z","timestamp":1755580837000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Association between the depression and cardiovascular risk in arthritis patients: a prospective cohort study from the CHARLS database"],"prefix":"10.3389","volume":"16","author":[{"given":"Xiaoyuan","family":"Tian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianglin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenan","family":"Qu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bocheng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1038\/s41572-025-00594-6","article-title":"Osteoarthritis","volume":"11","author":"Tang","year":"2025","journal-title":"Nat Rev Dis Primers."},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-024-01169-7","article-title":"Management strategies in rheumatoid arthritis","volume":"20","author":"Konzett","year":"2024","journal-title":"Nat Rev Rheumatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1038\/s41584-022-00827-y","article-title":"Global epidemiology of rheumatoid arthritis","volume":"18","author":"Finckh","year":"2022","journal-title":"Nat Rev Rheumatol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(20)30221-6","article-title":"Cardiovascular risk in inflammatory arthritis: rheumatoid arthritis and gout","volume":"3","author":"Hansildaar","year":"2021","journal-title":"Lancet Rheumatol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/ijms150711324","article-title":"Endothelial dysfunction in chronic inflammatory diseases","volume":"15","author":"Steyers","year":"2014","journal-title":"Int J Mol Sci"},{"key":"B6","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1038\/nri.2015.5","article-title":"The role of inflammation in depression: from evolutionary imperative to modern treatment target","volume":"16","author":"Miller","year":"2016","journal-title":"Nat Rev Immunol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2020.06.002","article-title":"The bidirectional relationship of depression and inflammation: double trouble","volume":"107","author":"Beurel","year":"2020","journal-title":"Neuron."},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.2174\/1570159X15666171123201142","article-title":"Imaging the role of inflammation in mood and anxiety-related disorders","volume":"16","author":"Felger","year":"2018","journal-title":"Curr Neuropharmacol."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.05.108","article-title":"Elucidating a bidirectional association between rheumatoid arthritis and depression: A systematic review and meta-analysis","volume":"311","author":"Ng","year":"2022","journal-title":"J Affect Disord"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket169","article-title":"The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis","volume":"52","author":"Matcham","year":"2013","journal-title":"Rheumatol (Oxford)."},{"key":"B11","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1038\/s41584-023-01037-w","article-title":"Immune mechanisms of depression in rheumatoid arthritis","volume":"19","author":"Brock","year":"2023","journal-title":"Nat Rev Rheumatol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.06.011","article-title":"Prevalence of depression: Comparisons of different depression definitions in population-based samples of older adults","volume":"221","author":"Sjoberg","year":"2017","journal-title":"J Affect Disord"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211284","article-title":"Do depression and anxiety reduce the likelihood of remission in rheumatoid arthritis and psoriatic arthritis? 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