Anxiety Independently Contributes to Elevated Inflammation in Humans with Obesity

OBJECTIVE: Anxious and depressive states are associated with increased cardiovascular disease (CVD) risk and a proinflammatory phenotype, although the latter appears to be at least partially explained by adiposity. We hypothesized that depression and anxiety would be associated with elevated inflammation independent of adiposity in persons with obesity at high risk of CVD. METHODS: We explored the relation between baseline anxiety as measured by the Beck Anxiety Inventory (BAI) and depression as measured by the Beck Depression Inventory-II (BDI-II), and baseline serum c-reactive protein (CRP) in a cross-sectional sample of 100 participants [mean (SD) age 57.8 (7.7) years; 64% female] with obesity [mean (SD) body mass index, BMI 37.3 (5.5) kg/m(2)] enrolled in a clinical trial for pharmacological weight loss interventions. RESULTS: BAI, but not BDI-II, scores were significantly correlated with CRP (rho=0.28, p=0.005). BMI was also highly correlated with CRP (rho=0.42, p<0.0001). In multivariate models, the relation between anxiety and CRP remained significant (p=0.038), independent of BMI, age and sex. CONCLUSION: Anxiety, but not depression, is associated with elevated inflammation in persons with obesity beyond that attributable to higher BMI. Further study is warranted to assess whether anxiety represents a potential therapeutic target to mitigate corresponding CVD risk associated with elevated inflammation in persons with obesity.