Cranial ultrasonography and circulatory markers of inflammation as predictors for atherosclerosis in patients with depression

Abstract Background Depression is recognized as a cardiovascular disease significant risk factor, particularly atherosclerosis. This work assessed the relationship between major depressive disorders (MDD) and atherosclerosis by evaluating circulation inflammatory markers and common carotid artery (CCA) intima-media thickness (IMT). Methods This case–control study included 30 patients, aged 40–50 years old, both sexes diagnosed with depression [Group (A)], and 30 healthy controls [Group (B)]. All patients were subjected to psychiatric assessments MINI International Neuropsychiatric Interview Arabic V 7.0.2 For DSM-5, the Beck Depression Inventory (BDI) questionnaire and the Hamilton scale for depression Arabic version, socioeconomic status (SES) for health research in Egypt and Quality of life Enjoyment and Satisfaction Questionnaire Short Form.carotid duplex imaging; and laboratory tests, including serum cholesterol, triglycerides, highly sensitive C- reactive protein (hs-CRP), interleukin -6 (IL-6), tumor necrosis factor-alpha (TNFα), and P and E selectins. Results Higher levels of serum total cholesterol, triglycerides, hs-CRP, TNFα, IL-6, and P-and E-selectin, and increased IMT with increased frequency of focal thickness, plaques on cranial ultrasonography of the carotid arteries were noted in Group A compared to Group B. Depression severity and suicidal ideation were significantly positively correlated with serum levels of total cholesterol, triglycerides, hs-CRP, IL-6, TNF-α, and P- and E-selectin as well as with IMT (p < 0.05). Conclusions The relationship between MDD, inflammation, and cardiovascular risk, with the severity of depression, is a significant predictor of increased atherosclerosis risk. MDD severity and suicidal ideation had a positive correlation with several markers of systemic inflammation and atherosclerosis, and CCA IMT. Clinical implications of our research In depression, incorporate hs-CRP and carotid IMT screening to identify high cardiovascular-risk subgroups, target elevated inflammation with agents like NSAIDs or statins, closely monitor suicidality given its link to atherosclerosis biomarkers, and integrate psychiatric–cardiovascular care—especially in low-resource settings—using accessible tools such as carotid ultrasonography to address the intertwined risks of depression, cardiovascular disease, and suicidal behavior in a comprehensive, preventive, and resource-sensitive manner.