The key findings reveal three critical insights: (1) Depression severity, measured by CES-D scores, exhibits a linear dose-response relationship with incident CVD in arthritis patients, independent of traditional metabolic risk factors; (2) Systemic inflammation, quantified by CRP levels, modifies this association, with high inflammation (CRP ≥3 mg/L) amplifying CVD risk specifically in depressed individuals; and (3) DM significantly potentiates the depression-CVD relationship, suggesting shared pathophysiological pathways involving insulin resistance and endothelial dysfunction (30). This evidence concerns the gene CRP and endothelial dysfunction.