Depression and Risk of Incident Asthma in Adults The CARDIA Study
Depression and Risk of Incident Asthma in Adults The CARDIA Study
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DOI：
10.1164/rccm.201307-1349oc
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发表时间：
2014-05-01
影响因子：
24.7
通讯作者：
Jacobs, David R., Jr.
中科院分区：
文献类型：
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作者：
Brunner, Wendy M.;Schreiner, Pamela J.;Jacobs, David R., Jr.
理论基础：哮喘与抑郁有关，但这种联系的暂时性尚未建立。目的：在一组中青年队列中，检验普遍存在的抑郁症状升高与哮喘之间的关系，以及哮喘流行与出现抑郁症状之间的关系。方法：我们在青年冠状动脉风险发展(CARDIA)队列中检验了哮喘与抑郁症状之间的双向纵向关联。首先，3614名没有哮喘的参与者根据CARDIA第五年考试中抑郁症状的增加进行了分类(n=856名抑郁症状上升对2758名没有上升的抑郁症状；年龄23-35岁)，并跟踪调查了20年，直到出现哮喘。然后，在CARDIA第五年检查中，3016名没有抑郁症状的参与者根据自我报告的当前哮喘状态(188例流行对2828例非流行)进行了分类，并进行了20年的跟踪调查，直到出现抑郁症状。测量和主要结果：调整协变量后，抑郁症状升高的参与者发生哮喘的相对风险为1.26(95%可信区间[CI]=1.02-1.56)。当抑郁状态被建模为哮喘发作前抑郁症状增加的报告总数时，调整后的危险比为1.15(95%CI=1.02-1.29)。有哮喘者和无哮喘者发生抑郁症状升高的风险无差异(调整风险比=0.92；95%CI=0.70-1.20)。结论：这项纵向观察性研究指出抑郁是成人哮喘发病风险的一个标志。另一方面，哮喘的流行与成人发病的抑郁症无关。
Rationale: Asthma is associated with depression, but the temporality of the association has not been established.Objectives: To examine the association between prevalent elevated depressive symptoms and incident asthma, and between prevalent asthma and incident elevated depressive symptoms in a cohort of young and middle-aged adults.Methods: We examined the longitudinal association between asthma and depressive symptoms bidirectionally in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort. First, 3,614 participants, free of asthma, were classified by elevated depressive symptoms at the CARDIA Year-5 exam (n=856 elevated vs. 2,758 not elevated; ages 23-35 yr) and followed for 20 years to incident asthma. Then, 3,016 participants, free of elevated depressive symptoms, were classified by self-reported current asthma status (n=188 prevalent vs. 2,828 not prevalent) at the CARDIA Year-5 exam and followed for 20 years until onset of elevated depressive symptoms.Measurements and Main Results: The relative hazard of incident asthma among those with elevated depressive symptoms was 1.26 (95% confidence interval [CI]=1.02-1.56) after adjustment for covariates. When depressive status was modeled as the total number of reports of elevated depressive symptoms before the onset of asthma, the adjusted hazard ratio was 1.15 (95% CI=1.02-1.29). The hazard of incident elevated depressive symptoms for those with asthma was no different than the hazard in those without asthma (adjusted hazard ratio=0.92; 95% CI=0.70-1.20).Conclusions: This longitudinal observational study points to depression as a marker of risk for incident adult-onset asthma. On the other hand, prevalent asthma is not associated with incident adult-onset depression.