Association of the Interaction Between Smoking and Depressive Symptom Clusters With Coronary Artery Calcification: The CARDIA Study.
Association of the Interaction Between Smoking and Depressive Symptom Clusters With Coronary Artery Calcification: The CARDIA Study.
复制标题
吸烟和抑郁症状群与冠状动脉钙化之间的相互作用的关联：CARDIA 研究。
DOI：
10.1080/15504263.2017.1287455
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发表时间：
2017
影响因子：
2.2
通讯作者：
Hitsman,Brian
中科院分区：
文献类型：
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作者：
CarrollMs,AllisonJ;Auer,Reto;Colangelo,LauraA;Carnethon,MercedesR;JacobsJr,DavidR;Stewart,JesseC;Widome,Rachel;Carr,JohnJeffrey;Liu,Kiang;Hitsman,Brian
目的：在心血管疾病(CVD)患者中，抑郁症状群与预后不同。很少有研究前瞻性地评估抑郁症状群和心血管疾病风险之间的关系。在此之前，我们观察到吸烟和全身性抑郁症状与冠状动脉钙化(CAC)存在协同关系。这项研究的目的是确定25年累积测量的抑郁症状相互作用吸烟是否在抑郁症状群(消极情绪、快感乏力和躯体症状)与冠心病相关方面存在差异。方法：在青年冠状动脉风险发展(CARDIA)研究中，参与者(N=3,189：54.5%女性；51.5%黑人；平均年龄=50.1岁)从1985-1986年到2010-2011年进行跟踪调查。吸烟暴露是通过累积香烟包装年数(每天吸烟的香烟包装×吸烟年限；第0至第25年)来衡量的。抑郁症状采用流行病学研究中心抑郁量表(CES-D)的14项3因素(负性情感、快感缺乏、躯体症状)模型(5年、10年、15年、20年和25年)进行评定。在25岁时对CAC进行评估。使用Logistic回归模型来评估吸烟与CAC之间的关系(=0 vs.>；0)，调整了与心血管疾病相关的社会人口学、行为和临床协变量。结果：907名参与者(占样本的28%)在25岁时CAC>；0。抑郁症状群在两组之间没有显著差异。在25岁时，只有累积吸烟暴露交互作用的累积躯体症状群与CAC>；0显著相关(p=.028)。具体地说，吸烟10年、20年或30年的成年人躯体症状升高(满分9分)，其优势比(95%可信区间)分别为2.06[1.08，3.93]，3.71[1.81，7.57]和6.68[2.87，15.53]，PS；0.05。负性情绪和快感缺乏与吸烟暴露的CAC>；0、PS>；05无显著交互作用。结论：在吸烟与心血管疾病风险之间的关系中，躯体症状似乎是抑郁症状学中特别相关的一组症状。
Objective: Depressive symptom clusters are differentially associated with prognosis among patients with cardiovascular disease (CVD). Few studies have prospectively evaluated the association between depressive symptom clusters and risk of CVD. Previously, we observed that smoking and global depressive symptoms were synergistically associated with coronary artery calcification (CAC). The purpose of this study was to determine whether the smoking by depressive symptoms interaction, measured cumulatively over 25 years, differed by depressive symptom cluster (negative affect, anhedonia, and somatic symptoms) in association with CAC.Methods: Participants (N= 3,189: 54.5% female; 51.5% Black; average age = 50.1 years) were followed from 1985–1986 through 2010–2011 in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Smoking exposure was measured by cumulative cigarette pack-years (cigarette packs smoked per day × number of years smoking; year 0 through year 25). Depressive symptoms were measured using a 14-item, 3-factor (negative affect, anhedonia, somatic symptoms) model of the Center for Epidemiologic Studies Depression (CES-D) Scale (years 5, 10, 15, 20, and 25). CAC was assessed at year 25. Logistic regression models were used to evaluate the association between the smoking by depressive symptom clusters interactions with CAC ( = 0 vs. > 0), adjusted for CVD-related sociodemographic, behavioral, and clinical covariates.Results: 907 participants (28% of the sample) had CAC > 0 at year 25. The depressive symptom clusters did not differ significantly between the two groups. Only the cumulative somatic symptom cluster by cumulative smoking exposure interaction was significantly associated with CAC > 0 at year 25 (p= .028). Specifically, adults with elevated somatic symptoms (score 9 out of 18) who had 10, 20, or 30 pack-years of smoking exposure had respective odds ratios (95% confidence intervals) of 2.06 [1.08, 3.93], 3.71 [1.81, 7.57], and 6.68 [2.87, 15.53],ps < .05. Negative affect and anhedonia did not significantly interact with smoking exposure associated with CAC >0,ps > .05.Conclusions: Somatic symptoms appear to be a particularly relevant cluster of depressive symptomatology in the relationship between smoking and CVD risk.