Patterns of cardiometabolic multimorbidity and the risk of depressive symptoms in a longitudinal cohort of middle-aged and older Chinese
Patterns of cardiometabolic multimorbidity and the risk of depressive symptoms in a longitudinal cohort of middle-aged and older Chinese
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DOI：
10.1016/j.jad.2022.01.030
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发表时间：
2022-01-11
影响因子：
6.6
通讯作者：
Xu, Beibei
中科院分区：
文献类型：
--
作者：
Huang, Zi-Ting;Luo, Yan;Xu, Beibei
背景：心脏代谢性疾病(CMD)与抑郁症相关。然而，目前尚不清楚共存的CMD是否会增加患抑郁症的风险。我们研究了中老年中国人心脏代谢多发病与抑郁症状之间的关系。方法：研究对象来自中国健康与退休纵向研究，年龄45岁(N=18002)。心脏代谢性多发病被定义为>；2 CMD共存，包括中风、心脏病、糖尿病、高血压和血脂异常。抑郁症状用流行病学研究中心抑郁量表进行评估。我们使用广义估计方程模型来检验心脏代谢多发病和抑郁症状之间的关系，包括疾病计数和流行疾病组合的剂量效应，以及特定CMD的个体和相加效应。结果：心脏代谢性多发病患病率为24.5%。较高数量的CMD对抑郁症状具有相加的剂量效应，这种效应在特定的CMD中持续存在。与不服用CMDs相比，仅患有中风、仅患有心脏病和仅患有糖尿病的患者出现抑郁症状的风险较高。与没有中风、心脏病或糖尿病的患者相比，涉及中风、心脏病或糖尿病的CMD组合均与抑郁症状的风险增加相关。限制：自我报告的慢性疾病。结论：中风、心脏病和糖尿病对CMD组合表现出个体和累加效应，而高血压和血脂异常仅与其他CMD组合中的抑郁症状相关。这些结果提示以人为中心的心理健康预防和治疗对于患有单个或多个CMD的中老年人来说是可行的。
Background: Cardiometabolic diseases (CMDs) are associated with depression. However, it is unclear whether coexisting CMDs may increase the risk of depression. We examined associations between cardiometabolic multimorbidity and depressive symptoms among middle-aged and older Chinese. Methods: Participants aged >45 years were enrolled from the China Health and Retirement Longitudinal Study 2011-2018 (N =18,002). Cardiometabolic multimorbidity was defined as the coexistence of >2 CMDs, including stroke, heart disease, diabetes, hypertension, and dyslipidemia. Depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale. We used generalized estimating equation models to examine associations between cardiometabolic multimorbidity and depressive symptoms, including the dose effect of disease count and prevalent disease combinations, as well as individual and additive effects of specific CMDs. Results: The prevalence of cardiometabolic multimorbidity was 24.5%. A higher number of CMDs had an additive dose effect on depressive symptoms that persisted consistently in specific CMDs. Stroke only, heart disease only, and diabetes only were each associated with a higher risk of depressive symptoms compared with no CMDs. CMD combinations involving stroke, heart disease, or diabetes were each associated with an increased risk of depressive symptoms compared with the absence of stroke, heart disease, or diabetes. Limitation: Self-reported chronic conditions. Conclusion: Stroke, heart disease, and diabetes showed individual and additive effects on CMD combinations, whereas hypertension and dyslipidemia only showed associations with depressive symptoms in combinations with other CMDs. These results suggest person-centered healthcare of mental health prevention and treatment for middle-aged and older adults with individual or multiple CMDs.