Coronary and aortic calcification in women with a history of major depression
Coronary and aortic calcification in women with a history of major depression
复制标题
DOI：
10.1001/archinte.165.11.1229
复制
发表时间：
2005-06-13
影响因子：
--
通讯作者：
Sutton-Tyrrell, K
中科院分区：
文献类型：
--
作者：
Agatisa, PIK;Matthews, KA;Sutton-Tyrrell, K
背景：虽然抑郁症是临床心脏病的危险因素，但其与亚临床动脉粥样硬化的关系尚不清楚。我们假设有复发性重度抑郁症病史的中年妇女会表现出动脉粥样硬化的证据。方法：对58例非裔美国妇女和152例健康白人中年妇女进行了冠状动脉和主动脉钙化的电子束断层扫描。研究人员对妇女进行了《精神疾病诊断与统计手册》第四版的结构化临床访谈和当前抑郁症状的自我报告测量。结果：冠状动脉钙化103例（49%），主动脉钙化144例（54%）；高钙化评分设置在样本分布的75%左右（即冠状动脉钙评分为>= 10 [n = 49名女性]，主动脉钙评分为> 100 [n = 53名女性]）。有复发性重度抑郁症病史的女性（n = 53）与有单一抑郁病史或无抑郁病史的女性相比，在任何部位发生冠状动脉钙化或高级别钙化的可能性更大。在逐步调整心血管危险因素和社会人口统计学特征后，与单次发作或无抑郁史相比，复发性重度抑郁史与任何冠状动脉钙化相关的比值比（ORs）为2.46(95%可信区间[CI]， 1.06-5.67)，与高冠状动脉钙化相关的比值比为2.71 (95% CI, 1.08-6.81)，与高主动脉钙化相关的比值比为3.39 （95% CI, 1.34-8.63）。进一步调整腰臀比降低了抑郁症复发史与钙化（OR, 2.24; 95% CI, 0.94-5.32）和高钙化（OR, 2.31; 95% CI, 0.89-5.99）之间的相关性。结论：在无冠状动脉疾病的无症状中年妇女样本中，复发性重度抑郁症与冠状动脉和主动脉钙化独立相关。腰臀比在一定程度上介导了这种关联。我们的研究结果表明，复发性重度抑郁症可能是女性早期动脉粥样硬化的一个危险因素。
Background: Although depression is a well-documented risk factor for clinical heart disease, its association with subclinical atherosclerosis is unclear. We hypothesized that middle-aged women with a history of recurrent major depression would show evidence of atherosclerosis.Methods: Coronary and aortic calcification was measured by electron beam tomography in 58 African American and 152 white healthy middle-aged women. Women were administered the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and a self-report measure of current depressive symptoms.Results: Coronary calcification was found in 103 women (49%) and aorta calcification in 144 women (54%); high calcification scores were set at approximately 75% of the sample distribution (ie, at >= 10 for the coronary calcium score [n = 49 women] and at > 100 for the aorta calcium score [n = 53 women]). Women with a history of recurrent major depression (n = 53) were more likely to have any coronary calcification or calcification in the high category at either site compared with women with a history of a single episode of depression or no depression. After stepwise forward adjustment for cardiovascular risk factors and sociodemographic characteristics, a history of recurrent major depression, compared with a single episode or no history, was associated with odds ratios (ORs) of 2.46 (95% confidence interval [CI], 1.06-5.67) for any coronary calcification, 2.71 (95% CI, 1.08-6.81) for high coronary calcification, and 3.39 (95% CI, 1.34-8.63) for high aortic calcification. Further adjustments for waist-hip ratio reduced the association between history of recurrent depression and any calcification (OR, 2.24; 95% CI, 0.94-5.32) and high calcification (OR, 2.31; 95% CI, 0.89-5.99).Conclusions: in this sample of asymptomatic middle-aged women without known coronary disease, recurrent major depression was independently associated with coronary and aortic calcification. Waist-hip ratio in part mediated the association. Our findings suggest that recurrent major depression may be a risk factor for early atherosclerosis in women.