Interaction between smoking and depressive symptoms with subclinical heart disease in the Coronary Artery Risk Development in Young Adults (CARDIA) study.
Interaction between smoking and depressive symptoms with subclinical heart disease in the Coronary Artery Risk Development in Young Adults (CARDIA) study.
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吸烟与抑郁症状与年轻人冠状动脉风险发展（CADCIA）研究中的亚临床心脏病之间的相互作用。
DOI：
10.1037/hea0000425
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发表时间：
2017-02
期刊：
影响因子：
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通讯作者：
Hitsman B
中科院分区：
文献类型：
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作者：
Carroll AJ;Carnethon MR;Liu K;Jacobs DR;Colangelo LA;Stewart JC;Carr JJ;Widome R;Auer R;Hitsman B
评估 25 年累积的吸烟暴露和抑郁症状是否与亚临床心脏病（通过冠状动脉钙化 (CAC) 测量）存在协同关联。年轻人冠状动脉风险发展 (CARDIA) 研究从 1985 年到 2010 年对参与者（基线：54.5% 女性；51.5% 黑人；年龄范围 = 18-30 岁）进行了前瞻性随访。从第 0 年到第 25 年，每年都会查询吸烟状况，以计算吸烟暴露的包年数。每五年根据流行病学研究中心抑郁量表 (CES-D) 测量一次抑郁症状，以计算第 5 年至第 25 年的累积分数。使用三级多项 Logistic 回归来评估累积吸烟量、累积抑郁症状及其与第 25 年无 CAC（分数 = 0）相比，中度风险 CAC（分数 1-99）和高风险 CAC（分数 ≥ 100）之间的相互作用。调整模型用于社会人口统计学、临床和行为协变量。在 3,189 名成年人中，累积吸烟与抑郁症状的相互作用对于中等风险 CAC 并不显着 (p=.057)，但对于高风险 CAC 则显着 (p=.001)。对于有 30 包年吸烟史的成年人，平均 CES-D 评分 2、10 和 16 分别与高风险 CAC 的比值比（95% 置信区间）3.40 (2.36–4.90)、4.82 (3.03–7.66) 和 6.25 (3.31–11.83) 相关（所有 p<.05）。累积吸烟暴露和累积抑郁症状与亚临床心脏病具有协同关联，其中较高的终生吸烟暴露和抑郁症状与较高的 CAC 几率相关。
Evaluate whether smoking exposure and depressive symptoms accumulated over 25 years are synergistically associated with subclinical heart disease, measured by coronary artery calcification (CAC). Participants (baseline: 54.5% female; 51.5% Black; age range=18–30 years) were followed prospectively from 1985 to 2010 in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Smoking status was queried yearly from Year 0 to Year 25 to compute packyears of smoking exposure. Depressive symptoms were measured on the Center for Epidemiologic Studies Depression (CES-D) scale every five years to compute cumulative scores from Year 5 to Year 25. A three-level multinomial logistic regression was used to evaluate the association between cumulative smoking, cumulative depressive symptoms, and their interaction with moderate-risk CAC (score 1-99) and higher-risk CAC (score ≥100) compared to no CAC (score =0) at Year 25. Models were adjusted for sociodemographic, clinical, and behavioral covariates. Among 3,189 adults, the cumulative smoking x depressive symptoms interaction was not significant for moderate-risk CAC (p=.057), but was significant for higher-risk CAC (p=.001). For adults with a 30-packyear smoking history, average CES-D scores 2, 10, and 16 were respectively associated with odds ratios (95% confidence intervals) 3.40 (2.36–4.90), 4.82 (3.03–7.66), and 6.25 (3.31–11.83) for higher-risk CAC (all ps<.05). Cumulative smoking exposure and cumulative depressive symptoms have a synergistic association with subclinical heart disease, where higher lifetime smoking exposure and depressive symptoms are associated with greater odds of CAC.