Heart rate variability and depressive symptoms: a cross-lagged analysis over a 10-year period in the Whitehall II study
Heart rate variability and depressive symptoms: a cross-lagged analysis over a 10-year period in the Whitehall II study
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DOI：
10.1017/s003329171600060x
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发表时间：
2016-07-01
影响因子：
6.9
通讯作者：
Steptoe, A.
中科院分区：
文献类型：
--
作者：
Jandackova, V. K.;Britton, A.;Steptoe, A.
背景。抑郁症患者的心率变异性 (HRV) 往往较低，但人们对其时间顺序知之甚少。在一般人群的样本中，我们前瞻性地研究了 HRV 测量是否可以预测随后的抑郁症状，或者抑郁症状是否可以预测随后的 HRV 水平。对英国Whitehall II纵向人群队列研究第五阶段（1997-1999）和第九阶段（2007-2009）的数据进行了分析，平均随访时间为10.5年。前瞻性分析的样本量取决于分析结果，范围从 2334 名（644 名女性）到 2276 名（602 名女性）。获得仰卧休息 5 分钟期间的 HRV 测量值。抑郁症状通过一般健康问卷中的四种抑郁认知症状进行评估。结果。在随访评估中，男性抑郁症状与 HRV 测量值呈负相关，与抗抑郁药物的使用无关，但女性则不然。前瞻性地，较低的基线心率和较高的 HRV 测量值与基线时没有抑郁症状的男性随访时发生抑郁症状的可能性较低相关。在女性中也发现了类似但统计学上不显着的关联。对已知混杂因素（包括社会人口统计学和生活方式因素、心脏代谢状况或药物治疗）的调整并没有改变 HRV 对随访时抑郁症状的预测作用。无论性别，基线时的抑郁症状与随访时的心率或 HRV 均无关。结论。这些发现与自主神经系统在抑郁症发作中的病因学作用一致。
Background. People with depression tend to have lower heart rate variability (HRV), but the temporal sequence is poorly understood. In a sample of the general population, we prospectively examined whether HRV measures predict subsequent depressive symptoms or whether depressive symptoms predict subsequent levels of HRV.Method. Data from the fifth (1997-1999) and ninth (2007-2009) phases of the UK Whitehall II longitudinal population-based cohort study were analysed with an average follow-up of 10.5 years. The sample size for the prospective analysis depended on the analysis and ranged from 2334 (644 women) to 2276 (602 women). HRV measures during 5 min of supine rest were obtained. Depressive symptoms were evaluated by four cognitive symptoms of depression from the General Health Questionnaire.Results. At follow-up assessment, depressive symptoms were inversely associated with HRV measures independently of antidepressant medication use in men but not in women. Prospectively, lower baseline heart rate and higher HRV measures were associated with a lower likelihood of incident depressive symptoms at follow-up in men without depressive symptoms at baseline. Similar but statistically insignificant associations were found in women. Adjustments for known confounders including sociodemographic and lifestyle factors, cardiometabolic conditions or medication did not change the predictive effect of HRV on incident depressive symptoms at follow-up. Depressive symptoms at baseline were not associated with heart rate or HRV at follow-up in either sex.Conclusions. These findings are consistent with an aetiological role of the autonomic nervous system in depression onset.