Depression and thyroid axis function in coronary artery disease: Impact of cardiac impairment and gender
Depression and thyroid axis function in coronary artery disease: Impact of cardiac impairment and gender
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DOI：
10.1002/clc.4960290409
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发表时间：
2006-04-01
影响因子：
2.7
通讯作者：
Girdler, SS
中科院分区：
文献类型：
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作者：
Bunevicius, R;Varoneckas, G;Girdler, SS
背景：据报道，冠心病(CAD)患者的抑郁率增加。在心脏病中，抑郁会增加残疾，降低生活质量，增加死亡率。假设：本研究旨在探讨冠心病患者抑郁与甲状腺轴功能的关系。方法：共73例冠心病患者接受了医院焦虑和抑郁量表(HADS)的抑郁评估。结果：与无抑郁症状的冠心病患者相比，有抑郁症状的冠心病患者心力衰竭发生率高(p=0.04)，NT-proBNP浓度高(p=0.02)，游离三碘甲腺原氨酸(T-3)浓度低(p=0.04)。他们还显示出低T-3综合征更高发生率的强烈趋势(p=0.058)。NT-ProBNP浓度升高与总T-3浓度降低(r=-0.294，p=0.011)和反向T-3浓度升高(r=0.353，p=0.002)相关。在男性中，抑郁得分越高，总T-3浓度越低(r=-0.289，p=0.034)，NT-proBNP浓度越高(r=0.380，p=0.005)，抑郁症状越明显。结论：冠心病患者抑郁症状与甲状腺轴功能改变和心脏损害有关，尤其是男性。
Background: Increased rates of depression are reported in coronary artery disease (CAD). In heart disease, depression increases disability, reduces quality of life, and increases mortality.Hypothesis: The study was undertaken to examine the relationship between depression and thyroid axis function in patients with CAD.Methods: In all, 73 patients with CAD, consecutively admitted to a cardiac rehabilitation hospital., were assessed for depression using the Hospital Anxiety and Depression scale (HADS). Blood was drawn for assessment of thyroid axis hormones and the N-amino terminal fragment of the pro-B-type natriuretic peptide (NT-pro BNP).Results: The patients with CAD with depressive symptoms had a higher prevalence of cardiac failure (p = 0.04), higher NT-pro BNP concentrations (p = 0.02), and lower free triiodothyronine (T-3) concentrations (p = 0.04) than patients with CAD but without depressive symptoms. They also showed a strong trend (p = 0.058) toward a higher incidence of the low T-3 syndrome. Higher NT-pro BNP concentrations were related to lower total T-3 concentrations (r = -0.294, p = 0.011) and to higher reverse T-3 concentrations (r = 0.353, p = 0.002). In men, higher scores of depression were related to lower total T-3 concentration (r = -0.289, p = 0.034) and to higher NT-pro BNP concentration (r = 0.380, p = 0.005).Conclusion: These findings suggest that symptoms of depression in patients with CAD are associated with changes in thyroid axis function and with cardiac impairment, especially in men.