Panagiotakos Demosthenes B, Pitsavos Christos, Chrysohoou Christina, Tsetsekou Efi, Papageorgiou Charalambos, Christodoulou George, Stefanadis Christodoulos
Department of Dietetics and Nutrition, Harokopio University, Athens, Greece.
Eur Heart J. 2004 Mar;25(6):492-9. doi: 10.1016/j.ehj.2004.01.018.
Depression is associated with an increase in cardiovascular disease, but the underlying mechanisms are not well understood. The aim of this study was to examine the associations of depressive symptoms with inflammation and coagulation factors related to cardiovascular risk in persons free of cardiovascular disease.
A random algorithm was developed and stratified by gender-age and multistage sampling was performed during 2001-2002. In this study, we analysed data from 453 men (19-89 years old) and 400 women (18-84 years old). Inflammation markers were C-reactive protein (CRP), serum amyloid A, white blood cell (WBC) and total platelet counts; and coagulation factors including homocysteine and fibrinogen. Depression was assessed with the Zung Self-Rating Depression Scale (ZDRS range 0-100) after validation for the study population. A ZDRS score of 50 or more classified a person as mildly depressive. Statistical adjustments were made for risk factors (age, gender, smoking, diabetes mellitus, and physical activity level).
Women had significantly higher scores on the Zung depression scale than men (47 +/- 9 vs. 43 +/- 10, p<0.001). Thus, 21% of men and 27% of women had mild depression, while 4% of men and 6% of women had severe depressive symptomatology. The depression scale correlated positively with C-reactive protein levels (p<0.05), white blood cell count (p<0.05), and fibrinogen (p<0.05) in both genders after adjustment for control variables.
This study revealed that depression was associated with inflammation and coagulation factors in cardiovascular disease-free people, suggesting a possible pathway leading to an increased frequency of events of coronary heart disease in depressive individuals.
抑郁症与心血管疾病的增加有关，但其潜在机制尚未完全明确。本研究的目的是在无心血管疾病的人群中，探讨抑郁症状与心血管风险相关的炎症和凝血因子之间的关联。
开发了一种随机算法，并按性别年龄进行分层，于2001年至2002年进行多阶段抽样。在本研究中，我们分析了453名男性（19 - 89岁）和400名女性（18 - 84岁）的数据。炎症标志物包括C反应蛋白（CRP）、血清淀粉样蛋白A、白细胞（WBC）和血小板总数；凝血因子包括同型半胱氨酸和纤维蛋白原。在对研究人群进行验证后，使用zung自评抑郁量表（ZDRS范围0 - 100）评估抑郁情况。ZDRS评分50分及以上被归类为轻度抑郁。对风险因素（年龄、性别、吸烟、糖尿病和身体活动水平）进行了统计调整。
女性在zung抑郁量表上的得分显著高于男性（47±9 vs. 43±10，p<0.001）。因此，21%的男性和27%的女性有轻度抑郁，而分别有4%的男性和6%的女性有严重抑郁症状。在调整控制变量后，抑郁量表与男女两性的C反应蛋白水平（p<0.05）、白细胞计数（p<0.05）和纤维蛋白原（p<0.05）呈正相关。
本研究表明，在无心血管疾病的人群中，抑郁与炎症和凝血因子有关，提示这可能是导致抑郁个体冠心病事件发生率增加的一条潜在途径。
