Tulane Center for Cardiovascular Health, Tulane University Health Sciences Center, New Orleans, LA, USA.
Am J Med. 2009 Dec;122(12):1151.e1-8. doi: 10.1016/j.amjmed.2009.07.016.
Although there is growing evidence that symptoms of depression influence the development of coronary artery disease, information on the underlying subclinical atherosclerotic process is scant in young adults. The study examined the association between symptoms of depression and subclinical atherosclerosis, determined by carotid intima-media thickness in asymptomatic young individuals.
A cross-sectional study was performed in Bogalusa, Louisiana, a semi-rural biracial (black-white) community. A sample of 996 individuals aged 24 to 44 years (71% were white and 43% were male) enrolled in the Bogalusa Heart Study. The variables included symptoms of depression measured by the Center for Epidemiological Studies-Depression Scale; intima-media thickness of different segments of carotid artery by B-mode ultrasonography; measures of adiposity and glucose homeostasis, lipoproteins, and blood pressure; and cigarette smoking status.
Both the adjusted and the unadjusted associations between depression score and carotid bulb intima-media thickness were significant, whereas similar associations with internal carotid and common carotid thickness were nonsignificant. In the multivariable regression model, after adjusting for all covariates, a positive effect of depression scores (Center for Epidemiological Studies-Depression score) and a negative effect of interaction between depression score ratio of total cholesterol (TC)/high-density lipoprotein (HDL) were significant. In a subgroup analysis (among individuals with a ratio of TC/HDL < or = 5) a positive effect of depression on carotid bulb intima-media thickness was significant, whereas the interaction between depression and ratio of TC/HDL was nonsignificant. In subsequent analysis, if individuals with a higher ratio of TC/HDL were included, both depression and negative interaction term were significant.
The observations show the detrimental effect of depression on subclinical vascular changes in asymptomatic young individuals. The findings underscore the need for considering depression in risk factor profiling. Further study is recommended to investigate the basis of a lower carotid bulb intima-media thickness among subjects with a high depression score and a high ratio of TC/HDL.
尽管越来越多的证据表明抑郁症状会影响冠状动脉疾病的发展，但关于无症状年轻人亚临床动脉粥样硬化过程的信息却很少。本研究检测了无症状年轻个体中抑郁症状与亚临床动脉粥样硬化之间的相关性，这种相关性通过颈动脉内膜中层厚度来确定。
在路易斯安那州的博加卢萨进行了一项横断面研究，这是一个半农村的黑白混合（黑人和白人）社区。博加卢萨心脏研究纳入了 996 名年龄在 24 至 44 岁之间的个体（71%为白人，43%为男性）。研究变量包括用流行病学研究中心抑郁量表测量的抑郁症状；B 型超声检测的颈动脉不同节段的内膜中层厚度；体脂和葡萄糖稳态、脂蛋白和血压的测量；以及吸烟状况。
抑郁评分与颈动脉球部内膜中层厚度之间的调整和未调整关联均具有统计学意义，而与内颈动脉和总颈动脉厚度的类似关联则无统计学意义。在多元回归模型中，调整所有协变量后，抑郁评分（流行病学研究中心抑郁量表评分）的正向作用和抑郁评分与总胆固醇（TC）/高密度脂蛋白（HDL）比值之间的交互作用的负向作用具有统计学意义。在亚组分析（在 TC/HDL 比值≤5 的个体中），抑郁对颈动脉球部内膜中层厚度的正向作用具有统计学意义，而抑郁与 TC/HDL 比值之间的交互作用则无统计学意义。在随后的分析中，如果纳入 TC/HDL 比值较高的个体，抑郁和负向交互项均具有统计学意义。
这些观察结果表明，抑郁对无症状年轻个体亚临床血管变化有不利影响。这些发现强调了在危险因素分析中需要考虑抑郁。建议进一步研究以探讨在 TC/HDL 比值较高的个体中出现较高抑郁评分和较低颈动脉球部内膜中层厚度的基础。
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