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冠心病患者的抑郁与白细胞端粒长度:来自“心脏与灵魂研究”的数据。

Depression and leukocyte telomere length in patients with coronary heart disease: data from the Heart and Soul Study.

机构信息

Interdisciplinary Center for Psychiatric Epidemiology, University Medical Center Groningen, CC72 Hanzeplein 1, 9713 GZ Groningen, The Netherlands.

出版信息

Psychosom Med. 2011 Sep;73(7):541-7. doi: 10.1097/PSY.0b013e31821b1f6e. Epub 2011 May 19.

Abstract

OBJECTIVE

Shortened telomere length has been associated with mortality in patients with coronary heart disease (CHD) and is considered as an emerging marker of biologic age. Whether depression is associated with telomere length or trajectory has not been evaluated in patients with CHD.

METHODS

In a prospective cohort study, we measured leukocyte telomere length in 952 participants with stable CHD at baseline and in 608 of these participants after 5 years of follow-up. The presence of major depressive disorder in the past month was assessed using the computerized diagnostic interview schedule at baseline. We used linear and logistic regression models to evaluate the association of depression with baseline and 5-year change in leukocyte telomere length.

RESULTS

Of the 952 participants, 206 (22%) had major depression at baseline. After the adjustment for age and sex, the patients with current major depressive disorder had shorter baseline telomere length than those without depression (mean [standard error] = 0.86 [0.02] versus 0.90 [0.01]; p = .02). This association was similar (but no longer statistically significant) after adjustment for body mass index, smoking, diabetes, left ventricular ejection fraction, statin use, antidepressant use, physical inactivity, and anxiety (0.85 [0.02] versus 0.89 [0.01], p = .06). Depression was not predictive of 5-year change in telomere length after adjustment for the mentioned covariates and baseline telomere length.

CONCLUSIONS

Depression is associated with reduced leukocyte telomere length in patients with CHD but does not predict 5-year change in telomere length. Future research is necessary to elucidate the potential mechanisms underlying the association between depression and telomere length.

摘要

目的

端粒缩短与冠心病(CHD)患者的死亡率相关,被认为是生物年龄的新兴标志物。在 CHD 患者中,尚未评估抑郁与端粒长度或轨迹之间的关系。

方法

在一项前瞻性队列研究中,我们在基线时测量了 952 名稳定 CHD 患者的白细胞端粒长度,并在 5 年随访后测量了其中 608 名患者的白细胞端粒长度。在基线时使用计算机化诊断访谈时间表评估过去一个月是否存在重度抑郁症。我们使用线性和逻辑回归模型来评估抑郁与白细胞端粒长度的基线和 5 年变化之间的关系。

结果

在 952 名参与者中,有 206 名(22%)在基线时有重度抑郁症。在校正年龄和性别后,当前患有重度抑郁症的患者的端粒长度比没有抑郁症的患者短(平均值[标准误差] = 0.86[0.02] 与 0.90[0.01];p =.02)。在调整体重指数、吸烟、糖尿病、左心室射血分数、他汀类药物使用、抗抑郁药使用、体力活动不足和焦虑后,这种关联仍然相似(但不再具有统计学意义)(0.85[0.02] 与 0.89[0.01],p =.06)。在调整上述协变量和基线端粒长度后,抑郁与端粒长度 5 年变化无关。

结论

抑郁与 CHD 患者白细胞端粒长度缩短有关,但不能预测端粒长度 5 年变化。需要进一步研究阐明抑郁与端粒长度之间关联的潜在机制。

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