Cardiovascular Imaging and Clinical Research Core Laboratory, Cardiovascular Division, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8086, St, Louis, MO 63110, USA.
BMC Cardiovasc Disord. 2013 Sep 8;13:66. doi: 10.1186/1471-2261-13-66.
Coronary artery disease (CAD) is a major cause of death and disability worldwide. Depression has complex bidirectional adverse associations with CAD, although the mechanisms mediating these relationships remain unclear. Compared to European Americans, African Americans (AAs) have higher rates of morbidity and mortality from CAD. Although depression is common in AAs, its role in the development and features of CAD in this group has not been well examined. This project hypothesizes that the relationships between depression and CAD can be explained by common physiological pathways and gene-environment interactions. Thus, the primary aims of this ongoing project are to: a) determine the prevalence of CAD and depression phenotypes in a population-based sample of community-dwelling older AAs; b) examine the relationships between CAD and depression phenotypes in this population; and c) evaluate genetic variants from serotoninP and inflammatory pathways to discover potential gene-depression interactions that contribute significantly to the presence of CAD in AAs.
METHODS/DESIGN: The St. Louis African American Health (AAH) cohort is a population-based panel study of community-dwelling AAs born in 1936-1950 (inclusive) who have been followed from 2000/2001 through 2010. The AAH-Heart study group is a subset of AAH participants recruited in 2009-11 to examine the inter-relationships between depression and CAD in this population. State-of-the-art CAD phenotyping is based on cardiovascular characterizations (coronary artery calcium, carotid intima-media thickness, cardiac structure and function, and autonomic function). Depression phenotyping is based on standardized questionnaires and detailed interviews. Single nucleotide polymorphisms of selected genes in inflammatory and serotonin-signaling pathways are being examined to provide information for investigating potential gene-depression interactions as modifiers of CAD traits. Information from the parent AAH study is being used to provide population-based prevalence estimates. Inflammatory and other biomarkers provide information about potential pathways.
This population-based investigation will provide valuable information on the prevalence of both depression and CAD phenotypes in this population. The study will examine interactions between depression and genetic variants as modulators of CAD, with the intent of detecting mechanistic pathways linking these diseases to identify potential therapeutic targets. Analytic results will be reported as they become available.
冠心病（CAD）是全球范围内导致死亡和残疾的主要原因。抑郁症与 CAD 之间存在复杂的双向不利关联，尽管介导这些关系的机制仍不清楚。与欧洲裔美国人相比，非裔美国人（AAs）的 CAD 发病率和死亡率更高。尽管抑郁症在 AAs 中很常见，但它在该人群中 CAD 的发展和特征中的作用尚未得到充分研究。该项目假设，抑郁症和 CAD 之间的关系可以通过常见的生理途径和基因-环境相互作用来解释。因此，正在进行的该项目的主要目标是：a）在基于人群的社区居住的老年 AAs 样本中确定 CAD 和抑郁症表型的患病率；b）在该人群中检查 CAD 和抑郁症表型之间的关系；c）评估来自 5-羟色胺 P 和炎症途径的遗传变异，以发现可能导致 CAD 在 AAs 中显著存在的潜在基因-抑郁相互作用。
方法/设计：圣路易斯非裔美国人健康（AAH）队列是一项基于人群的社区居住的 1936-1950 年（含）出生的非裔美国人的纵向研究，自 2000/2001 年开始一直随访至 2010 年。AAH-心脏研究小组是 AAH 参与者的一个子集，他们于 2009-11 年招募，以检查该人群中抑郁症和 CAD 之间的相互关系。先进的 CAD 表型基于心血管特征（冠状动脉钙、颈动脉内膜中层厚度、心脏结构和功能以及自主功能）。抑郁症表型基于标准化问卷和详细访谈。正在检查选定的炎症和 5-羟色胺信号通路中的基因的单核苷酸多态性，以提供信息来研究潜在的基因-抑郁相互作用作为 CAD 特征的修饰因子。来自父 AAH 研究的信息用于提供基于人群的患病率估计。炎症和其他生物标志物提供了有关潜在途径的信息。
这项基于人群的研究将提供有关该人群中抑郁症和 CAD 表型的患病率的宝贵信息。该研究将检查抑郁症和遗传变异之间作为 CAD 调节剂的相互作用，目的是检测将这些疾病联系起来以确定潜在治疗靶点的机制途径。分析结果将在可用时报告。
