颈动脉斑块存在和内中膜厚度与老年人抑郁症状的纵向关联：三城市研究。
Longitudinal association of carotid plaque presence and intima-media thickness with depressive symptoms in the elderly: the three-city study.
机构信息
From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France (C.P., M.-C.P., J.-P.E.); UPMC University Paris 06, UMR-S943, Paris, France (O.G.); INSERM, UMR-S943, Paris, France (O.G.); INSERM, U1061, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (K.R.); University of Montpellier 1, Montpellier, France (K.R.); INSERM, U897, Epidemiology and Biostatistics, Institute of Public Health and Development (ISPED), Bordeaux, France (C.H.); University of Bordeaux, Bordeaux, France (C.H.); INSERM, Clinical Investigation Center Clinical Epidemiology (CIC-1401), Bordeaux, France (C.H.); and INSERM, U897 (C.T., C.D.) and CIC-1401, Clinical epidemiology branch, Bordeaux Hospital (C.D.), Bordeaux University, Bordeaux, France.
出版信息
Arterioscler Thromb Vasc Biol. 2015 May;35(5):1279-83. doi: 10.1161/ATVBAHA.114.305061. Epub 2015 Apr 2.
OBJECTIVE
To investigate prospectively whether subclinical vascular disease is associated with future depressive symptoms in the elderly.
APPROACH AND RESULTS
A multicenter cohort of community-dwelling individuals aged 65 to 85 years was examined for carotid plaque presence and common carotid artery intima-media thickness at baseline and followed up after 2, 4, 7, and 10 years. At baseline and follow-up examinations, depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). High level of depressive symptoms was defined as a CES-D score >16 in men and >22 in women. Among 4125 participants (58% women) at baseline, men more frequently showed carotid plaque presence and had higher mean common carotid artery intima-media thickness than women. After adjustment for major cardiovascular risk factors, carotid plaque presence was associated with a higher CES-D score at the 10-year follow-up in men (+1.46; 95% confidence interval, 0.71-2.20; P<0.001), but not in women. When restricting analyses to individuals without cardiovascular disease at baseline, carotid plaque presence increased the likelihood of high level of depressive symptoms at follow-up examinations in men (odds ratio, 1.47; 95% confidence interval, 1.06-2.05; P=0.022), but not in women. One SD increase in log-transformed common carotid artery intima-media thickness was associated with a higher CES-D score at the 10-year follow-up in women (+0.55; 95% confidence interval, 0.16-0.95; P=0.006) and men (+0.40; 95% confidence interval, 0.02-0.78; P=0.037). Common carotid artery intima-media thickness did not increase the likelihood of high level of depressive symptoms at follow-up in both sexes.
CONCLUSIONS
Subclinical vascular disease is associated with the progression of depressive symptoms in elderly men and women and the occurrence of high level of depressive symptoms in elderly men.
目的
前瞻性研究亚临床血管疾病与老年人未来抑郁症状的关系。
方法和结果
对 65 至 85 岁的社区居民进行了一项多中心队列研究，在基线时检查颈动脉斑块的存在情况和颈总动脉内膜中层厚度，并在 2、4、7 和 10 年后进行随访。在基线和随访检查时，使用流行病学研究中心抑郁量表（CES-D）评估抑郁症状。高抑郁症状水平定义为男性 CES-D 评分>16，女性 CES-D 评分>22。在 4125 名参与者（58%为女性）中，男性更常出现颈动脉斑块存在，且颈总动脉内膜中层厚度的平均值高于女性。在调整主要心血管危险因素后，颈动脉斑块的存在与男性在 10 年随访时 CES-D 评分较高有关（+1.46；95%置信区间，0.71-2.20；P<0.001），但在女性中没有相关性。当将分析限制在基线时无心血管疾病的个体中时，颈动脉斑块的存在增加了男性在随访检查时出现高抑郁症状的可能性（优势比，1.47；95%置信区间，1.06-2.05；P=0.022），但在女性中没有相关性。log 转换后的颈总动脉内膜中层厚度每增加 1 个标准差与女性在 10 年随访时 CES-D 评分较高有关（+0.55；95%置信区间，0.16-0.95；P=0.006）和男性（+0.40；95%置信区间，0.02-0.78；P=0.037）。颈总动脉内膜中层厚度并未增加两性在随访时出现高抑郁症状的可能性。
结论
亚临床血管疾病与老年男女抑郁症状的进展以及老年男性高抑郁症状的发生有关。
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