Butnoriene Jurate, Bunevicius Adomas, Saudargiene Ausra, Nemeroff Charles B, Norkus Antanas, Ciceniene Vile, Bunevicius Robertas
Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Institute of Neurosciences, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Int J Cardiol. 2015;190:360-6. doi: 10.1016/j.ijcard.2015.04.122. Epub 2015 Apr 16.
Studies investigating specifically whether metabolic syndrome (MetS) and common psychiatric disorders are independently associated with mortality are lacking. In a middle-aged general population, we investigated the association of the MetS, current major depressive episode (MDE), lifetime MDE, and generalized anxiety disorder (GAD) with ten-year all-cause and cardiovascular disease mortality.
From February 2003 until January 2004, 1115 individuals aged 45 years and older were randomly selected from a primary care practice and prospectively evaluated for: (1) MetS (The World Health Organization [WHO], National Cholesterol Education Program/Adult Treatment Panel III and International Diabetes Federation [IDF] definitions); (2) current MDE and GAD, and lifetime MDE (Mini International Neuropsychiatric Interview); and (3) conventional cardiovascular risk factors. Follow-up continued through January, 2013.
During the 9.32 ± 0.47 years of follow-up, there were 248 deaths, of which 148 deaths were attributed to cardiovascular causes. In women, WHO-MetS and IDF-MetS were associated with greater all-cause (HR-values range from 1.77 to 1.91; p-values ≤ 0.012) and cardiovascular (HR-values range from 1.83 to 2.77; p-values ≤ 0.013) mortality independent of cardiovascular risk factors and MDE/GAD. Current GAD predicted greater cardiovascular mortality (HR-values range from 1.86 to 1.99; p-values ≤ 0.025) independently from MetS and cardiovascular risk factors. In men, the MetS and MDE/GAD were not associated with mortality.
In middle aged women, the MetS and GAD predicted greater 10-year cardiovascular mortality independently from each other; 10-year all-cause mortality was independently predicted by the MetS. MetS and GAD should be considered important and independent mortality risk factors in women.
缺乏专门研究代谢综合征（MetS）和常见精神障碍是否与死亡率独立相关的研究。在中年普通人群中，我们调查了MetS、当前重度抑郁发作（MDE）、终生MDE和广泛性焦虑障碍（GAD）与十年全因死亡率和心血管疾病死亡率之间的关联。
从2003年2月至2004年1月，从一家初级保健机构中随机选取1115名45岁及以上的个体，并对其进行前瞻性评估：（1）MetS（世界卫生组织[WHO]、国家胆固醇教育计划/成人治疗小组III和国际糖尿病联盟[IDF]的定义）；（2）当前的MDE和GAD，以及终生MDE（迷你国际神经精神访谈）；（3）传统心血管危险因素。随访持续至2013年1月。
在9.32±0.47年的随访期间，有248人死亡，其中148例死亡归因于心血管原因。在女性中，WHO-MetS和IDF-MetS与更高的全因死亡率（HR值范围为1.77至1.91；p值≤0.012）和心血管死亡率（HR值范围为1.83至2.77；p值≤0.013）相关，独立于心血管危险因素和MDE/GAD。当前的GAD独立于MetS和心血管危险因素预测更高的心血管死亡率（HR值范围为1.86至1.99；p值≤0.025）。在男性中，MetS和MDE/GAD与死亡率无关。
在中年女性中，MetS和GAD相互独立地预测更高的10年心血管死亡率；MetS独立预测10年全因死亡率。MetS和GAD应被视为女性重要且独立的死亡风险因素。
