Yu C Q, Chen Y P, Lv J, Guo Y, Sherliker P, Bian Z, Zhou H Y, Tan Y L, Chen J S, Chen Z M, Li L M
Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.
Nuffield Department of Population Health, University of Oxford, Oxford OX37LF, United Kingdom.
Beijing Da Xue Xue Bao Yi Xue Ban. 2016 Jun 18;48(3):465-71.
To investigate the associations of major depressive disorder with coronary heart disease (CHD) and stroke in Chinese adults aged 30-79 years.
In 2004-2008, China Kadoorie Biobank was conducted in 10 geographically defined regions (5 urban and 5 rural) of China. A total number of 512 891 participants aged 30-79 years were recruited in the baseline survey. A laptop-based electronic questionnaire was administrated face-to-face by trained health workers, collecting the general demographic and socio-economic status, dietary and other lifestyle behaviours (e.g. smoking, alcohol drinking, physical activity), medical history and family history of common chronic diseases. Major depressive episodes (MDE) in the past 12 months were assessed with the World Health Organization composite international diagnostic interview-short form (CIDI-SF). The physical measurements included the heights and weights, which were used to calculate the body mass indexes (BMI).Chi squared and t test were used to compare the differences in participants characteristics according to their major depressive disorder. Logistic models were employed to estimate the odds ratios (OR) and 95% CI of their major depressive disorder with prevalent coronary heart disease and stroke.
Among the 512 891 participants, 3 281 (0.6%) showed an MDE in the preceding 12 months, 15 472 (3.0%) reported prevalent CHD, and 8 884 (1.7%) reported prevalent stroke. Major depressive disorder was significantly associated with an increased risk of CHD and risk of stroke. Age- and gender-adjusted ORs (95% CI) were 1.80 (1.53-2.12) for CHD and 2.53 (2.09-3.05) for stroke. The associations were significant after further adjustment for potential confounders, such as other socio-demographic status, smoking, alcohol drinking, physical activity, and BMI, prevalent hypertension, diabetes as well as family history of cardiovascular diseases (OR=1.83, 95% CI=1.54-2.18 for CHD; OR=2.19, 95% CI=1.79-2.69 for stroke). Moreover, gender significantly interacted with MDE on prevalent stroke (P for multiplicative interaction=0.013). The men with an MDE in the past 12 months had the highest risk of stroke in the joint analyses of gender and depression disorder (OR=5.02, 95% CI=3.70-6.82).
The findings from this large cross-sectional study suggest that the presence of MDE is a risk factor for both CHD and stroke in Chinese adults aged 30-79 years, but further prospective studies are warranted to validate the results.
调查中国30 - 79岁成年人中重度抑郁症与冠心病（CHD）及中风之间的关联。
2004 - 2008年，在中国10个地理区域（5个城市和5个农村）开展了中国嘉道理生物银行研究。基线调查共招募了512891名30 - 79岁的参与者。由经过培训的卫生工作者面对面使用基于笔记本电脑的电子问卷，收集一般人口统计学和社会经济状况、饮食及其他生活方式行为（如吸烟、饮酒、体育活动）、病史以及常见慢性病的家族史。采用世界卫生组织复合国际诊断访谈简表（CIDI - SF）评估过去12个月内的重度抑郁发作（MDE）。身体测量包括身高和体重，用于计算体重指数（BMI）。采用卡方检验和t检验比较根据参与者是否患有重度抑郁症得出的特征差异。使用逻辑模型估计患有重度抑郁症与冠心病和中风患病率之间的比值比（OR）及95%置信区间（CI）。
在512891名参与者中，3281人（0.6%）在之前12个月内出现MDE，15472人（3.0%）报告患有冠心病，8884人（1.7%）报告患有中风。重度抑郁症与冠心病风险增加及中风风险增加显著相关。年龄和性别调整后的OR（95%CI），冠心病为1.80（1.53 - 2.12），中风为2.53（2.09 - 3.05）。在进一步调整潜在混杂因素后，这种关联仍然显著，这些因素包括其他社会人口统计学状况、吸烟、饮酒、体育活动及BMI、高血压患病率、糖尿病以及心血管疾病家族史（冠心病：OR = 1.83，95%CI = 1.54 - 2.18；中风：OR = 2.19，95%CI = 1.79 - 2.69）。此外，性别与MDE在中风患病率上存在显著交互作用（相乘交互作用P = 0.013）。在性别和抑郁症联合分析中，过去12个月内患有MDE的男性中风风险最高（OR = 5.02，95%CI = 3.70 - 6.82）。
这项大型横断面研究的结果表明，MDE的存在是中国30 - 79岁成年人患冠心病和中风的危险因素，但需要进一步的前瞻性研究来验证这些结果。
