Ren Yan, Jia Jiao, Sa Jian, Qiu Li-Xia, Cui Yue-Hua, Zhang Yue-An, Yang Hong, Liu Gui-Fen
Department of Psychiatry, Shanxi Da Yi Hospital, Taiyuan, Shanxi 030032, China.
Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China.
Chin Med J (Engl). 2017 Mar 5;130(5):542-548. doi: 10.4103/0366-6999.200536.
While depression and certain cardiac biomarkers are associated with acute myocardial infarction (AMI), the relationship between them remains largely unexplored. We examined the association between depressive symptoms and biomarkers in patients with AMI.
We performed a cross-sectional study using data from 103 patients with AMI between March 2013 and September 2014. The levels of depression, N-terminal proB-type natriuretic peptide (NT-proBNP), and troponin I (TnI) were measured at baseline. The patients were divided into two groups: those with depressive symptoms and those without depressive symptoms according to Zung Self-rating Depression Scale (SDS) score. Baseline comparisons between two groups were made using Student's t-test for continuous variables, Chi-square or Fisher's exact test for categorical variables, and Wilcoxon test for variables in skewed distribution. Binomial logistic regression and multivariate linear regression were performed to assess the association between depressive symptoms and biomarkers while adjusting for demographic and clinical variables.
Patients with depressive symptoms had significantly higher NT-proBNP levels as compared to patients without depressive symptoms (1135.0 [131.5, 2474.0] vs. 384.0 [133.0, 990.0], Z = -2.470, P = 0.013). Depressive symptoms were associated with higher NT-proBNP levels (odds ratio [OR] = 2.348, 95% CI: 1.344 to 4.103, P = 0.003) and higher body mass index (OR = 1.169, 95% confidence interval [CI]: 1.016 to 1.345, P = 0.029). The total SDS score was associated with the NT-proBNP level (β= 0.327, 95% CI: 1.674 to 6.119, P = 0.001) after multivariable adjustment. In particular, NT-proBNP was associated with three of the depressive dimensions, including core depression (β = 0.299, 95% CI: 0.551 to 2.428, P = 0.002), cognitive depression (β = 0.320, 95% CI: 0.476 to 1.811, P = 0.001), and somatic depression (β = 0.333, 95% CI: 0.240 to 0.847, P = 0.001). Neither the overall depressive symptomatology nor the individual depressive dimensions were associated with TnI levels.
Depressive symptoms, especially core depression, cognitive depression, and somatic depression, were related to high NT-proBNP levels in patients with AMI.
虽然抑郁症与某些心脏生物标志物与急性心肌梗死（AMI）有关，但它们之间的关系在很大程度上仍未得到探索。我们研究了AMI患者抑郁症状与生物标志物之间的关联。
我们进行了一项横断面研究，使用了2013年3月至2014年9月期间103例AMI患者的数据。在基线时测量抑郁水平、N末端B型利钠肽原（NT-proBNP）和肌钙蛋白I（TnI）水平。根据zung自评抑郁量表（SDS）评分，将患者分为两组：有抑郁症状的患者和无抑郁症状的患者。两组之间的基线比较采用连续变量的Student's t检验、分类变量的卡方检验或Fisher精确检验以及偏态分布变量的Wilcoxon检验。进行二项逻辑回归和多元线性回归，以评估抑郁症状与生物标志物之间的关联，同时调整人口统计学和临床变量。
与无抑郁症状的患者相比，有抑郁症状的患者NT-proBNP水平显著更高（1135.0[131.5,2474.0]对384.0[133.0,990.0]，Z=-2.470，P=0.013）。抑郁症状与较高的NT-proBNP水平相关（优势比[OR]=2.348，95%可信区间：1.344至4.103，P=0.003）和较高的体重指数（OR=1.169，95%可信区间[CI]：1.016至1.345，P=0.029）。多变量调整后，SDS总分与NT-proBNP水平相关（β=0.327，95%CI：1.674至6.119，P=0.001）。特别是，NT-proBNP与三个抑郁维度相关，包括核心抑郁（β=0.299，95%CI：0.551至2.428，P=0.002）、认知抑郁（β=0.320，95%CI：0.476至1.811，P=0.001）和躯体抑郁（β=0.333，95%CI：0.240至0.847，P=0.001）。总体抑郁症状学和个体抑郁维度均与TnI水平无关。
抑郁症状，尤其是核心抑郁、认知抑郁和躯体抑郁，与AMI患者的高NT-proBNP水平有关。
