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无症状抑郁症患者亚临床动脉粥样硬化的无创评估。

Noninvasive assessment of subclinical atherosclerosis in persons with symptoms of depression.

机构信息

Center for Healthcare Advancement and Outcomes, Baptist Health Medical Group, Miami, FL, USA; University of Manchester, Faculty of Biology, Medicine and Health, Manchester, United Kingdom; Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.

Center for Healthcare Advancement and Outcomes, Baptist Health Medical Group, Miami, FL, USA.

出版信息

Atherosclerosis. 2017 Sep;264:92-99. doi: 10.1016/j.atherosclerosis.2017.07.010. Epub 2017 Jul 12.

Abstract

BACKGROUND AND AIMS

Depression is a mood disorder characterized by persistent feelings of loss of interest along with a cluster of clinical symptoms. It is a significant public health concern affecting 350 million people worldwide. Depression has an association with increased risk of cardiovascular disease. The World Health Organization estimates both depression and coronary artery disease to be the two major causes of disability-adjusted life years by year 2020. Early identification of subclinical cardiovascular disease in people suffering from depression may significantly impact risk stratification of these patients.

METHODS

An electronic search of MEDLINE database was carried out using PubMed and OvidSP. Subclinical atherosclerosis was identified by coronary artery calcium (CAC). A total of 24 studies were identified to be included in the review.

RESULTS

In this review of twenty-four studies, we found that twelve studies identified a positive association between depression and subclinical atherosclerosis. Ten studies found no significant association between depressive symptoms and coronary calcification. Whereas, two studies showed negative association.

CONCLUSIONS

There is mixed evidence assessing the relationship between depression and CAC. Depressive symptoms may represent a potentially modifiable risk factor for early prevention of cardiovascular disease especially in younger patients with moderate to severe depression.

摘要

背景与目的

抑郁症是一种以持续失去兴趣为特征的情绪障碍,伴有一系列临床症状。它是一个重大的公共卫生问题,影响着全球 3.5 亿人。抑郁症与心血管疾病风险增加有关。世界卫生组织估计,到 2020 年,抑郁症和冠状动脉疾病将成为残疾调整生命年的两个主要原因。在患有抑郁症的人群中早期识别亚临床心血管疾病可能会显著影响这些患者的风险分层。

方法

使用 PubMed 和 OvidSP 在 MEDLINE 数据库中进行电子检索。亚临床动脉粥样硬化通过冠状动脉钙(CAC)来识别。共确定了 24 项研究纳入综述。

结果

在对 24 项研究的综述中,我们发现 12 项研究表明抑郁症与亚临床动脉粥样硬化之间存在正相关。10 项研究发现抑郁症状与冠状动脉钙化之间没有显著关联。而两项研究则显示出负相关。

结论

评估抑郁症与 CAC 之间关系的证据存在差异。抑郁症状可能代表心血管疾病早期预防的一个潜在可改变的危险因素,尤其是在患有中重度抑郁症的年轻患者中。

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