From the Université Paris Descartes (Wiernik, Lemogne), Sorbonne Paris Cité, Faculté de Médecine; Inserm, U894 (Wiernik, Lemogne), Centre Psychiatrie et Neurosciences; AP-HP (Lemogne), Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie de l'adulte et du sujet âgé; Equipe de Recherche en Epidémiologie Nutritionnelle (EREN) (Fezeu, Arnault, Hercberg, Kesse-Guyot, Galan), Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, SMBH Université Paris 13, Bobigny; and Département de Santé Publique (Hercberg), Hôpital Avicenne, Bobigny, France.
Psychosom Med. 2018 Jun;80(5):460-467. doi: 10.1097/PSY.0000000000000592.
Although it has been suggested that alexythymia is associated with cardiovascular diseases, studies are scarce and a causal relationship is questionable. This study explored the prospective association between alexithymia and cardiovascular events in middle-aged participants without cardiovascular history at baseline.
The 26-item Toronto Alexithymia Scale (TAS-26) was completed by 5586 participants of the French SUpplémentation en VItamines et Minéraux AntioXydants cohort (41.4% of men, M [SD] age = 52.2 [6.3] years) in 1996-1997. Covariates measured at baseline included age, occupational status, depressive symptoms, smoking status, body mass index, hypertension, diabetes, hypercholesterolemia, and hypertriglyceridemia. The follow-up ran from January 1, 1998, to the date of the first cardiovascular event, the date of death or September 1, 2007, whichever occurred first. Cardiovascular events were validated by an independent expert committee. Hazard ratios and 95% confidence intervals were computed with Cox regressions.
During an average of 8.9 years of follow-up, 171 first cardiovascular events were validated. After adjustment for age, sex, and occupational status, there was no association between baseline alexithymia and cardiovascular events at follow-up (hazard ratio [95% confidence interval] for 15 points of TAS-26 = 1.00 [0.81-1.23], p > .99). Adjusting for all covariates, using binary TAS-26 cut-offs or TAS-26 subscores yielded similar nonsignificant results.
In this large prospective study, alexithymia and cardiovascular events were not associated among a nonclinical population. This casts some doubt on whether alexithymia could be a meaningful target in the prevention of cardiovascular diseases.
Clinicaltrials.gov (NCT00272428).
尽管已有研究表明述情障碍与心血管疾病相关，但相关研究较少，且因果关系仍存在争议。本研究旨在探讨无心血管疾病史的中年参与者在基线时的述情障碍与心血管事件的前瞻性关联。
1996-1997 年，法国 SUpplémentation en VItamines et Minéraux AntioXydants 队列的 5586 名参与者（41.4%为男性，平均[标准差]年龄=52.2[6.3]岁）完成了 26 项多伦多述情障碍量表（TAS-26）。基线时测量的协变量包括年龄、职业状况、抑郁症状、吸烟状况、体重指数、高血压、糖尿病、高胆固醇血症和高三酰甘油血症。随访时间从 1998 年 1 月 1 日开始，至首次心血管事件、死亡日期或 2007 年 9 月 1 日（以先发生者为准）。心血管事件由独立的专家委员会进行验证。使用 Cox 回归计算风险比和 95%置信区间。
在平均 8.9 年的随访期间，有 171 例首次心血管事件得到验证。在校正年龄、性别和职业状况后，基线述情障碍与随访期间的心血管事件之间无关联（TAS-26 得分为 15 分时的风险比[95%置信区间]为 1.00 [0.81-1.23]，p>.99）。调整所有协变量、使用二分 TAS-26 截断值或 TAS-26 子量表，得到的结果相似，均无统计学意义。
在这项大型前瞻性研究中，非临床人群中述情障碍与心血管事件之间无关联。这使得述情障碍是否可以成为预防心血管疾病的有意义的目标产生了一些质疑。
Clinicaltrials.gov（NCT00272428）。
