Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Neurology, Jining No. 1 People's Hospital, Jiankang Road 6, Jining, 272111, Shandong, China.
BMC Geriatr. 2018 Nov 6;18(1):265. doi: 10.1186/s12877-018-0957-2.
The relationship between kidney function and depressive symptoms among elderly people has been rarely investigated in settings of the general population. The aim of our study was to examine the association of serum cystatin C (cysC) and impaired kidney function with geriatric depressive symptoms among older people living in a rural community in China.
This population-based cohort study included 1440 individuals (age ≥ 60 years) who were recruited for the Confucius Hometown Aging Project in 2010-2011; of the 1124 persons who were free of depressive symptoms, 669 (59.5%) were re-examined in 2014-2016. At baseline, data on demographics, lifestyle factors, health conditions, and medical history were collected through interviews, clinical examinations, and laboratory tests. We defined impaired kidney function as the cystatin C-based estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m, and depressive symptoms as a score ≥ 5 on the 15-item Geriatric Depression Scale. Data were analyzed using multiple logistic and Cox proportional-hazards models.
Of the 1440 participants, 316 (21.9%) were defined to have geriatric depressive symptoms at baseline. Serum cysC levels of 1.01-1.25 and > 1.25 mg/L (vs. ≤1.00 mg/L) were associated with a multiple-adjusted odds ratio (OR) of 1.41 (95% CI 1.01-1.97) and 3.20 (2.32-4.41), respectively, for having geriatric depressive symptoms (P < 0.001). Of the 669 people who were free of depressive symptoms at baseline, 157 had incident depressive symptoms at the follow-up examination. The multiple-adjusted hazard ratio (HR) for incident depressive symptoms were 2.16 (95% CI 1.43-3.27) for serum cysC > 1.25 mg/L (vs. < 1.00 mg/L). Impaired kidney function was cross-sectionally (multiple-adjusted OR = 2.95; 95% CI 2.22-3.92) and longitudinally (multiple-adjusted HR 1.54; 95% CI 1.03-2.30) associated with an increased risk of geriatric depressive symptoms.
Elevated serum cysC levels and impaired kidney function are associated with an increased risk of geriatric depressive symptoms among Chinese older people living in a rural community.
在一般人群中，肾功能与老年人抑郁症状之间的关系很少被研究。我们的研究旨在探讨血清胱抑素 C（cysC）和肾功能受损与中国农村社区老年人老年抑郁症状之间的关系。
本研究为基于人群的队列研究，纳入了 2010-2011 年孔子故乡老龄化项目中 1440 名（年龄≥60 岁）的参与者；在无抑郁症状的 1124 人中，有 669 人（59.5%）在 2014-2016 年期间进行了复查。基线时，通过访谈、临床检查和实验室检查收集了人口统计学、生活方式因素、健康状况和病史数据。我们将基于胱抑素 C 的估算肾小球滤过率（eGFR）<60ml/min/1.73m 定义为肾功能受损，并将抑郁症状定义为 15 项老年抑郁量表评分≥5。使用多变量逻辑和 Cox 比例风险模型进行数据分析。
在 1440 名参与者中，有 316 名（21.9%）在基线时被定义为患有老年抑郁症状。血清 cysC 水平为 1.01-1.25 和>1.25mg/L（与≤1.00mg/L 相比）与患老年抑郁症状的多变量调整比值比（OR）分别为 1.41（95%CI 1.01-1.97）和 3.20（2.32-4.41）（P<0.001）。在基线时无抑郁症状的 669 人中，有 157 人在随访检查时出现了新发抑郁症状。血清 cysC>1.25mg/L（与<1.00mg/L 相比）的新发抑郁症状的多变量调整风险比（HR）为 2.16（95%CI 1.43-3.27）。肾功能受损与老年抑郁症状的发生呈横断面（多变量调整 OR=2.95；95%CI 2.22-3.92）和纵向（多变量调整 HR 1.54；95%CI 1.03-2.30）相关。
在中国农村社区的老年人中，血清 cysC 水平升高和肾功能受损与老年抑郁症状的风险增加有关。
