Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.
Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, First Hospital of China Medical University, Shenyang, 110001, China.
BMC Psychiatry. 2020 May 24;20(1):254. doi: 10.1186/s12888-020-02668-z.
The present study aimed to assess the cumulative incidence of major depressive disorder (MDD) among rural Chinese residents. Furthermore, we intended to estimate whether metabolic syndrome (MetS) was associated with MDD by both cross-sectional and prospective analysis.
Data of 11,675 residents (46.3% men) was used for cross-sectional analysis. The residents were followed up with median 4.66 years. MDD was diagnosed using the Patient Health Questionnaire-9 (PHQ-9). The data of 2796 individuals without any depressive symptoms was used for prospective analysis.
With median of 4.66 years follow-up, the cumulative incidence of MDD among rural residents was 3.9%. Women had significantly higher cumulative incidence of MDD than men (5.3% for women and 2.9% for men, P < 0.01). The incidence of MDD was significantly higher among women with MetS (7.3% vs. 3.8%, P < 0.001), hypertriglyceridemia (7.0% vs. 4.5%, P < 0.001) or elevated blood pressure (6.4% vs. 3.4%, P < 0.001) at baseline compared with those without them. There was no incidence difference of MDD among men with or without baseline metabolic disorders. In prospective study, after adjusting possible confounders, baseline MetS was associated with higher incidence of MDD (OR: 1.82, 95%CI: 1.01, 3.27, P = 0.045) in women but not men (OR: 1.84, 95%CI: 0.88, 3.83, P = 0.104).
Cumulative incidence of MDD in rural China was higher among women than among men. Baseline MetS was associated with higher cumulative incidence of MDD in women but not men. More concern should be put on women with MetS in case of onset depressive symptom in future.
本研究旨在评估中国农村居民中重度抑郁症（MDD）的累积发病率。此外，我们还打算通过横断面和前瞻性分析来评估代谢综合征（MetS）是否与 MDD 相关。
使用 11675 名居民（46.3%为男性）的数据进行横断面分析。居民随访中位数为 4.66 年。使用患者健康问卷-9（PHQ-9）诊断 MDD。使用没有任何抑郁症状的 2796 名个体的数据进行前瞻性分析。
在中位随访 4.66 年后，农村居民的 MDD 累积发病率为 3.9%。女性的 MDD 累积发病率明显高于男性（女性为 5.3%，男性为 2.9%，P<0.01）。在基线时患有 MetS（7.3%比 3.8%，P<0.001）、高甘油三酯血症（7.0%比 4.5%，P<0.001）或高血压（6.4%比 3.4%，P<0.001）的女性中，MDD 的发病率明显更高。在基线时患有或不患有代谢紊乱的男性中，MDD 的发病率没有差异。在前瞻性研究中，调整了可能的混杂因素后，基线 MetS 与女性 MDD 的发病率更高相关（OR：1.82，95%CI：1.01，3.27，P=0.045），但与男性无关（OR：1.84，95%CI：0.88，3.83，P=0.104）。
中国农村地区 MDD 的累积发病率在女性中高于男性。基线 MetS 与女性而非男性的 MDD 累积发病率升高相关。未来应更加关注患有 MetS 的女性，以防出现抑郁症状。
