Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd. Dallas,Dallas, TX, USA.
Department of Internal Medicine, Division of Cardiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
J Affect Disord. 2020 Nov 1;276:267-271. doi: 10.1016/j.jad.2020.07.042. Epub 2020 Jul 18.
Previous studies have yielded mixed results regarding the relationship between depressive symptoms and coronary artery calcium (CAC). This analysis sought to evaluate this relationship using a multiethnic, population-based cohort.
Data were extracted from the second phase of the Dallas Heart Study (DHS-2). Depressive symptom severity was measured with the 16-item Quick Inventory of Depressive Symptomatology-Self Report (QIDS), a validated depressive symptom severity scale. A regression analysis was performed using QIDS score as the predictor variable and CAC as the outcome variable. Covariates included age, sex, ethnicity, diabetes, hypertension, smoking, systolic blood pressure, total cholesterol, HDL cholesterol, and body mass index.
The cohort consisted of 2,293 individuals with a mean age of 50 years and included 47.1% female and 47.1% black participants. The mean QIDS score was 4.37(±3.69), and 43.3% had CAC > 0. Regression results indicated that QIDS does not statistically significantly predict whether one does or does not have CAC, when controlling for age, sex, and ethnicity (β = 0.088, p = .240, OR = 1.092, 95% CI 0.943-1.264).
Cross sectional design is limited to one point in time, very depressed patients with higher CAC burden may not have participated, and depressive symptoms may be associated with subclinical atherosclerosis differently with a formal diagnosis of depression.
Depressive symptoms were not associated with presence or severity of CAC in a multiethnic population based sample. Future studies are needed to determine if other prognostic markers of coronary heart disease are associated with depressive symptoms.
先前的研究对于抑郁症状与冠状动脉钙（CAC）之间的关系得出了相互矛盾的结果。本分析旨在使用多民族、基于人群的队列来评估这种关系。
数据来自达拉斯心脏研究（DHS-2）的第二阶段。使用 16 项贝克抑郁自评量表（QIDS）来衡量抑郁症状的严重程度，这是一种经过验证的抑郁症状严重程度量表。使用 QIDS 评分作为预测变量，CAC 作为结果变量进行回归分析。协变量包括年龄、性别、种族、糖尿病、高血压、吸烟、收缩压、总胆固醇、高密度脂蛋白胆固醇和体重指数。
队列包括 2293 名平均年龄为 50 岁的个体，其中 47.1%为女性，47.1%为黑人。平均 QIDS 评分为 4.37（±3.69），43.3%的人 CAC>0。回归结果表明，在控制年龄、性别和种族后，QIDS 并不能在统计学上显著预测一个人是否有 CAC（β=0.088，p=0.240，OR=1.092，95%CI 0.943-1.264）。
横断面设计仅限于一个时间点，可能没有包括 CAC 负担较高的非常抑郁的患者，并且抑郁症状与亚临床动脉粥样硬化的关系可能与正式诊断的抑郁症不同。
在一个多民族人群样本中，抑郁症状与 CAC 的存在或严重程度无关。需要进一步的研究来确定其他冠心病的预后标志物是否与抑郁症状相关。
