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冠心病患者的抑郁、营养与结局之间的关系。

Associations between depression, nutrition, and outcomes among individuals with coronary artery disease.

机构信息

School of Medicine, South China University of Technology, Guangzhou, China; Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

出版信息

Nutrition. 2021 Jun;86:111157. doi: 10.1016/j.nut.2021.111157. Epub 2021 Jan 14.

Abstract

OBJECTIVES

Depression and malnutrition are prevalent among people with coronary artery disease (CAD) and can affect their prognosis, but the relationship between depression and malnutrition and its co-effect on prognosis is not clear. We sought to explore that relationship and its effects.

METHODS

In this study, the nutritional and emotional statuses of 547 people with CAD were assessed using the Controlling Nutritional Status (CONUT) score and the Patient Health Questionnaire-9. The average follow-up period was 2.1 y, after which we explored the relationship between depression and nutrition and prognosis.

RESULTS

A total of 41% of the participants were found to have mild malnutrition, 10% moderate to severe malnutrition, 26% had mild depression, and 11% had moderate to severe depression. A total of 20.6% of the participants were found to have comorbidities of depression and malnutrition; and both moderate to severe depression (adjusted hazard ratio [HR], 1.674; 95% confidence interval [CI], 1.098-2.551) and moderate to severe malnutrition (adjusted HR, 1.686; 95% CI, 1.073-2.648) were observed to be risk factors for the composite end point. Participants with comorbidities of depression and malnutrition were found to have increased risk of cardiovascular death (HR, 5.390; 95% CI, 1.483-19.589) and composite end point (adjusted HR, 1.791; 95% CI, 1.133-2.833) compared to those without both depression and malnutrition.

CONCLUSIONS

Depression and malnutrition were found to be risk factors for adverse outcomes in people with CAD. People with CAD should pay attention to their emotional and nutritional statuses, and interventions must be timely and efficient.

摘要

目的

抑郁和营养不良在冠心病(CAD)患者中较为普遍,可能影响其预后,但抑郁和营养不良之间的关系及其对预后的共同影响尚不清楚。我们试图探讨这种关系及其影响。

方法

本研究采用 CONUT 评分和患者健康问卷-9 评估了 547 例 CAD 患者的营养和情绪状况。平均随访时间为 2.1 年,之后我们探讨了抑郁与营养和预后之间的关系。

结果

共有 41%的参与者存在轻度营养不良,10%存在中重度营养不良,26%存在轻度抑郁,11%存在中重度抑郁。共有 20.6%的参与者存在抑郁和营养不良的共病;中重度抑郁(调整后的危险比 [HR],1.674;95%置信区间 [CI],1.098-2.551)和中重度营养不良(调整后的 HR,1.686;95% CI,1.073-2.648)均为复合终点的危险因素。与无抑郁和营养不良的患者相比,共病抑郁和营养不良的患者发生心血管死亡(HR,5.390;95% CI,1.483-19.589)和复合终点(调整后的 HR,1.791;95% CI,1.133-2.833)的风险增加。

结论

抑郁和营养不良是 CAD 患者不良结局的危险因素。CAD 患者应注意自己的情绪和营养状况,必须及时有效地进行干预。

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