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儿童期发病的抑郁症与青年期动脉僵硬度。

Childhood-onset depression and arterial stiffness in young adulthood.

机构信息

Department of Epidemiology, University of Pittsburgh, PA, USA.

Department of Psychiatry, University of Pittsburgh, PA, USA.

出版信息

J Psychosom Res. 2021 Sep;148:110551. doi: 10.1016/j.jpsychores.2021.110551. Epub 2021 Jun 17.

Abstract

OBJECTIVES

The literature on childhood-onset depression and future compromised vascular function is suggestive but limited. The objective of this study was to determine if arterial stiffness, a predictor of future cardiovascular disease (CVD), measured in young adulthood, is associated with childhood-onset depression.

METHODS

Cardiometabolic risk factors and pulse wave velocity (PWV), a measure of arterial stiffness, were cross-sectionally assessed in young adults with a history of childhood-onset depression (clinical diagnosis of major depressive episode or dysthymic disorder; N = 294 probands; initially recruited via child mental health facilities across Hungary; mean age of first depressive episode = 10.4 years), their never-depressed full biological siblings (N = 269), and never-depressed controls (N = 169). The mean ages of probands, siblings, and controls at the PWV visit were 25.6, 25.0, and 21.7 years, respectively, and 8.8% of the probands were in a current depressive episode.

RESULTS

Controlling for age, sex, age*sex, education, and family clusters, PWV (m/s) did not statistically differ across the groups (probands = 7.01; siblings = 6.98; controls = 6.81). However, after adjusting for key covariates, there were several across-group differences in CVD risk factors: compared to controls, probands and siblings had higher diastolic blood pressure and lower high-density lipoprotein cholesterol, probands had higher triglycerides, and siblings had higher body mass index (all p < 0.05).

CONCLUSION

We found limited evidence of an association between a history of childhood-onset depression and young adulthood arterial stiffness. However, our findings of elevated cardiovascular risk factors in those with childhood-onset depression suggest that pediatric depression may predispose to increased CVD risk later in life and warrants further investigation.

摘要

目的

儿童期发病的抑郁症与未来血管功能受损的文献提示存在关联,但证据有限。本研究旨在确定成年早期测量的动脉僵硬度(心血管疾病 [CVD] 的预测指标)是否与儿童期发病的抑郁症相关。

方法

在曾患有儿童期发病的抑郁症(经匈牙利各地儿童心理健康机构初步招募的重性抑郁发作或恶劣心境障碍的临床诊断;共 294 例患者;首发抑郁发作的平均年龄为 10.4 岁)的年轻成年人、其从未患过抑郁症的同胞兄弟姐妹(共 269 例)和从未患过抑郁症的对照组(共 169 例)中,同时评估了心血管代谢危险因素和脉搏波速度(PWV,动脉僵硬度的测量指标)。患者、同胞兄弟姐妹和对照组接受 PWV 检查时的平均年龄分别为 25.6 岁、25.0 岁和 21.7 岁,8.8%的患者处于当前抑郁发作中。

结果

校正年龄、性别、年龄*性别、教育程度和家庭聚类后,各组之间的 PWV(m/s)无统计学差异(患者=7.01;同胞=6.98;对照组=6.81)。然而,在调整了关键协变量后,存在一些跨组间心血管危险因素的差异:与对照组相比,患者和同胞兄弟姐妹的舒张压较高,高密度脂蛋白胆固醇较低,患者的甘油三酯较高,而同胞兄弟姐妹的体重指数较高(均 p<0.05)。

结论

我们发现儿童期发病的抑郁症与成年早期动脉僵硬度之间的关联证据有限。然而,我们发现儿童期发病的抑郁症患者存在心血管风险因素升高,提示儿童期抑郁可能导致成年后心血管疾病风险增加,值得进一步研究。

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