Department of Social Research, Population Research Unit, University of Helsinki, Helsinki, Finland
Department of Public Health, University of Helsinki, Helsinki, Finland.
J Epidemiol Community Health. 2022 Mar;76(3):281-284. doi: 10.1136/jech-2021-216451. Epub 2021 Aug 18.
Depression is a risk factor for coronary heart disease (CHD), but less is known whether genetic susceptibility to CHD or regional-level social indicators modify this association.
Risk factors of CHD including a Polygenic Risk Score (PRS) were measured for 19 999 individuals residing in Finland in 1997, 2002, 2007 and 2012 (response rates 60%-75%). During the register-based follow-up until 2015, there were 1381 fatal and non-fatal incident CHD events. Unemployment rate, degree of urbanisation and crime rate of the municipality of residence were used as regional level social indicators. HRs were calculated using register-based antidepressant purchases as a non-reversible time-dependent covariate.
Those having depression and in the highest quartile of PRS had somewhat higher CHD risk than predicted only by the main effects of depression and PRS (HR for interaction 1.53, 95% CI 0.95 to 2.45). Depression was moderately associated with CHD in high crime (HR 1.51, 95% CI 1.20 to 1.90) and weakly in low crime regions (HR 1.07, 95% CI 0.86 to 1.33; p value of interaction=0.087). Otherwise, we did not found evidence for interactions.
Those having both depression and high genetic susceptibility need a special attention in healthcare for CHD.
抑郁症是冠心病（CHD）的一个风险因素，但对于 CHD 的遗传易感性或区域社会指标是否会改变这种关联，人们知之甚少。
对 1997 年、2002 年、2007 年和 2012 年居住在芬兰的 19999 人进行了 CHD 的危险因素（包括多基因风险评分（PRS））测量（响应率为 60%-75%）。在基于登记的随访中，直至 2015 年，发生了 1381 例致命和非致命的 CHD 事件。居住地的失业率、城市化程度和犯罪率被用作区域社会指标。使用基于登记的抗抑郁药购买情况作为非可逆的时间相关协变量来计算 HR。
与仅由抑郁和 PRS 的主要作用预测的 CHD 风险相比，患有抑郁症且处于 PRS 最高四分位数的人具有略高的 CHD 风险（交互作用的 HR 为 1.53，95%CI 为 0.95 至 2.45）。在高犯罪地区，抑郁与 CHD 中度相关（HR 为 1.51，95%CI 为 1.20 至 1.90），而在低犯罪地区则较弱（HR 为 1.07，95%CI 为 0.86 至 1.33；交互作用的 p 值=0.087）。否则，我们没有发现交互作用的证据。
患有抑郁和高遗传易感性的人需要特别注意 CHD 的医疗保健。
