Department of Preventive Medicine, School of Basic Medicine and Public Health, Jinan University, Guangzhou, 510632, China; Department of Psychiatry, New York University School of Medicine, One Park Ave, New York, NY 10016, Unites States; Department of Mathematics and Statistics, College of Arts and Sciences, University at Albany, State University of New York, 1400 Washington Ave, Albany, NY 12222, Unites States.
Department of Preventive Medicine, School of Basic Medicine and Public Health, Jinan University, Guangzhou, 510632, China.
J Affect Disord. 2022 Feb 15;299:264-272. doi: 10.1016/j.jad.2021.12.019. Epub 2021 Dec 11.
Popular mediation method only considers a single activity as a mediator instead of all 24-hour physical activity, such as a four-way decomposition method. We investigated the mediation of 24-hour movement continuum between chronic diseases (cardiovascular disease [CVD] and diabetes) and depression using a novel compositional mediation model.
24-hour activity data measured by accelerometer were obtained from NHANES 2005-2006. Adjusted coefficient with 95% confidence interval (95% CI) for PHQ-9 total score and adjusted odds ratio (OR) with 95% CI for depression were computed from compositional mediation models.
In total, 2,375 participants aged ≥ 20 were included in our analysis. Both diabetes and CVD were associated with increased sedentary behavior (SB) and sleep and reduced moderate-to-vigorous physical activity (MVPA) and light-intensity physical activity (LPA), leading to an increased likelihood of depression. Although not all component indirect effects were associated with PHQ-9 total score and depression, the total indirect effect was significantly associated with both PHQ-9 total score (coefficient (95% CI) for diabetes: 0.162 (0.081, 0.261); coefficient (95% CI) for CVD: 1.139 (1.061, 1.240)) and depression (OR (95% CI) for diabetes: 0.235 (0.126, 0.362); OR (95% CI) for CVD: 1.200 (1.088, 1.346)) using the compositional mediation model.
We developed a compositional mediation model for continuous and binary outcomes, which can handle entire compositional mediators as a unit. The mediation of 24-hour movement continuum mediated the association between diabetes, CVD, and depression. Our findings present potential interventions for reducing risk of depression among patients with CVD and diabetes.
流行的中介方法仅考虑单一活动作为中介，而不是所有 24 小时的身体活动，如四向分解法。我们使用一种新的组成中介模型研究了慢性病（心血管疾病[CVD]和糖尿病）和抑郁之间 24 小时运动连续体的中介作用。
从 NHANES 2005-2006 中获取加速度计测量的 24 小时活动数据。从组成中介模型中计算 PHQ-9 总分的调整系数（95%置信区间[95%CI]）和抑郁的调整比值比（OR）（95%CI）。
总共纳入了 2375 名年龄≥20 岁的参与者。糖尿病和 CVD 均与久坐行为（SB）和睡眠增加以及中高强度体力活动（MVPA）和低强度体力活动（LPA）减少相关，从而增加了抑郁的可能性。虽然并非所有成分间接效应均与 PHQ-9 总分和抑郁相关，但总间接效应与 PHQ-9 总分（糖尿病的系数（95%CI）：0.162（0.081，0.261）；CVD 的系数（95%CI）：1.139（1.061，1.240））和抑郁（糖尿病的 OR（95%CI）：0.235（0.126，0.362）；CVD 的 OR（95%CI）：1.200（1.088，1.346））均显著相关使用组成中介模型。
我们开发了一种用于连续和二项结果的组成中介模型，该模型可以将整个组成中介作为一个整体进行处理。24 小时运动连续体的中介作用介导了糖尿病、CVD 和抑郁之间的关联。我们的研究结果为降低 CVD 和糖尿病患者抑郁风险提供了潜在的干预措施。
