Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha, China; Department of Pathophysiology, Xiangya Hospital, Central South University, Changsha, China.
Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha, China.
J Affect Disord. 2022 Sep 1;312:1-8. doi: 10.1016/j.jad.2022.06.003. Epub 2022 Jun 8.
Cardiometabolic diseases (CMDs) including hypertension, coronary heart disease, diabetes and stroke, are always combined with each other, leading to cardiometabolic multimorbidity (CMM). Mood disorder was associated with onset of CMD. However, the impact of mood disorder on the transition from single CMD to CMM was poorly understood.
A total of 95,351 participants with single CMD, with median age of 59 (range 40 to 71) years from UK Biobank were enrolled at baseline. Competing risk regression models were used to estimated hazard ratios (HRs) and 95 % confidence intervals (CIs) of association between mood disorder categories and progress from single CMD to CMM. Association of mood disorder with mortality, and life expectancy differences were also calculated by flexible parametric proportion-hazard models.
Relative associations were observed between mood disorder and the progress from first onset of CMD to CMM. Adjusted HRs for progress to CMM from those with comorbid CMD plus depression or bipolar were increased (depression: 1.23 [1.19 1.27]; bipolar: 1.47 [1.31 1.66]), compared with those with the sole CMD. Mood disorder also had impact on all-cause mortality (depression: 1.17 [1.10 1.24]; bipolar: 2.03 [1.74 2.32]) and reduced life expectancy estimates for those with single CMD.
This cohort primarily comprises White individuals. Covariates only measured at baseline and assumed unchanged during follow-up.
Mood disorder conferred greater hazard on the CMM and mortality outcome. This study highlighted the importance of depression and bipolar in disease progression, from single CMD, to multimorbidity or mortality.
心血管代谢疾病（CMD）包括高血压、冠心病、糖尿病和中风等，常相互合并，导致心血管代谢合并症（CMM）。心境障碍与 CMD 的发病相关。然而，心境障碍对从单一 CMD 向 CMM 转变的影响尚未完全明确。
共纳入 95351 例来自英国生物库的、基线时年龄 59 岁（40 岁至 71 岁）、患有单一 CMD 的患者。使用竞争风险回归模型估计心境障碍类别与从单一 CMD 进展为 CMM 之间的关联的风险比（HR）和 95%置信区间（CI）。还通过灵活参数比例风险模型计算心境障碍与死亡率和预期寿命差异的关系。
观察到心境障碍与从首次 CMD 发作到 CMM 的进展之间存在相对关联。与单一 CMD 患者相比，合并 CMD 加抑郁或双相障碍患者进展为 CMM 的校正 HR 增加（抑郁：1.23[1.19 1.27]；双相：1.47[1.31 1.66]）。心境障碍对全因死亡率（抑郁：1.17[1.10 1.24]；双相：2.03[1.74 2.32]）也有影响，并降低了患有单一 CMD 患者的预期寿命估计。
本队列主要由白种人组成。协变量仅在基线时测量，并假定在随访期间保持不变。
心境障碍使 CMM 和死亡率的发生风险增加。这项研究强调了抑郁和双相障碍在从单一 CMD 到多种合并症或死亡率的疾病进展中的重要性。
