Chen Xi, Liu Zhelong, Yang Yan, Chen Gang, Wan Qin, Qin Guijun, Yan Li, Wang Guixia, Qin Yingfen, Luo Zuojie, Tang Xulei, Huo Yanan, Hu Ruying, Ye Zhen, Shi Lixin, Gao Zhengnan, Su Qing, Mu Yiming, Zhao Jiajun, Chen Lulu, Zeng Tianshu, Li Qiang, Shen Feixia, Chen Li, Zhang Yinfei, Wang Youmin, Deng Huacong, Liu Chao, Wu Shengli, Yang Tao, Li Mian, Xu Yu, Xu Min, Wang Tiange, Zhao Zhiyun, Lu Jieli, Bi Yufang, Yu Xuefeng, Wang Weiqing, Ning Guang
Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Branch of National Clinical Research Center for Metabolic Disease, Wuhan, China.
Front Cardiovasc Med. 2022 May 26;9:865063. doi: 10.3389/fcvm.2022.865063. eCollection 2022.
We aimed to evaluate the association between depression and major cardiovascular events and test whether the relationship between depression and cardiovascular events is influenced by lifestyle or metabolic risk factors.
The China Cardiometabolic Disease and Cancer Cohort (4C) Study was a nationwide, multicenter, prospective cohort study. About 92,869 participants without cardiovascular disease or cancer at baseline were included. Depression status was evaluated by the Patient Health Questionnaire-9 (PHQ-9). Lifestyle information was collected by the questionnaire, and metabolic risk factors including waist circumference, blood pressure, lipid profiles, and plasma glucose were measured. Major cardiovascular events including cardiovascular death, myocardial infarction, stroke, and hospitalized or treated heart failure events were validated based on medical records.
During an average of 3.8 years of follow-up, we detected 2,076 cardiovascular events and showed that participants with depressive symptoms had an increased risk for cardiovascular events after adjustments [hazard ratio (HR): 1.29; 95% confidence index (CI): 1.08-1.53]. Stratified on metabolic risk status, the relationship between depression and cardiovascular events tended to be stronger according to the increasing numbers of metabolic risk factors, with HR (95% CI) of 0.98 (0.72-1.35) in the category with 0-2 metabolic risk factors, 1.36 (0.996-1.87) and 1.47 (1.13-1.92) for those with 3, and 4-5 metabolic risk factors, respectively, indicating an interaction effect ( = 0.039).
Depression was independently associated with an increased risk of major cardiovascular events. The effect was particularly prominent among populations at higher metabolic risk.
我们旨在评估抑郁症与主要心血管事件之间的关联，并测试抑郁症与心血管事件之间的关系是否受生活方式或代谢风险因素的影响。
中国心血管代谢疾病与癌症队列（4C）研究是一项全国性、多中心、前瞻性队列研究。纳入了约92,869名基线时无心血管疾病或癌症的参与者。通过患者健康问卷-9（PHQ-9）评估抑郁状态。通过问卷收集生活方式信息，并测量包括腰围、血压、血脂谱和血糖在内的代谢风险因素。根据医疗记录验证包括心血管死亡、心肌梗死、中风以及住院或治疗的心力衰竭事件在内的主要心血管事件。
在平均3.8年的随访期间，我们检测到2076例心血管事件，并表明抑郁症状的参与者在调整后心血管事件风险增加[风险比（HR）：1.29；95%置信区间（CI）：1.08 - 1.53]。根据代谢风险状态分层，抑郁症与心血管事件之间的关系随着代谢风险因素数量的增加而趋于更强，0 - 2个代谢风险因素组的HR（95%CI）为0.98（0.72 - 1.35），3个代谢风险因素组为1.36（0.996 - 1.87），4 - 5个代谢风险因素组为1.47（1.13 - 1.92），表明存在交互作用（P = 0.039）。
抑郁症与主要心血管事件风险增加独立相关。这种影响在代谢风险较高的人群中尤为突出。
