抑郁症状在睡眠障碍与心血管疾病关联中的中介作用:对2017 - 2020年美国国家健康与营养检查调查(NHANES)的分析
Mediation of the association between sleep disorders and cardiovascular disease by depressive symptoms: An analysis of the National health and Nutrition Examination Survey (NHANES) 2017-2020.
作者信息
Zhou Wen, Sun Lu, Zeng Liang, Wan Laisiqi
机构信息
Department of Psychosomatic Diseases, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
出版信息
Prev Med Rep. 2023 Mar 21;33:102183. doi: 10.1016/j.pmedr.2023.102183. eCollection 2023 Jun.
We aimed to investigate the role of depressive symptoms between sleep disorders and cardiovascular disease (CVD). Data used in this cross-sectional study were collected from the National Health and Nutrition Examination Survey (NHANES) database in the United States between 2017 and 2020. Univariate and multivariate logistic regression analyses were performed. Causal mediation analysis was conducted to investigate the role of depressive symptoms between sleep disorders and CVD. Subgroup analyses were performed in populations with diabetes, hypercholesteremia, and hypertension. A total of 5,173 participants were included, and 652 (12.6%) participants had CVD. Sleep disorders [odds ratio (OR) = 1.66; 95% confidence interval (CI), 1.35-2.03] and depressive symptoms (OR = 1.92; 95 %CI, 1.44-2.56) were associated with greater odds of CVD, and sleep disorders (OR = 3.87; 95 %CI, 3.09-4.84) were also related to greater odds of depressive symptoms after adjusting for confounders. Causal mediation analysis showed that the average direct effect (ADE) was 0.041 (95 %CI, 0.021-0.061; < 0.001), the average causal mediation effect (ACME) was 0.007 (95 %CI, 0.003-0.012; = 0.002), and 15.0% (0.150, 95 %CI, 0.055-0.316; = 0.002) of the association of sleep disorders with CVD appeared to be mediated through depressive symptoms. Subgroup analyses indicated that the mediating effect of depressive symptoms on sleep disorders and CVD was also observed in populations with hypercholesterolemia or hypertension (all < 0.05). Depressive symptoms may be a mediator in the relationship between sleep disorders and CVD. Improving depressive symptoms in patients may reduce the odds of CVD due to sleep disorders.
我们旨在研究抑郁症状在睡眠障碍与心血管疾病(CVD)之间所起的作用。本横断面研究中使用的数据收集自2017年至2020年美国国家健康与营养检查调查(NHANES)数据库。进行了单因素和多因素逻辑回归分析。开展因果中介分析以研究抑郁症状在睡眠障碍与CVD之间的作用。对患有糖尿病、高胆固醇血症和高血压的人群进行了亚组分析。总共纳入了5173名参与者,其中652名(12.6%)参与者患有CVD。睡眠障碍[比值比(OR)=1.66;95%置信区间(CI),1.35 - 2.03]和抑郁症状(OR = 1.92;95%CI,1.44 - 2.56)与CVD的较高发病几率相关,在调整混杂因素后,睡眠障碍(OR = 3.87;95%CI,3.09 - 4.84)也与抑郁症状的较高发病几率相关。因果中介分析表明,平均直接效应(ADE)为0.041(95%CI,0.021 - 0.061;P < 0.001),平均因果中介效应(ACME)为0.007(95%CI,0.003 - 0.012;P =