He Dingliu, Fan Yayun, Qiao Yanan, Liu Siyuan, Zheng Xiaowei, Zhu Juanjuan
Department of Clinical Nutrition, Yancheng No.1 People's Hospital, Affiliated Hospital of Medical School, Nanjing University, Yancheng, 224001, PR China.
Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, PR China.
J Psychosom Res. 2023 Sep;172:111422. doi: 10.1016/j.jpsychores.2023.111422. Epub 2023 Jun 23.
Previous studies reported that depression was associated with a high risk of arthritis. However, the effect of different long-term depressive symptom trajectory patterns on the risk of arthritis has not been evaluated. Our study aimed to explore the association between depressive symptom trajectories and the risk of arthritis.
A total of 5583 participants from the China Health and Retirement Longitudinal Study from 2011 to 2018 were included in this analysis. Group-based trajectory modeling was used to identify depressive symptom trajectories, and a multivariable competitive Cox regression model was used to examine the association of depressive symptom trajectories with arthritis during follow-up.
Five depressive symptom trajectories were identified in our research: stable-high, decreasing, increasing, stable-moderate and stable-low. Compared with participants in the stable-low trajectory group, those in the stable-moderate, increasing, decreasing and stable-high trajectory groups had a higher cumulative risk of arthritis, with HRs (95% CIs) for arthritis of 1.64 (1.30, 2.07), 1.86 (1.30, 2.66), 1.99 (1.41, 2.80) and 2.19 (1.38, 3.48), respectively. Participants with the stable-high symptoms trajectory had the highest cumulative risk of arthritis. There was still a high risk of arthritis, although the depression state was reduced and remained at a level that is generally considered reasonable.
The higher depressive symptoms trajectories were significantly associated with the increased risk of arthritis, and the long-term depressive symptoms trajectories may be a strong predictor of having arthritis.
既往研究报告称抑郁症与患关节炎的高风险相关。然而，不同的长期抑郁症状轨迹模式对关节炎风险的影响尚未得到评估。我们的研究旨在探讨抑郁症状轨迹与关节炎风险之间的关联。
本分析纳入了2011年至2018年中国健康与养老追踪调查中的5583名参与者。采用基于群体的轨迹模型来识别抑郁症状轨迹，并使用多变量竞争Cox回归模型来检验随访期间抑郁症状轨迹与关节炎之间的关联。
我们的研究确定了五种抑郁症状轨迹：持续高症状、下降型、上升型、持续中度症状和持续低症状。与持续低症状轨迹组的参与者相比，持续中度症状、上升型、下降型和持续高症状轨迹组的参与者患关节炎的累积风险更高，关节炎的风险比（95%置信区间）分别为1.64（1.30，2.07）、1.86（1.30，2.66）、1.99（1.41，2.80）和2.19（1.38，3.48）。持续高症状轨迹的参与者患关节炎的累积风险最高。尽管抑郁状态有所减轻并维持在一般认为合理的水平，但患关节炎的风险仍然很高。
较高的抑郁症状轨迹与关节炎风险增加显著相关，长期抑郁症状轨迹可能是患关节炎的有力预测指标。
