Gerber Markus, Cody Robyn, Beck Johannes, Brand Serge, Donath Lars, Eckert Anne, Hatzinger Martin, Imboden Christian, Kreppke Jan-Niklas, Lang Undine E, Ludyga Sebastian, Mans Sarah, Mikoteit Thorsten, Oswald Anja, Schweinfurth-Keck Nina, Zahner Lukas, Faude Oliver
Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland.
Psychiatric Clinic Sonnenhalde, Riehen, Switzerland.
Front Psychiatry. 2023 Jun 20;14:1193004. doi: 10.3389/fpsyt.2023.1193004. eCollection 2023.
Compared to the general population, individuals with depression have an increased risk for cardiovascular diseases. Nevertheless, little is known so far whether cardiorespiratory fitness (CRF) moderates this relationship. Therefore, we examined whether common physiological cardiovascular risk factors differ between patients with depression and healthy (non-depressed) controls, whether patients and controls differ in CRF, and whether higher CRF is associated with a lower cardiovascular risk in both patients and healthy controls. Additionally, we examined whether within the patient sample, cardiovascular risk factors differ between patients with mild, moderate and severe depression, and whether the relationship between symptom severity and cardiovascular risk is moderated by patients' CRF levels.
Data from a multi-centric, two-arm randomized controlled trial (RCT) was analyzed, including 210 patients (F32, single episode: = 72, F33, recurrent major depression: = 135, F31-II, bipolar type II: = 3) and 125 healthy controls. Waist circumference, body mass index, body fat, blood pressure, cholesterol levels, triglycerides, and blood glucose were considered as cardiovascular risk markers. CRF was assessed with a submaximal ergometer test. Differences between groups were examined via -tests and (multivariate) analyses of covariance.
Compared to healthy controls, patients with depression had a higher cardiovascular risk as evident from about half of the examined indicators. In the total sample, participants with good CRF had more favourable scores across nearly all risk markers than counterparts with poor CRF. For most variables, no interaction occurred between group and fitness, indicating that in patients and controls, similar differences existed between participants with poor and good CRF. Few differences in risk markers were found between patients with mild, moderate and severe depression, and no interaction occurred between depression severity and CRF.
Patients with depression and healthy controls differ in several cardiovascular risk markers, putting patients at increased risk for CVDs. In contrast, people with good CRF show more favourable cardiovascular risk scores, a relationship which was observed in both healthy controls and patients with depression. Physical health of psychiatric patients should receive the clinical attention that it deserves. Lifestyle interventions targeting healthy diet and/or physical activity are recommended as a physically active and healthy lifestyle contributes equally to patients' mental well-being and cardiovascular health.
与普通人群相比，抑郁症患者患心血管疾病的风险更高。然而，迄今为止，关于心肺适能（CRF）是否会调节这种关系，我们知之甚少。因此，我们研究了抑郁症患者与健康（非抑郁）对照者之间常见的生理心血管危险因素是否存在差异，患者与对照者在CRF方面是否存在差异，以及较高的CRF是否与患者和健康对照者较低的心血管风险相关。此外，我们还研究了在患者样本中，轻度、中度和重度抑郁症患者之间的心血管危险因素是否存在差异，以及症状严重程度与心血管风险之间的关系是否受患者CRF水平的调节。
分析了一项多中心、双臂随机对照试验（RCT）的数据，包括210例患者（F32，单次发作：=72例，F33，复发性重度抑郁症：=135例，F31-II，双相II型：=3例）和125例健康对照者。腰围、体重指数、体脂、血压、胆固醇水平、甘油三酯和血糖被视为心血管风险标志物。通过次极量测力计测试评估CRF。通过t检验和（多变量）协方差分析检查组间差异。
与健康对照者相比，抑郁症患者的心血管风险更高，约一半的检测指标表明了这一点。在总样本中，CRF良好的参与者在几乎所有风险标志物上的得分都比CRF差的参与者更有利。对于大多数变量，组与适能之间没有相互作用，这表明在患者和对照者中，CRF差和良好的参与者之间存在类似的差异。轻度、中度和重度抑郁症患者之间在风险标志物上几乎没有差异，抑郁症严重程度与CRF之间也没有相互作用。
抑郁症患者和健康对照者在几种心血管风险标志物上存在差异，这使患者患心血管疾病的风险增加。相比之下，CRF良好的人显示出更有利的心血管风险评分，这种关系在健康对照者和抑郁症患者中均有观察到。精神科患者的身体健康应得到应有的临床关注。建议针对健康饮食和/或体育活动的生活方式干预，因为积极健康生活方式对患者的心理健康和心血管健康同样有益。
