Zheng Xiaowei, Jiang Minglan, Ren Xiao, Han Longyang
Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China.
Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China.
J Psychosom Res. 2023 Nov;174:111480. doi: 10.1016/j.jpsychores.2023.111480. Epub 2023 Sep 1.
Previous studies had reported a significant association between depressive symptoms and inflammation. The aim of present study was to evaluate the combined effect of depressive symptoms and inflammation level on the risk of cardiovascular disease (CVD).
A total of 9647 participants from the China Health and Retirement Longitudinal Study were included. Multivariate Cox proportional hazards regression model was used to evaluate the associations between depressive symptoms, inflammation level and new-onset CVD, stroke and cardiac events.
There were 1731 respondents experienced CVD (including 560 stroke and 1306 cardiac events) during the follow-up period. Compared to individuals without depressive symptoms and low hsCRP level, the adjusted hazard ratios (95% confidence intervals) were 1.23(1.09-1.38), 1.41(1.21-1.63) and 1.61(1.40-1.87) for those with high hsCRP level alone, with depressive symptoms alone, with both depressive symptoms and high hsCRP, respectively. There were additive and multiplicative effect of depressive symptoms and inflammation on the risk of CVD, stroke and cardiac events (as categorical variables). Furthermore, we found significant additive and multiplicative interactions of depressive symptoms and inflammation with CVD (as continuous variables).
Our findings indicated that there was a multiplicative effect of depressive symptoms and inflammation on the risk of CVD. Larger-sample prospective cohort studies are still required to test the potential application of combination of depressive symptoms and inflammation as a screening method to identify individuals at risk of CVD.
既往研究报道了抑郁症状与炎症之间存在显著关联。本研究旨在评估抑郁症状和炎症水平对心血管疾病（CVD）风险的联合影响。
纳入了来自中国健康与养老追踪调查的9647名参与者。采用多变量Cox比例风险回归模型评估抑郁症状、炎症水平与新发CVD、中风和心脏事件之间的关联。
在随访期间，有1731名受访者发生了CVD（包括560例中风和1306例心脏事件）。与无抑郁症状且hsCRP水平低的个体相比，单独hsCRP水平高、单独有抑郁症状、既有抑郁症状又有hsCRP水平高的个体的校正风险比（95%置信区间）分别为1.23（1.09 - 1.38）、1.41（1.21 - 1.63）和1.61（1.40 - 1.87）。抑郁症状和炎症对CVD、中风和心脏事件风险（作为分类变量）存在相加和相乘效应。此外，我们发现抑郁症状和炎症与CVD（作为连续变量）之间存在显著的相加和相乘交互作用。
我们的研究结果表明，抑郁症状和炎症对CVD风险存在相乘效应。仍需要更大样本的前瞻性队列研究来检验将抑郁症状和炎症相结合作为一种筛查方法以识别CVD风险个体的潜在应用。
