Wang Juping, Zhao Le, Guan Hongwei, Wang Juxia, Gao Qian, Liang Jie, Zhao Liangyuan, He Simin, Wang Tong
Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China; Department of Mathematics, School of Basic Medical Science, Shanxi Medical University, Taiyuan, China.
Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China.
J Affect Disord. 2024 Apr 1;350:222-229. doi: 10.1016/j.jad.2024.01.075. Epub 2024 Jan 9.
A compositional mediation model of survival outcomes was established to explore whether 24-h time-use behaviors mediate the relationship between depression and mortality.
4137 adults from the National Health and Nutrition Examination Survey (NHANES 2005-2006) were followed up to 2019. Cox proportional hazards regression model was used to estimate the total effect of depression on mortality. Compositional data analysis was used to examine the relationship between 24-h time-use compositions and mortality. Furthermore, we constructed a compositional mediation model for survival outcomes to investigate the mediating effect of 24-h time-use behaviors on depression and mortality.
Compared with participants without depression, depressive patients had a significantly higher risk of overall mortality (HR = 1.49, 95 % CI: 1.25,1.79), cardiovascular disease -specific mortality (HR =1.89, 95 % CI: (1.37,2.63)) and mortality from causes other than cardiovascular disease or cancer (HR = 1.62, 95 % CI: (1.25,2.08)). Physical activity, especially moderate-to-vigorous physical activity, significantly mediated the relationship between depression and all-cause and CVD-specific mortality.
Despite being a cohort study, the exposure and mediatiors were measured at the baseline. Further research is necessary to require a temporal order between the exposure and mediating variables.
Our findings indicate that 24-h time-use behaviors link depression to mortality. In particular, increasing the time spent on physical activity can reduce the risk of death in patients with depression. This finding provides potential interventions for reducing the risk of death in patients with depression.
建立了生存结局的构成性中介模型，以探讨24小时时间利用行为是否介导抑郁与死亡率之间的关系。
对来自美国国家健康与营养检查调查（2005 - 2006年NHANES）的4137名成年人进行随访至2019年。采用Cox比例风险回归模型估计抑郁对死亡率的总效应。使用构成数据分析来检验24小时时间利用构成与死亡率之间的关系。此外，我们构建了生存结局的构成性中介模型，以研究24小时时间利用行为对抑郁和死亡率的中介作用。
与无抑郁的参与者相比，抑郁患者的全因死亡率（HR = 1.49，95%CI：1.25，1.79）、心血管疾病特异性死亡率（HR = 1.89，95%CI：（1.37，2.63））以及心血管疾病或癌症以外原因导致的死亡率（HR = 1.62，95%CI：（1.25，2.08））显著更高。身体活动，尤其是中等到剧烈的身体活动，显著介导了抑郁与全因死亡率和心血管疾病特异性死亡率之间的关系。
尽管是队列研究，但暴露和中介因素是在基线时测量的。需要进一步研究以确定暴露和中介变量之间的时间顺序。
我们的研究结果表明，24小时时间利用行为将抑郁与死亡率联系起来。特别是，增加身体活动时间可以降低抑郁患者的死亡风险。这一发现为降低抑郁患者的死亡风险提供了潜在的干预措施。
