Baoshan Center for Disease Control and Prevention, Shanghai 201901, China.
Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, Suzhou Medical College of Soochow University, Suzhou, China.
J Affect Disord. 2024 Sep 1;360:242-248. doi: 10.1016/j.jad.2024.05.159. Epub 2024 May 29.
Previous studies had reported depression symptoms and TG/HDLC ratio may share pathophysiological pathway. The aim was to investigate the combined effects of depression symptoms and TG/HDL-C ratio on the risk of CMM.
This cohort study extracted data from 2011 to 2018 of CHARLS. The CMM event occurred from 2013 to 2018, defined as suffering from more than one of stroke, cardiac events, and diabetes mellitus. Cox proportional hazards regression models were used to assess the association between the baseline combined effects of depression symptoms and TG/HDL-C ratio with incidence of CMM, stroke, cardiac events, and diabetes mellitus.
A total of 8349 participants (3966 men and 4383 women) were included in the study, with a mean age of 58.5 years. During a 7-year follow-up survey, 370 (4.43 %) participants developed CMM. Compared to individuals with no depression symptoms and low TG/HDLC ratio, the multivariable-adjusted HRs (95%CI) for the new-onset CMM for patients with the depression symptoms alone, high TG/HDLC ratio alone, and depression symptoms and high TG/HDLC ratio were 1.37 (95 % CI = 0.95-1.98), 1.62 (95 % CI = 1.22-2.14), 1.94 (95 % CI = 1.39-2.72), respectively (P < 0.001).
Firstly, potential confounding factors such as dietary intake and nutrition were not collected at the time of study design. Secondly, exposure to the outcome was self-reported, which may cause recall bias or misclassification. Finally, the population was aged ≥45 years, so the results cannot be generalized to all age groups.
Our findings indicated that patients with depression and high TG/HDLC ratio had a higher risk of developing CMM.
先前的研究报告称抑郁症状和 TG/HDLC 比值可能存在共同的病理生理途径。本研究旨在探讨抑郁症状和 TG/HDL-C 比值联合对 CMM 风险的影响。
本队列研究从 CHARLS 中提取了 2011 年至 2018 年的数据。CMM 事件发生于 2013 年至 2018 年,定义为患有中风、心脏事件和糖尿病中的一种以上疾病。采用 Cox 比例风险回归模型评估基线时抑郁症状和 TG/HDL-C 比值联合对 CMM、中风、心脏事件和糖尿病发生的相关性。
本研究共纳入 8349 名参与者(男 3966 名,女 4383 名),平均年龄为 58.5 岁。在 7 年的随访调查中,370 名(4.43%)参与者发生了 CMM。与无抑郁症状且 TG/HDLC 比值低的个体相比,仅存在抑郁症状、TG/HDLC 比值高以及抑郁症状和 TG/HDLC 比值高的患者新发生 CMM 的多变量校正 HR(95%CI)分别为 1.37(95%CI=0.95-1.98)、1.62(95%CI=1.22-2.14)和 1.94(95%CI=1.39-2.72)(P<0.001)。
首先,在研究设计时没有收集饮食摄入和营养等潜在混杂因素。其次,暴露于结局的情况是自我报告的,这可能导致回忆偏倚或分类错误。最后,该人群年龄≥45 岁,因此结果不能推广到所有年龄组。
本研究结果表明,患有抑郁和高 TG/HDLC 比值的患者发生 CMM 的风险更高。