Huang Xinghe, Liang Jie, Zhang Junyu, Fu Jiayi, Xie Wuxiang, Zheng Fanfan
School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China.
Peking University Clinical Research Institute, Peking University First Hospital, Beijing 100191, China.
Psychol Med. 2024 Nov 18;54(15):1-9. doi: 10.1017/S0033291724002381.
To explore the association of cardiovascular-kidney-metabolic (CKM) health with the risk of depression and anxiety and to investigate the joint association of CKM health and social connection with depression and anxiety.
This prospective cohort study included 344 956 participants from the UK Biobank. CKM syndrome was identified as a medical condition with the presence of metabolic risk factors, cardiovascular disease, and chronic kidney disease, and was classified into five stages (stage 0-4) in this study. Loneliness and social isolation status were determined by self-reported questionnaires. Cox proportional hazards models were applied for analyses.
Compared with participants in stage 0, the HRs for depression were 1.17 (95% CI 1.10-1.25), 1.40 (95% CI 1.33-1.48), and 2.14 (95% CI 1.98-2.31) for participants in stage 1, 2-3, and 4, respectively. Similarly, participants in stage 2-3 (HR = 1.20, 95% CI 1.14-1.26) and stage 4 (HR = 1.63, 95% CI 1.51-1.75) had greater risks of incident anxiety. We found additive interactions between loneliness and CKM health on the risk of depression and anxiety. Participants simultaneously reported being lonely and in stage 4 had the greatest risk of depression (HR = 4.44, 95% CI 3.89-5.07) and anxiety (HR = 2.58, 95% CI 2.21-3.01) compared with those without loneliness and in stage 0. We also observed an additive interaction between social isolation and CKM health on the risk of depression.
Our findings suggest the importance of comprehensive interventions to improve CKM health and social connection to reduce the disease burden of depression and anxiety.
探讨心血管-肾脏-代谢（CKM）健康与抑郁和焦虑风险之间的关联，并研究CKM健康与社会联系对抑郁和焦虑的联合关联。
这项前瞻性队列研究纳入了来自英国生物银行的344956名参与者。CKM综合征被确定为一种存在代谢危险因素、心血管疾病和慢性肾脏病的医学状况，在本研究中分为五个阶段（0-4期）。通过自我报告问卷确定孤独和社会隔离状态。应用Cox比例风险模型进行分析。
与0期参与者相比，1期、2-3期和4期参与者患抑郁症的风险比（HR）分别为1.17（95%CI 1.10-1.25）、1.40（95%CI 1.33-1.48）和2.14（95%CI 1.98-2.31）。同样，2-3期（HR = 1.20，95%CI 1.14-1.26）和4期（HR = 1.63，95%CI 1.51-1.75）的参与者发生焦虑的风险更高。我们发现孤独与CKM健康之间在抑郁和焦虑风险上存在相加交互作用。与无孤独感且处于0期的参与者相比，同时报告孤独且处于4期的参与者患抑郁症（HR = 4.44，95%CI 3.89-5.07）和焦虑症（HR = 2.58，95%CI 2.21-3.01）的风险最高。我们还观察到社会隔离与CKM健康之间在抑郁风险上存在相加交互作用。
我们的研究结果表明，采取综合干预措施改善CKM健康和社会联系对于减轻抑郁和焦虑的疾病负担具有重要意义。
