Nakada Shinya, Celis-Morales Carlos, Pell Jill P, Ho Frederick K
School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
School of Health and Wellbeing, University of Glasgow, Glasgow, UK; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow; Human Performance Laboratory, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile; Centro de Investigación en Medicina de Altura (CEIMA), Universidad Arturo Prat, Iquique, Chile.
J Affect Disord. 2025 Mar 1;372:564-571. doi: 10.1016/j.jad.2024.12.060. Epub 2024 Dec 16.
Few studies have investigated whether and which anxiety and affective disorders are associated with the risk of venous thromboembolism. We aimed to examine whether anxiety disorder, depression, and bipolar disorder increase the risk of venous thromboembolism, independent of socioeconomic confounders and each other, in a UK general population.
This is a prospective cohort study using UK Biobank. Participants were excluded if they were diagnosed with venous thromboembolism before the baseline assessment, if they were first diagnosed with anxiety disorder, depression, or bipolar disorder thereafter, or if they had missing sociodemographic data. Diagnosed anxiety disorder, depression, and bipolar disorder were ascertained through hospital admission data and incident venous thromboembolism, pulmonary embolism, and deep vein embolism were ascertained through both hospital admission and death certificate data. Hazard ratios were calculated, adjusted for sociodemographic confounders and comorbid anxiety and affective disorders.
Our main analysis included 455,705 participants, of whom 53.6 % were female, with a mean age (standard deviation) of 56.6 (8.1) years. Anxiety disorder, depression, and bipolar disorder were associated with venous thromboembolism both before and after adjusting for sociodemographic confounders. After adjustment for comorbid anxiety and affective disorders, depression (HR: 2.00; 95 % CI: 1.68-2.38) and bipolar disorder (HR: 2.08; 95 % CI: 1.28-3.37) remained associated with venous thromboembolism, but anxiety did not (HR: 1.17; 95 % CI: 0.88-1.57). Similar results were found for pulmonary embolism and deep vein embolism.
Depression and bipolar disorder were associated with the risk of venous thromboembolism. Further research is required to understand the mechanism underlying their increased risk.
很少有研究调查焦虑症和情感障碍是否以及哪些与静脉血栓栓塞风险相关。我们旨在研究在英国普通人群中，焦虑症、抑郁症和双相情感障碍是否会增加静脉血栓栓塞风险，且独立于社会经济混杂因素以及它们彼此之间的影响。
这是一项使用英国生物银行的前瞻性队列研究。如果参与者在基线评估前被诊断为静脉血栓栓塞，在此后首次被诊断为焦虑症、抑郁症或双相情感障碍，或者有缺失的社会人口统计学数据，则将其排除。通过医院入院数据确定已诊断的焦虑症、抑郁症和双相情感障碍，通过医院入院和死亡证明数据确定新发静脉血栓栓塞、肺栓塞和深静脉栓塞。计算风险比，并针对社会人口统计学混杂因素以及共病的焦虑症和情感障碍进行调整。
我们的主要分析纳入了455,705名参与者，其中53.6%为女性，平均年龄（标准差）为56.6（8.1）岁。在调整社会人口统计学混杂因素前后，焦虑症、抑郁症和双相情感障碍均与静脉血栓栓塞相关。在调整共病的焦虑症和情感障碍后，抑郁症（风险比：2.00；95%置信区间：1.68 - 2.38）和双相情感障碍（风险比：2.08；95%置信区间：1.28 - 3.37）仍与静脉血栓栓塞相关，但焦虑症则不然（风险比：1.17；95%置信区间：0.88 - 1.57）。肺栓塞和深静脉栓塞也得到了类似结果。
抑郁症和双相情感障碍与静脉血栓栓塞风险相关。需要进一步研究以了解其风险增加背后的机制。
