Büschges Julia Charlotte, Beyer Ann-Kristin, Schmidt-Trucksäss Arno, Berger Klaus, Neuhauser Hannelore
Department of Epidemiology and Health Monitoring, Robert Koch Institute, Gerichtstr. 27, D-13347, Berlin, Germany.
DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
Eur J Epidemiol. 2025 Jan;40(1):17-26. doi: 10.1007/s10654-024-01189-3. Epub 2025 Jan 3.
An association of mental health and in particular depression with cardiovascular disease has been shown in adults and to a lesser extent in the young. Recently improved measurement methods of carotid-intima media thickness (CIMT) and carotid stiffness (CS) allow more differentiated analyses of this link. We examined 4,361 participants of the nationwide KiGGS cohort aged 3-17 years at baseline and 14-28 years at follow-up. Using linear and logistic regressions, we analyzed cross-sectional and longitudinal associations of mental health with systolic blood pressure (SBP), body mass index (BMI) and total cholesterol (TC) as well as CIMT and CS from high-resolution carotid sonography at follow-up. Mental health in children was measured with the Strength and Difficulties Questionnaire (SDQ) and in adults with the Mental Health Inventory (MHI-5) and the Patient Health Questionnaire (PHQ-9). Childhood SDQ scores were associated longitudinally with SBP, BMI and TC (-0.03≤ ß≥ 0.02) but not with CIMT or CS one decade later. Similarly, SDQ at follow-up was associated cross-sectionally with SBP, BMI and TC, but not CIMT or CS. MHI-5 scores were not linked to any outcome. PHQ-9 scores in young adults were associated cross-sectionally with SBP and BMI (-0.26≤ ß≥ 0.01), but not with CIMT or CS. Our study shows that children, adolescents and young adults with impaired mental health also have an increased long-term cardiovascular risk through higher BMI and TC. However, in this sample with predominantly mild mental health impairments carotid remodeling was not evident.
心理健康尤其是抑郁症与心血管疾病之间的关联在成年人中已得到证实，在年轻人中也有一定程度的体现。最近，颈动脉内膜中层厚度（CIMT）和颈动脉僵硬度（CS）测量方法的改进使得对这种关联的分析更加细致。我们对全国KiGGS队列中4361名3至17岁的参与者进行了研究，基线时测量其相关指标，随访时他们的年龄为14至28岁。我们使用线性回归和逻辑回归分析了心理健康与收缩压（SBP）、体重指数（BMI）、总胆固醇（TC）以及随访时高分辨率颈动脉超声测量的CIMT和CS之间的横断面和纵向关联。儿童的心理健康用长处和困难问卷（SDQ）进行测量，成年人则用心理健康量表（MHI - 5）和患者健康问卷（PHQ - 9）进行测量。儿童时期的SDQ得分在纵向与SBP、BMI和TC相关（-0.03≤β≥0.02），但十年后与CIMT或CS无关。同样，随访时的SDQ在横断面上与SBP、BMI和TC相关，但与CIMT或CS无关。MHI - 5得分与任何结果均无关联。年轻成年人的PHQ - 9得分在横断面上与SBP和BMI相关（-0.26≤β≥0.01），但与CIMT或CS无关。我们的研究表明，心理健康受损的儿童、青少年和年轻成年人由于BMI和TC较高，长期心血管疾病风险也会增加。然而，在这个主要为轻度心理健康受损的样本中，颈动脉重塑并不明显。
