Yang Zhaoru, Liu Ce, He Li, Zhao Hao, Jian Jiabei, Chen Huan, Wei Huanhuan, Niu Jingping, Luo Bin
Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China.
Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China.
Soc Sci Med. 2025 Feb;366:117701. doi: 10.1016/j.socscimed.2025.117701. Epub 2025 Jan 13.
Social isolation and loneliness are associated with an increased risk of various diseases and all-cause mortality. Coronary heart disease (CHD) is the main cause of heart disease deaths worldwide, which affects people's quality of life and longevity. However, the causal relationship between social isolation, loneliness, and CHD remains uncertain. This study aims to explore the potential impacts of social isolation and loneliness on the risk of CHD, thereby helping identify those most susceptible to these conditions. A total of 442,811 individuals (mean and sd of age = 56.24 ± 8.07, 55.8% women, 91.5% white) were included in the study. The UK Biobank cohort study documented 25,120 CHD cases during a mean follow-up of 14.77 years. The relationship between loneliness, social isolation and CHD were first examined using the COX proportional risk model. A two-sample Mendelian randomization (MR) study was then conducted to further the association. We found that the hazard ratio (95% CI) of coronary heart disease (CHD) when comparing the most socially isolated groups to the least was 1.15 (1.05-1.26; P = 0.0017). Additionally, the hazard ratio (95% CI) for comparing the presence of loneliness to its absence was 1.15 (1.10-1.20; P < 0.001).Subgroup analyses showed that the risk of CHD was higher in individuals with low sleep quality who experienced social isolation and in women who experienced loneliness. MR analyses further revealed that individuals who felt lonely (OR = 1.03; 95% CI: 1.01,1.06) and those less involved in sports/social activities (OR = 1.02; 95% CI: 1.00,1.04) had a higher likelihood of developing CHD. MR provided further evidence supporting the causal relationship between social isolation, loneliness and CHD risk. Our findings suggest a significant association between social isolation, loneliness and increased risk of coronary heart disease. These findings suggest that both social isolation and loneliness are critical risk factors for CHD.
社交隔离和孤独与患各种疾病及全因死亡率增加的风险相关。冠心病（CHD）是全球心脏病死亡的主要原因，它影响人们的生活质量和寿命。然而，社交隔离、孤独与冠心病之间的因果关系仍不明确。本研究旨在探讨社交隔离和孤独对冠心病风险的潜在影响，从而帮助确定那些最易受这些情况影响的人群。共有442,811人（年龄均值和标准差=56.24±8.07，55.8%为女性，91.5%为白人）纳入本研究。英国生物银行队列研究在平均14.77年的随访期间记录了25,120例冠心病病例。首先使用COX比例风险模型检验孤独、社交隔离与冠心病之间的关系。然后进行了双样本孟德尔随机化（MR）研究以进一步探讨这种关联。我们发现，将社交隔离程度最高的组与最低的组进行比较时，冠心病的风险比（95%置信区间）为1.15（1.05 - 1.26；P = 0.0017）。此外，比较有孤独感与无孤独感时的风险比（95%置信区间）为1.15（1.10 - 1.20；P < 0.001）。亚组分析表明，经历社交隔离且睡眠质量低的个体以及经历孤独的女性患冠心病的风险更高。MR分析进一步揭示，感到孤独的个体（比值比=1.03；95%置信区间：1.01,1.06）和较少参与体育/社交活动的个体（比值比=1.02；95%置信区间：1.00,1.04）患冠心病的可能性更高。MR提供了进一步的证据支持社交隔离、孤独与冠心病风险之间的因果关系。我们的研究结果表明社交隔离、孤独与冠心病风险增加之间存在显著关联。这些发现表明，社交隔离和孤独都是冠心病的关键风险因素。
