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抑郁症状轨迹与慢性肝病风险:来自中国健康与养老追踪调查(CHARLS)的证据

Trajectories of depressive symptoms and risk of chronic liver disease: evidence from CHARLS.

作者信息

Yang Xikun, Ma Jiangping, Li Hui

机构信息

Central Laboratory, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China.

School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China.

出版信息

BMC Gastroenterol. 2025 May 7;25(1):338. doi: 10.1186/s12876-025-03943-7.

Abstract

BACKGROUND

It is unclear whether there is a association between the long-term depressive symptoms and chronic liver disease(CLD). The aim of present study was to investigate the relationship between the trajectories of depressive symptoms and CLD in middle-aged and older Chinese adults.

METHODS

The study included data from 7351 Chinese individuals, which from the China Health and Retirement Longitudinal Study (CHARLS). Latent Class Growth Model (LCGM) and Growth Mixture Model (GMM) identified five categories of depressive symptom trajectories from 2011 to 2015. Multiple logistic regression models were used to analyze the relationship between depressive symptom trajectories and CLD in 2015-2020.

RESULTS

We identified five distinct trajectories of depressive symptoms characterized by persistent low CES-D scores throughout follow-up (low-stable; 4621 cases [62.86%]); high starting CES-D scores but then declining (high-decreasing; 824 cases [11.21%]); persistent high CES-D scores during follow-up (high-stable; 508 cases [6.91%]); starting moderate CES-D scores but then increasing (moderate-increasing; 844 cases [11.48%]); and low starting CES-D scores that increased and then remitted through follow-up (remitting; 554 cases [7.54%]). A total of 420 (5.71%) participants developed chronic liver disease during follow-up. The ORs (95% CI) for the risk of developing chronic liver disease in participants on the moderate-increasing trajectory, high-decreasing trajectory, and high-stable trajectory were 1.44 (1.05-1.93), 1.59 (1.17-2.12), and 2.25 (1.62-3.08), respectively, compared with participants on the low-stable trajectory.

CONCLUSION

In Chinese middle-aged and older adults, individuals with moderate-increasing, high-decreasing, and high-stable trajectories of depressive symptoms over time had an increased risk of developing CLD.

摘要

背景

长期抑郁症状与慢性肝病(CLD)之间是否存在关联尚不清楚。本研究的目的是调查中国中老年人群中抑郁症状轨迹与CLD之间的关系。

方法

该研究纳入了来自中国健康与养老追踪调查(CHARLS)的7351名中国人的数据。潜在类别增长模型(LCGM)和增长混合模型(GMM)从2011年至2015年确定了五类抑郁症状轨迹。使用多重逻辑回归模型分析2015年至2020年抑郁症状轨迹与CLD之间的关系。

结果

我们确定了五种不同的抑郁症状轨迹,其特征分别为:在整个随访期间CES-D得分持续较低(低稳定型;4621例[62.86%]);起始CES-D得分较高但随后下降(高下降型;824例[11.21%]);随访期间CES-D得分持续较高(高稳定型;508例[6.91%]);起始CES-D得分中等但随后上升(中等上升型;844例[11.48%]);起始CES-D得分较低,随后上升并在随访期间缓解(缓解型;554例[7.54%])。共有420名(5.71%)参与者在随访期间患上了慢性肝病。与低稳定型轨迹的参与者相比,中等上升型轨迹、高下降型轨迹和高稳定型轨迹的参与者患慢性肝病风险的比值比(95%置信区间)分别为1.44(1.05 - 1.93)、1.59(1.17 - 2.12)和2.25(1.62 - 3.08)。

结论

在中国中老年人群中,随着时间推移,抑郁症状轨迹为中等上升型、高下降型和高稳定型的个体患CLD的风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bd3/12057118/180c24a3f77b/12876_2025_3943_Fig1_HTML.jpg

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