Ma Cui, Zhao De-Feng, Zhai Lu, Huo Rong-Rui, Liu Yu-Hua
Department of Nursing, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China.
Cardiovascular Intensive Care Unit, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Gen Hosp Psychiatry. 2025 Sep-Oct;96:183-192. doi: 10.1016/j.genhosppsych.2025.07.013. Epub 2025 Jul 20.
To examine the association of depressive symptoms with cardiovascular disease (CVD) risk in middle-aged and older adults with Cardiovascular-Kidney-Metabolic (CKM) syndrome stages 0-3 and to assess whether this association varies by CKM syndrome stages. Also, interactions of depressive symptoms with CKM syndrome stages in relation to CVD risk were evaluated.
This study analyzed data from the China Health and Retirement Longitudinal Study (CHARLS). Incident CVD events were identified based on self-reported physician-diagnosed (Participants were asked whether they had ever been diagnosed with disease by a physician). Cox proportional hazards regression models were used to estimate the association between depressive symptoms and CVD risk with interaction analyses across CKM syndrome stages.
Among 3440 participants, 1833 (53.3 %) were women. Over the 7-year follow-up, 696 (20.2 %) developed CVD. After full adjustment, elevated depressive symptoms were associated with a 27.0 % higher CVD risk (HR, 1.27; 95 % CI, 1.07-1.50). Of the 10 individual depressive symptoms, only restless sleep (HR, 1.23; 95 % CI, 1.04-1.44), loneliness (HR, 1.26; 95 % CI, 1.05-1.52), and bothered by little things (HR, 1.21; 95 % CI, 1.01-1.45) were significantly associated with incident CVD. Moreover, depressive symptoms and CKM syndrome stages exhibited both multiplicative and additive interactions. Notably, in CKM syndrome stage 3, depressive symptoms were associated with a 36.0 % higher CVD risk (HR, 1.36; 95 % CI, 1.09-1.70).
Elevated depressive symptoms are associated with increased CVD risk in middle-aged and older adults with CKM syndrome stages 0-3, with a synergistic effect observed as CKM syndrome progresses. Highlighting the integration of mental health assessments into CKM risk stratification may enhance early intervention strategies and reduce CVD burden.
研究心血管 - 肾脏 - 代谢（CKM）综合征0 - 3期的中老年人抑郁症状与心血管疾病（CVD）风险之间的关联，并评估这种关联是否因CKM综合征阶段而异。此外，还评估了抑郁症状与CKM综合征阶段在CVD风险方面的相互作用。
本研究分析了中国健康与养老追踪调查（CHARLS）的数据。根据自我报告的医生诊断确定新发CVD事件（参与者被问及是否曾被医生诊断患有疾病）。使用Cox比例风险回归模型估计抑郁症状与CVD风险之间的关联，并对CKM综合征各阶段进行交互分析。
在3440名参与者中，1833名（53.3%）为女性。在7年的随访中，696名（20.2%）发生了CVD。经过全面调整后，抑郁症状加重与CVD风险高27.0%相关（风险比[HR]，1.27；95%置信区间[CI]，1.07 - 1.50）。在10种个体抑郁症状中，只有睡眠不安（HR，1.23；95% CI，1.04 - 1.44）、孤独感（HR，1.26；95% CI，1.05 - 1.52）和为小事烦恼（HR，1.21；95% CI，1.01 - 1.45）与新发CVD显著相关。此外，抑郁症状与CKM综合征阶段表现出乘法和加法交互作用。值得注意的是，在CKM综合征3期，抑郁症状与CVD风险高
