Yang Hui, Cao Juan, Huang Lin, Xie Zhijun, Zhou Yuejun, Wang Yiqing, Wen Chengping
College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China.
Medical College of Zhejiang University, Hangzhou, China.
Front Public Health. 2025 Jul 17;13:1551356. doi: 10.3389/fpubh.2025.1551356. eCollection 2025.
The relationship between lung function and depression in middle-aged and older adults remains poorly understood. To address this knowledge gap, we conducted cross-sectional and longitudinal analyses using data from the nationally representative China Health and Retirement Longitudinal Study (CHARLS) to examine the association between peak expiratory flow (PEF) status and depression among middle-aged and older Chinese adults.
A total of 15,137 participants aged 45 years and older were included from the 2015 China Health and Retirement Longitudinal Study (CHARLS). Participants were categorized into three PEF status groups based on their percentage of predicted PEF: severe impairment (<80%), average lung function (80-100%), and good lung function (≥100%). A total of 12,304 participants were included in the longitudinal analysis from 2015 to 2018. To address potential confounding, propensity score matching was employed using a gradient-boosting model to balance covariates between participants with and without depression. Logistic regression analyses as well as restricted cubic spline (RCS) regression analyses were performed to examine the association between (PEF) status and depression incidence.
The prevalence of depression was 9.53% ( = 1,044) in the cross-sectional sample, with higher rates observed in participants with poorer lung function (9.53, 7.11, and 5.03% for good, moderately good, and poorer lung function, respectively). During a 3.6-year follow-up, 6.73% ( = 130) of participants developed depression. Fully adjusted logistic regression analysis demonstrated a significant inverse linear association between PEF percentage and depression risk (OR: 0.898, 95% CI: 0.862-0.935, per 1 SD increase). These findings were corroborated by restricted cubic spline (RCS) regression analysis, which revealed a linear relationship without evidence of nonlinearity ( for nonlinearity = 0.631).
Our study revealed a noteworthy correlation between PEF percentage and depression among the middle-aged and older population. The PEF percentage emerges as a valuable tool that may enhance the primary prevention and treatment of depression.
中老年人肺功能与抑郁之间的关系仍未得到充分理解。为填补这一知识空白，我们利用具有全国代表性的中国健康与养老追踪调查（CHARLS）的数据进行了横断面和纵向分析，以研究中国中老年人的呼气峰值流速（PEF）状况与抑郁之间的关联。
从2015年中国健康与养老追踪调查（CHARLS）中纳入了总共15137名年龄在45岁及以上的参与者。根据预测PEF的百分比，将参与者分为三个PEF状况组：严重受损（<80%）、肺功能一般（80-100%）和肺功能良好（≥100%）。2015年至2018年的纵向分析共纳入了12304名参与者。为解决潜在的混杂因素，采用倾向得分匹配法，使用梯度提升模型来平衡有抑郁和无抑郁参与者之间的协变量。进行逻辑回归分析以及受限立方样条（RCS）回归分析，以研究PEF状况与抑郁发病率之间的关联。
横断面样本中抑郁的患病率为9.53%（n = 1044），肺功能较差的参与者中患病率更高（肺功能良好、中等良好和较差的参与者分别为9.53%、7.11%和5.03%）。在3.6年的随访期间，6.73%（n = 130）的参与者出现了抑郁。完全调整后的逻辑回归分析表明，PEF百分比与抑郁风险之间存在显著的负线性关联（OR：0.898，95%CI：0.862-0.935，每增加1个标准差）。受限立方样条（RCS）回归分析证实了这些发现，该分析揭示了一种线性关系，没有非线性证据（非线性检验P = 0.631）。
我们的研究揭示了中老年人中PEF百分比与抑郁之间存在显著相关性。PEF百分比成为一种可能加强抑郁症一级预防和治疗的有价值工具。
