Associations Between Depression, Arterial Stiffness, and Metabolic Syndrome Among Adults in the UK Biobank Population Study: A Mediation Analysis.
JAMA Psychiatry
; 77(6): 598-606, 2020 06 01.
Article
em En
| MEDLINE
| ID: mdl-31995135
ABSTRACT
Importance Previous research has linked a history of depression with arterial stiffness (AS) during midlife. Objective:
To assess the association of depression with elevated midlife AS and to investigate the extent to which this association is mediated via metabolic syndrome (MetS). Design, Settings, andParticipants:
This population-based retrospective cohort study analyzed data collected between March 2006 and December 2010 from 124â¯445 participants aged 40 to 69 years from the UK Biobank. Participants without data on AS at baseline (n = 332â¯780) or who reported a previous diagnosis of cardiovascular disease (n = 45â¯374) were not eligible. Data analysis was performed from May to August 2019. Exposures Lifetime history of depression was assessed via verbal interview and linked hospital-based clinical depression diagnosis. Metabolic syndrome was defined as the presence of 3 or more of hypertension, dyslipidemia, hyperglycemia, hypertriglyceridemia, and unhealthy waist circumference. Main Outcomes andMeasures:
Peripherally assessed AS index (ASI) using digital photoplethysmography.Results:
Of 124â¯445 included participants with ASI assessed, 71â¯799 (57.7%) were women, and the mean (SD) age was 56 (8) years. A total of 10â¯304 participants (8.3%) reported a history of depression. Study findings indicated a significant direct association between depression and ASI levels (ß = 0.25; 95% CI, 0.17-0.32). A significant indirect association was also observed between depression and ASI levels (ß = 0.10; 95% CI, 0.07-0.13), indicating that 29% of the association of depression with ASI was mediated by MetS. The proportion of mediation increased to 37% when C-reactive protein was added to the MetS criteria (direct association ß = 0.21; 95% CI, 0.15-0.28; indirect association ß = 0.13; 95% CI, 0.10-0.17). Concerning components of MetS, the strongest indirect association was for waist circumference, accounting for 25% of the association between depression and ASI levels (direct association ß = 0.26; 95% CI, 0.18-0.34; indirect association ß = 0.09; 95% CI, 0.06-0.11). Among men, hypertriglyceridemia accounted for 19% of the association between depression and ASI (direct association ß = 0.22; 95% CI, 0.05-0.40; indirect association ß = 0.05; 95% CI, 0.02-0.08). Conclusions and Relevance One-third of the association of depression with elevated ASI levels during midlife may be accounted for by combined MetS and inflammatory processes. Unhealthy waist circumference and hypertriglyceridemia emerged as the most important potential targets for preventive interventions within women and men, respectively.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndrome Metabólica
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Depressão
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Rigidez Vascular
Tipo de estudo:
Observational_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
JAMA Psychiatry
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Reino Unido