Association of mental health in childhood, adolescence and young adulthood with cardiovascular risk factors and carotid remodeling below age 30 - results from the KiGGS cohort study

Abstract

An association of mental health and in particular depression with cardiovascular disease has been shown in adults and to a lesser extent in the young. Recently improved measurement methods of carotid-intima media thickness (CIMT) and carotid stiffness (CS) allow more differentiated analyses of this link. We examined 4,361 participants of the nationwide KiGGS cohort aged 3–17 years at baseline and 14–28 years at follow-up. Using linear and logistic regressions, we analyzed cross-sectional and longitudinal associations of mental health with systolic blood pressure (SBP), body mass index (BMI) and total cholesterol (TC) as well as CIMT and CS from high-resolution carotid sonography at follow-up. Mental health in children was measured with the Strength and Difficulties Questionnaire (SDQ) and in adults with the Mental Health Inventory (MHI-5) and the Patient Health Questionnaire (PHQ-9). Childhood SDQ scores were associated longitudinally with SBP, BMI and TC (-0.03≤ ß≥ 0.02) but not with CIMT or CS one decade later. Similarly, SDQ at follow-up was associated cross-sectionally with SBP, BMI and TC, but not CIMT or CS. MHI-5 scores were not linked to any outcome. PHQ-9 scores in young adults were associated cross-sectionally with SBP and BMI (-0.26≤ ß≥ 0.01), but not with CIMT or CS. Our study shows that children, adolescents and young adults with impaired mental health also have an increased long-term cardiovascular risk through higher BMI and TC. However, in this sample with predominantly mild mental health impairments carotid remodeling was not evident.