儿童和青少年重度抑郁障碍与心血管疾病风险

IF 2.8 3区 医学 Q1 PEDIATRICS
Jessica Muha, Susan C Campisi, Kimberley Tsujimoto, Eric Tu, Sri Mahavir Agarwal, Alene Toulany, Chloe A Hamza, Daphne J Korczak
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引用次数: 0

摘要

目的:青年重性抑郁障碍(MDD)是早发性心血管疾病(CVD)的独立危险因素。虽然以前的研究已经考虑了与抑郁症相关的个体心血管疾病风险因素,但本研究使用一种有效的复合测量方法来检查患有重度抑郁症的儿童和青少年中抑郁症与心血管疾病风险之间的关系。方法:通过门诊精神病学项目招募患有重度抑郁症的青少年,并进行半结构化的精神病学诊断评估以确认诊断。健康对照参与者从社区环境中招募。所有参与者都完成了流行病学研究中心儿童抑郁量表,以评估抑郁症状。持续代谢综合征评分是一种有效的青年心血管代谢风险评估方法,使用CVD危险因素的综合标准化z分数计算,包括空腹血糖、体重指数、血压、空腹甘油三酯和高密度脂蛋白胆固醇。分层多元回归模型在考虑协变量的同时检验了抑郁(诊断和症状)与心血管疾病风险之间的关联。结果:受试者(N=277;73.6%为女性),平均年龄15.2岁(SD=1.8)。与健康对照组(n=81, mean=-0.39, SD=2.77)相比,抑郁症青年(n=196, mean= 0.77, SD=2.98)患心血管疾病的风险显著升高;p = .002)。抑郁诊断和抑郁症状与CVD风险增加相关(β=0.40, p= 0.004;β= 0.15,p =。在调整协变量后,分别为02)。结论:与健康青少年相比,患有重度抑郁症的青少年患心血管疾病的风险增加,这突出了抑郁症与心血管疾病之间关联的早期证据。因此,儿童期和青春期可能是针对青少年抑郁症患者心血管健康进行预防性干预的关键时期。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Major Depressive Disorder and Cardiovascular Disease Risk in Children and Adolescents.

Objective: Major Depressive Disorder (MDD) in youth is an independent risk factor for premature cardiovascular disease (CVD). While previous research has considered individual CVD risk factors in relation to depression, this study examined the association between depression and CVD risk among children and adolescents with MDD using a validated composite measure.

Methods: Youth with MDD were recruited through an outpatient psychiatry program and underwent semi-structured psychiatric diagnostic assessment to confirm diagnosis. Healthy control participants were recruited from community settings. All participants completed the Center for Epidemiological Studies Depression Scale for Children to assess depressive symptoms. The Continuous Metabolic Syndrome score, a validated measure for cardiometabolic risk assessment in youth, was computed using aggregated standardized z-scores of CVD risk factors including fasting blood glucose, body mass index, blood pressure, fasting triglycerides and high-density lipoprotein cholesterol. Hierarchical multiple regression models tested the association between depression (diagnosis and symptoms) and CVD risk while accounting for covariates.

Results: Participants (N=277; 73.6% female) had a mean age of 15.2 (SD=1.8) years. Cardiovascular disease risk was significantly higher among youth with depression (n=196, mean =0.77, SD=2.98) compared with healthy controls (n=81, mean=-0.39, SD=2.77; p=.002). Depression diagnosis and depressive symptoms were associated with increased CVD risk (β=0.40, p=.004; β=0.15, p=.02, respectively), after adjusting for covariates.

Conclusions: Adolescents with MDD demonstrate increased cardiovascular disease risk compared with healthy youth, highlighting early evidence of association between depression and cardiovascular disease. Consequently, childhood and adolescence may serve as crucial periods for preventive intervention targeting cardiovascular health among youth with depression.

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来源期刊
Academic Pediatrics
Academic Pediatrics PEDIATRICS-
CiteScore
4.60
自引率
12.90%
发文量
300
审稿时长
60 days
期刊介绍: Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.
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