中国中老年人群抑郁症状与胃肠道疾病风险的关联:一项基于CHARLS的横断面与纵向研究OA
Association between depressive symptoms and risk of gastrointestinal diseases in middle-aged and older Chinese adults:a cross-sectional and longitudinal study based on CHARLS
目的 评估我国中老年人抑郁症状与胃肠道疾病(GID)风险的横断面及纵向关联.方法 基于中国健康与养老追踪调查(CHARLS)2011-2018年数据,采用横断面与纵向研究相结合的设计.横断面研究纳入15 014名≥45岁中老年人,纵向研究从中筛选8154名基线无GID的参与者随访至2018年.通过多因素logistic回归分析流行病学研究中心抑郁量表(CES-D)评分与GID的横断面关联;采用多因素Cox比例风险回归模型、Kaplan-Meier曲线、限制性立方样条(RCS)及亚组分析评估基线抑郁症状与新发GID的纵向关联,并通过敏感性分析验证结果的稳健性.结果 多因素logistic回归分析结果显示,CES-D评分每增加1分,GID风险增加6%(OR=1.06,95%CI 1.05～1.07);与无/轻度抑郁症状者相比,中度和重度抑郁症状者的GID风险分别增加76%(OR=1.76,95%CI 1.61～1.92)和升高1.40倍(OR=2.40,95%CI 2.08～2.78).在随访期间,共1881例(23.1%)首次被诊断为GID.多因素Cox回归分析结果显示,抑郁症状严重程度每增加1分,GID风险增加4%(HR=1.04,95%CI 1.02～1.05);RCS分析显示抑郁症状与GID风险呈非线性剂量-反应关系(总体P值<0.001,非线性P值=0.009).亚组分析显示在不同人群中关联的一致性(交互作用P值>0.05).敏感性分析中,按CES-D评分四分位分组后,最高分位组(Q4)风险较最低组(Q1)增加84%(HR=1.84,95%CI 1.58～2.16).结论 在我国中老年人群中,抑郁症状加重与GID风险的增加相关.
Objective To evaluate the cross-sectional and longitudinal associations between depressive symptoms and gastrointestinal diseases(GID)among middle-aged and older adults in China.Methods Based on data from the China Health and Retirement Longitudinal Study(CHARLS,2011-2018),a study integrating cross-sectional and longitudinal design was conducted.The cross-sectional analysis included 15,014 participants aged≥45 years.For the longitudinal analysis,8154 participants without GID at baseline were followed until 2018.Multivariable logistic regression was employed to examine the cross-sectional association between Center for Epidemiologic Studies Depression Scale(CES-D)scores and GID.Multivariable Cox proportional hazards regression models,Kaplan-Meier curves,restricted cubic spline(RCS),and subgroup analyses were used to assess the longitudinal association between baseline depressive symptoms and incident GID.Sensitivity analyses were performed to validate the robustness of the results.Results Multivariable logistic regression revealed that each 1-point increase in CES-D score was associated with a 6%higher risk of GID(OR=1.06,95%CI 1.05-1.07).Compared with participants having no/mild depressive symptoms,those with moderate and severe symptoms had 76%higher risk(OR=1.76,95%CI 1.61-1.92)and a 1.40-fold higher risk(OR=2.40,95%CI 2.08-2.78)of GID,respectively.During follow-up,1881 participants(23.1%)were newly diagnosed with GID.Multivariable Cox regression showed that each 1-point increase in the severity of depressive symptoms score was associated with a 4%increase in GID risk(HR=1.04,95%CI 1.02-1.05).RCS analysis indicated a nonlinear dose-response relationship between depressive symptoms and GID risk(P for overall association<0.001,P for nonlinearity=0.009).Subgroup analyses demonstrated consistent associations across subgroups(P for interaction>0.05).Sensitivity analyses showed that participants in the highest quartile(Q4)of CES-D scores had an 84%higher risk of GID(HR=1.84,95%CI 1.58-2.16)compared with those in the lowest quartile(Q1).Conclusion Elevated depressive symptoms are associated with an increased risk of GID in middle-aged and older Chinese adults.
田菁;肖准;黄一鸣;赵小诺;陈田田;王丽欣;马素平
河南中医药大学第一附属医院脾胃肝胆科,河南 郑州 450000||河南中医药大学第一临床医学院,河南 郑州 450000河南中医药大学第一附属医院脾胃肝胆科,河南 郑州 450000河南中医药大学第一临床医学院,河南 郑州 450000河南中医药大学第一临床医学院,河南 郑州 450000河南中医药大学第一临床医学院,河南 郑州 450000河南中医药大学第一临床医学院,河南 郑州 450000河南中医药大学第一附属医院脾胃肝胆科,河南 郑州 450000
医药卫生
抑郁症状胃肠道疾病中老年人群中国健康与养老追踪调查
depressive symptomsgastrointestinal diseasesmiddle-aged and older adultsChina Health and Retirement Longitudinal Study
《解放军医学杂志》 2026 (2)
188-195,8
This work was supported by the National Natural Science Foundation of China Youth Program(82104772),the China Postdoctoral Science Foundation(2022M721067),the Henan Provincial Science and Technology Tackling Program(222102310502),the Henan Provincial Union Fund for Science and Technology Research and Development Plan(222301420062),the Henan Provincial Special Project of Scientific Research on Traditional Chinese Medicine(2022ZY2008),the Scientific Research Project for the"Double First-Class"Creation of Traditional Chinese Medicine in Henan Province(HSRP-DFCTCM-2023-3-20),and the Second Batch of Discipline Construction Projects for Henan Provincial Characteristic Key Disciplines of Traditional Chinese Medicine(STG-ZYX02-202109) 国家自然科学基金青年基金(82104772)中国博士后科学基金(2022M721067)河南省科技攻关计划(222102310502)河南省科技研发计划联合基金(222301420062)河南省中医药科学研究专项(2022ZY2008)河南省中医学"双一流"创建科学研究专项课题(HSRP-DFCTCM-2023-3-20)河南省特色骨干学科中医学第二批学科建设项目(STG-ZYX02-202109)
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