睡眠障碍-抑郁共病与血管健康相关指标的关联:基于NHANES数据的性别与年龄分层分析OA

Objective:Cardiovascular disease(CVD)is a leading global health threat.Comorbidity of sleep disorders and depression may further exacerbate cardiovascular risk,and this association may be influenced by gender and age.This study aims to evaluate the association between sleep disorder-depression comorbidity and cardiovascular health indicators using data from the National Health and Nutrition Examination Survey(NHANES)2013-2018,and to examine differences across gender and age groups. Methods:Participants aged≥18 years with complete data were included from NHANES 2013-2018,excluding those with severe cognitive impairment.Sleep status was assessed via questionnaire(sleep duration<7 h or>9 h,poor sleep quality),and depression was assessed using the Patient Health Questionnaire-9(PHQ-9;PHQ-9≥10 indicated depression).Participants with both sleep abnormalities and depression were defined as the comorbidity group,and the remainder as the non-comorbidity group.Cardiovascular health indicators collected included blood pressure,obesity indices,blood lipids,and high-sensitivity C-reactive protein(hs-CRP).Multivariate Logistic regression was used to analyze the association between comorbidity status and cardiovascular outcomes,with stratified analyses by gender and age. Results:The comorbidity group was significantly older than the non-comorbidity group[(56.2±12.3)years vs(45.8±13.5)years],and had a higher proportion of females(62.3％vs 48.5％).Rates of hypertension(48.7％vs 22.6％),obesity(52.4％vs 30.4％),and hs-CRP levels[3.20(1.80,5.40)mg/L vs 1.50(0.80,2.60)mg/L]were significantly higher in the comorbidity group than in the non-comorbidity group(all P<0.001).Sleep disorder-depression comorbidity was significantly associated with increased risk of hypertension(OR=2.89,95％CI 2.43 to 3.44),obesity(OR=3.12,95％CI 2.65 to 3.67),hypertriglyceridemia(OR=2.56,95％CI 2.21 to 2.96),and elevated hs-CRP(OR=3.45,95％CI 2.98 to 4.00)(all P<0.001).Women(OR=3.21,95％CI 2.64 to 3.91)and older adults(≥65 years;OR=3.56,95％CI 2.89 to 4.38)showed higher hypertension risk,suggesting gender-and age-related heterogeneity in the association between comorbidity and cardiovascular health indicators(all P<0.001). Conclusion:Sleep disorder-depression comorbidity is significantly associated with multiple adverse cardiovascular health indicators,with stronger associations observed in women and older adults.Elevated hs-CRP levels suggest that inflammatory responses may contribute to the link between sleep disorder-depression and vascular health impairment.