Frontiers in Cardiovascular Medicine (May 2022)
Depression Status, Lifestyle, and Metabolic Factors With Subsequent Risk for Major Cardiovascular Events: The China Cardiometabolic Disease and Cancer Cohort (4C) Study
- Xi Chen,
- Xi Chen,
- Zhelong Liu,
- Zhelong Liu,
- Yan Yang,
- Yan Yang,
- Gang Chen,
- Qin Wan,
- Guijun Qin,
- Li Yan,
- Guixia Wang,
- Yingfen Qin,
- Zuojie Luo,
- Xulei Tang,
- Yanan Huo,
- Ruying Hu,
- Zhen Ye,
- Lixin Shi,
- Zhengnan Gao,
- Qing Su,
- Yiming Mu,
- Jiajun Zhao,
- Lulu Chen,
- Tianshu Zeng,
- Qiang Li,
- Feixia Shen,
- Li Chen,
- Yinfei Zhang,
- Youmin Wang,
- Huacong Deng,
- Chao Liu,
- Shengli Wu,
- Tao Yang,
- Mian Li,
- Mian Li,
- Yu Xu,
- Yu Xu,
- Min Xu,
- Min Xu,
- Tiange Wang,
- Tiange Wang,
- Zhiyun Zhao,
- Zhiyun Zhao,
- Jieli Lu,
- Jieli Lu,
- Yufang Bi,
- Yufang Bi,
- Xuefeng Yu,
- Xuefeng Yu,
- Weiqing Wang,
- Weiqing Wang,
- Guang Ning,
- Guang Ning
Affiliations
- Xi Chen
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Xi Chen
- Branch of National Clinical Research Center for Metabolic Disease, Wuhan, China
- Zhelong Liu
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Zhelong Liu
- Branch of National Clinical Research Center for Metabolic Disease, Wuhan, China
- Yan Yang
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Yan Yang
- Branch of National Clinical Research Center for Metabolic Disease, Wuhan, China
- Gang Chen
- Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
- Qin Wan
- The Affiliated Hospital of Luzhou Medical College, Luzhou, China
- Guijun Qin
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Li Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guixia Wang
- The First Hospital of Jilin University, Changchun, China
- Yingfen Qin
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Zuojie Luo
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Xulei Tang
- The First Hospital of Lanzhou University, Lanzhou, China
- Yanan Huo
- 0Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, Nanchang, China
- Ruying Hu
- 1Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- Zhen Ye
- 1Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- Lixin Shi
- 2Affiliated Hospital of Guiyang Medical College, Guiyang, China
- Zhengnan Gao
- 3Dalian Municipal Central Hospital, Dalian, China
- Qing Su
- 4Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yiming Mu
- 5Chinese People’s Liberation Army General Hospital, Beijing, China
- Jiajun Zhao
- 6Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
- Lulu Chen
- 7Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Tianshu Zeng
- 7Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Qiang Li
- 8The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Feixia Shen
- 9The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Li Chen
- 0Qilu Hospital of Shandong University, Jinan, China
- Yinfei Zhang
- 1Central Hospital of Shanghai Jiading District, Shanghai, China
- Youmin Wang
- 2The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Huacong Deng
- 3The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chao Liu
- 4Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
- Shengli Wu
- 5Karamay Municipal People’s Hospital, Xinjiang, China
- Tao Yang
- 6The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Mian Li
- 7Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Mian Li
- 8Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yu Xu
- 7Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yu Xu
- 8Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Min Xu
- 7Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Min Xu
- 8Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Tiange Wang
- 7Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Tiange Wang
- 8Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Zhiyun Zhao
- 7Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Zhiyun Zhao
- 8Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Jieli Lu
- 7Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Jieli Lu
- 8Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yufang Bi
- 7Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yufang Bi
- 8Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Xuefeng Yu
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Xuefeng Yu
- Branch of National Clinical Research Center for Metabolic Disease, Wuhan, China
- Weiqing Wang
- 7Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Weiqing Wang
- 8Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Guang Ning
- 7Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Guang Ning
- 8Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- DOI
- https://doi.org/10.3389/fcvm.2022.865063
- Journal volume & issue
-
Vol. 9
Abstract
BackgroundWe aimed to evaluate the association between depression and major cardiovascular events and test whether the relationship between depression and cardiovascular events is influenced by lifestyle or metabolic risk factors.MethodsThe China Cardiometabolic Disease and Cancer Cohort (4C) Study was a nationwide, multicenter, prospective cohort study. About 92,869 participants without cardiovascular disease or cancer at baseline were included. Depression status was evaluated by the Patient Health Questionnaire-9 (PHQ-9). Lifestyle information was collected by the questionnaire, and metabolic risk factors including waist circumference, blood pressure, lipid profiles, and plasma glucose were measured. Major cardiovascular events including cardiovascular death, myocardial infarction, stroke, and hospitalized or treated heart failure events were validated based on medical records.ResultsDuring an average of 3.8 years of follow-up, we detected 2,076 cardiovascular events and showed that participants with depressive symptoms had an increased risk for cardiovascular events after adjustments [hazard ratio (HR): 1.29; 95% confidence index (CI): 1.08–1.53]. Stratified on metabolic risk status, the relationship between depression and cardiovascular events tended to be stronger according to the increasing numbers of metabolic risk factors, with HR (95% CI) of 0.98 (0.72–1.35) in the category with 0–2 metabolic risk factors, 1.36 (0.996–1.87) and 1.47 (1.13–1.92) for those with 3, and 4–5 metabolic risk factors, respectively, indicating an interaction effect (P = 0.039).ConclusionDepression was independently associated with an increased risk of major cardiovascular events. The effect was particularly prominent among populations at higher metabolic risk.
Keywords
- depression
- lifestyle risk factor
- metabolic risk factor
- major cardiovascular event
- prospective cohort study
