Zhongguo quanke yixue (May 2022)
Association between Free Triiodothyronine and Depression in Patients with Coronary Heart Disease
Abstract
Background Cardiovascular disease and psychological disease are the two major public health problems threatening the health of Chinese residents. At present, there are about 11 million patients with coronary heart disease (CHD) in China. The comorbidity rate of coronary heart disease hospitalized patients with depression can reach 51%, and the combined major depression is 3.1% to 11.2%. At present, there are few studies on the association between thyroid function and depression status in CHD patients. Objective To explore the association between thyroid function and depression status in patients with CHD. Methods From October 2017 to February 2018, 561 patients diagnosed CHD from the Department of Cardiology of Guangdong Provincial People's Hospital were selected, and divided into coronary heart disease without depression group and CHD combined depression group according to whether depression was combined, which was evaluated by the patient health Questionnaire-9 (PHQ-9) . The gender, age, body mass index (BMI) , comorbid diseases (hypertension, diabetes, dyslipidemia, acute myocardial infarction) , the levels of high-sensitivity C-reactive protein (hs-CRP) , high-sensitivity troponin T (hs-cTnT) , N-terminal-B-type natriuretic peptide precursor (NT-proBNP) , serum free triiodothyronine, free thyroxine, thyroid-stimulating hormone, free triiodothyronine (FT3) , free thyroxine (FT4) and thyroid stimulating hormone (TSH) of patients wre recorded. Univariate and multivariate Logistic regression was used to analyze the effect of FT3 on the risk of depression in patients with CHD. Results CHD without depression group included 350 cases (62.4%) , CHD complicated with depression group included 211 cases (37.6%) , with 148 mild depression cases (26.4%) , 46 moderate depression cases (8.2%) , 17 severe depression cases (3.0%) . The level of FT3 in the CHD complicated with depression group was lower than that in the CHD without depression group (P<0.05) , but there was no significant difference in FT4 and TSH levels between the CHD complicated with depression group and the CHD without depression group (P>0.05) . PHQ-9 score was negatively correlated with FT3 level (rs=-0.114, P<0.05) and positively correlated with age (rs=0.093) and hs-CRP (rs=0.090) (P<0.05) in the CHD combined with depression group. The results of the univariate and multivariate Logistic regression to analyze the effect of FT3 on the risk of depression in patients with CHD showed that for each standard deviation of FT3, the risk of depression in patients with CHD decreased by 20%〔OR=0.8, 95%CI (0.67, 0.96) 〕. Similar results were observed in the FT3 quintile stratified analysis, in which the lowest risk of incident depression was observed in CHD patients in the FT3 quartile (4.98-5.34 pmol / L) , andunivariate analysis (unadjusted) showed a significant trend in OR values among the quintiles of FT3 (P<0.05) . Conclusion The level of serum FT3 in patients with CHD complicated with depression was lower than that in patients without depression, and the level of FT3 in severe depression group was more significant. FT3 may be a potential biochemical marker of depression in patients with CHD, and it is recommended that patients with CHD and depression should be evaluated for thyroid function.
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