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Association between Cardiovascular-Kidney-Metabolic Syndrome and Depressive Symptoms in Middle-Aged and Older Chinese
Wenjin Pei1, Jinhao Shi1, Chenyi Liu1
1Nanfang Hospital, Southern Medical University, Guangzhou, China.
Insights
Cardiovascular-Kidney-Metabolic (CKM) syndrome is linked to worse depression. Higher CKM stages and progression correlate with increased depressive symptoms, emphasizing integrated care needs.
Area of Science:
- Public Health Research
- Clinical Medicine
- Epidemiology
Background:
- Cardiovascular-Kidney-Metabolic (CKM) syndrome and depressive disorder are significant global health concerns.
- Existing research links depression to individual CKM components, but the integrated CKM syndrome-depression relationship is unclear.
Purpose of the Study:
- To investigate the association between the integrated Cardiovascular-Kidney-Metabolic (CKM) syndrome and depressive symptoms.
- To examine how CKM syndrome stage and progression relate to depression severity.
Main Methods:
- Utilized data from 8,088 participants in cross-sectional and 1,803 in longitudinal analyses from the China Health and Retirement Longitudinal Study (CHARLS).
- Classified CKM syndrome using American Heart Association (AHA) criteria and assessed depressive symptoms with the CES-D-10 scale.
- Employed regression models for association analysis, including subgroup and interaction tests.
Main Results:
- Higher CKM stages significantly correlated with increased depressive symptom severity (CES-D-10 scores).
- Stage 4 CKM patients exhibited scores exceeding the threshold for severe depression (P < 0.001).
- Longitudinal analysis showed CKM stage progression independently predicted higher CES-D-10 scores (β = 0.31).
Conclusions:
- CKM syndrome, particularly stage 4, shows a significant association with depressive symptoms.
- A positive relationship exists between CKM progression and depressive symptom severity.
- Highlights the critical need for integrated physical and mental healthcare for CKM patients.
Introduction:
Cardiovascular-kidney-metabolic (CKM) syndrome and depressive disorder represent major public health burdens. While associations between depression and individual components of CKM syndrome have been established, the relationship between depression and CKM syndrome as an integrated clinical construct remains poorly understood.
Methods:
Data from the China Health and Retirement Longitudinal Study (CHARLS) were used, including 8,088 participants in cross-sectional analyses and 1,803 in longitudinal analyses. CKM syndrome was classified according to the American Heart Association (AHA) staging criteria, and depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). The association between CKM stage and depressive symptoms was evaluated using ordinary least squares regression models with five levels of covariate adjustment. Subgroup analyses and interaction tests were conducted to investigate interaction effects across different populations.
Results:
Higher CKM stages were significantly associated with increased depressive symptom severity. In the cross-sectional analysis (2011), mean CES-D-10 scores were 8.6 ± 6.4, 8.6 ± 6.3, 8.1 ± 6.2, and 10.7 ± 6.9 for the total population and CKM stages 0-1, 2-3, and 4, respectively. Scores in stage 4 exceeded the threshold for severe depressive symptoms and were significantly higher than those in other stages (p < 0.001). Subgroup analyses further confirmed the robustness of these findings. In longitudinal analyses, progression in CKM stage over a 4-year period was independently associated with an increase in CES-D-10 scores in the fully adjusted model (β = 0.31, 95% CI: 0.07-0.54).
Conclusions:
CKM syndrome is significantly associated with depressive symptoms, especially in stage 4. There is a positive relationship between CKM progression and depressive symptom severity, highlighting the need for integrated physical and mental health care for CKM patients.
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