中国三省老年代谢综合征患者抑郁状况分析

王丹; 冯雪菲; 齐士格; 王秋童; 胡亚男; 王志会; 王宝华

文章摘要

王丹,冯雪菲,齐士格,王秋童,胡亚男,王志会,王宝华.中国三省老年代谢综合征患者抑郁状况分析[J].中华流行病学杂志,2023,44(4):568-574

中国三省老年代谢综合征患者抑郁状况分析

Depression status of elderly patients with metabolic syndrome in three provinces of China

收稿日期:2022-09-26 出版日期:2023-04-18

DOI：10.3760/cma.j.cn112338-20220926-00809

中文关键词: 代谢综合征老年人抑郁影响因素

英文关键词: Metabolic syndrome Elderly Depression Influence factor

基金项目:财政部重大公共卫生专项（131091106000150003）

作者	单位	E-mail
王丹	中国疾病预防控制中心慢性非传染性疾病预防控制中心肿瘤及重点慢病防控实验室, 北京 100050 中国医科大学公共卫生学院, 沈阳 110122
冯雪菲	中国疾病预防控制中心慢性非传染性疾病预防控制中心肿瘤及重点慢病防控实验室, 北京 100050
齐士格	中国疾病预防控制中心慢性非传染性疾病预防控制中心老年健康室, 北京 100050
王秋童	中国疾病预防控制中心慢性非传染性疾病预防控制中心肿瘤及重点慢病防控实验室, 北京 100050
胡亚男	中国医科大学公共卫生学院, 沈阳 110122
王志会	中国疾病预防控制中心慢性非传染性疾病预防控制中心老年健康室, 北京 100050
王宝华	中国疾病预防控制中心慢性非传染性疾病预防控制中心肿瘤及重点慢病防控实验室, 北京 100050	baohua2000@126.com

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中文摘要:

目的了解我国老年MS患者的抑郁状况及其影响因素，探索老年MS各组分与抑郁的关系。方法基于“老年期重点疾病预防和干预”项目，采用多阶段分层整群随机抽样方法，2019年在辽宁、河南和广东三省16个县（区）共完成16 199名≥60岁老年人的问卷调查，剔除缺失变量1 001名，最终纳入有效样本为15 198名。通过问卷调查和体格检查了解调查对象MS患病情况，使用PHQ-9抑郁筛查量表评估调查对象近半个月内的抑郁状况。采用logistic回归分析老年MS及其组分与抑郁的关系及其影响因素。结果共纳入15 198名≥60岁老年人，MS患病率为10.84%，其中MS患者的抑郁症状检出率为25.49%。有0、1、2、3、4项MS异常组分数目的患者抑郁症状检出率分别为14.56%、15.17%、18.01%、25.21%、26.65%，MS异常组分数目与抑郁症状检出率呈正相关关系，组间差异有统计学意义（P<0.05）。MS、超重/肥胖、高血压、糖尿病、血脂异常患者存在抑郁症状的风险分别是未患该病人群的1.73倍（OR=1.73，95%CI：1.51~1.97）、1.13倍（OR=1.13，95%CI：1.03~1.24）、1.25倍（OR=1.25，95%CI：1.14~1.38）、1.41倍（OR=1.41，95%CI：1.24~1.60）、1.81倍（OR=1.81，95%CI：1.61~2.04）。多因素logistic回归分析结果显示，存在睡眠障碍者抑郁症状检出率高于睡眠正常者（OR=4.89，95%CI：3.79~6.32），认知功能异常患者抑郁症状检出率是正常人群的2.12倍（OR=2.12，95%CI：1.56~2.89）；工具性日常生活活动能力（IADL）受损患者抑郁症状检出率是正常人群的2.31倍（OR=2.31，95%CI：1.64~3.26）。饮茶（OR=0.73，95%CI：0.54~0.98）、体育锻炼（OR=0.67，95%CI：0.49~0.90）是老年MS患者抑郁的保护因素（P<0.05）。结论老年MS及其组分异常患者抑郁风险高于正常人群，睡眠障碍、认知功能受损、IADL受损是老年MS患者抑郁的重要影响因素，饮茶、加强体育锻炼有助于降低疾病风险。

英文摘要:

Objective To understand the depression status and its influencing factors in elderly patients with MS in China and to explore the correlation between various components of elderly MS and depression. Methods This study is based on the "Prevention and Intervention of Key Diseases in Elderly" project. We used a multi-stage stratified cluster random sampling method to complete 16 199 elderly aged 60 years and above in 16 counties (districts) in Liaoning, Henan, and Guangdong Provinces in 2019, excluding 1 001 missing variables. Finally, 15 198 valid samples were included for analysis. The respondents' MS disease was obtained through questionnaires and physical examinations, and the respondents' depression status within the past half month was assessed using the PHQ-9 Depression Screening Scale. The correlation between elderly MS and its components and depression and its influencing factors were analyzed by logistic regression.Results A total of 15 198 elderly aged 60 years and above were included in this study, with the prevalence of MS at 10.84% and the detection rate of depressive symptoms in MS patients at 25.49%. The detection rates of depressive symptoms in patients with 0, 1, 2, 3, and 4 MS abnormal group scores were 14.56%, 15.17%, 18.01%, 25.21%, and 26.65%, respectively. The number of abnormal components of MS was positively correlated with the detection rate of depressive symptoms, and the difference between groups was statistically significant (P＜0.05). The risk of depression symptoms in patients with MS, overweight/obesity, hypertension, diabetes, and dyslipidemia was 1.73 times (OR=1.73, 95%CI:1.51-1.97), 1.13 times (OR=1.13, 95%CI:1.03-1.24), 1.25 times (OR=1.25, 95%CI:1.14-1.38), 1.41 times (OR=1.41, 95%CI:1.24-1.60), 1.81 times (OR=1.81,95%CI:1.61-2.04), respectively, more than those without the disease. Multivariate logistic regression analysis showed that the detection rate of depressive symptoms in patients with sleep disorders was higher than that with normal sleep (OR=4.89, 95%CI: 3.79-6.32). The detection rate of depressive symptoms in patients with cognitive dysfunction was 2.12 times higher than that in the average population (OR=2.12, 95%CI: 1.56-2.89). The detection rate of depressive symptoms in patients with impaired instrumental activities of daily living (IADL) was 2.31 times (OR=2.31, 95%CI: 1.64-3.26) higher than that in the average population. Tea drinking (OR=0.73, 95%CI: 0.54-0.98) and physical exercise (OR=0.67, 95%CI: 0.49-0.90) seemed to be protective factors for depression in elderly MS patients (P＜0.05). Conclusions Older patients with MS and its component abnormalities have a higher risk of depression than the average population. Sleep disorders, cognitive impairment, and IADL impairment are important influencing factors for depression in elderly MS patients, while tea drinking and physical exercise may help to reduce the risk of the disease.

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