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

Abstract

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].Chinese journal of Epidemiology,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

Received:September 26, 2022

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

KeyWord: 代谢综合征老年人抑郁影响因素

English Key Word: Metabolic syndrome Elderly Depression Influence factor

FundProject:财政部重大公共卫生专项（131091106000150003）

Author Name	Affiliation	E-mail
Wang Dan	Cancer and Key Chronic Disease Control and Prevention Laboratory, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China School of Public Health, China Medical University, Shenyang 110122, China
Feng Xuefei	Cancer and Key Chronic Disease Control and Prevention Laboratory, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Qi Shige	Division of Elderly Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Wang Qiutong	Cancer and Key Chronic Disease Control and Prevention Laboratory, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Hu Yanan	School of Public Health, China Medical University, Shenyang 110122, China
Wang Zhihui	Division of Elderly Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Wang Baohua	Cancer and Key Chronic Disease Control and Prevention Laboratory, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China	baohua2000@126.com

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Abstract:

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。

English Abstract:

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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