分位数回归分析冠心病患者中体重指数对抑郁的影响  

Quantile Regression of Depression and Body Mass Index in Patients with Coronary Artery Disease in China

作　　者：陆益花[1] 姜赟[2] 沈毅[1] 

机构地区：[1]南通大学公共卫生学院,226019 [2]南通瑞慈医院心胸外科

出　　处：《中国卫生统计》2017年第5期745-748,共4页Chinese Journal of Health Statistics

基　　金：南通市科技项目(MS12016002)

摘　　要：目的本研究旨在评估冠心病患者中抑郁的状况,分析BMI对抑郁的影响。方法共纳入580名冠心病患者,采用抑郁自测量表(SDS)评估患者抑郁状况,用分位数回归的方法分析BMI对抑郁的影响。结果冠心病患者中抑郁的比例为48.10%,低体重、正常体重、超重和肥胖的患者SDS评分存在差异(P<0.001),超重和肥胖者抑郁状况较好。总人群、男性和女性中,回归系数分别从第5分位数的-0.36、-0.26和-0.46变化为第95分位数的-0.88、-1.09和-0.75。不同分位数下BMI对抑郁的影响在总人群(P=0.04)和男性(P=0.006)中均存在差异,在女性中无差异。结论冠心病患者中BMI对抑郁的影响也存在"肥胖悖论",BMI对抑郁的影响在不同胖瘦程度的人群中存在差异。Objective Depression and obesity are two major disorders associated with coronary heart disease （ CHD） , and both have a high prevalence. Different studies concluded different outcomes about the relation between body mass index （ BMI） and depression. The aim of this study was to assess the status of depression and investigate the relationship between de-pression and BMI in CHD patients using quantile regression. Methods 580 patients were enrolled. Depression was tested using the Zung Self-Rating Depression Scale （ SDS） . Demographic data and clinical data were recorded. Quantile regression was con-ducted to determine whether BMI was a predictor of depression. Results SDS scores were significant different in underweight, normal weight,overweight and obesity group （P〈0. 001）. Overweight and obesity patients were least depressed. Differences in SDS scores increased steeply as depression increased at 5th,10th,25th,50th,75th,90th and 95th percentiles,with the coefficients ranging from -0. 36 to -0. 88 in total population,-0. 26 to -1. 09 in male and -0. 46 to -0. 75 in female respectively. The effects of BMI on depression were significantly different in different quantiles of depression in total population （ P=0. 04 ） and in male （P=0. 006）,but no difference in female. Conclusion There was also a phenomenon of ＆quot;obesity paradox＆quot; between BMI and depression in CHD patients. The effects of BMI on depression were significantly different in different quantiles in total population and in male.

关 键 词：冠状动脉粥样硬化性心脏病 体重指数 抑郁 分位数回归 

分 类 号：R541.4[医药卫生—心血管疾病]