背景:胆结石,一种常见的消化系统疾病,造成了巨大的公共卫生负担。同时,抑郁症被认为是一种健康风险。然而,关于抑郁症对胆结石形成的影响的信息有限。这项研究调查了抑郁症对胆结石风险的因果影响。
方法:使用国家健康和营养调查(NHANES)数据,我们进行了一项观察性研究.使用患者健康问卷-9(PHQ-9)评估抑郁症的严重程度。多变量逻辑回归和亚组分析探讨了抑郁症与胆结石风险之间的相关性。孟德尔随机化(MR)分析,利用全基因组关联研究(GWAS)数据,减少观察偏差,阐明因果关系。逆方差加权(IVW)是主要方法,敏感性分析验证了结果。
结果:在观察性研究(7707名参与者)中,轻度胆囊结石风险升高(OR:1.58,95%CI1.31-1.90,P<0.001),中等(OR:2.07,95%CI1.59-2.67,P<0.001),和重度(OR:2.41,95%CI1.70-3.34,P<0.001)抑郁组(P为趋势<0.001)。亚组分析显示,65岁以下的女性,非西班牙裔黑人,肥胖个体,吸烟者,以及那些受过大学或更高学历的人。孟德尔随机化表明遗传预测的抑郁症与较高胆石症风险之间存在因果关系(OR:2.06,95%CI1.34-3.17,P=0.001),通过敏感性分析和多队列验证进行验证。
结论:抑郁独立增加胆结石风险,尤其是65岁以下的女性,非西班牙裔黑人,肥胖个体,吸烟者,以及那些受过大学或更高学历的人。需要通过多中心进一步验证,前瞻性队列研究。
BACKGROUND: Gallstone, a common digestive disorder, poses a significant public health burden. Concurrently, depression is acknowledged as a health risk. However, limited information exists on depression\'s impact on
gallstone formation. This study investigates depression\'s causal effect on
gallstone risk.
METHODS: Using National Health and Nutrition Examination Survey (NHANES) data, we conducted an observational study. The severity of depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Multivariable logistic regression and subgroup analyses explored the correlation between depression and gallstone risk. Mendelian Randomization (MR) analysis, leveraging Genome-Wide Association Studies (GWAS) data, reduced observational bias and elucidated causality. Inverse Variance Weighting (IVW) was the primary method, with sensitivity analyses validating results.
RESULTS: In the observational study (7707 participants),
gallstone risk was elevated in mild (OR: 1.58, 95 % CI 1.31-1.90, P < 0.001), moderate (OR: 2.07, 95 % CI 1.59-2.67, P < 0.001), and severe (OR: 2.41, 95 % CI 1.70-3.34, P < 0.001) depression groups (P for trend <0.001). Subgroup analyses revealed a stronger association in those under 65, females, non-Hispanic Black, individuals with obesity, smokers, and those with college education or higher. Mendelian Randomization indicated a causal link between genetically predicted depression and higher cholelithiasis risk (OR: 2.06, 95 % CI 1.34-3.17, P = 0.001), validated through sensitivity analyses and multi-cohort verification.
CONCLUSIONS: Depression independently increases
gallstone risk, particularly in those under 65, females, non-Hispanic Black, individuals with obesity, smokers, and those with college education or higher. Further validation is needed through multi-center, prospective cohort studies.