Department of Geriatric Digestive Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Department of Geriatric Digestive Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Experimental Teaching Center for Clinical Skills, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
J Affect Disord. 2024 Oct 1;362:606-614. doi: 10.1016/j.jad.2024.07.119. Epub 2024 Jul 17.
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.
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.
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.
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.
胆石症是一种常见的消化系统疾病,对公众健康构成重大负担。同时,抑郁被认为是一种健康风险。然而,关于抑郁对胆石形成的影响的信息有限。本研究旨在探讨抑郁对胆石症风险的因果影响。
利用国家健康与营养调查(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)评估抑郁严重程度。多变量逻辑回归和亚组分析探讨了抑郁与胆石症风险之间的相关性。利用全基因组关联研究(GWAS)数据进行的孟德尔随机分析(MR)减轻了观察性偏倚并阐明了因果关系。逆方差加权(IVW)是主要方法,敏感性分析验证了结果的稳健性。
在观察性研究(7707 名参与者)中,轻度(OR:1.58,95%CI 1.31-1.90,P<0.001)、中度(OR:2.07,95%CI 1.59-2.67,P<0.001)和重度(OR:2.41,95%CI 1.70-3.34,P<0.001)抑郁组的胆石症风险升高(趋势 P<0.001)。亚组分析显示,在 65 岁以下、女性、非西班牙裔黑人、肥胖者、吸烟者以及具有大学学历或更高学历的人群中,相关性更强。孟德尔随机分析表明,遗传预测的抑郁与更高的胆石症风险之间存在因果关系(OR:2.06,95%CI 1.34-3.17,P=0.001),敏感性分析和多队列验证验证了这一结果。
抑郁独立增加胆石症风险,尤其是在 65 岁以下、女性、非西班牙裔黑人、肥胖者、吸烟者以及具有大学学历或更高学历的人群中。需要通过多中心、前瞻性队列研究进一步验证。