摘要
目的:探索缺血性卒中人群中血液炎症标志物对肥胖与抑郁状态的中介作用.方法:运用一般资料调查法、汉密尔顿抑郁量表对317例缺血性卒中患者进行评估.采用SPSS 25.0、统计软件R包4.2.2进行描述性分析、相关分析、中介分析;采用百分位Bootstrap法检验中介效应的显著性.结果:调整年龄、性别、教育、吸烟、饮酒、高血压、糖尿病、冠心病、高脂血症、是否服用抗抑郁药、是否服用抗炎药物、TOAST分型、NIHSS评分等因素后,肥胖和较高的BMI与白细胞计数、淋巴细胞计数水平升高呈正相关(白细胞计数:β=0.76,P=0.044;β=0.06,P=0.002;淋巴细胞计数:β=0.37,P=0.008;β=0.03,P＜0.001);与抑郁状态呈正相关(OR=3.47,P=0.017;OR=1.10,P=0.001).纳入中介变量血液炎症标志物后肥胖对抑郁状态的直接作用仍具有统计学意义;控制肥胖指标后,血液炎症标志物与抑郁状态呈正相关(白细胞计数:OR=1.23,P=0.019;淋巴细胞计数:OR=1.62,P=0.027;NAR:OR=3.36,P=0.034).中介效应分析显示,白细胞计数、淋巴细胞计数在BMI对抑郁状态的影响中均存在部分中介效应,中介效应占其总效应的比例分别为9.77%和13.95%.结论:白细胞计数、淋巴细胞计数等血液炎症标志物在肥胖对抑郁状态的影响中均具有部分中介效应.
Abstract
Objective:To investigate the mediating effect of blood inflammatory markers on the relationship between obesity and depression in individuals with ischemic stroke.Methods:A total of 317 patients with ischemic stroke were assessed using the General Information Survey method and the Hamilton Depression Scale Descriptive analysis,correlation analysis,and mediation analysis were performed using SPSS 25.0 and statistical software R package 4.2.2.The significance of the mediation effect was tested using the percentile Bootstrap method.Results:After adjusted for age,gender,education levels,smoking status,alcohol consumption,hypertension,diabetes,coronary heart disease,hyperlipidemia,use of antidepressants,use of anti-inflammatory drugs,TOAST classification,NIHSS score,obesity and higher body mass index were found to be positively correlated with increased white blood cell count(WBC)and lymphocyte count(LYM)(WBC:β=0.76,P=0.044;β=0.06,P=0.002;LYM:β=0.37,P=0.008;β=0.03,P<0.001).Furthermore,there was a positive correlation between obesity and depressive symptoms(WBC:OR=3.47,P=0.017;LYM:OR=1.10,P=0.001).After including the mediating variable of blood inflammatory markers,the direct effect of obesity on depressive symptoms remained statistically significant.Additionally,when controlling for obesity indicators,a positive correlation between blood inflammatory markers and depressive symptoms was observed(WBC:OR=1.23,P=0.019;LYM:OR=1.62,P=0.027;NAR:OR=3.36,P=0.034).Analysis of the mediating effect indicated that the association between body mass index and depression was partially mediated by WBC and LYM,with the proportion of mediating effect being 9.77%and 13.95%,respectively.Conclusion:Blood inflammatory markers such as WBC and LYM exhibit a partial mediating effect in the relationship between obesity and depression.
维普
万方数据