Pediatric depression and subsequent cardiac risk factors: a longitudinal study

儿童抑郁症和随后的心脏危险因素：一项纵向研究

• 批准号: 8816435
• 负责人: MARIA KOVACS
• 金额: $ 69.59万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-18 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8816435
• 关键词: 17 year old; 18 year old; 9 year old; Address; Adolescence; Adolescent; Adult; Adverse effects; Affect; Age; Behavioral; Biological; Biological Markers; Blood Pressure; Blood Vessels; C-reactive protein; Calmodulin 1; Cardiac; Cardiovascular Diseases; Child; Childhood; Clinical; Coronary heart disease; Data; Databases; Depressed mood; Depressive disorder; Development; Disease; Disease Marker; Elderly; Enrollment; Event; Exposure to; Family; Goals; Health; Health behavior; Heart Diseases; Hungary; Hypertension; Individual; Inflammation; Inflammatory; Intercellular adhesion molecule 1; Interleukin-6; LDL Cholesterol Lipoproteins; Lead; Life; Link; Longevity; Longitudinal Studies; Major Depressive Disorder; Measures; Mediating; Mental Depression; Metabolic syndrome; Morbidity - disease rate; Outcome; Pattern; Physiologic pulse; Physiological; Positioning Attribute; Prevention; Process; Prospective Studies; Public Health; Recording of previous events; Reporting; Research; Risk; Risk Factors; Risk Marker; Role; Sampling; Severities; Siblings; Smoking; Stress; Testing; Time; attributable mortality; base; cardiovascular risk factor; child depression; cigarette smoking; cohort; depressive symptoms; design; disability; disorder control; early onset; follow-up; heart disease risk; indexing; middle age; mortality; peer; pre-clinical; proband; public health relevance; sedentary; young adult

DESCRIPTION (provided by applicant): In this revised application, we addressed the IRG's concerns: we clarified the number/type of assessments on the 3 subject groups; proposed a further Hypothesis that mirrors better the use of childhood archival data about probands and their sibs; added ICAM-1 to our biological markers; and responded to various other concerns. Our study focuses on depression and coronary heart disease (CHD), which are enormous public health problems across the world. Depression not only predicts new onset CHD, and morbidity, and mortality in those with existing CHD but also is associated with behavioral risk factors (e.g. smoking, being sedentary) for eventual CHD. Although the depression-CHD link is well established, the causal role of depression is still being debated, and its most "cardiotoxic" features are yet to be confirmed. Notably, although both depression and CHD often originate in the pre-adult years, few studies have examined their association with behavioral CHD risk factors in a developmental context. We propose to assess 3 established samples of young adults in Hungary: a) probands (n=325), whom we have followed since childhood, when they had their first episode of major depression around the mean age of 9 years, b) never-depressed siblings of probands (n=325), and c) normal peer controls (n=155). We recently reported that: a) proband families have elevated rates of parental CV disease, b) by adolescence (mean age=17 years), being a proband predicted increased rates of behavioral risk factors for CHD (e.g., smoking, being sedentary), and c) rates of behavioral risk factors were highest among probands, lowest among controls, and intermediate among never depressed siblings of probands. The goal of the proposed study is to assess, for the first time, traditional biological risk factors (e.g., LDL cholesterol, blood pressure), along with behavioral risk factors, and several markers of CHD risk: pulse wave velocity, interleukin-6 and C-reactive protein (inflammation), ICAM-1 (endothelial function), and the metabolic syndrome. Our hypotheses address the levels of CHD risk markers as a function of subject group, the role of behavioral risk factors in adolescence in the link between depression and preclinical physiological outcomes, the impact of developmental trajectories of stress and risk variables on physiological outcomes among probands-sibs, and the most "cardiotoxic" clinical features of depression. Our extensive archival data on subjects' psychiatric history, family stress events, parental history of cardiovascular disease, socio-demographic variables, and various behavioral risk factors for CHD will yield a unique characterization of the unfolding relationships among depression, behavioral risk factors, and early markers of CHD risk. The sibling design will help isolate the contribution of depression to early markers of CHD risk by controlling for the adverse health impact of several family-based variables. Given the public health burden posed by depression and CHD, their study in young adults is particularly warranted, because risk factors and/or preclinical signs of CHD risk may be easier to modify earlier, rather than later, in the lifespan.

描述（由申请人提供）：在此修订的申请中，我们解决了IRG的关注点：我们阐明了这三个主题组的评估数量/类型；提出了一个进一步的假设，可以更好地反映出有关证据及其SIBS的儿童档案数据的使用；在我们的生物标记中添加了ICAM-1；并回应了其他各种问题。我们的研究重点是抑郁症和冠状动脉疾病（CHD），这些疾病是全球巨大的公共卫生问题。抑郁症不仅可以预测现有冠心病患者的新发病，发病率和死亡率，而且还与最终CHD的行为危险因素（例如吸烟，久坐）有关。尽管抑郁症CHD连接已经良好，但抑郁症的因果作用仍在争论中，其最“心脏毒性”的特征尚未得到证实。值得注意的是，尽管抑郁症和冠心病通常都起源于成年前几年，但很少有研究检查了他们在发育环境中与行为冠心病风险因素的关联。我们建议评估匈牙利的3个已建立的年轻人样本：a）概率（n = 325），我们从小就遵循了他们，当时他们在平均9岁的平均年龄左右有重大抑郁症的第一集，b）概率的兄弟姐妹（n = 325）（n = 325），以及c）正常的同伴控制（n = 155）。我们最近报道：a）a）概率家庭的父母CV疾病率升高，b）在青春期（平均年龄= 17岁），作为一个概率，预测冠心病行为风险因素的率提高（例如，吸烟，久坐的耐久）和c）行为风险因素在对照组中最高，在对照组中最高，并且在对照组中最高，并且在对照组中最高，并且在不断构成的中间位于从不压实的si si -nerveStect sipersationssipations neversipations中。拟议的研究的目的是首次评估传统的生物危险因素（例如LDL胆固醇，血压）以及行为危险因素以及几种CHD风险的标记：脉搏波速度，白介素6和C-RECTIVE蛋白（炎症），ICAM-1（ICAM-1），ICAM-1（ICAM-1）（ICAM-1（内皮功能）和getaphelial Function）和Metabolic androme syndrome syndrome。我们的假设解决了冠心病风险标志物的水平，这是受试者群体的函数，行为风险因素在抑郁症与临床前生理结果之间的联系中的作用，压力变量和风险变量对探针SIB生理结果的影响，以及抑郁症的最大临床特征。我们有关受试者的精神病病史，家庭压力事件，心血管疾病的父母历史，社会人口统计学变量以及各种冠心病行为风险因素的广泛档案数据将产生抑郁症之间不展开关系的独特表征，行为风险因素和早期的CHD风险标记。同胞设计将通过控制几种基于家庭的变量对健康的不利影响来帮助隔离抑郁症对冠心病风险的早期标志的贡献。鉴于抑郁症和冠心病造成的公共卫生负担，他们在年轻人中的研究尤其有必要，因为危险因素和/或CHD风险的临床前迹象可能更易于更早，而不是较晚的寿命。