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Association Between Lipid Profile and Depressive Symptoms Among Chinese Older People: Mediation by Cardiovascular Diseases?

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Abstract

Background

The potential mediating effect of cardiovascular diseases (CVDs) (e.g., ischemic heart disease and stroke) on the association between abnormal serum lipids and late-life depressive symptoms has not been investigated.

Purpose

We aimed to examine the associations between serum lipids and elevated depressive symptoms among older Chinese people and to determine the extent to which CVDs mediate their associations.

Method

This cross-sectional study included 1,529 participants (age ≥60 years, 59.2 % women) in the Confucius Hometown Aging Project. In June 2010–July 2011, data were collected through an interview, clinical examinations, and laboratory tests. Abnormal serum lipids were defined according to international criteria and use of hypolipidemic drugs. Presence of elevated depressive symptoms was defined as the 15-item Geriatric Depression Scale score ≥5. Data were analyzed with logistic and mediation models controlling for potential confounders.

Results

The prevalence of depressive symptoms was 20.3 %. Depressive symptomatology was significantly associated with high total cholesterol, high triglycerides, low high-density lipoprotein cholesterol (HDL-C), high low-density lipoprotein cholesterol (LDL-C), and dyslipidemia (p < 0.05). The mediating effects on the associations of serum lipids with depressive symptoms were statistically significant for ischemic heart disease and stroke with the proportion of mediating effects over the total effects ranging 4.7–7.0 % and 7.3–12.1 %, respectively.

Conclusion

Elevated depressive symptoms are associated with lipid profile characterized by high cholesterol, high triglycerides, low HDL-C, high LDL-C, and dyslipidemia; the associations are partially mediated by ischemic heart disease and stroke. These findings imply that unfavorable lipid profile may be involved in late-life depressive symptoms independent of atherosclerotic disorders.

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Acknowledgments

The Confucius Hometown Aging Project (CHAP) was supported in part by grants from the Department of Science and Technology (2008GG00221), Department of Health (2009–067), and Natural Science Foundation (ZR2010HL031) of Shandong Province, China and by the Young Scholar Grant for Strategic Research in Epidemiology at Karolinska Institutet, Stockholm, Sweden. Dr. C Qiu was supported by Swedish Research Council and Karolinska Institutet. The authors wish to thank all the study participants for their invaluable contribution to the project and all the staff in the CHAP Study Group for their collaboration in data collection and management.

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Correspondence to Yajun Liang.

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Yajun Liang and Zhongrui Yan contributed equally to this work.

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Liang, Y., Yan, Z., Cai, C. et al. Association Between Lipid Profile and Depressive Symptoms Among Chinese Older People: Mediation by Cardiovascular Diseases?. Int.J. Behav. Med. 21, 590–596 (2014). https://doi.org/10.1007/s12529-013-9358-2

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