Cardiovascular disease burden is associated with worsened depression symptoms in the U.S. general population

Deciphering the therapeutic potential of SheXiangXinTongNing: Interplay between gut microbiota and brain metabolomics in a CUMS mice model, with a focus on tryptophan metabolism

Depression, a prevalent and multifaceted mental disorder, has emerged as a significant public health concern due to its escalating prevalence and heightened risk of severe suicidality. Given its profound impact, the imperative for preventing and intervening in depression is paramount. Substantial evidence underscores intricate connections between depression and cardiovascular health. SheXiangXinTongNing (XTN), a recognized traditional Chinese medicine for treating Coronary Heart Disease (CHD), prompted our exploration into its antidepressant effects and underlying mechanisms. In this investigation, we assessed XTN's antidepressant potential using the chronic unpredictable mild stress (CUMS) mice model and behavioral tests. Employing network pharmacology, we delved into the intricate mechanisms at play. We characterized the microbial composition and function in CUMS mice, both with and without XTN treatment, utilizing 16S rRNA sequencing and metabolomics analysis. The joint analysis of these results via Cytoscape identified pivotal metabolic pathways. In the realm of network pharmacology, XTN administration exhibited antidepressant effects by modulating pathways such as IL-17, neuroactive ligand-receptor interaction, PI3K-Akt, cAMP, calcium, and dopamine synapse signaling pathways. Our findings revealed that XTN significantly mitigated depression-like symptoms and cognitive deficits in CUMS mice by inhibiting neuroinflammation and pyroptosis. Furthermore, 16S rRNA sequencing unveiled that XTN increased the alpha-diversity and beta-diversity of the gut microbiome in CUMS mice. Metabolomics analysis identified brain metabolites crucial for distinguishing between the CUMS and CUMS+XTN groups, with a focus on pathways like Tryptophan metabolism and Linoleic acid metabolism. Notably, specific bacterial families, including Alloprevotella, Helicobacter, Allobaculum, and Clostridia, exhibited robust co-occurring relationships with brain tryptophan metabolomics, hinting at the potential mediating role of gut microbiome alterations and metabolites in the efficacy of XTN treatment. In conclusion, our study unveils modifications in microbial compositions and metabolic functions may be pivotal in understanding the response to XTN treatment, offering novel insights into the mechanisms underpinning the efficacy of antidepressants.

Factors influencing the association between depressive symptoms and cardiovascular disease in US population

Cardiovascular disease (CVD) and depression are common diseases that lead to adverse health outcomes. Depressive Symptoms may be a risk factor for CVD. But few studies focused on the impact of socioeconomic factors, common medical history and dietary intake about this association. This study analyzed National Health and Nutrition Examination Survey (NHANES) 2007-2016. Complex sampling-weighted logistic regression models were used to compare the odds ratios (ORs) of CVD in participants with different depressive symptoms. 11,516 NHANES participants aged ≥ 40 years were included in the final analysis, of whom 1842 had CVD. Compared with participants with no/minimal depression, participants with mild, moderate, and moderately severe/severe depression had OR values of 1.25 (95%  CI 1.01-1.54), 1.98 (95% CI 1.32-2.96), and 2.41 (95% CI 1.63-3.57). The association of depressive symptoms with CVD follow a dose-dependent pattern. The interactions of depressive symptoms with gender (Interaction P = 0.009), diabetes (Interaction P = 0.010), household income level (Interaction P = 0.002), dietary cholesterol intake (Interaction P = 0.017) on CVD were observed. More severe depressive symptoms are associated with increased risk of CVD in US population. The association may be more pronounced in the female population, population with diabetes, low family income level, or high dietary cholesterol intake.

Cardiovascular Outcome in Patients with Major Depression: Role of Obstructive Sleep Apnea Syndrome, Insomnia Disorder, and COMISA

In this study, the 10-year cardiovascular risk associated with comorbid sleep disorders (insomnia disorder, obstructive sleep apnea syndrome, and COMISA [comorbid insomnia and sleep apnea]) was investigated for patients with major depression. To enable our analysis, 607 patients with major depression were selected from the data register of the Sleep Unit. High 10-year cardiovascular risk was considered present when the Framingham Risk Score was ≥10%. The 10-year cardiovascular risk associated with comorbid sleep disorders has been assessed using logistic regression analyzes. High 10-year cardiovascular risk is significant (40.4%) in patients with major depression. After successive introduction of the different confounders, multivariate logistic regressions showed that for patients with major depression high 10-year cardiovascular risk was significantly associated with COMISA but was not significantly associated with insomnia disorder or obstructive sleep apnea syndrome alone. Thus, these results highlight the existence of a negative synergistic action between insomnia disorder and obstructive sleep apnea syndrome on the 10-year cardiovascular risk in patients with major depression, which demonstrates the importance of researching and treating COMISA to improve the prognosis of this specific population subgroup characterized by higher cardiovascular morbidity and mortality.

Association of depression trajectories and subsequent hypertension and cardiovascular disease: findings from the CHARLS cohort

OBJECTIVES

Little evidence regarding the associations of longitudinal trajectories of depressive symptoms and incident hypertension and cardiovascular diseases (CVDs). This study aimed to evaluate the relationships between trajectories of depressive symptoms and new-onset hypertension and CVDs among the Chinese middle-aged and older general population.

METHODS

This prospective cohort study used data from a nationally representative sample aged older than 45 years of Chinese residents recruited for the China Health and Retirement Longitudinal Study (CHARLS). The depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). The outcomes of the study were new-onset hypertension and CVDs.

RESULTS

A total of 6071 participants were included in the final analysis and four trajectories of CES-D-10 were identified, including low-stable, medium-decreasing, medium-increasing, and high-stable trajectories. Until 2018, 1668 (27.5%) and 959 (15.8%) participants were newly diagnosed with hypertension and CVDs, respectively. Compared with participants with a low-stable trajectory, individuals with other three trajectories had a significantly higher risk of hypertension and CVDs. The results remained robust in several sensitivity analyses. The restricted cubic spline (RCS) showed an S-shaped relationship between the mean CES-D-10 score and hypertension/CVDs ( P for nonlinear <0.001). Hypertension partially mediated the association between CES-D-10 and CVDs.

CONCLUSION

Among Chinese aged older than 45 years' general adults, depressive symptoms were prevalent and associated with higher risks of incident hypertension and CVDs. Depressive symptoms mediated the development of CVDs by promoting hypertension progression. Immediate efforts are needed to improve depression management in China to further prevent CVDs.

Childhood emotional abuse and depression among Chinese adolescent sample: A mediating and moderating dual role model of rumination and resilience

BACKGROUND

Childhood emotional abuse (CEA) has been identified as a distal risk factor for later depression in adolescents. However, the underlying psychological mechanisms between CEA and adolescent depression are still poorly understood.

OBJECTIVES

This study aimed to explore the roles of rumination and resilience played in the association between CEA and depression among Chinese adolescents.

PARTICIPANTS AND SETTING

The sample included 919 students (52.56 % boys) with an average age of 13.47 years from a central province in China.

METHODS

Participants completed multiple measurements of CEA, rumination, resilience, and depression. Multivariate path analysis was applied to examine the relations among these variables.

RESULTS

Results showed (a) CEA was significantly positively related to adolescent depression; (b) Rumination partially mediated the relationship between CEA and depression and moderated the relationship between resilience and depression; (c) Resilience partially mediated the relationship between CEA and depression and moderated the relationship between rumination and depression.

CONCLUSIONS

The results revealed that both rumination and resilience played not only mediating but also moderating roles in the relationship between CEA and depression among Chinese adolescent sample, suggesting that the indirect effects of CEA on depression via resilience and rumination are dependent on each other. Hence, these findings deepened the understanding of the psychological mechanisms between CEA and depression and had several practical implications.