临床与病理杂志2026，Vol.46Issue(4)：505-513,9.DOI:10.11817/j.issn.2095-6959.2026.250583
睡眠障碍-抑郁共病与血管健康相关指标的关联:基于NHANES数据的性别与年龄分层分析
Association between sleep disorder-depression comorbidity and cardiovascular health indicators:Gender-and age-stratified analysis based on NHANES data
摘要
Abstract
Objective:Cardiovascular disease(CVD)is a leading global health threat.Comorbidity of sleep disorders and depression may further exacerbate cardiovascular risk,and this association may be influenced by gender and age.This study aims to evaluate the association between sleep disorder-depression comorbidity and cardiovascular health indicators using data from the National Health and Nutrition Examination Survey(NHANES)2013-2018,and to examine differences across gender and age groups. Methods:Participants aged≥18 years with complete data were included from NHANES 2013-2018,excluding those with severe cognitive impairment.Sleep status was assessed via questionnaire(sleep duration<7 h or>9 h,poor sleep quality),and depression was assessed using the Patient Health Questionnaire-9(PHQ-9;PHQ-9≥10 indicated depression).Participants with both sleep abnormalities and depression were defined as the comorbidity group,and the remainder as the non-comorbidity group.Cardiovascular health indicators collected included blood pressure,obesity indices,blood lipids,and high-sensitivity C-reactive protein(hs-CRP).Multivariate Logistic regression was used to analyze the association between comorbidity status and cardiovascular outcomes,with stratified analyses by gender and age. Results:The comorbidity group was significantly older than the non-comorbidity group[(56.2±12.3)years vs(45.8±13.5)years],and had a higher proportion of females(62.3％vs 48.5％).Rates of hypertension(48.7％vs 22.6％),obesity(52.4％vs 30.4％),and hs-CRP levels[3.20(1.80,5.40)mg/L vs 1.50(0.80,2.60)mg/L]were significantly higher in the comorbidity group than in the non-comorbidity group(all P<0.001).Sleep disorder-depression comorbidity was significantly associated with increased risk of hypertension(OR=2.89,95％CI 2.43 to 3.44),obesity(OR=3.12,95％CI 2.65 to 3.67),hypertriglyceridemia(OR=2.56,95％CI 2.21 to 2.96),and elevated hs-CRP(OR=3.45,95％CI 2.98 to 4.00)(all P<0.001).Women(OR=3.21,95％CI 2.64 to 3.91)and older adults(≥65 years;OR=3.56,95％CI 2.89 to 4.38)showed higher hypertension risk,suggesting gender-and age-related heterogeneity in the association between comorbidity and cardiovascular health indicators(all P<0.001). Conclusion:Sleep disorder-depression comorbidity is significantly associated with multiple adverse cardiovascular health indicators,with stronger associations observed in women and older adults.Elevated hs-CRP levels suggest that inflammatory responses may contribute to the link between sleep disorder-depression and vascular health impairment.关键词
睡眠障碍/抑郁/心血管疾病/联合影响/炎症反应/性别差异/年龄分层/NHANESKey words
sleep disorder/depression/cardiovascular disease/combined effect/inflammatory response/gender differences/age stratification/NHANES分类
医药卫生引用本文复制引用
陈雷,邓鸿儒,孟令丙..睡眠障碍-抑郁共病与血管健康相关指标的关联:基于NHANES数据的性别与年龄分层分析[J].临床与病理杂志,2026,46(4):505-513,9.基金项目
国家自然科学基金(82400543,82304864) （82400543,82304864）
中国医学科学院医学与健康科技创新工程项目(2025-12M-XHXX-034).This work was supported by the National Natural Science Foundation(82400543,82304864)and the Chinese Academy of Medical Sciences Innovation Fund for Medical Science and Health(2025-12M-XHXX-034),China. （2025-12M-XHXX-034）
