Association of 20-Year Longitudinal Depressive Symptoms with Left Ventricular Geometry Outcomes in the Coronary Artery Risk Development in Young Adults Study: A Role for Androgens?

Laura A. Colangelo*, Allison J. Carroll, Amanda M. Perak, Samuel S. Gidding, Joao A.C. Lima, Donald M. Lloyd-Jones

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective Depression is a risk factor for coronary heart disease and left ventricular hypertrophy (LVH) is a potent predictor of coronary heart disease events. Whether depression is associated with LVH has received limited investigation. This study assessed cross-sectional and 20-year longitudinal associations of depressive symptoms with LVH outcomes after accounting for important known confounders. Methods From 5115 participants enrolled in 1985-1986 in the Coronary Artery Risk Development in Young Adults Study, 2533 had serial measures of depressive symptoms and subsequent echocardiography to measure normal LV geometry, concentric remodeling, and LVH. The primary exposure variable was trajectories of the Center for Epidemiologic Studies Depression (CES-D) scale score from 1990-1991 to 2010-2011. Multivariable polytomous logistic regression was used to assess associations of trajectories with a composite LV geometry outcome created using echocardiogram data measured in 2010-2011 and 2015-2016. Sex-specific conflicting results led to exploratory models that examined potential importance of testosterone and sex hormone-binding globulin. Results Overall CES-D and Somatic subscale trajectories had significant associations with LVH for female participants only. Odds ratios for the subthreshold (mean CES-D ≈ 14) and stable (mean CES-D ≈ 19) groups were 1.49 (95% confidence interval = 1.05-2.13) and 1.88 (95% confidence interval = 1.16-3.04), respectively. For female participants, sex hormone-binding globulin was inversely associated with LVH, and for male participants, bioavailable testosterone was positively associated with concentric geometry. Conclusions Findings from cross-sectional and longitudinal regression models for female participants, but not male ones, and particularly for Somatic subscale trajectories suggested a plausible link among depression, androgens, and LVH. The role of androgens to the depression-LVH relation requires additional investigation in future studies.

Original languageEnglish (US)
Pages (from-to)60-71
Number of pages12
JournalPsychosomatic medicine
Volume86
Issue number2
DOIs
StatePublished - Feb 1 2024

Keywords

  • AIC = Akaike information criterion
  • BMI = body mass index
  • BP = blood pressure
  • CARDIA = Coronary Artery Risk development in Young Adults
  • CES-D = Center for Epidemiologic Studies Depression
  • CHD = coronary heart disease
  • CI = confidence interval
  • Center for Epidemiologic Studies Depression
  • HPA = hypothalamic-pituitary-adrenal
  • LVH = left ventricular hypertrophy
  • OR = odds ratio
  • SBP = systolic blood pressure
  • SHBG = sex hormone-binding globulin
  • depressive symptoms
  • left ventricular hypertrophy
  • left ventricular remodeling
  • sex hormone-binding globulin
  • testosterone

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology

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