Depression and mortality: Artifact of measurement and analysis?

Background Previous research demonstrates various associations between depression, cardiovascular disease (CVD) incidence and mortality, possibly as a result of the different methodologies used to measure depression and analyse relationships. This analysis investigated the association between depression, CVD incidence (CVDI) and mortality from CVD (MCVD), smoking related conditions (MSRC), and all causes (MALL), in a sample data set, where depression was measured using items from a validated questionnaire and using items derived from the factor analysis of a larger questionnaire, and analyses were conducted based on continuous data and grouped data. Methods Data from the PRIME Study (N=9798 men) on depression and 10-year CVD incidence and mortality were analysed using Cox proportional hazards models. Results Using continuous data, both measures of depression resulted in the emergence of positive associations between depression and mortality (MCVD, MSRC, MALL). Using grouped data, however, associations between a validated measure of depression and MCVD, and between a measure of depression derived from factor analysis and all measures of mortality were lost. Limitations Low levels of depression, low numbers of individuals with high depression and low numbers of outcome events may limit these analyses, but levels are usual for the population studied. Conclusions These data demonstrate a possible association between depression and mortality but detecting this association is dependent on the measurement used and method of analysis. Different findings based on methodology present clear problems for the elucidation and determination of relationships. The differences here argue for the use of validated scales where possible and suggest against over-reduction via factor analysis and grouping. CrownCopyright © 2013PublishedbyElsevierB.V.Allrightsreserved

I021 Impact du polymorphisme génétique C(-260)T du CD14 sur la pression pulsée en fonction d’autres facteurs de risque cardiovasculaires : etude populationnelle transversale à partir du registre monica

Objectif de l’étudeLe CD14 est à l’intersection entre l’inflammation, les maladies infectieuses et le syndrome métabolique. Une corrélation positive entre la concentration plasmatique du CD14 soluble (sCD14) et la rigidité aortique a été décrite dans une étude transversale. Mais différents résultats ont été retrouvés sur l’incidence des évènements cardiovasculaires en fonction du polymorphisme C(-260)T du gène du CD14.L’objectif de cette étude est d’étudier l’influence du polymorphisme C(-260)T du CD14 sur la pression pulsée et indirectement sur le risque cardiovasculaire à partir de l’étude populationnelle transversale MONICA.Déroulement de l’étude1 155 sujets âgés entre 35 et 64 ans, en prévention primaire, ont été recrutés à partir des listes électorales de la Haute Garonne entre 1995 et 1997.MéthodesLa pression pulsée brachiale était mesurée au repos à 2 reprises puis moyennée. La concentration plasmatique du sCD14 a été mesurée par méthode immunoenzymatique. La randomisation est de type mendélienne. Les sujets ont été répartis en fonction du polymorphisme C(-260)T du CD14 après génotypage : homozygotes CC, homozygotes TT ou hétérozygotes CT.RésultatsLes sujets homozygotes TT ont une pression pulsée (PP) significativement plus basse et une concentration en sCD14 significativement plus élevée. Après ajustement avec les principaux facteurs confondants (âge, sexe, facteurs de risque cardiovasculaires traités), seul le génotype du CD14 reste corrélé à la PP. Cette corrélation n’intervient qu’en présence de facteurs de risque traités. Les diabétiques traités homozygotes TT sont ceux qui bénéficient de la plus importante baisse de PP par rapport aux homozygotes diabétiques CC (− 19,4mmHg, p=0,006).ConclusionCette étude suggère que les facteurs de risque ont un impact différent sur la pression pulsée en fonction du polymorphisme C(-260)T du CD14. Cette observation pourrait contribuer à affiner le risque cardiovasculaire absolu individuel, les sujets homozygotes TT ayant un risque cardiovasculaire moindre

0098: Erythrocyte membrane phospholipid fatty acids, dairy intakes and cardiovascular risk

IntroductionThe impact of dairy fats on cardiovascular risk has been debated. Circulating Pentadecanoic (15:0) and heptadecanoic (17:0) saturated fatty acids are good biomarkers of dairy product consumption as they are mainly provided by dairy fats. We described the prevalence of cardiovascular risk factors according to erythrocyte membrane phospholipid content in 15:0 and 17:0 fatty acids.Methods402 women and men aged 45-64 were randomly selected in 2005-2007, from the general population of three French areas. Nutritional data were collected through a 3-day food record. Fatty acid content was measured in erythrocyte membrane phospholipids.ResultsErythrocyte membrane contents in 15:0 and 17:0 fatty acids significantly increased with the consumption of dairy products collected during the 3-day food record. Prevalence of hypertension significantly decreased from the lowest to the highest quartile of 15:0 erythrocyte content (48.1%; 33.3%; 29.9%; 25.5%; p=0.005). A similar trend was observed for metabolic syndrome prevalence (39.4%; 28.1%; 25.2%; 21.3%; p=0.029). Prevalence of hypertension, hypertriglyceridaemia, overweight and metabolic syndrome significantly decreased from the lowest to the highest quartile of 17:0 erythrocyte content (44.1%; 36.5%; 28.1%; 25.6%; p=0.020 for hypertension; 30.3%; 15.4%; 16.9%; 16.7%; p=0.017 for hypertriglyceridaemia; 68.1%; 58.7%; 46.6%; 44.4%; p=0.002 for overweight; and 43.2%; 26.9%; 22.5%; 17.8%; p<0.001 for metabolic syndrome). All these relationships remained significant after adjustment for age and gender. The link did not reach significance level for diabetes.ConclusionElevated erythrocyte membrane phospholipid contents in 15:0 and 17:0 saturated fatty acids are associated with a lower prevalence of the metabolic syndrome and several of its components. These results suggest that saturated fat intake should not be systematically associated with high cardiovascular risk and can be considered as part of a balanced diet

Frequency of fruit and vegetable consumption and coronary heart disease in France and Northern Ireland: the PRIME study

Fruit and vegetable consumption is associated with low CHD risk in the USA and Northern Europe. There is, in contrast, little information about these associations in other regions of Europe. The goal of the present study was to assess the relationship between frequency of fruit and vegetable intake and CHD risk in two European populations with contrasting cardiovascular incidence rates; France and Northern Ireland. The present prospective study was in men aged 50-59 years, free of CHD, who were recruited in France (n 5982) and Northern Ireland (n 2105). Fruit and vegetable intake was assessed by a food-frequency questionnaire. Incident cases of acute coronary events and angina were recorded over a 5-year follow-up. During follow-up there was a total of 249 ischaemic events. After adjustment on education level, smoking, physical activity, alcohol consumption, employment status, BMI, blood pressure, serum total and HDL-cholesterol, the relative risks (RR) of acute coronary events were 0·67 (95% CI 0·44, 1·03) and 0·64 (95% CI 0·41, 0·99) in the 2nd and 3rd tertiles of citrus fruit consumption, respectively (P for trend <0·03). Similar results were observed in France and Northern Ireland. In contrast, the RR of acute coronary events for ‘other fruit' consumption were 0·70 (95% CI 0·31, 1·56) and 0·52 (95% CI 0·24, 1·14) respectively in Northern Ireland (trend P<0·05) and 1·29 (95% CI 0·69, 2·4) and 1·15 (95% CI 0·68, 1·94) in France (trend P=0·5; interaction P<0·04). There was no evidence for any association between vegetable intake and total CHD events. In conclusion, frequency of citrus fruit, but not other fruits, intake is associated with lower rates of acute coronary events in both France and Northern Ireland, suggesting that geographical or related factors might affect the relationship between fruit consumption and CHD ris