Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov 18;54(15):1-9.
doi: 10.1017/S0033291724002381. Online ahead of print.

Association of cardiovascular-kidney-metabolic health and social connection with the risk of depression and anxiety

Xinghe Huang  1 , Jie Liang  1 , Junyu Zhang  1 , Jiayi Fu  1 , Wuxiang Xie  2   3 , Fanfan Zheng  1
Affiliations

Association of cardiovascular-kidney-metabolic health and social connection with the risk of depression and anxiety

Xinghe Huang et al. Psychol Med. .

Abstract

Background: To explore the association of cardiovascular-kidney-metabolic (CKM) health with the risk of depression and anxiety and to investigate the joint association of CKM health and social connection with depression and anxiety.

Methods: This prospective cohort study included 344 956 participants from the UK Biobank. CKM syndrome was identified as a medical condition with the presence of metabolic risk factors, cardiovascular disease, and chronic kidney disease, and was classified into five stages (stage 0-4) in this study. Loneliness and social isolation status were determined by self-reported questionnaires. Cox proportional hazards models were applied for analyses.

Results: Compared with participants in stage 0, the HRs for depression were 1.17 (95% CI 1.10-1.25), 1.40 (95% CI 1.33-1.48), and 2.14 (95% CI 1.98-2.31) for participants in stage 1, 2-3, and 4, respectively. Similarly, participants in stage 2-3 (HR = 1.20, 95% CI 1.14-1.26) and stage 4 (HR = 1.63, 95% CI 1.51-1.75) had greater risks of incident anxiety. We found additive interactions between loneliness and CKM health on the risk of depression and anxiety. Participants simultaneously reported being lonely and in stage 4 had the greatest risk of depression (HR = 4.44, 95% CI 3.89-5.07) and anxiety (HR = 2.58, 95% CI 2.21-3.01) compared with those without loneliness and in stage 0. We also observed an additive interaction between social isolation and CKM health on the risk of depression.

Conclusions: Our findings suggest the importance of comprehensive interventions to improve CKM health and social connection to reduce the disease burden of depression and anxiety.

Keywords: anxiety; cardiovascular-kidney-metabolic syndrome; depression; loneliness; social isolation.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Figure 1.
Figure 1.
Joint associations of social isolation and the stage of CKM syndrome with incident depression and anxiety. HRs were adjusted for age, sex, ethnicity, Deprivation Index, education level, smoking status, alcohol consumption, and physical activity. CKM, cardiovascular-kidney-metabolic; CI, confidence interval; HR, hazard ratio.
Figure 2.
Figure 2.
Joint associations of loneliness and the stage of CKM syndrome with incident depression and anxiety. HRs were adjusted for age, sex, ethnicity, Deprivation Index, education level, smoking status, alcohol consumption, and physical activity. CKM, cardiovascular-kidney-metabolic; CI, confidence interval; HR, hazard ratio.
See this image and copyright information in PMC

References

    1. Austin, P. C., Lee, D. S., & Fine, J. P. (2016). Introduction to the analysis of survival data in the presence of competing risks. Circulation, 133(6), 601–609. doi:10.1161/CIRCULATIONAHA.115.017719 - DOI - PMC - PubMed
    1. Bautovich, A., Katz, I., Smith, M., Loo, C. K., & Harvey, S. B. (2014). Depression and chronic kidney disease: A review for clinicians. Australian and New Zealand Journal of Psychiatry, 48(6), 530–541. doi:10.1177/0004867414528589 - DOI - PubMed
    1. Belvederi Murri, M., Pariante, C., Mondelli, V., Masotti, M., Atti, A. R., Mellacqua, Z., … Amore, M. (2014). HPA axis and aging in depression: Systematic review and meta-analysis. Psychoneuroendocrinology, 41, 46–62. doi:10.1016/j.psyneuen.2013.12.004 - DOI - PubMed
    1. Burrows, N. R., Koyama, A., & Pavkov, M. E. (2022)). Reported cases of end-stage kidney disease-United States, 2000–2019. Morbidity and Mortality Weekly Report, 71(11), 412–415. doi:10.15585/mmwr.mm7111a3 - DOI - PMC - PubMed
    1. Cen, M., Song, L., Fu, X., Gao, X., Zuo, Q., & Wu, J. (2024). Associations between metabolic syndrome and anxiety, and the mediating role of inflammation: Findings from the UK Biobank. Brain, Behavior, and Immunity, 116, 1–9. doi:10.1016/j.bbi.2023.11.019 - DOI - PubMed

LinkOut - more resources