TY  - JOUR
T1  - TRiglycerides, depression, and risk of ischemic stroke—reply
AU  - Freiberg J, Tybjærg-Hansen A, Nordestgaard BG
Y1  - 2009/04/01
N1  - 10.1001/jama.2009.411
JO  - JAMA
SP  - 1338
EP  - 1339
VL  - 301
IS  - 13
N2  - 
Unfortunately, we do not have information on depression in the Copenhagen City Heart Study and therefore cannot include this cardiovascular risk factor in our multivariate analyses. However, for the 1991-1994 examination of the Copenhagen City Heart Study, we do have information on vital exhaustion (a psychological measure characterized by fatigue and depressive symptoms) associated with depression. Using a 17-item questionnaire, participants from the 1991-1994 examination of the Copenhagen City Heart Study were grouped in 4 categories with increasing vital exhaustion.2 For depression or vital exhaustion to confound our risk estimates, these factors must be associated with both nonfasting triglycerides and risk of ischemic stroke. We therefore tested whether increasing scores for vital exhaustion were associated with increasing levels of nonfasting triglycerides and found no such association (Cuzick test for trend as an extension of Wilcoxon rank-sum test, P = .07). Although vital exhaustion may not be equivalent to depression, based on this finding we nevertheless find it unlikely that our results of increasing nonfasting triglycerides being associated with increasing risk of ischemic stroke (in the current study) and myocardial infarction, ischemic heart disease, and early death2 would be confounded to a large extent by depression.

SN  - 0098-7484
M3  - doi: 10.1001/jama.2009.411
UR  - http://dx.doi.org/10.1001/jama.2009.411
ER  -