Article(id=1324044717683515861, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202509353, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1758470400000, receivedDateStr=2025-09-22, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793606460256, onlineDateStr=2026-11-02, pubDate=1779638400000, pubDateStr=2026-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793606460256, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793606460256, creator=13701087609, updateTime=1793606460256, updator=13701087609, issue=Issue{id=1324044701648695723, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='10', pageStart='1729', pageEnd='1920', issueExtLink='null', onlineDate='null', pubDate='1779638400000', pubDateStr='2026-05-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793606456434, creator='13701087609', updateTime=1793670074552, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311535425815306, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311535425815307, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1742, endPage=1747, ext={EN=ArticleExt(id=1324044719713558998, articleId=1324044717683515861, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Mediating role of sleep quality between multimorbidity and depressive symptoms in patients with pneumoconiosis, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective To explore the mediating role of sleep quality in the relationship between multimorbidity and depressive symptoms in patients with pneumoconiosis.
Methods Based on the baseline data from the West China Pneumoconiosis Prospective Specialized Disease Cohort, latent class analysis was employed to categorize nine common multimorbidities among pneumoconiosis patients. Logistic regression models were used to analyze the associations between the number of multimorbidities, multimorbidity patterns, and depressive symptoms. The Bootstrap method was employed to examine the mediating effect of sleep quality.
Results 40.97% patients with pneumoconiosis exhibited depressive symptoms. Latent class analysis identified four multimorbidity patterns: relatively healthy, cardiovascular-metabolic, respiratory system, and multimorbidity. Logistic regression showed that the number of multimorbidities (OR=1.34, 95%CI: 1.23-1.46), the cardiovascular-metabolic pattern (OR=1.82, 95%CI: 1.02-3.25), and the multimorbidity pattern (OR=3.16, 95%CI: 1.97-5.06) were positively associated with depressive symptoms. Mediation analysis indicated that sleep quality partially mediated the relationship between the number of multimorbidities and depressive symptoms (β=0.53, 95%CI: 0.41-0.66), with a mediation effect proportion of 61.63%. Regarding the multimorbidity pattern, sleep quality fully mediated the relationship with depressive symptoms, with a mediation effect value of 2.11(95%CI:1.46-2.78) and an effect proportion of 69.41%.
Conclusion The number of multimorbidities, cardiovascular-metabolic pattern, and multimorbidity pattern are associated with a higher risk of depression in pneumoconiosis patients. Sleep quality partially mediates the relationship between the number of multimorbidities and depressive symptoms, while it fully mediates the relationship between the multimorbidity pattern and depressive symptoms.
, authors=Ying-ying FENG, Xue-mei TAN, Wen DU, Qiu-rong HE, Ding-zi ZHOU, Li-jun PENG, Yu-qin YAO, Ya-jia LAN, Qin ZHANG, authorsList=Ying-ying FENG, Xue-mei TAN, Wen DU, Qiu-rong HE, Ding-zi ZHOU, Li-jun PENG, Yu-qin YAO, Ya-jia LAN, Qin ZHANG, authorCompany=null, correspAuthors=Qin ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324044720753746393, articleId=1324044717683515861, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=睡眠质量在尘肺病患者共病与抑郁症状间的中介作用, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的 探讨睡眠质量在尘肺病患者共病与抑郁症状间的中介作用。
方法 基于华西尘肺病前瞻性专病队列基线数据，运用潜在类别分析对尘肺病9种常见共病进行分组，采用logistic回归模型分析共病数量、共病模式与抑郁症状的关联，并通过Bootstrap法检验睡眠质量的中介效应。
结果 40.97%尘肺病患者存在抑郁症状。潜在类别分析识别出四类共病模式：相对健康类、心脑血管-代谢类、呼吸系统类和多病共存类。Logistic回归显示，共病数量（OR=1.34，95%CI：1.23~1.46）、心脑血管-代谢类（OR=1.82，95%CI：1.02~3.25）及多病共存类（OR=3.16，95%CI：1.97~5.06）与抑郁症状呈正向关联。中介分析表明，睡眠质量在共病数量与抑郁症状之间起部分中介作用（β=0.53，95%CI：0.41～0.66），中介效应占比为61.63%；在多病共存类与抑郁症状之间起完全中介作用，中介效应值为2.11（95%CI：1.46~2.78），效应占比69.41%。
结论 尘肺病患者的共病数量、心脑血管-代谢类及多病共存类共病模式与较高抑郁风险相关。睡眠质量在共病数量与抑郁症状间发挥部分中介作用，在多病共存类与抑郁症状间则起完全中介作用。
, authors=冯莹莹, 谭雪梅, 杜文, 何秋蓉, 周丁子, 彭莉君, 姚于勤, 兰亚佳, 张勤, authorsList=冯莹莹, 谭雪梅, 杜文, 何秋蓉, 周丁子, 彭莉君, 姚于勤, 兰亚佳, 张勤, authorCompany=null, correspAuthors=张勤, authorNote=
冯莹莹（2001—），女，硕士在读，研究方向：劳动卫生与环境卫生学
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本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=nnAJzHdNcayoRD+y/TitSw==, magXml=t83YjY6pEZ4ieoyqf8QCZw==, pdfUrl=null, pdf=z6LRHUiUy3vHCKS7mGx6/A==, pdfFileSize=645549, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=Q63Ld9fei9NVpYMrSjnwcg==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=Pewjho6qQBLeT3Su5dKk/w==, mapNumber=null, fund=null)}, authors=[Author(id=1324045046860882351, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044717683515861, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1324045046936379825, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044717683515861, authorId=1324045046860882351, language=EN, stringName=Ying-ying FENG, firstName=Ying-ying, middleName=null, lastName=FENG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=West China Occupational Pneumoconiosis Cohort Study workgroup, West China School of Public and West China Fourth Hospital, Chengdu, Sichuan 610041, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1324045047032848818, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044717683515861, authorId=1324045046860882351, language=CN, stringName=冯莹莹, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=四川大学华西公共卫生学院/华西第四医院，华西职业性尘肺病队列工作组，四川 成都 610041, bio={"content":"
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Conditional probability plot for multimorbidity patterns, figureFileSmall=uZSxUA4h/8P3Lh7kRa3RIA==, figureFileBig=Q63Ld9fei9NVpYMrSjnwcg==, tableContent=null), ArticleFig(id=1324045054096056807, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044717683515861, language=CN, label=图1, caption=
共病模式的条件概率图, figureFileSmall=uZSxUA4h/8P3Lh7kRa3RIA==, figureFileBig=Q63Ld9fei9NVpYMrSjnwcg==, tableContent=null), ArticleFig(id=1324045054217691624, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044717683515861, language=EN, label=Table 1, caption=
Prevalence of depressive symptoms in patients with pneumoconiosis
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | | 无抑郁症状
（n=1 307） | 有抑郁症状
（n=907） | χ2值 | P值 |
|---|
| 年龄（岁） | <40 | 58（4.44） | 21（2.32） | 10.56 | 0.014 |
| 40~50 | 211（16.14） | 161（17.75） | | |
| 50~60 | 701（53.63） | 461（50.83） | | |
| >60 | 337（25.78） | 264（29.11） | | |
| 性别 | 女 | 17（1.30） | 15（1.65） | 0.47 | 0.494 |
| 男 | 1 290（98.70） | 892（98.35） | | |
| 民族 | 汉族 | 1 223（93.57） | 852（93.94） | 0.12 | 0.729 |
| 少数民族 | 84（6.43） | 55（6.06） | | |
| 文化程度 | 小学及以下 | 691（52.87） | 569（62.73） | 23.96 | <0.001 |
| 初中 | 502（38.41） | 290（31.97） | | |
| 高中及以上 | 114（8.72） | 48（5.29） | | |
| 婚姻状况 | 已婚 | 1 231（94.19） | 835（92.06） | 3.87 | 0.144 |
| 未婚 | 20（1.53） | 19（2.09） | | |
| 其他 | 56（4.28） | 53（5.84） | | |
| 家庭年收入（万元） | <2 | 617（47.21） | 481（53.03） | 8.36 | 0.015 |
| 2~5 | 422（32.29） | 274（30.21） | | |
| >5 | 268（20.50） | 152（16.76） | | |
| BMI（kg/m2） | <18.5 | 78（5.97） | 129（14.22） | 43.81 | <0.001 |
| 18.5~23.9 | 711（54.40） | 465（51.27） | | |
| 23.9~28.0 | 435（33.28） | 261（28.78） | | |
| >28.0 | 83（6.35） | 52（5.73） | | |
| 吸烟状况 | 不吸烟 | 219（16.76） | 144（15.88） | 2.28 | 0.319 |
| 已戒烟 | 794（60.75） | 579（63.84） | | |
| 吸烟 | 294（22.49） | 184（20.29） | | |
| 锻炼频率（次/月） | ≤12 | 899（68.78） | 656（72.33） | 3.22 | 0.073 |
| >12 | 408（31.22） | 251（27.67） | | |
| 久坐时长（小时/天） | <5 | 1 056（80.80） | 652（71.89） | 24.11 | < 0.001 |
| ≥5 | 251（19.20） | 255（28.11） | | |
| 接尘工龄（年） | <10 | 323（24.71） | 224（24.70） | 1.10 | 0.778 |
| 10~19.9 | 444（33.97） | 291（32.08） | | |
| 19.9~30 | 317（24.25） | 227（25.03） | | |
| >30 | 223（17.06） | 165（18.19） | | |
| 接尘类型 | 矽尘 | 956（73.14） | 680（74.97） | 1.96 | 0.376 |
| 煤矿粉尘 | 216（16.53） | 130（14.33） | | |
| 其他粉尘 | 135（10.33） | 97（10.69） | | |
| 尘肺期别 | 壹期 | 418（31.98） | 276（30.43） | 1.43 | 0.489 |
| 贰期 | 303（23.18） | 201（22.16） | | |
| 叁期 | 586（44.84） | 430（47.41） | | |
| 共病 | 否 | 635（48.58） | 336（37.05） | 28.96 | < 0.001 |
| 是 | 672（51.42） | 571（62.95） | | |
| 睡眠质量差 | 否 | 709（54.24） | 110（12.13） | 407.52 | < 0.001 |
| 是 | 598（45.75） | 797（87.87） | | |
), ArticleFig(id=1324045054288994793, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044717683515861, language=CN, label=表1, caption=
尘肺病患者抑郁症状现况
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| 变量 | | 无抑郁症状
（n=1 307） | 有抑郁症状
（n=907） | χ2值 | P值 |
|---|
| 年龄（岁） | <40 | 58（4.44） | 21（2.32） | 10.56 | 0.014 |
| 40~50 | 211（16.14） | 161（17.75） | | |
| 50~60 | 701（53.63） | 461（50.83） | | |
| >60 | 337（25.78） | 264（29.11） | | |
| 性别 | 女 | 17（1.30） | 15（1.65） | 0.47 | 0.494 |
| 男 | 1 290（98.70） | 892（98.35） | | |
| 民族 | 汉族 | 1 223（93.57） | 852（93.94） | 0.12 | 0.729 |
| 少数民族 | 84（6.43） | 55（6.06） | | |
| 文化程度 | 小学及以下 | 691（52.87） | 569（62.73） | 23.96 | <0.001 |
| 初中 | 502（38.41） | 290（31.97） | | |
| 高中及以上 | 114（8.72） | 48（5.29） | | |
| 婚姻状况 | 已婚 | 1 231（94.19） | 835（92.06） | 3.87 | 0.144 |
| 未婚 | 20（1.53） | 19（2.09） | | |
| 其他 | 56（4.28） | 53（5.84） | | |
| 家庭年收入（万元） | <2 | 617（47.21） | 481（53.03） | 8.36 | 0.015 |
| 2~5 | 422（32.29） | 274（30.21） | | |
| >5 | 268（20.50） | 152（16.76） | | |
| BMI（kg/m2） | <18.5 | 78（5.97） | 129（14.22） | 43.81 | <0.001 |
| 18.5~23.9 | 711（54.40） | 465（51.27） | | |
| 23.9~28.0 | 435（33.28） | 261（28.78） | | |
| >28.0 | 83（6.35） | 52（5.73） | | |
| 吸烟状况 | 不吸烟 | 219（16.76） | 144（15.88） | 2.28 | 0.319 |
| 已戒烟 | 794（60.75） | 579（63.84） | | |
| 吸烟 | 294（22.49） | 184（20.29） | | |
| 锻炼频率（次/月） | ≤12 | 899（68.78） | 656（72.33） | 3.22 | 0.073 |
| >12 | 408（31.22） | 251（27.67） | | |
| 久坐时长（小时/天） | <5 | 1 056（80.80） | 652（71.89） | 24.11 | < 0.001 |
| ≥5 | 251（19.20） | 255（28.11） | | |
| 接尘工龄（年） | <10 | 323（24.71） | 224（24.70） | 1.10 | 0.778 |
| 10~19.9 | 444（33.97） | 291（32.08） | | |
| 19.9~30 | 317（24.25） | 227（25.03） | | |
| >30 | 223（17.06） | 165（18.19） | | |
| 接尘类型 | 矽尘 | 956（73.14） | 680（74.97） | 1.96 | 0.376 |
| 煤矿粉尘 | 216（16.53） | 130（14.33） | | |
| 其他粉尘 | 135（10.33） | 97（10.69） | | |
| 尘肺期别 | 壹期 | 418（31.98） | 276（30.43） | 1.43 | 0.489 |
| 贰期 | 303（23.18） | 201（22.16） | | |
| 叁期 | 586（44.84） | 430（47.41） | | |
| 共病 | 否 | 635（48.58） | 336（37.05） | 28.96 | < 0.001 |
| 是 | 672（51.42） | 571（62.95） | | |
| 睡眠质量差 | 否 | 709（54.24） | 110（12.13） | 407.52 | < 0.001 |
| 是 | 598（45.75） | 797（87.87） | | |
), ArticleFig(id=1324045054372880874, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044717683515861, language=EN, label=Table 2, caption=
Fitting indicators of latent class models for multimorbidity
, figureFileSmall=null, figureFileBig=null, tableContent=
| 类别数 | AIC | BIC | aBIC | Entropy | LMR（P值） | 类别概率 |
|---|
| 1 | 11 023.59 | 11 074.91 | 11 046.32 | | | 1 |
| 2 | 10 695.64 | 10 803.99 | 10 743.63 | 0.60 | <0.001 | 0.78/0.22 |
| 3 | 10 598.90 | 10 764.27 | 10 672.14 | 0.69 | <0.001 | 0.76/0.17/0.07 |
| 4 | 10 572.86 | 10 795.26 | 10 671.36 | 0.89 | <0.001 | 0.60/0.03/0.31/0.06 |
| 5 | 10 572.01 | 10 851.43 | 10 695.75 | 0.83 | 0.022 | 0.05/0.05/0.32/0.03/0.55 |
| 6 | 10 571.08 | 10 907.53 | 10 720.08 | 0.89 | 0.022 | 0.01/0.56/0.03/0.04/0.33/0.03 |
), ArticleFig(id=1324045054448378347, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044717683515861, language=CN, label=表2, caption=
共病的潜在类别模型拟合指标
, figureFileSmall=null, figureFileBig=null, tableContent=
| 类别数 | AIC | BIC | aBIC | Entropy | LMR（P值） | 类别概率 |
|---|
| 1 | 11 023.59 | 11 074.91 | 11 046.32 | | | 1 |
| 2 | 10 695.64 | 10 803.99 | 10 743.63 | 0.60 | <0.001 | 0.78/0.22 |
| 3 | 10 598.90 | 10 764.27 | 10 672.14 | 0.69 | <0.001 | 0.76/0.17/0.07 |
| 4 | 10 572.86 | 10 795.26 | 10 671.36 | 0.89 | <0.001 | 0.60/0.03/0.31/0.06 |
| 5 | 10 572.01 | 10 851.43 | 10 695.75 | 0.83 | 0.022 | 0.05/0.05/0.32/0.03/0.55 |
| 6 | 10 571.08 | 10 907.53 | 10 720.08 | 0.89 | 0.022 | 0.01/0.56/0.03/0.04/0.33/0.03 |
), ArticleFig(id=1324045054544847340, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044717683515861, language=EN, label=Table 3, caption=
Logistic regression analysis of the association between multimorbidity and depressive symptoms
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| 变量 | 模型1 | 模型2 | 模型3 |
|---|
| OR（95%CI） | P值 | OR（95%CI） | P值 | OR（95%CI） | P值 |
|---|
| 共病数量 | 1.41（1.30~1.53） | <0.001 | 1.34（1.23~1.46） | <0.001 | 1.18（1.06~1.30） | 0.002 |
| 共病模式（以相对健康类为参考） | | | | | | |
| 心脑血管-代谢类 | 1.96（1.12~3.44） | 0.019 | 1.82（1.02~3.25） | 0.041 | 1.46（0.75~2.84） | 0.267 |
| 呼吸系统类 | 1.42（1.18~1.70） | <0.001 | 1.20（0.99~1.46） | 0.066 | 1.11（0.88~1.39） | 0.392 |
| 多病共存类 | 3.92（2.48~6.20） | <0.001 | 3.16（1.97~5.06） | <0.001 | 1.81（1.05~3.13） | 0.033 |
), ArticleFig(id=1324045054620344813, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044717683515861, language=CN, label=表3, caption=
共病与抑郁症状的logistic回归分析
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | 模型1 | 模型2 | 模型3 |
|---|
| OR（95%CI） | P值 | OR（95%CI） | P值 | OR（95%CI） | P值 |
|---|
| 共病数量 | 1.41（1.30~1.53） | <0.001 | 1.34（1.23~1.46） | <0.001 | 1.18（1.06~1.30） | 0.002 |
| 共病模式（以相对健康类为参考） | | | | | | |
| 心脑血管-代谢类 | 1.96（1.12~3.44） | 0.019 | 1.82（1.02~3.25） | 0.041 | 1.46（0.75~2.84） | 0.267 |
| 呼吸系统类 | 1.42（1.18~1.70） | <0.001 | 1.20（0.99~1.46） | 0.066 | 1.11（0.88~1.39） | 0.392 |
| 多病共存类 | 3.92（2.48~6.20） | <0.001 | 3.16（1.97~5.06） | <0.001 | 1.81（1.05~3.13） | 0.033 |
), ArticleFig(id=1324045054708425198, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044717683515861, language=EN, label=Table 4, caption=
Bootstrap analysis of the mediating effect of sleep quality on the relationship between comorbidity and depression in patients with pneumoconiosis
, figureFileSmall=null, figureFileBig=null, tableContent=
| 分类 | 效应类型 | β（95%CI） | P值 | 效应占比（%） |
|---|
| 共病数量 | 总效应 | 0.86（0.64~1.08） | <0.001 | 100.00 |
| 直接效应 | 0.33（0.16~0.51） | <0.001 | 38.37 |
| 间接效应 | 0.53（0.41~0.66） | <0.001 | 61.63 |
| 多病共存类 | 总效应 | 3.04（1.84~4.25） | <0.001 | 100.00 |
| 直接效应 | 0.93（-0.08~1.92） | 0.070 | 30.59 |
| 间接效应 | 2.11（1.46~2.78） | <0.001 | 69.41 |
), ArticleFig(id=1324045054779728367, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044717683515861, language=CN, label=表4, caption=
睡眠质量在尘肺病患者共病与抑郁间中介效应的Bootstrap检验结果
, figureFileSmall=null, figureFileBig=null, tableContent=
| 分类 | 效应类型 | β（95%CI） | P值 | 效应占比（%） |
|---|
| 共病数量 | 总效应 | 0.86（0.64~1.08） | <0.001 | 100.00 |
| 直接效应 | 0.33（0.16~0.51） | <0.001 | 38.37 |
| 间接效应 | 0.53（0.41~0.66） | <0.001 | 61.63 |
| 多病共存类 | 总效应 | 3.04（1.84~4.25） | <0.001 | 100.00 |
| 直接效应 | 0.93（-0.08~1.92） | 0.070 | 30.59 |
| 间接效应 | 2.11（1.46~2.78） | <0.001 | 69.41 |
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