Evidence mapPaperPMID 42311567Full record

ArticleFrontiers in psychiatry2026

External factors show reproducible local symptom-biomarker associations in middle-aged and older adults with heart disease.

Haoke Shi, Lihua Yang, Yijie Fang, Hongping Lu, Yangyang Huang, Zhiyong Xiao, Yongxin Long, Peng Li, Fengzhi Shi, Hongwu Liao and 1 more

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Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Haoke Shi *School of Nursing, University of South China, Hengyang, Hunan, China.
Lihua Yang *Affiliated Hospital of Xiangnan University, Chenzhou, Hunan, China.
Yijie FangHealth School of Nuclear Industry, Hengyang, Hunan, China.
Hongping LuDepartment of Pain Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei, China.
Yangyang HuangSchool of Nursing, University of South China, Hengyang, Hunan, China.
Zhiyong XiaoSchool of Horticulture, Hunan Agricultural University, Changsha, Hunan, China.
Yongxin LongSchool of Nursing, University of South China, Hengyang, Hunan, China.
Peng LiSchool of Nursing, University of South China, Hengyang, Hunan, China.
Fengzhi ShiSchool of Nursing, University of South China, Hengyang, Hunan, China.
Hongwu LiaoHealth School of Nuclear Industry, Hengyang, Hunan, China.
Xinhong YinSchool of Nursing, University of South China, Hengyang, Hunan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Depression in middle-aged and older adults with heart disease is clinically heterogeneous, but this heterogeneity is often assessed using total symptom scores or symptom-only approaches. We examined whether multimorbidity burden, caregiving status, and sex were associated with a joint depressive symptom-biomarker network and whether the main patterns were reproducible in an independent hospital cohort. Methods: We analyzed 1,685 participants with heart disease from the China Health and Retirement Longitudinal Study as a discovery cohort and 506 patients from an independent hospital cohort for external replication. We estimated a joint depressive symptom-biomarker network and examined node-specific associations of the three external factors, as well as subgroup differences in network structure and global connectivity. Results: The external factors were associated with heterogeneous local patterns in the joint symptom-biomarker network, whereas significant subgroup differences in overall network structure or global connectivity were not observed. The factor-specific patterns were broadest across domains for multi-morbidity burden, weaker and more localized for caregiving status, and clearest and most reproducible for sex, particularly involving high-density lipoprotein cholesterol, triglycerides, and cystatin C. Across both cohorts, depressed mood consistently showed the highest centrality among symptom nodes. Conclusions: In middle-aged and older adults with heart disease, depressive heterogeneity was reflected more clearly in reproducible local symptom-biomarker associations than in broad network-wide differences. These findings support an assessment-oriented approach that integrates external factors and routinely available biomarkers when characterizing depressive heterogeneity in this population.

Indexed as

biomarkerscaregiving statusdepressionexternal replicationheart diseasemultimorbiditynetwork analysissex

Identifiers

PMID42311567
PMCPMC13269108

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.