Results
Based on a sample of 51,774 participants from the Guangdong Provincial Mental Health Database, four groups were compared: healthy (n = 48,657), anxiety alone (n = 285), depression alone (n = 1677), and CAD (n = 1155). Factors such as sex, age, district, insomnia, BMI, education, marital status, income, smoking, drinking, dietary regularity, exercise frequency, electronic device use, daily steps, sedentary time, and physical chronic diseases were observed significant differences across four groups (p < 0.05). In univariable analyses, factors associated with CAD (vs. healthy) included female sex, younger age, urban residence, insomnia, irregular diet, prolonged electronic device use, prolonged sedentary time, and lack of exercise. Multivariable analysis revealed that insomnia (OR = 14.64, 95% CI: 12.49-17.15), irregular diet (OR = 2.96, 95% CI: 2.45-3.58), prolonged electronic device use (OR = 1.78, 95% CI: 1.51-2.11), physical chronic diseases (OR = 1.59, 95% CI: 1.38-1.82), and female (OR = 1.19, 95% CI: 1.04-1.37) were independently associated with higher risk of CAD (all p < 0.05). Older age, married/cohabiting status, higher income, occasionally regular exercise, moderate steps, and moderate sedentary time were protective factors (ORs 0.41-0.80, all p < 0.05). District, smoking, and BMI were not retained in the multivariable model. The logistic regression model showed an AUC of 0.866 (95% CI: 0.845-0.886), and the decision tree model showed an AUC of 0.839 (95% CI: 0.818-0.860). The Hosmer-Lemeshow test indicated good calibration for the logistic model (χ2 = 2.09, df = 3, p = 0.553).
