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Gan YY, Yang J, Zhai L, Liao Q, Huo RR. Specific depressive symptoms, body mass index and diabetes in middle-aged and older Chinese adults: Analysis of data from the China Health and Retirement Longitudinal Study (CHARLS). J Affect Disord 2024; 369:S0165-0327(24)01710-5. [PMID: 39413885 DOI: 10.1016/j.jad.2024.10.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 10/11/2024] [Accepted: 10/12/2024] [Indexed: 10/18/2024]
Abstract
BACKGROUND This study examined the association between specific depressive symptoms and incident diabetes, and whether overweight or obesity mediates this relationship among middle-aged and older adults in China. METHODS In a nationally representative prospective cohort study of 11,893 middle-aged and older Chinese adults without baseline diabetes, we used Cox models to assess the association between depressive symptoms and diabetes. The quantile g-computation (qgcomp) model evaluated the contribution of 10 specific depressive symptoms to diabetes risk, and a two-stage regression method explored the mediation effect of overweight or obesity. RESULTS Over a median follow-up of 7.1 years, 1314 cases of diabetes were identified. Elevated depressive symptoms were associated with increased diabetes risk (HR 1.23; 95 % CI 1.09-1.38). Eight out of 10 depressive symptoms were significantly associated to diabetes, with loneliness (weight = 18 %; HR 1.23; 95 % CI 1.10-1.39), restless sleep (weight = 17 %; HR 1.16; 95 % CI 1.04-1.29), and bother (weight = 15 %; HR 1.19; 95 % CI 1.07-1.33) being the primary contributors. Mediation analysis showed that overweight and obesity reduced the depression-diabetes risk association by 8.21 % and 12.61 %, respectively. LIMITATIONS Diagnosis of diabetes was self-reported. CONCLUSIONS Eight out of ten specific depressive symptoms were associated to diabetes, overweight and obesity may partially mitigate the effect of depressive symptoms on diabetes among middle-aged and older adults in China. CLINICAL IMPLICATIONS Our results highlight the importance of tailoring diabetes prevention and management strategies according to specific depressive symptoms among middle-aged and older adults in China.
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Affiliation(s)
- Ying-Yuan Gan
- Department of Scientific Research, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jie Yang
- Department of Infection Control, The Second People's Hospital of Qinzhou, Qinzhou, China
| | - Lu Zhai
- Department of Smart Health Elderly Care Services and Management, School of Nursing, Guangxi Health Science College, Nanning, China
| | - Qian Liao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, China
| | - Rong-Rui Huo
- Department of Experimental Research, Guangxi Medical University Cancer Hospital, Nanning, China.
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Zhang X, Wang Y, Yang X, Li Y, Gui J, Mei Y, Liu H, Guo LL, Li J, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Li J, Liu M, Hua Y, Zhang L. Obesity and lipid indices as predictors of depressive symptoms in middle-aged and elderly Chinese: insights from a nationwide cohort study. BMC Psychiatry 2024; 24:351. [PMID: 38730360 PMCID: PMC11088055 DOI: 10.1186/s12888-024-05806-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/02/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Depressive symptoms are one of the most common psychiatric disorders, with a high lifetime prevalence rate among middle-aged and elderly Chinese. Obesity may be one of the risk factors for depressive symptoms, but there is currently no consensus on this view. Therefore, we investigate the relationship and predictive ability of 13 obesity- and lipid-related indices with depressive symptoms among middle-aged and elderly Chinese. METHODS The data were obtained from The China Health and Retirement Longitudinal Study (CHARLS). Our analysis includes individuals who did not have depressive symptoms at the baseline of the CHARLS Wave 2011 study and were successfully follow-up in 2013 and 2015. Finally, 3790 participants were included in the short-term (from 2011 to 2013), and 3660 participants were included in the long-term (from 2011 to 2015). The average age of participants in short-term and long-term was 58.47 years and 57.88 years. The anthropometric indicators used in this analysis included non-invasive [e.g. waist circumference (WC), body mass index (BMI), and a body mass index (ABSI)], and invasive anthropometric indicators [e.g. lipid accumulation product (LAP), triglyceride glucose index (TyG index), and its-related indices (e.g. TyG-BMI, and TyG-WC)]. Receiver operating characteristic (ROC) analysis was used to examine the predictive ability of various indicators for depressive symptoms. The association of depressive symptoms with various indicators was calculated using binary logistic regression. RESULTS The overall incidence of depressive symptoms was 20.79% in the short-term and 27.43% in the long-term. In males, WC [AUC = 0.452], LAP [AUC = 0.450], and TyG-WC [AUC = 0.451] were weak predictors of depressive symptoms during the short-term (P < 0.05). In females, BMI [AUC = 0.468], LAP [AUC = 0.468], and TyG index [AUC = 0.466] were weak predictors of depressive symptoms during the long-term (P < 0.05). However, ABSI cannot predict depressive symptoms in males and females during both periods (P > 0.05). CONCLUSION The research indicates that in the middle-aged and elderly Chinese, most obesity- and lipid-related indices have statistical significance in predicting depressive symptoms, but the accuracy of these indicators in prediction is relatively low and may not be practical predictors.
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Affiliation(s)
- Xiaoyun Zhang
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Ying Wang
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Xue Yang
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Yuqing Li
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Jiaofeng Gui
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Yujin Mei
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Lei-Lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Jinlong Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, People's Republic of China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China.
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Nour MO, Hafiz TA, Alharbi KK. Measuring the relationship between body mass index and depression among Saudi adult population: A nationwide cross-sectional study. PLoS One 2023; 18:e0293799. [PMID: 37972096 PMCID: PMC10653455 DOI: 10.1371/journal.pone.0293799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 10/19/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The prevalence of obesity and depression shows an accelerating trend with increased risk of morbidity and disability. The exact underlying relationship between them is unclear. We aimed to evaluate the prevalence of body mass index (BMI) and depression and their associations in a large sample of Saudi adults. METHODS We administered a nationwide cross-sectional web-based survey using a snowball sampling method among Saudi adults aged 18-60 years. We used a validated Arabic version of Beck's Depression Inventory-II (BDI-II) for depression assessment. We classified BMI into underweight, normal weight, overweight, and obesity. We used logistic regression analysis to determine the factors associated with depression. RESULTS Among 4,683 Saudi adults, different grades of depression were present in 43.3%, most (25.2%) with a mild condition. Overweight and obesity were present in 26.4% and 21%, respectively. We found a positive association between BMI and BDI-II score (ρ = 0.14, p = 0.006). BMI was significantly higher among those who were older, males, married, living in the Eastern region of Saudi Arabia, educated at a pre-university level, employed, at high family-income levels, smokers, and people with chronic diseases. Depression score was significantly higher among married, non-employees, non-smokers, people with chronic diseases, and those with BMI ≥ 25 kg/m2. Non-smoking, presence of chronic diseases, and being overweight or obese were significantly associated with depression. CONCLUSIONS Saudi adults were suffering from different grades of depression, overweight, and obesity. A positive association between BMI and BDI-II score was observed. Depression score did not differ by age, sex, geographical region, educational level, or family income. Non-smoking, presence of chronic diseases, and being overweight or obese were significantly associated with depression. Further longitudinal research is required to understand the factors underpinning causal relationships between BMI and depression, the subgroups' variation, and mediating strategies.
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Affiliation(s)
- Mohamed O. Nour
- Department of Health Promotion and Education, Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
- Department of Public Health and Community Medicine, Damietta Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Tamara Abdulrahman Hafiz
- Department of Health Promotion and Education, Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Khulud K. Alharbi
- Department of Health Services Management, Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
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Xu J, Zhang H, Zhang T, Sun J, Shi Q, Liu J, Tian G, Zhang B, Wang H, Wu Q, Kang Z. The "jolly fat" for the middle-aged and older adults in China, was education level considered? J Affect Disord 2022; 317:347-353. [PMID: 36057286 DOI: 10.1016/j.jad.2022.08.093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/10/2022] [Accepted: 08/26/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Several studies have found a negative association between obesity and depression in Chinese middle-aged and elderly, suggesting the existence of "jolly fat". This study aims to investigate whether "jolly fat" is applicable among middle-aged and elderly with different education levels, and to provide a new perspective for depression screening and obesity interventions in middle-aged and older adults. METHODS 10,018 individuals aged 45 years and over in China Family Panel Study (2018) were selected for analysis. A short version of Center for Epidemiological Research Depression Scale was used to assess depression. Body mass index was applied to define obesity status. Subgroup analysis of multiple logistic regression was performed to explore whether the relationship between obesity and depression was influenced by education levels. RESULTS The prevalence of obesity and depression was 9.02 % and 22.96 % among participants. Obesity reduced the probability of depression in middle-aged and elderly with primary school education or below (OR = 0.71, 95 % CI = 0.56-0.91) while not affecting those with junior high school education or above (OR = 0.80, 95 % CI = 0.57-1.13). LIMITATIONS The results cannot be interpreted as causality due to the cross-sectional design. Besides, we cannot directly measure the body composition of the participants. CONCLUSIONS "Jolly fat" existed among middle-aged and elderly with low education, but not in those with junior high school education or above. Health care providers need to monitor the psychological status of low-educated middle-aged and older adults who are seen as needing to lose weight, while the underweight group should be the key target of depression screening.
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Affiliation(s)
- Jinpeng Xu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Hongyu Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Ting Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Jiale Sun
- Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Qi Shi
- School of Health Management, Harbin Medical University, Harbin, China
| | - Jian Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Guomei Tian
- Department of Nuclear Medicine, The Fourth Hospital of Harbin Medical University, Harbin, China
| | - Bokai Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Haixin Wang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Zheng Kang
- School of Health Management, Harbin Medical University, Harbin, China.
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Wang S, Yang Q. Does weight impact adolescent mental health? Evidence from China. HEALTH ECONOMICS 2022; 31:2269-2286. [PMID: 35947534 DOI: 10.1002/hec.4574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 06/02/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
In this paper, we examine the causal impact of weight on adolescent mental health. Using the China Family Panel Studies, we find significant negative effects of adolescent weight, instrumented by cohort-level parental body mass index (BMI), on mental illness. In particular, a one standard deviation increase in adolescent BMI z-score decreases the K6 score by 0.766 (or 0.232 standard deviations). This finding is contrary to recent evidence from adults. We find this contrast can partly be explained by the different impacts of adolescent weight on self-image and social relationships. Unlike adults, heavy adolescents feel that they are popular among peers in China.
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Affiliation(s)
- Si Wang
- Center for Economics, Finance and Management Studies (CEFMS), Hunan University, Changsha, China
| | - Qingqing Yang
- School of Labor and Human Resources, Renmin University of China, Beijing, China
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Fang J, Wen Z, Ouyang J, Huang G, Liu X. The reciprocal longitudinal relationship between body mass index and subjective well-being in China. Soc Sci Med 2022; 297:114829. [DOI: 10.1016/j.socscimed.2022.114829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 10/19/2022]
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Associations between lifestyle behaviour changes and the optimal well-being of middle-aged Japanese individuals. Biopsychosoc Med 2021; 15:8. [PMID: 33794954 PMCID: PMC8017852 DOI: 10.1186/s13030-021-00210-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/22/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Psychological well-being has been associated with reduced mortality rates in both healthy and diseased populations. However, there is considerably less evidence on the effect of lifestyle behaviours on positive health outcomes such as well-being. This study examines the association between lifestyle behaviours and optimal well-being. METHODS From a total of 4324 Japanese individuals who participated in an annual health check-up in 2017, this study recruited 2295 participants (mean age: 49.3 ± 8.4 years; female: 54.3%) without a history of cerebrovascular, cardiovascular, or chronic renal disease and not on medication for hypertension, diabetes, or dyslipidaemia. The World Health Organization-Five Well-Being Index (WHO-5) scores were compared to self-reported scores on each of the following items: dietary habits, physical activity, smoking, alcohol consumption, and sleep quality. Logistic regression analysis was used to examine the association between optimal well-being (the top quartile of WHO-5 scores) and individual lifestyle behaviours. The association between change in dietary habits and physical activity from 2016 to 2017 and optimal well-being was also investigated. RESULTS Good dietary habits and regular physical activity were associated with higher raw WHO-5 scores and were positively associated with optimal well-being after adjusting for age, sex, body mass index (BMI), and sleep quality. Raw WHO-5 scores were significantly higher in those who maintained good dietary and physical activity behaviours than in those who did not. Furthermore, maintaining regular physical activity for two years was positively associated with optimal well-being, after adjusting for age, sex, BMI, and sleep quality. CONCLUSION These results demonstrate that not only currently practising good dietary and physical activity behaviours but also maintaining such behaviours over time is associated with optimal well-being. Maintaining good lifestyle behaviours, particularly regarding physical activity, could potentially improve people's well-being.
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Liu X, Chen S, Tan A, Zhou J, Liu W. Stay Slim or Get Fat?: An Examination of the "Jolly Fat" Effect in Chinese Older Adults. Risk Manag Healthc Policy 2021; 14:1271-1279. [PMID: 33790672 PMCID: PMC8005362 DOI: 10.2147/rmhp.s302270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/11/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose The association between body mass index (BMI) and health-related quality of life (HRQOL) has not been verified neither in China nor in any other Asian country. This study aimed to examine the association between BMI and HRQOL in the Chinese older adults population. Methods A total of 5018 older adults from the China’s Health-Related Quality of Life Survey for Older Adults 2018 was included in this study. The HRQOL was measured by the Chinese version of the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD). Multiple linear regression analysis was used to explore the associations between BMI and HRQOL among the older adults in rural, urban, and total samples. Results After adjusting all the confounders, compared with normal weight group, underweight was negatively correlated with the total scores of HRQOL among the older adults in rural (B= −2.310, p < 0.01), urban (B= −1.019, p < 0.001), and total samples (B= −2.351, p < 0.001), whereas overweight was positively associated with the total scores of HRQOL among the older adults in rural samples (B= 0.888, p < 0.05). The results showed that obesity was not associated with the total scores of HRQOL among the older adults in rural (B= −1.214, p > 0.05), urban (B= −0.074, p > 0.05), and total samples (B= −1.461, p > 0.05). Conclusion This study suggests that obese Chinese older adults did not show a better quality of life than those of normal weight. But this result does not deny the “jolly fat” hypothesis entirely, as the overweight older adults from rural areas showed better HRQOL. Moreover, underweight older people show a poorer HRQOL. The relationship between BMI and HRQOL in the older adults needs to be differentiated according to different characteristics of the population.
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Affiliation(s)
- Xiaojun Liu
- Department of Health Management, School of Public Health, Fujian Medical University, Fuzhou, Fujian, 350122, People's Republic of China
| | - Shuoni Chen
- Department of Global Health, Wuhan University, Wuhan, Hubei, 430072, People's Republic of China
| | - Anran Tan
- Department of Global Health, Wuhan University, Wuhan, Hubei, 430072, People's Republic of China
| | - Jiayi Zhou
- Department of Global Health, Wuhan University, Wuhan, Hubei, 430072, People's Republic of China
| | - Wenbin Liu
- Department of Health Management, School of Public Health, Fujian Medical University, Fuzhou, Fujian, 350122, People's Republic of China
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Cui N, Cui J, Xu X, Aslam B, Bai L, Li D, Wu D, Ma Z, Sun J, Baloch Z. Health Conditions, Lifestyle Factors and Depression in Adults in Qingdao, China: A Cross-Sectional Study. Front Psychiatry 2021; 12:508810. [PMID: 34054589 PMCID: PMC8160228 DOI: 10.3389/fpsyt.2021.508810] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 04/07/2021] [Indexed: 01/19/2023] Open
Abstract
Background: Depression is a common mental illness. Previous studies suggested that health conditions and lifestyle factors were associated with depression. However, only few studies have explored the risk factors of depression in a large representative sample of the general population in the world. Methods: A population-based cross-sectional survey was conducted in the 2006 survey and 2009 survey in Qingdao, China. The participants with insufficient information were excluded: Zung score, body mass index (BMI), diabetes items, physical activity, smoking, or drinking. Finally, a total of 3,300 participants were included in this analysis. The category of depression was used in the Zung self-rating depression scale (ZSDS). The associations between different indicators of health conditions (diabetic status, BMI), lifestyle factors (physical activity, smoking, and alcohol consumption), and depression were assessed by the logistic regression model. Results: The mean Zung scores for all participants, male participants, and female participants were 29.73 ± 7.57, 28.89 ± 7.30, 30.30 ± 7.70, respectively. In all participants, those who were pre-diabetes status (OR: 1.53, 95% CI: 1.04-2.27), and irregular physical activity (OR: 0.39, 95% CI: 0.17-0.89) had an increased risk of depression. In man, the analysis showed an increased risk of depression those with pre-diabetes (OR: 2.49, 95% CI: 1.25-4.97), previously diagnosed diabetes (OR: 4.44, 95% CI: 1.58, 12.48), and in those irregular activities (OR: 0.07, 95% CI: 0.01-0.61). In women, those who were underweight (OR: 5.66, 95% CI: 1.04-30.71) had a greater risk of depression. Conclusions: These results suggested that health conditions and lifestyle factors were the potential risk factors for depression. Men with pre-diabetes, previously diagnosed diabetes, and irregular activity had an increased risk for depression; women with underweight status had a higher risk for depression.
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Affiliation(s)
- Nan Cui
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jing Cui
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Xinpeng Xu
- Research Center for Health Policy and Management, Nanjing University, Nanjing, China
| | - Bilal Aslam
- Biomedical Research Center, Northwest Minzu University, Lanzhou, China.,Department of Microbiology, Government College University, Faisalabad, Pakistan
| | - Lan Bai
- Research Center for Health Policy and Management, Nanjing University, Nanjing, China
| | - Decheng Li
- Research Center for Health Policy and Management, Nanjing University, Nanjing, China
| | - Di Wu
- Research Center for Health Policy and Management, Nanjing University, Nanjing, China
| | - Zhongren Ma
- Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Jianping Sun
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Zulqarnain Baloch
- Biomedical Research Center, Northwest Minzu University, Lanzhou, China
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Liao W, Luo Z, Hou Y, Cui N, Liu X, Huo W, Wang F, Wang C. Age and gender specific association between obesity and depressive symptoms: a large-scale cross-sectional study. BMC Public Health 2020; 20:1565. [PMID: 33069213 PMCID: PMC7568408 DOI: 10.1186/s12889-020-09664-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/08/2020] [Indexed: 01/09/2023] Open
Abstract
Background This is a cross-sectional study to explore the age and gender specific association between obesity and depression in Chinese rural adults. Methods A total of 29,900 eligible participants from the Henan Rural Cohort Study were included. Standard anthropometric measurements were undertaken to obtain data on body mass index (BMI) and waist circumference (WC). The Patient Health Questionnaire-2 (PHQ-2) was utilized to discover depressive symptoms. Logistic regression was performed to explore the association between obesity (independent variable) and depressive symptoms (dependent variable). Results There were 1777 subjects with depressive symptoms, accounting for 5.94%. After multivariable adjustment, compared with normal weight group, the odds ratios (ORs) [95% confidence interval (CI)] for depressive symptoms in underweight, overweight and general obese groups were 1.41 (1.08–1.84), 0.87 (0.78–0.97) and 0.86 (0.74–0.99), respectively. Similarly, the OR (95% CI) of abdominal obesity group was 0.84 (0.76–0.93). Besides, there was linear decreasing trend of WC with depressive symptoms, but not BMI. Moreover, the inverse association between obesity and depressive symptoms was stronger in men and the elderly than that in women and the young. Conclusion Underweight was associated with a higher prevalence of depressive symptoms, which indicated that health care should pay attention to underweight as well as obesity, especially for women and the young. Clinical trial registration The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06.
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Affiliation(s)
- Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 100 Kexue Avenue, Zhengzhou, 450001, Henan, PR China
| | - Zhicheng Luo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 100 Kexue Avenue, Zhengzhou, 450001, Henan, PR China
| | - Yitan Hou
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
| | - Ningning Cui
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 100 Kexue Avenue, Zhengzhou, 450001, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 100 Kexue Avenue, Zhengzhou, 450001, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 100 Kexue Avenue, Zhengzhou, 450001, Henan, PR China
| | - Fang Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, PR China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 100 Kexue Avenue, Zhengzhou, 450001, Henan, PR China.
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Association of Body Fat With Health-Related Quality of Life and Depression in Nonagenarians: The Mugello Study. J Am Med Dir Assoc 2019; 20:564-568. [PMID: 30852165 DOI: 10.1016/j.jamda.2019.01.128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/07/2019] [Accepted: 01/13/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The association of body fat with health status and depression in the oldest old is still debated. The aim of this cross-sectional study is to investigate the association of body fat with health-related quality of life and depression in a sample of nonagenarians. DESIGN Data are from the Mugello study, a community-based project conducted in Italian older adults aged 90 years. SETTING AND PARTICIPANTS Total body fat was assessed by body impedance assessment. Participants were divided into 3 groups according to gender-specific tertiles of body fat percentage (BF%). Self-perceived mental and physical health status were assessed by the Mental Component Summary (MCS) and the Physical Component Summary (PCS) subscales derived from the 12-item Short Form Health Survey. Lower scores of MCS and PCS indicated poorer mental health and physical health status, respectively. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale, and a score ≥5 was used to identify participants with depression. RESULTS The mean age of 251 study participants was 92.5 years, and 173 (68.9%) were women. Participants were included in the low (n = 83), medium (n = 83), and high (n = 85) BF% groups. In the whole sample, mean scores at PCS progressively declined with the increasing BF% group (P = .004). This association was stronger in women, although no significant interaction was observed between the gender and BF% group (P = .63). No significant association between BF% and MCS was documented. Medium and high BF% were associated with a significantly higher probability of depression as compared with low BF% [odds ratio (OR) 2.15, 95% confidence interval (CI) 1.04-4.44, and OR 2.15, 95% CI 1.06-4.34, respectively]. This association was stronger in women, although no significant interaction was observed between gender and BF% group (P = .70). CONCLUSIONS AND IMPLICATIONS High BF% is significantly positively associated with poor health-related quality of life and depression, underpinning the clinical relevance to test BF% in older adults. These associations appear to be stronger in women than in men, highlighting the need to investigate deep inside this gender discrepancy.
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Cho SJ, Lee HJ, Rhee SJ, Kim EY, Kim KN, Yoon DH, Ahn YM. The relationship between visceral adiposity and depressive symptoms in the general Korean population. J Affect Disord 2019; 244:54-59. [PMID: 30316052 DOI: 10.1016/j.jad.2018.09.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 08/26/2018] [Accepted: 09/15/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND In Korea, depressive symptoms or depression are prevalent. Metabolic syndrome is the representative medical condition associated with depression. This study examined the association between clinically significant depressive symptoms and intra-abdominal fat, measured using abdominal computed tomography, in a large sample of the Korean population who underwent routine health examination. METHODS People who underwent routine health examinations at the Seoul National University Hospital Healthcare System, Gangnam Center, from October 2004 to July 2012 were included in the study. There were 11,434 cases of individuals with CT scan data and entries in the Beck Depression Inventory (BDI). Of these, 1156 men and women underwent CT scans more than once. In these cases, we analyzed the first scan. RESULTS We analyzed 4945 male and 2293 female participants; 333 participants (171 male, 162 female) were in the clinically depressed group. After controlling for confounding factors, we found that clinically depressive symptoms were associated with visceral adiposity in women. Per 1 cm2 of visceral adipose tissue area, the risk of being clinically depressed increased 1.006-fold. Similarly, per 1% increase in the ratio of visceral and total adipose tissue area in women, the risk increased 1.028-fold. CONCLUSIONS Our large-sample study showed depressive symptoms are associated with intra-abdominal fat and the ratio of visceral and total adipose area in women, after controlling for confounding factors including BMI, hypertension, and diabetes.
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Affiliation(s)
- Sung Joon Cho
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyun Jeong Lee
- Cancer Survivorship Branch, National Cancer Control Institute, Goyang, Republic of Korea
| | - Sang Jin Rhee
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Eun Young Kim
- Department of Psychiatry and Behavioral Science, College of Medicine, Seoul National University, Seoul, Republic of Korea; Mental Health Center, Seoul National University Health Care Center, Seoul, Republic of Korea
| | - Kyoung-Nam Kim
- Division of Public Health and Preventive Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Preventive Medicine, Seoul National University, College of Medicine, Seoul, Republic of Korea
| | - Dae Hyun Yoon
- Department of Psychiatry, Seoul National University Hospital, Healthcare System Gangnam Center, Seoul, Republic of Korea.
| | - Yong Min Ahn
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University, College of Medicine, Seoul, Republic of Korea.
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