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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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Li X, Li X, Sun L, Yang L, Wang C, Yuan T, Lei Y, Li J, Liu M, Zhang D, Hua Y, Liu H, Zhang L. The bidirectional relationship between activities of daily living and frailty during short-and long-term follow-up period among the middle-aged and older population: findings from the Chinese nationwide cohort study. Front Public Health 2024; 12:1382384. [PMID: 38746004 PMCID: PMC11091387 DOI: 10.3389/fpubh.2024.1382384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/12/2024] [Indexed: 05/16/2024] Open
Abstract
Objective Frailty and activities of daily living (ADL) disability are common conditions among older population. Studies on the bidirectional relationship between frailty and ADL are limited. The current study examined the cross-sectional and longitudinal associations between frailty and ADL in middle-aged and older Chinese individuals. Methods The data was collected through the China Health and Retirement Longitudinal Study (CHARLS), conducted in 2011, 2013, and 2015, encompassing 17,284 individuals aged ≥45 years. We excluded individuals without follow-up data. 2,631 participants finished the baseline survey. The definition of ADL disability encompasses difficulty in engaging in either basic activities of daily living (BADL) or instrumental activities of daily living (IADL). Frailty was assessed according to the Fried criteria. Logistic regression was utilized to examine odds ratios (ORs) and 95% confidence intervals (CIs) for assessing the cross-sectional relationships between ADL with frailty at baseline. The prediction effects were explored using Cox proportional hazards analysis, testing hazard ratios (HRs) and 95%CIs. Results In cross-sectional analysis, BADL [OR = 6.660 (4.519-9.815)], IADL [OR = 5.950 (4.490-7.866)], and ADL [OR = 5.658 (4.278-7.483)] exhibited significant associations with frailty; frailty demonstrated significant associations with BADL [OR = 6.741 (4.574-9.933)], IADL [OR = 6.042 (4.555-8.016)] and ADL [OR = 5.735 (4.333-7.591)]. In longitudinal analysis, IADL and ADL were significantly associated with frailty in participants without baseline frailty in the short-term period [IADL: HR = 1.971 (1.150-3.379), ADL: HR = 1.920 (1.146-3.215)], IADL exhibited a significant association with frailty in the long-term period [HR = 2.056 (1.085-3.895)]. There was no significant link observed between frailty and an elevated risk of disability onset in BADL, IADL and ADL during the short-term period. When considering the long-term perspective, frailty exhibited a significant association with an elevated risk of disability onset in BADL [HR= 1.820 (1.126-2.939)] and IADL [HR = 1.724 (1.103-2.694)]. Conclusion In middle-aged and older adults, ADL and IADL disability predicted frailty after 2-year follow-up, IADL disability predicted frailty after 4-year follow-up. Moreover, frailty did not predict BADL, IADL and ADL disability after 2-year follow-up. However, frailty predicted BADL and IADL disability after 4-year follow-up.
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Affiliation(s)
- Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Xiaoguang Li
- National Center For Occupational Safety and Health, National Health Commission of the People’s Republic of China, Beijing, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wanna Medical College, Wuhu, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, China
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Wang Y, Zhang X, Li Y, Gui J, Mei Y, Yang X, 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-related indices as a predictor of type 2 diabetes in a national cohort study. Front Endocrinol (Lausanne) 2024; 14:1331739. [PMID: 38356678 PMCID: PMC10864443 DOI: 10.3389/fendo.2023.1331739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/26/2023] [Indexed: 02/16/2024] Open
Abstract
Objective Type 2 diabetes mellitus (T2DM) remains a major and widespread public health concern throughout the world. The prevalence of T2DM in the elderly has risen to the top of the list of public health concerns. In this study, obesity- and lipid-related indices were used to predict T2DM in middle-aged and elderly Chinese adults. Methods The data came from the China Health and Retirement Longitudinal Study (CHARLS), including 7902 middle-aged and elderly participants aged 45 years or above. The study assessed the association of obesity- and lipid-related indices and T2DM by measuring 13 indicators, including body mass index (BMI), waist circumference(WC), waist-height ratio (WHtR), conicity index(CI), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), triglyceride glucose index (TyG-index) and its correlation index (TyG-BMI, TyG-WC, TyG-WHtR). The association of 13 obesity- and lipid-related indices with T2DM was investigated by binary logistic regression. Additionally, the predictive anthropometric index was evaluated, and the ideal cut-off value was established using the receiver operating characteristic (ROC) curve analysis and area under the curve (AUC). Results The study included 7902 participants, of whom 3638(46.04) and 4264(53.96) were male and female. The prevalence of T2DM in mid-aged and old adults in China was 9.02% in males and 9.15% in females. All the above 13 indicators show a modest predictive power (AUC>0.5), which was significant for predicting T2DM in adults (middle-aged and elderly people) in China (P<0.05). The results revealed that TyG-WHtR [AUC =0.600, 95%CI: 0.566-0.634] in males and in females [AUC =0.664, 95%CI: 0.636-0.691] was the best predictor of T2DM (P<0.05). Conclusion Most obesity- and lipid-related indices have important value in predicting T2DM. Our results can provide measures for the early identification of T2DM in mid-aged and elderly Chinese to reduce the prevalence of T2DM and improve health.
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Affiliation(s)
- Ying Wang
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Xiaoyun Zhang
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Yuqing Li
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Jiaofeng Gui
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Yujin Mei
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Xue Yang
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, An Hui, China
| | - Lei-lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Linghe District, Jinzhou, Liaoning, 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, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu, An Hui, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu, An Hui, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wanna Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu, An Hui, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
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Li Y, Gui J, Liu H, Guo LL, Li J, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Wei H, Li J, Liu M, Hua Y, Zhang L. Predicting metabolic syndrome by obesity- and lipid-related indices in mid-aged and elderly Chinese: a population-based cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1201132. [PMID: 37576971 PMCID: PMC10419183 DOI: 10.3389/fendo.2023.1201132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Objective To predict the optimal cut-off values for screening and predicting metabolic syndrome(MetS) in a middle-aged and elderly Chinese population using 13 obesity and lipid-related indicators, and to identify the most suitable predictors. Methods The data for this cross-sectional investigation came from the China Health and Retirement Longitudinal Study (CHARLS), including 9457 middle-aged and elderly people aged 45-98 years old. We examined 13 indicators, including waist circumference (WC), body mass index (BMI), waist-height ratio (WHtR), visceral adiposity index (VAI), a body shape index (ABSI), body roundness index (BRI), lipid accumulation product index (LAP), conicity index (CI), Chinese visceral adiposity index (CVAI), triglyceride-glucose index (TyG-index) and their combined indices (TyG-BMI, TyG-WC, TyG-WHtR). The receiver operating characteristic curve (ROC) was used to determine the usefulness of indicators for screening for MetS in the elderly and to determine their cut-off values, sensitivity, specificity, and area under the curve (AUC). Association analysis of 13 obesity-related indicators with MetS was performed using binary logistic regression analysis. Results A total of 9457 middle-aged and elderly Chinese were included in this study, and the overall prevalence of the study population was 41.87% according to the diagnostic criteria of NCEP ATP III. According to age and gender, the percentage of males diagnosed with MetS was 30.67% (45-54 years old: 30.95%, 55-64 years old: 41.02%, 65-74 years old: 21.19%, ≥ 75 years old: 6.84%). The percentage of females diagnosed with MetS was 51.38% (45-54 years old: 31.95%, 55-64 years old: 39.52%, 65-74 years old: 20.43%, ≥ 75 years old: 8.10%). The predictive power of Tyg-related parameters was more prominent in both sexes. In addition, LAP and CVAI are also good at predicting MetS. ABSI had a poor prediction ability. Conclusions Among the middle-aged and elderly population in China, after adjusting for confounding factors, all the indicators except ABSI had good predictive power. The predictive power of Tyg-related parameters was more prominent in both sexes. In addition, LAP and CVAI are also good at predicting MetS.
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Affiliation(s)
- Yuqing Li
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Jiaofeng Gui
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Haiyang Liu
- Health Center, Wannan Medical College, Wuhu, An Hui, China
| | - Lei-lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, 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, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Huanhuan Wei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
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Wang Y, Zhang X, Li Y, Gui J, Mei Y, Yang X, 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. Predicting depressive symptom by cardiometabolic indicators in mid-aged and older adults in China: a population-based cross-sectional study. Front Psychiatry 2023; 14:1153316. [PMID: 37351000 PMCID: PMC10282944 DOI: 10.3389/fpsyt.2023.1153316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/19/2023] [Indexed: 06/24/2023] Open
Abstract
Objective Depressive symptom is a serious mental illness often accompanied by physical and emotional problems. The prevalence of depressive symptom in older adults has become an increasingly important public health priority. Our study used cardiometabolic indicators to predict depressive symptom in middle-aged and older adults in China. Methods The data came from the China Health and Retirement Longitudinal Study 2011 (CHARLS2011), which was a cross-sectional study. The analytic sample included 8,942 participants aged 45 years or above. The study evaluated the relationship between cardiometabolic indicators and depression by measuring 13 indicators, including body mass index (BMI), waist circumference, waist-height ratio (WHtR), conicity index, visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), triglyceride glucose index (TyG-index) and its correlation index (TyG-BMI, TyG-waist circumference, TyG-WHtR). Binary logistic regression analysis was used to examine the association between thirteen cardiometabolic indicators and depressive symptom. In addition, the receiver operating characteristic (ROC) curve analysis and area under curve (AUC) were used to evaluate the predictive anthropometric index and to determine the optimum cut-off value. Results The study included 8,942 participants, of whom 4,146 (46.37%) and 4,796 (53.63%) were male and female. The prevalence of depressive symptom in mid-aged and older adults in China was 41.12% in males and 55.05% in females. The results revealed that BMI [AUC = 0.440, 95%CI: 0.422-0.457], waist circumference [AUC = 0.443, 95%CI: 0.425-0.460], WHtR [AUC = 0.459, 95%CI: 0.441-0.476], LAP [AUC = 0.455, 95%CI: 0.437-0.472], BRI [AUC = 0.459, 95%CI: 0.441-0.476], CVAI [AUC = 0.449, 95%CI: 0.432-0.467], TyG-BMI [AUC = 0.447, 95%CI: 0.429-0.465], and TyG-waist circumference [AUC =0.452, 95%CI: 0.434-0.470] were weak predictors of depressive symptom (p < 0.05) in males. In females, BMI [AUC = 0.470, 95%CI: 0.453-0.486], LAP [AUC = 0.484, 95%CI: 0.467-0.500], TyG-BMI [AUC = 0.470, 95%CI: 0.454-0.487], and TyG-waist circumference [AUC =0.481, 95%CI: 0.465-0.498] were weak predictors of depressive symptom (p < 0.05). On the other side, VAI, ABSI, conicity index and TyG index could not predict depressive symptom in middle-aged and older adults. Conclusion Most cardiometabolic indicators have important value in predicting depressive symptom. Our results can provide measures for the early identification of depressive symptom in middle-aged and older adults in China to reduce the prevalence of depressive symptom and improve health.
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Affiliation(s)
- Ying Wang
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Xiaoyun Zhang
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Yuqing Li
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Jiaofeng Gui
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Yujin Mei
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Xue Yang
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, An Hui, China
| | - Lei-lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, 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, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wanna Medical College, Wuhu, An Hui, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
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Li Y, Gui J, Zhang X, Wang Y, Mei Y, Yang X, Liu H, Guo LL, Li J, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Wei H, Li J, Liu M, Hua Y, Zhang L. Predicting hypertension by obesity- and lipid-related indices in mid-aged and elderly Chinese: a nationwide cohort study from the China Health and Retirement Longitudinal Study. BMC Cardiovasc Disord 2023; 23:201. [PMID: 37081416 PMCID: PMC10120116 DOI: 10.1186/s12872-023-03232-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/09/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Currently, the study outcomes of anthropometric markers to predict the risk of hypertension are still inconsistent due to the effect of racial disparities. This study aims to investigate the most effective predictors for screening and prediction of hypertension (HTN) in the Chinese middle-aged and more elderly adult population and to predict hypertension using obesity and lipid-related markers in Chinese middle-aged and older people. METHODS The data for the cohort study came from the China Health and Retirement Longitudinal Study (CHARLS), including 4423 middle-aged and elderly people aged 45 years or above. We examined 13 obesity- and lipid-related indices, including waist circumference (WC), body mass index (BMI), waist-height ratio (WHtR), visceral adiposity index (VAI), a body shape index (ABSI), body roundness index (BRI), lipid accumulation product index (LAP), conicity index (CI), Chinese visceral adiposity index (CVAI), triglyceride-glucose index (TyG-index) and their combined indices (TyG-BMI, TyG-WC, TyG-WHtR). To compare the capacity of each measure to forecast the probability of developing HTN, the receiver operating characteristic curve (ROC) was used to determine the usefulness of anthropometric indices for screening for HTN in the elderly and determining their cut-off value, sensitivity, specificity, and area under the curve (AUC). Association analysis of 13 obesity-related anthropometric indicators with HTN was performed using binary logistic regression analysis. RESULTS During the four years, the incident rates of HTN in middle-aged and elderly men and women in China were 22.08% and 17.82%, respectively. All the above 13 indicators show a modest predictive power (AUC > 0.5), which is significant for predicting HTN in adults (middle-aged and elderly people) in China (P < 0.05). In addition, when WHtR = 0.501 (with an AUC of 0.593, and sensitivity and specificity of 63.60% and 52.60% respectively) or TYg-WHtR = 4.335 (with an AUC of 0.601, and sensitivity and specificity of 58.20% and 59.30% respectively), the effect of predicting the incidence risk of men is the best. And when WHtR = 0.548 (with an AUC of 0.609, and sensitivity and specificity of 59.50% and 56.50% respectively) or TYg-WHtR = 4.781(with an AUC of 0.617, and sensitivity and specificity of 58.10% and 60.80% respectively), the effect of predicting the incidence risk of women is the best. CONCLUSIONS The 13 obesity- and lipid-related indices in this study have modest significance for predicting HTN in Chinese middle-aged and elderly patients. WHtR and Tyg-WHtR are the most cost-effective indicators with moderate predictive value of the development of HTN.
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Affiliation(s)
- 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
| | - 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
| | - 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
| | - 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
| | - 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
| | - Huanhuan Wei
- 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
| | - 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, Wanna 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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7
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Gui J, Li 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-related indices as a predictor of hypertension in Mid-aged and Elderly Chinese: A Cross-sectional Study. RESEARCH SQUARE 2023:rs.3.rs-2708175. [PMID: 37034776 PMCID: PMC10081363 DOI: 10.21203/rs.3.rs-2708175/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Objective Middle-aged and elderly people in China probably suffer from hypertension. There is a close relationship between obesity-and lipid-related index and hypertension, which is recognized by recent studies. However, these studies have not systematically compared the relationship between the two. We aim to find the most effective obesity-and lipid-related index for predicting hypertension. Method A total of 9488 middle-aged and elderly people in China participated in this study. In this study, the subjects were divided into male and female groups by the definition of the 2018 Chinese Guidelines for Prevention and Treatment of Hypertension. Searching for the best predictors among 13 obesity-and lipid-related indicators through binary logistic regression analyses and receiver operator curve (ROC). These 13 indicators are body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), conicity index (CI), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), triglyceride glucose index (TyG-index) and its correlation index (TyG-BMI, TyG-WC, TyG-WHtR). Results After adjusting bias, all 13 indexes are risk factors for hypertension. In ROC curve analysis, thirteen obesity-and lipid-related factors can predict the occurrence of hypertension. Among them, CVAI has the best prediction effect (male: AUC = 0.660, female: AUC = 0.699). AUC for WHtR was equal to that for BRI and TyG - WHtR in identifying hypertension in male. Similarly, AUC of TyG-BMI and BMI were the same. In females, AUC for WHtR and BRI were the same when predicting hypertension. AUC of ABSI was much lower than other test indexes. Conclusion In predicting hypertension, thirteen obesity-and lipid-related factors are effective. In addition, in males and females, CVAI is the best indicator to indicate hypertension. TyG-WHtR, WHtR, and BRI performed well in predicting metabolic syndrome in both males and females. ABSI has a poor ability to predict hypertension.
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Affiliation(s)
| | | | | | | | - Jinlong Li
- North China University of Science and Technology
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8
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Lu Y, Zhang Z, Yang S. Heterogeneity Influence of Financial Digitalization and Inclusion on Employees’ Psychological States. Behav Sci (Basel) 2023; 13:bs13030263. [PMID: 36975288 PMCID: PMC10045181 DOI: 10.3390/bs13030263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/08/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
Digital inclusive finance (DIF) has the power to spawn a new system of Internet finance and realize financial inclusion. However, the role of DIF in improving the health status of individuals is largely unknown. This study aims to demonstrate whether and how the development of DIF impacts the mental health of Chinese employees. This paper performs an empirical study based on the city-level data of the digital inclusive financial index with the China family panel studies. Ordinary least squares (OLS), probit models and mediation techniques are employed with appropriate instruments to alleviate endogeneity concerns. The results show that DIF can help employees improve their mental health. The results were robust to a variety of checks. Moreover, increasing income is the main pathway in which DIF improves individual mental health. Finally, it also reveals the heterogeneous effects of DIF on individual mental health. That is, the use depth of DIF has a significant positive effect on mental health status, but not on other sub-indicators, such as coverage breadth and degree of digital service provision; on those vulnerable groups containing females and employees with low education, its decisive role is larger than their counterparts who are males and have high levels of education. These results highlight the vital role of DIF in improving the mental health status of individuals. Consequently, there is a need to strengthen the construction of financial infrastructure and achieve a deeper integration of the financial system with digital technologies.
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Affiliation(s)
- Yue Lu
- School of Business and Management, Jilin University, Changchun 130012, China
| | - Zuoqian Zhang
- School of Business, Qingdao University, Qingdao 266075, China
| | - Siying Yang
- School of Economics, Liaoning University, Shenyang 110136, China
- Correspondence:
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9
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Gui J, Li Y, Liu H, Guo LL, Li J, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Wei H, Li J, Liu M, Hua Y, Zhang L. Obesity- and lipid-related indices as a predictor of obesity metabolic syndrome in a national cohort study. Front Public Health 2023; 11:1073824. [PMID: 36875382 PMCID: PMC9980350 DOI: 10.3389/fpubh.2023.1073824] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/16/2023] [Indexed: 02/18/2023] Open
Abstract
Objective Metabolic syndrome is a common condition among middle-aged and elderly people. Recent studies have reported the association between obesity- and lipid-related indices and metabolic syndrome, but whether those conditions could predict metabolic syndrome is still inconsistent in a few longitudinal studies. In our study, we aimed to predict metabolic syndrome by obesity- and lipid-related indices in middle-aged and elderly Chinese adults. Method A national cohort study that consisted of 3,640 adults (≥45 years) was conducted. A total of 13 obesity- and lipid-related indices, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), conicity index (CI), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), and triglyceride glucose index (TyG-index) and its correlation index (TyG-BMI, TyG-WC, and TyG-WHtR), were recorded. Metabolic syndrome (MetS) was defined based on the criteria of the National Cholesterol Education Program Adult Treatment Panel III (2005). Participants were categorized into two groups according to the different sex. Binary logistic regression analyses were used to evaluate the associations between the 13 obesity- and lipid-related indices and MetS. Receiver operating characteristic (ROC) curve studies were used to identify the best predictor of MetS. Results A total of 13 obesity- and lipid-related indices were independently associated with MetS risk, even after adjustment for age, sex, educational status, marital status, current residence, history of drinking, history of smoking, taking activities, having regular exercises, and chronic diseases. The ROC analysis revealed that the 12 obesity- and lipid-related indices included in the study were able to discriminate MetS [area under the ROC curves (AUC > 0.6, P < 0.05)] and ABSI was not able to discriminate MetS [area under the ROC curves (AUC < 0.6, P > 0.05)]. The AUC of TyG-BMI was the highest in men, and that of CVAI was the highest in women. The cutoff values for men and women were 187.919 and 86.785, respectively. The AUCs of TyG-BMI, CVAI, TyG-WC, LAP, TyG-WHtR, BMI, WC, WHtR, BRI, VAI, TyG index, CI, and ABSI were 0.755, 0.752, 0.749, 0.745, 0.735, 0.732, 0.730, 0.710, 0.710, 0.674, 0.646, 0.622, and 0.537 for men, respectively. The AUCs of CVAI, LAP, TyG-WC, TyG-WHtR, TyG-BMI, WC, WHtR, BRI, BMI, VAI, TyG-index, CI, and ABSI were 0.687, 0.674, 0.674, 0.663, 0.656, 0.654, 0.645, 0.645, 0.638, 0.632, 0.607, 0.596, and 0.543 for women, respectively. The AUC value for WHtR was equal to that for BRI in predicting MetS. The AUC value for LAP was equal to that for TyG-WC in predicting MetS for women. Conclusion Among middle-aged and older adults, all obesity- and lipid-related indices, except ABSI, were able to predict MetS. In addition, in men, TyG-BMI is the best indicator to indicate MetS, and in women, CVAI is considered the best hand to indicate MetS. At the same time, TyG-BMI, TyG-WC, and TyG-WHtR performed better than BMI, WC, and WHtR in predicting MetS in both men and women. Therefore, the lipid-related index outperforms the obesity-related index in predicting MetS. In addition to CVAI, LAP showed a good predictive correlation, even more closely than lipid-related factors in predicting MetS in women. It is worth noting that ABSI performed poorly, was not statistically significant in either men or women, and was not predictive of MetS.
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Affiliation(s)
- Jiaofeng Gui
- Department of Graduate School, Wannan Medical College, Wuhu, Anhui, China
| | - Yuqing Li
- Department of Graduate School, Wannan Medical College, Wuhu, Anhui, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, Anhui, China
| | - Lei-lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, 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, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Huanhuan Wei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wanna Medical College, Wuhu, Anhui, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
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10
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Roy A, Barman P. Does BMI Really Matter to Our Overall Health? Findings from a Cross-sectional Analysis of Middle-aged and Older Adults in India. JOURNAL OF POPULATION AGEING 2023. [DOI: 10.1007/s12062-023-09413-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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11
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O'Loughlin J, Casanova F, Fairhurst-Hunter Z, Hughes A, Bowden J, Watkins ER, Freathy RM, Millwood IY, Lin K, Chen Z, Li L, Lv J, Walters RG, Howe LD, Kuchenbaecker K, Tyrrell J. Mendelian randomisation study of body composition and depression in people of East Asian ancestry highlights potential setting-specific causality. BMC Med 2023; 21:37. [PMID: 36726144 PMCID: PMC9893684 DOI: 10.1186/s12916-023-02735-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Extensive evidence links higher body mass index (BMI) to higher odds of depression in people of European ancestry. However, our understanding of the relationship across different settings and ancestries is limited. Here, we test the relationship between body composition and depression in people of East Asian ancestry. METHODS Multiple Mendelian randomisation (MR) methods were used to test the relationship between (a) BMI and (b) waist-hip ratio (WHR) with depression. Firstly, we performed two-sample MR using genetic summary statistics from a recent genome-wide association study (GWAS) of depression (with 15,771 cases and 178,777 controls) in people of East Asian ancestry. We selected 838 single nucleotide polymorphisms (SNPs) correlated with BMI and 263 SNPs correlated with WHR as genetic instrumental variables to estimate the causal effect of BMI and WHR on depression using the inverse-variance weighted (IVW) method. We repeated these analyses stratifying by home location status: China versus UK or USA. Secondly, we performed one-sample MR in the China Kadoorie Biobank (CKB) in 100,377 participants. This allowed us to test the relationship separately in (a) males and females and (b) urban and rural dwellers. We also examined (c) the linearity of the BMI-depression relationship. RESULTS Both MR analyses provided evidence that higher BMI was associated with lower odds of depression. For example, a genetically-instrumented 1-SD higher BMI in the CKB was associated with lower odds of depressive symptoms [OR: 0.77, 95% CI: 0.63, 0.95]. There was evidence of differences according to place of residence. Using the IVW method, higher BMI was associated with lower odds of depression in people of East Asian ancestry living in China but there was no evidence for an association in people of East Asian ancestry living in the USA or UK. Furthermore, higher genetic BMI was associated with differential effects in urban and rural dwellers within China. CONCLUSIONS This study provides the first MR evidence for an inverse relationship between BMI and depression in people of East Asian ancestry. This contrasts with previous findings in European populations and therefore the public health response to obesity and depression is likely to need to differ based on sociocultural factors for example, ancestry and place of residence. This highlights the importance of setting-specific causality when using genetic causal inference approaches and data from diverse populations to test hypotheses. This is especially important when the relationship tested is not purely biological and may involve sociocultural factors.
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Affiliation(s)
- Jessica O'Loughlin
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Francesco Casanova
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Zammy Fairhurst-Hunter
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Amanda Hughes
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Jack Bowden
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | | | - Rachel M Freathy
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Iona Y Millwood
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit (PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kuang Lin
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit (PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Robin G Walters
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit (PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | | | - Jessica Tyrrell
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
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12
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Zhang L, Li JL, Guo LL, Xu G, Yang L, Wang C, Yuan T, Zhang D, Li J, Lei Y, Sun L, Li X, Hua Y, Che H, Liu H. Weight changes and the incidence of depressive symptom in the middle-aged and older adults: findings from the Chinese nationwide cohort study. BMC Public Health 2022; 22:2282. [PMID: 36474202 PMCID: PMC9724314 DOI: 10.1186/s12889-022-14624-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous studies, predominantly in Western individuals, have reported weight gain or weight loss are related to the increased depressive symptoms at all ages, but no study of depressive symptoms has examined its relation to actual (not just self-reported) weight changes in the middle-aged and older adults. Evidence of the relationship in older Asian individuals remains sparse. The study aimed to examine the relationship between weight changes and incidence of depressive symptoms in a nationally representative sample of community-dwelling older Asians. METHOD Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), which included 17,284 adults aged 45 years. Participants were followed every two years using a face-to-face, computer-aided personal interview (CAPI) and structured questionnaire. We excluded participants with no follow-up data. The numbers of individuals who completed both the baseline and follow-up surveys were 3118 for the short-term (two years from 2011-2013) and the long-term (four years from 2011-2015). Additionally, to associate weight change with subsequent depressive symptoms, we also included 2472 participants without depressive symptom in 2013 and observed the incidence of depressive symptom in 2015 (subsequent term from 2013-2015). Finally, weight changes were classified as loss > -3%, stable-3-3%, gain3-6%, gain6-9%, and gain > 9%. Multivariable-adjusted cox regression in the study were used to assess the hazard ratios (HRs) of each weight change category. RESULTS The incidence of depressive symptoms was 20.72% in the 2011-2013, 27.04% in the 2011-2015, and 23.02% in 2013-2015. Weight loss > 3% for all intervals was associated with higher depressive symptoms than stable weight during the 2011-2013 [1.305(1.031,1.651)] among the total populations. When stratified by sex, the results in males and females were different from those in the total population [females:1.389(0.997, 1.935); males:1.263(0.902, 1.767)]. Weight loss > 3% for intervals was associated with higher depressive symptoms than stable weight during the 2013-2015[1.643(1.140, 2.368)] among the males and its effect was also stronger for the total in 2011-2013. Moreover, there was no significant association between weight gain and incident depressive symptom, and no significant interaction effect in terms of the sex*weight changes. CONCLUSION Our findings could inform health promotion interventions to body-weight management aimed at improving the health of the middle-aged and older adults, particularly in the total people with short-term weight loss and males with subsequent term weight loss.
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Affiliation(s)
- Lin Zhang
- grid.443626.10000 0004 1798 4069Department 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
| | - Jin-long Li
- grid.440734.00000 0001 0707 0296Department 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
| | - Lei-lei Guo
- grid.454145.50000 0000 9860 0426Department 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
| | - Guang Xu
- grid.454145.50000 0000 9860 0426Department of Radiotherapy, Third Affiliated Hospital of Jinzhou Medical University, No. 28, Section 2, Chongqing Road, Linghe District, Jinzhou City, Liaoning Province People’s Republic of China
| | - Liu Yang
- grid.443626.10000 0004 1798 4069Department 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
| | - Congzhi Wang
- grid.443626.10000 0004 1798 4069Department 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
- grid.443626.10000 0004 1798 4069Obstetrics 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
| | - Dongmei Zhang
- grid.443626.10000 0004 1798 4069Department 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
- grid.443626.10000 0004 1798 4069Department 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
| | - Yunxiao Lei
- grid.443626.10000 0004 1798 4069Obstetrics 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
| | - Lu Sun
- grid.443626.10000 0004 1798 4069Department 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
| | - Xiaoping Li
- grid.443626.10000 0004 1798 4069Department 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
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wanna Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province People’s Republic of China
| | - Hengying Che
- grid.452929.10000 0004 8513 0241Department of Nursing, Yijishan Hospital, the First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Yijishan District, Wuhu City, Anhui Province People’s Republic of China
| | - Haiyang Liu
- grid.443626.10000 0004 1798 4069Student Health Center, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province People’s Republic of China
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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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Zhang L, Yang L, Wang C, Yuan T, Zhang D, Wei H, Li J, Lei Y, Sun L, Li X, Hua Y, Che H, Li Y. Mediator or moderator? The role of obesity in the association between age at menarche and blood pressure in middle-aged and elderly Chinese: a population-based cross-sectional study. BMJ Open 2022; 12:e051486. [PMID: 35618334 PMCID: PMC9137347 DOI: 10.1136/bmjopen-2021-051486] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE We investigated the moderation/mediation between the age of menarche and obesity parameters in predicting blood pressure (BP) in middle-aged and elderly Chinese. DESIGN Our study is a population-based cross-sectional study. SETTING Participants in this study came from the China Health and Retirement Longitudinal Study (CHARLS). PARTICIPANTS The analytical sample included 4513 participants aged 45-96 years. MAIN OUTCOME MEASUREMENTS Data were selected from the CHARLS, a cross-sectional study. Between-group differences were evaluated using χ2, t-test and one-way analysis of variance. The trend of related variables by characteristics was also tested using contrast analysis, as appropriate. Then, correlations between characteristics, moderator, mediator, and independent and dependent variables were used by Spearman's correlation test and Pearson's correlation test. Finally, the mediation analysis was performed by model 4 in PROCESS V3.3 macro for SSPSS, and moderation analysis was used by model 1 for assessment. All covariates were adjusted in the moderation or mediation models. RESULTS In the correlation analysis, body mass index (BMI) and waist circle (WC) level were positively correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in women (BMI and DBP: r=0.221, p<0.001; WC and DBP: r=0.183, p<0.001; BMI and SBP: r=0.129, p<0.001; WC and SBP: r=0.177, p<0.001). Age of menarche was negatively correlated with DBP (r=-0.060, p<0.001). However, the age of menarche was not significantly correlated with SBP (r=-0.014, p=0.335). In the moderator analysis, after controlling for the potential confounders, the interaction term of obesity parameters×age of menarche was not significant for predicting either DBP (BMI: B=0.0260, SE=0.0229, p=0.2556, 95% CI -0.0189 to 0.071; WC: B=0.0099, SE=0.0074, p=0.1833, 95% CI -0.0047 to 0.0244) or SBP (BMI: B=0.0091, SE=0.0504, p=0.8561, 95% CI -0.0897 to 0.108; WC: B=-0.0032, SE=0.0159, p=0.8427, 95% CI -0.0343 to 0.028). All correlations were significant correlation between age of menarche, obesity parameters and BP except the path of the menarche age→SBP (with the addition of the BMI indicator: β=-0.0004, B=-0.0046, p=0.9797, 95% CI -0.3619 to 0.3526; with the addition of the WC indicator: β=0.0004, B=0.0044, p=0.9804, 95% CI -0.3439 to 0.3526) in crude model. In general, after controlling for potential confounders, BMI (DBP: β=-0.0471, B= -0.2682, p=0.0021, 95% CI -0.4388 to -0.0976; SBP: β=-0.0515, B=-0.6314, p<0.001, 95% CI -0.9889 to -0.2739) and WC (DBP: β=-0.0474, B= -0.2689, p<0.001, 95% CI -0.4395 to -0.0984; SBP: β=-0.0524, B=-0.6320, p<0.001, 95% CI -0.9832 to -0.2807) partly mediated the relationship between age of menarche and BP. CONCLUSIONS The interaction term of obesity parameters×age of menarche was not significant for predicting either DBP or SBP in women. Moreover, obesity parameters partly mediated the relationship between the age of menarche and BP.
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Affiliation(s)
- Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Huanhuan Wei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
- School of Nursing, Henan University of Science and Technology, Luoyang, Henan, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Hengying Che
- Department of Nursing, Yijishan Hospital, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Yuanzhen Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, 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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Wang JM, Yang KD, Wu SY, Zou XG, Liao YS, Yang B, Xie BN, Huang Y, Li SJ, Ma HJ. Platelet Parameters, C-Reactive Protein, and Depression: An Association Study. Int J Gen Med 2022; 15:243-251. [PMID: 35023962 PMCID: PMC8747525 DOI: 10.2147/ijgm.s338558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/23/2021] [Indexed: 01/01/2023] Open
Abstract
Objective This study aims to investigate the correlation of platelet parameters and C-reactive protein (CRP) with depression. Methods The clinical data of 61 patients with depression and 30 healthy control subjects were collected to compare the platelet parameters, CRP levels, and Hamilton Depression Rating Scale (HAMD) scores of the two groups for correlation analysis. Results The results revealed that the body mass index (BMI) of patients with depression was lower (P < 0.05) than that of the healthy control subjects, and that this difference was more significant in women than in men. Patients with severe depression showed an increased mean platelet volume (MPV) (P < 0.05). In the patients with depression, MPV was positively correlated (P < 0.05) with HAMD scores for work and interest, gastrointestinal symptoms, hopelessness, the anxiety/somatization factor, and the hopelessness factor. Platelet count (PLT) was negatively correlated (P < 0.05) with HAMD scores for hypochondriasis, and plateletcrit (PCT) was negatively correlated (P < 0.05) with HAMD scores for middle insomnia and hypochondriasis. Platelet distribution width (PDW) was positively correlated (P < 0.05) with HAMD scores for gastrointestinal and systemic symptoms as well as hopelessness. Higher CRP levels (P < 0.05) were found in the patients with depression than in the healthy control subjects. Furthermore, in the patients with depression, CRP levels were positively correlated (P < 0.05) with HAMD scores for guilt and the cognitive impairment factor. Conclusion Classical platelet parameters (PLT, MPV, PCT, PDW) and CRP were shown to be associated with specific depressive symptoms and cognitive impairment factors, including sleep, gastrointestinal symptoms, hypochondriasis, losing interest in work, and despair. These results suggest that both platelet parameters and CRP could be suitable biomarkers for predicting the occurrence and prognosis of depression, thus providing a new target for its treatment.
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Affiliation(s)
- Jin-Min Wang
- Department of Internal Neurology, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, 350003, Fujian, People's Republic of China
| | - Kan-Di Yang
- Department of Internal Neurology, Anxi County Hospital, Quanzhou, Fujian, 362400, People's Republic of China
| | - Song-Ying Wu
- Institute of Clinical Research, Fujian Academy of Chinese Medical Sciences, Fuzhou, 350003, Fujian, People's Republic of China
| | - Xiang-Gu Zou
- Institute of Clinical Research, Fujian Academy of Chinese Medical Sciences, Fuzhou, 350003, Fujian, People's Republic of China
| | - Yuan-Sheng Liao
- Department of Internal Neurology, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, 350003, Fujian, People's Republic of China
| | - Bin Yang
- Department of Internal Neurology, Fuzhou Traditional Chinese Medicine Hospital, Fuzhou, 350001, Fujian, People's Republic of China
| | - Bu-Ni Xie
- Department of Internal Neurology, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, 350003, Fujian, People's Republic of China
| | - Yan Huang
- Department of Internal Neurology, Fuzhou Traditional Chinese Medicine Hospital, Fuzhou, 350001, Fujian, People's Republic of China
| | - Shi-Ju Li
- Department of Internal Neurology, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, 350003, Fujian, People's Republic of China
| | - Hui-Jun Ma
- Department of General, Qiaokou Han Jia Dun Street Community Health Service Center, Wuhan, 430000, Hubei, People's Republic of China
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Zhou R, Zheng YJ, Yun JY, Wang HM. The Effects of Urban Green Space on Depressive Symptoms of Mid-Aged and Elderly Urban Residents in China: Evidence from the China Health and Retirement Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020717. [PMID: 35055539 PMCID: PMC8775628 DOI: 10.3390/ijerph19020717] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/29/2021] [Accepted: 01/06/2022] [Indexed: 02/04/2023]
Abstract
The aim of this study is to assess the impacts of urban green space on depressive symptoms among Chinese urban residents aged 45 and older. In total, 7397 urban respondents were included in this study. Each respondent participated in the China Health and Retirement Longitudinal Study Wave 3 (2015). Environmental-level variables were retrieved from the National Bureau of Statistics database. Both unadjusted and adjusted methods were used in the multilevel regression analysis. Almost one-third of the sample population suffered from depressive symptoms (31.20%). The multilevel logistic regression model showed that green coverage ratio of city-built districts is negatively associated with the prevalence of depressive symptoms among urban mid-aged (OR = 0.79, p < 0.05) and elderly (OR = 0.75, p < 0.05) residents, and the public recreational green space helps to reduce elderly people’s depressive symptoms (OR = 0.77, p < 0.05). This study adds insights about the impact of green space and other environmental factors on depressive symptoms among mid-aged and elderly urban dwellers. It is important to provide enough and accessible overall urban green spaces; additionally, attention should also be paid to specific green space forms such as public recreational green space.
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Liu H, Yang X, Guo LL, Li JL, Xu G, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Wei H, Li J, Liu M, Hua Y, Li Y, Che H, Zhang L. Frailty and Incident Depressive Symptoms During Short- and Long-Term Follow-Up Period in the Middle-Aged and Elderly: Findings From the Chinese Nationwide Cohort Study. Front Psychiatry 2022; 13:848849. [PMID: 35463534 PMCID: PMC9021567 DOI: 10.3389/fpsyt.2022.848849] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/21/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Prefrailty and frailty are two common conditions among older individuals. Recent studies have reported the association between frailty and depressive symptoms, but whether those conditions could predict depressive symptoms is still inconsistent in a few longitudinal studies. In our study, we aimed to estimate the cross-sectional and longitudinal associations between frailty and incident depressive symptoms in a nationally representative sample of community-dwelling middle-aged and older Chinese adults. METHOD Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), which included 17,284 adults aged ≥ 45 years. Participants were followed every two years using a face-to-face, computer-aided personal interview (CAPI) and structured questionnaire. We excluded participants with no follow-up data. The numbers of individuals who completed the baseline surveys were 2,579 and follow-up surveys were 839 for the short-term (2 years from 2011 to 2013) and 788 for the long-term (4 years from 2011 to 2015). In addition, Frailty was measured by the Fried criteria and depressive symptoms were estimated by the Chinese version of the Center for Epidemiologic Studies-Depression scale (CES-D). Logistic regression was used to analyze the odds ratio (OR), and 95% confidence interval (CI) for the cross-sectional associations of frailty and its components with depressive symptoms in the participants at baseline. Cox proportional hazards analysis was conducted using the hazard ratio (HR), and 95% confidence interval (CI) for the prospective associations of baseline frailty and pre-frailty and its component in the participants without depressive symptoms at baseline. RESULTS At baseline, 57.93% of participants had depressive symptoms and 55.84% had pre-frail and 11.63% had frailty. In the cross-sectional analysis, both pre-frailty (OR = 5.293, 95%CI 4.363-6.422) and frailty (OR = 16.025, 95%CI 10.948-23.457) were associated with depressive symptoms. In the longitudinal analysis, frailty [HR = 1.395 (0.966-2.013)] and pre-frailty [HR = 2.458 (0.933, 6.479)] were not significantly associated with incident depressive symptoms in a full-adjusted model among participants free of baseline depressive symptoms during the short-term. However, frailty [HR = 1.397 (1.017, 1.920)] and pre-frailty [HR = 2.992 (1.210, 7.397)] were significantly associated with incident depressive symptoms during the short term. In the components of frailty, slowness [HR = 1.597 (1.078, 2.366)] was associated with an increased risk of depressive symptoms onset during the short-term. Weakness [HR = 2.08 (1.055, 4.104)] and exhaustion [HR = 1.928 (1.297, 2.867)] were associated with increased risk of depressive symptoms onset during the short-term. CONCLUSION Among the middle-aged and older adults, frailty, pre-frailty did not predict depressive symptoms during 2 years of follow-up, when accounting for the potential confounders, slowness considered alone predicted depressive symptoms. Additionally, frailty, pre-frailty predicted depressive symptoms during 4 years of follow-up, when accounting for the potential confounders, weakness and exhaustion considered alone predicted depressive symptoms.
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Affiliation(s)
- Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, China
| | - Xu Yang
- Department of Radiotherapy, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Lei-Lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Jin-Long 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, China
| | - Guang Xu
- Department of Radiotherapy, Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Huanhuan Wei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Yuanzhen Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, China
| | - Hengying Che
- Department of Nursing, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, China
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Akkaya Demir S, Akder RN, Meseri R. Is it chicken or the egg: Obesity, anxiety and depression in hospital workers. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2021. [DOI: 10.3233/mnm-211567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Healthcare workers are susceptible to obesity, anxiety and depression. OBJECTIVE: To determine the prevalence and association of obesity, anxiety and depression symptoms in individuals working in a hospital. METHODS: In this cross-sectional study all of the employees of a hospital were invited to participate (n = 150). Anxiety (via Beck Anxiety Scale) and depression symptoms (via Beck Depression Scale) and obesity were dependent and independent variables. Obesity was determined both with body mass index (BMI) and abdominal obesity (Waist circumference-WC). Data were collected with face-to-face interviews and anthropometric measurements were done. Data were analyzed using SPSS version 25.0 with student t-test, chi-square and correlation tests. Significance was set at a p-value < 0.05. RESULTS: Among the participants who agreed to participate (n = 131, 64.1% females), 35.1% were obese and 50.4% were abdominally obese. The 35.9% had moderate-severe anxiety symptoms, 19.1% had moderate-severe depression symptoms. Both BMI and WC had positive, moderate and significant correlation with anxiety and depression scores. After adjusting for socio-demographic variables obesity (both with BMI and WC) was an independent factor for anxiety and depression symptom presence, whereas after adjusted for these variables anxiety and depression symptom presence was an independent factor for obesity and abdominal obesity (p = 0.001 for all). CONCLUSIONS: There is a correlation between anxiety, depression and obesity. In addition to nutrition interventions in combating obesity, services that will improve mental health should be provided together as teamwork.
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Affiliation(s)
| | - Rana Nagihan Akder
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ege University, Izmir, Turkey
| | - Reci Meseri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ege University, Izmir, Turkey
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20
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Zhang L, Yang L, Wang C, Yuan T, Zhang D, Wei H, Li J, Lei Y, Sun L, Li X, Hua Y, Che H, Li Y. Combined Effect of Famine Exposure and Obesity Parameters on Hypertension in the Midaged and Older Adult: A Population-Based Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5594718. [PMID: 34604385 PMCID: PMC8486537 DOI: 10.1155/2021/5594718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/07/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Undernutrition early in life may increase the incidence of adverse effects on adult health. The relations between undernutrition and obesity parameters (body mass index (BMI) and WC (waist circle)) and hypertension were often contradictory. Our study is aimed at identifying the combined effects of famine exposure and obesity parameters on hypertension in middle-aged and older Chinese. DESIGN A population-based cross-sectional study. Setting. Data were selected from the China Health and Retirement Longitudinal Study Wave2011 (CHARLS Wave2011). Participants. The sample included 12945 individuals aged 45 to 96. Main Outcome Measurements. The study analyzed data from 12945 middle-aged and older Chinese selected from CHARLS Wave2011. Differences between baseline characteristics and famine exposure/BMI levels/WC levels were evaluated using the t-, Chi-square- (χ 2-), and F-test. Then, the difference in the prevalence of hypertension between baseline characteristics was estimated by the t- and χ 2-test. Finally, multivariable-adjusted logistic regression models were used to explore the associations of famine exposure and obesity parameters with odds of prevalence of hypertension. RESULTS Among the 12945 participants, 1548 (11.96%) participants had been exposed to the Chinese famine during the fetal group, whereas 5101 (39.41%) participants and 4362 (33.70%) participants had been exposed to the famine during childhood and adolescence/adult group, respectively. Regarding the participants with BMI levels, 3746 (28.94%) were overweight, and 1465 (11.32%) were obese, whereas 5345 (41.29%) of the participants with WC levels were obese, respectively. Furthermore, 1920 (31.17%) had hypertension in males and 2233 (32.91%) in females. In multivariable-adjusted models, famine exposure and obesity parameters were related with prevalence of hypertension independently in total populations ((1) model threec, famine exposure with prevalence of hypertension: the fatal-exposed vs. no-exposed group (OR1.27; 95% CI 1.08, 1.49); childhood-exposed vs. no-exposed group (OR1.64; 95% CI 1.44, 1.87); the adolescence/adult-exposed vs. no-exposed group (OR3.06; 95% CI 2.68, 3.50); P for trend < 0.001; (2) model threee, famine exposure with prevalence of hypertension: the fatal-exposed vs. no-exposed group (OR1.25; 95% CI 1.06, 1.47); childhood-exposed vs. no-exposed group (OR1.52; 95% CI 1.34, 1.73); the adolescence/adult-exposed vs. no-exposed group (OR2.66; 95% CI 2.33, 3.03); P for trend < 0.001; (3) model threeg, BMI levels with prevalence of hypertension: overweight vs. normal (OR1.75; 95% CI 1.60, 1.91); obesity vs. normal (OR2.79; 95% CI 2.48, 3.15); P for trend < 0.001; (4) WC levels with prevalence of hypertension: overweight vs. normal (OR1.42; 95% CI 1.36, 1.48)). When stratified by sex, results in both males and females were mostly similar to those in the total population. In general, interaction analysis in the multivariable-adjusted model, compared with the combination of normal BMI/WC levels and no-exposed famine group, all groups trended towards higher odds of prevalence of hypertension (the greatest increase in odds, adolescence/adult-exposed group with obesity in BMI levels: (OR8.13; 95% CI 6.18, 10.71); adolescence/adult-exposed group with obesity in WC levels: (OR6.36; 95% CI 5.22, 7.75); P for interaction < 0.001). When stratified by sex, the results in both males and females were also similar to those in the total population. CONCLUSION Our data support a strongly positive combined effect of famine exposure and obesity parameters on hypertension in middle-aged and elderly Chinese.
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Affiliation(s)
- Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Huanhuan Wei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, 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, Anhui Province, 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, Anhui Province, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
| | - Hengying Che
- Department of Nursing, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Yijishan District, Wuhu City, Anhui Province, China
| | - Yuanzhen Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, China
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Zhang L, Yang L, Wang C, Yuan T, Zhang D, Wei H, Li J, Lei Y, Sun L, Li X, Hua Y, Che H, Li Y. Individual and combined association analysis of famine exposure and serum uric acid with hypertension in the mid-aged and older adult: a population-based cross-sectional study. BMC Cardiovasc Disord 2021; 21:420. [PMID: 34488649 PMCID: PMC8420034 DOI: 10.1186/s12872-021-02230-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/30/2021] [Indexed: 01/02/2023] Open
Abstract
Background Malnutrition in early life may affect health in later life. The associations between malnutrition and serum uric acid (SUA) and hypertension were inconsistent. The present study aimed to investigate the individual and combined association between famine exposure and serum uric acid and hypertension in middle-aged and older Chinese. Methods Data were selected from the China Health and Retirement Longitudinal Study (CHARLS) Wave2011. The analytic sample included 9368 individuals aged 45 to 90. Differences between baseline characteristics and famine exposure/SUA level were evaluated using the Chi-square test, t-test, and F-test. Then, the differences in the prevalence of hypertension between characteristic groups was also estimated by the Chi-square and t-test. Finally, multivariable-adjusted logistic regression models examined association of famine exposure and serum uric acid with odds of prevalence of hypertension. Results A total of 9368 individuals were enrolled in the study, 4366 (46.61%) and 5002 (53.39%) were male and female, respectively. Among males, 459 (10.51%) had been exposed to the Chinese famine during the fetal stage, whereas 1760 (40.31%) and 1645 (37.68%) had been exposed to the famine during childhood and adolescence/adult stage, respectively. Among females, 635 (12.69%) had been exposed to the Chinese famine during the fetal stage, whereas 1988 (39.74%) and 1569 (31.37%) had been exposed to the famine during childhood and adolescence/adult stage, respectively. Regarding the participants with SUA level measurements, 290 (6.64%) reported having Hyperuricemia (HUA) in males and 234 (4.68%) in the females. Furthermore, 1357 (31.08%) reported having hypertension in male and 1619 (32.37%) in the female. In multivariable-adjusted model, famine exposure and serum uric acid were associated with prevalence of hypertension independently in total populations [(1) Model fourd, fatal exposed group vs non-exposed group: 1.25 (95% CI 1.03, 1.52); childhood-exposed group vs non-exposed group:1.60 (95% CI 1.37, 1.87); adolescence/adult exposed group vs non-exposed group: 2.87 (95% CI 2.44, 3.37), P for trend < 0.001; (2) Model four e, high vs normal:1.73 (95% CI 1.44, 2.08)]. When stratified by sex, the results in both males and females were similar to those in the total population. In general, interaction analysis in the multivariable-adjusted model, compared with the combination of normal SUA level and no-exposed famine stage, all groups trended towards higher odds of prevalence of hypertension [the greatest increase in odds, adolescence/adult exposed stage and high SUA level in total participants: OR4.34; 95%CI 3.24, 5.81; P for interaction < 0.001]. When stratified by sex, the results in both males and females were also similar to those in the total population. Conclusion Our data support a strongly positive individual and combined association of famine exposure and serum uric acid with hypertension in middle-aged and elderly Chinese.
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Affiliation(s)
- 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
| | - 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
| | - 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
| | - 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
| | - 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
| | - Huanhuan Wei
- 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
| | - 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
| | - 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
| | - 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
| | - 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
| | - 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
| | - Hengying Che
- Department of Nursing, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Yijishan District, Wuhu City, Anhui Province, People's Republic of China.
| | - Yuanzhen 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.
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Wang N, Zou J, Fang S, Zhou J. Association between daytime napping and obesity in Chinese middle-aged and older adults. J Glob Health 2021; 10:020804. [PMID: 33312510 PMCID: PMC7719355 DOI: 10.7189/jogh.10.020804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background No studies have assessed the association between daytime napping and obesity in China. The study aimed to examine the association between daytime napping and obesity among Chinese middle-aged and older adults, and to evaluate the difference between the aforementioned association in men and women. Methods Overall, 14 685 participants aged 45 years and older were included by using data from China Health and Retirement Longitudinal Study (CHARLS) in 2015. A multivariable logistic regression model was used to investigate the relationship between daytime napping and obesity after adjusting for potential confounders. Stratified analyses were performed to examine the association differences by sex. Besides, the Cochran-Armitage test for trend was used to detect if there was a significant dose-response relationship between daytime napping and obesity. Results The mean age of participants was 60.32, and the mean daytime napping duration was 38.97 minutes. In the sample, compared with no daytime napping group, the risks of being obese were higher in both moderate daytime napping group (1-60 minute/d) (odds ratio OR = 1.27, 95% confidence interval (CI) = 1.13-1.44) and extend long daytime napping group (>60 minute/d) (OR = 1.34, 95% CI = 1.15-1.56). In sex stratification, these significant correlations only existed in women but not in men. Compared with no daytime napping, women who napped 1-60 minute/d and over 60 minute/d were more likely to be obese (OR = 1.37, 95% CI = 1.18-1.59 and OR = 1.49, 95% CI = 1.23-1.81, respectively). Besides, the Cochran-Armitage trend test revealed that the prevalence rate of obesity increased as the daytime napping duration increased (P < 0.001). Conclusions The study established the relationship between daytime napping and obesity in a general Chinese population. The association, however, was only detected among women. Furthermore, there was a dose-response relationship between daytime napping and obesity among women. Future studies may verify this association by using a longitudinal design and focus on the mechanisms behind such association.
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Affiliation(s)
- Nan Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Junyi Zou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shu Fang
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Junmin Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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Fan VS, Mahadevan R, Leung J. Effect of income inequality, community infrastructure and individual stressors on adult depression. Health Promot Int 2021; 36:46-57. [PMID: 32277828 DOI: 10.1093/heapro/daaa036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This paper considers the impact of variables at three different levels-city, community and individual-on the depression of adults aged 45 years and above in China. Evidence shows that community factors, such as infrastructure and elderly centres, are critical to reduce depression but the effect of city-level factors such as lowering income inequality and improving public health investment is different for the segments of poor and non-poor as well as the rural and urban residents. This highlights the need to consider targeted policy mix options to avoid resource misallocation. Lastly, Chinese females' depression has worsened over time with ageing, particularly those who drink alcohol or are less educated are prone to depression prompting the need for specialist women health centres.
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Affiliation(s)
- Vanessa Sha Fan
- China Institute of Innovation and Development, Beijing Normal University, Zhuhai Campus, Guangdong 519087, P.R. China
| | - Renuka Mahadevan
- School of Economics, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Janni Leung
- School of Psychology, The University of Queensland, Brisbane, Queensland 4072, Australia & National Drug and Alcohol Research Center, University of New South Wales, Sydney, New South Wales 2052, Australia
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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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Engda AS, Belete H, Tilahun FA, Demeke SM, Engidaw NA, Wubetu AD, Asefa EY. Prevalence of Depression and Associated Factors Among Normal and Overweight Reproductive Age Women, Ethiopia: Community-Based Comparative Cross-Sectional Study. Int J Womens Health 2021; 13:337-347. [PMID: 33790658 PMCID: PMC7997582 DOI: 10.2147/ijwh.s301778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background Depression and overweight are serious public health problems and the most common complications of childbearing age with many negative consequences on the mental health of women and their children in the world. Even though both have a serious impact, no study has been done in Ethiopia. Therefore, this study aimed to assess and compare the prevalence of depression and associated factors among normal and overweight reproductive-age women in Debre Berhan town. Methods A community-based comparative cross-sectional study was conducted from April– June 2020. Patient health questionnaire-9 was used to measure the level of depression and list of threatening experience for stressful life events. Body mass index values of 18.5–24.9 and 25–29.9 kg/m2 were used to classify as normal, and overweight, respectively. The data were entered into Epi Data V. 4.6 and were analyzed using SPSS V. 25. A statistically significant association was declared at a p-value < 0.05. Results From 1530 participants the response rate were 96.1% and 100% for normal and overweight women, respectively. The prevalence of depression among normal weight women was 26.02% (95% CI: 23.3%, 28.73%) whereas among overweight was 32.89% (95% CI: 28.85%, 36.93%). For women who have normal weight; being exposed to stressful life events, having poor social support, and body image disturbance were statistically significant factors. For women who have overweight, stressful life events, body image disturbance, and experienced weight stigma were significantly associated. Conclusion and Recommendation Depression among overweight women was high compared to normal weight in Debre Berhan town. Promoting social support at any aspect of health care services are very important to minimize depression. Especially for overweight women, encouraging management of medical illness, coping mechanisms for different stressful life events and potentiating self-confidence towards body image are a vital means to prevent depression. Health promotion program targeting reproductive age women with significant associated factors are important to overcome overweight and depression in Debre Berhan town.
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Affiliation(s)
- Abayneh Shewangzaw Engda
- Department of Psychiatry, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Habte Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Fikir Addisu Tilahun
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Solomon Moges Demeke
- Department of Psychiatry, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Nigus Alemnew Engidaw
- Department of Psychiatry, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abate Dargie Wubetu
- Department of Psychiatry, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Eyosiyas Yeshialem Asefa
- Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
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Yang F, Li Z, Wang GW, Shi XX, Fu C. Cognitive function and its influencing factors in empty-nest elderly and non-empty-nest elderly adults in China. Aging (Albany NY) 2021; 13:4552-4563. [PMID: 33495422 PMCID: PMC7906192 DOI: 10.18632/aging.202416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 11/08/2020] [Indexed: 01/06/2023]
Abstract
INTRODUCTION We investigated cognitive function and its influencing factors in empty-nest and non-empty-nest elderly adults in China. RESULTS Cognitive function was better in empty-nest elderly living as a couple but worse in those living alone than in non-empty-nest elderly. Older age, rural habitation, poorer instrumental activities of daily living, and depression were risk factors for cognitive decline, while higher education was protective. Women had poorer cognitive function than men among non-empty-nest elderly and empty-nest elderly living as a couple. Among non-empty-nest elderly, those who were divorced/widowed/never married, underweight or economically active exhibited poorer cognitive function. Having two or more chronic diseases and being overweight were associated with better cognitive function among empty-nest elderly living as a couple. CONCLUSION These findings suggest that cognitive function is poorest in empty-nest elderly living alone and best in empty-nest elderly living as a couple. The factors influencing cognitive function differed according to empty-nest status, which should be considered in interventions. METHODS 5549 elderly from the 2015 China Health and Retirement Longitudinal Study were included in this study. Cognitive function was evaluated using the Telephone Interview for Cognitive Status, episodic memory tests and visuospatial ability assessments. Factors influencing cognitive function were determined via multiple linear regression analysis.
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Affiliation(s)
- Fan Yang
- Department of Information Center, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei, China
| | - Zhen Li
- Qinghai Provincial Center for Diseases Prevention and Control, Xining 810010, Qinghai, China
| | - Guo-Wen Wang
- Department of Education, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
| | - Xiu-Xin Shi
- Office of Medical Quality Control, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China
| | - Chang Fu
- Department of Health Psychology, School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China
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Adiposity-related risks among the middle-aged and elderly Chinese: the role of siesta and nocturnal sleep duration. NUTR HOSP 2021; 38:797-806. [PMID: 33586991 DOI: 10.20960/nh.03448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: increasingly, research suggests that lack of sleep is linked to adiposity worldwide, but few studies have been conducted in middle-aged and elderly Chinese subjects. The purpose of the present study was to analyze the association of siesta and nocturnal sleep duration with the prevalence of adiposity in middle-aged and elderly Chinese individuals. Methods: a total of 7,891 community dwelling Chinese subjects who had participated in the 2015 China Health and Retirement Longitudinal Study were included. A four-stage random sampling method was used to select participants. Siesta and nocturnal sleep duration was self-reported. Adiposity, including general obesity and abdominal obesity, was assessed. Multiple logistic analyses were conducted to explore the association between siesta, nocturnal sleep duration, and adiposity. Results: people with long siesta durations (≥ 1 hour/day) were significantly associated with an increased risk for abdominal obesity, independently and in all subgroup analyses, when compared to those without regular siesta. ORs after adjustment of confounding factors included: all subjects, OR = 1.45, 95 % CI, 1.23 to 1.70; middle-aged subjects, OR = 1.46, 95 % CI, 1.15 to 1.86; elderly, OR = 1.43, 95 % CI, 1.14 to 1.78. Conclusions: our data show that siesta duration plays a role in the prevalence of age-specific abdominal obesity. Individuals with long siesta durations are more likely to have abdominal obesity among the middle-aged and elderly population when compared to those without regular siesta. The results of this study need to be confirmed by further studies.
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Hoang MT, Do KN, Pham HQ, Nguyen CT, Ha GH, Vu GT, Tran BX, Latkin C, Ho RCM, Ho CS. Psychological distress among mountainous farmers in Vietnam: a cross-sectional study of prevalence and associated factors. BMJ Open 2020; 10:e038490. [PMID: 32764088 PMCID: PMC7412583 DOI: 10.1136/bmjopen-2020-038490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Psychological distress has been known as a major health problem among farmers across the world. In Vietnam, approximately 50% of farmers have lived in rural and mountainous areas. Yet, little has been known about how psychological distress impacts mountainous farmers' health. OBJECTIVES This study aimed to examine the prevalence and risk factors related to psychological distress among mountainous farmers in Vietnam. DESIGN AND SETTING A cross-sectional study was performed from August to September 2018 in Moc Chau district, Vietnam. A structured questionnaire and face-to-face interviews were used for data collection. PARTICIPANTS A random sample of 197 farmers aged at least 18 years, spoke Vietnamese, was not suffering from severe diseases and residing in Moc Chau at the time of the survey were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES The Kessler Psychological Distress Scale (K6) was employed to measure psychological distress. The tobit and logistic regressions were applied to indicate associated factors. RESULTS The prevalence of psychological distress was 38.2% (95% CI 31.3% to 45.5%). Having a greater comorbidities (OR=6.17; 95% CI 1.44 to 26.43), drinking alcohol (OR=3.86; 95% CI 1.02 to 14.59) and obtaining health information from health workers (OR=3.77; 95% CI 1.22 to 11.66) were positively associated with the prevalence of psychological distress. By contrast, being overweight (OR=0.29; 95% CI 0.09 to 0.93), adopting books as the primary source of health information (OR=0.11; 95% CI 0.01 to 0.8), and receiving a higher number of home visits by community health workers (CHWs) (OR=0.38; 95% CI 0.14 to 0.99) were negatively associated with the prevalence of psychological distress. CONCLUSION This study highlighted a high prevalence of psychological distress among mountainous farmers. Providing routine psychological and physical health screening, developing CHWs to provide clinical support and raising health awareness are critical implications for reducing psychological distress in this population.
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Affiliation(s)
- Men Thi Hoang
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Pharmacy, Duy Tan University, Da Nang, Viet Nam
| | - Khanh Nam Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Medicine, Duy Tan University, Da Nang, Viet Nam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Medicine, Duy Tan University, Da Nang, Viet Nam
| | - Giang Hai Ha
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Pharmacy, Duy Tan University, Da Nang, Viet Nam
| | - Giang Thu Vu
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Viet Nam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Carl Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Cyrus Sh Ho
- Department of Psychological Medicine, National University Hospital, Singapore
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Luo H, Ren X, Li J, Wu K, Wang Y, Chen Q, Li N. Association between obesity status and successful aging among older people in China: evidence from CHARLS. BMC Public Health 2020; 20:767. [PMID: 32448262 PMCID: PMC7245862 DOI: 10.1186/s12889-020-08899-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 05/12/2020] [Indexed: 02/05/2023] Open
Abstract
Background The paper aimed to examine the association between obesity status and successful aging among elderly adults in China and further find gender differences in the effect of components of successful aging on obesity status. Methods The data came from the follow-up survey(2015) of China Health and Retirement Longitudinal Study (CHARLS) and 4019 dwellers age 60 and over are included. Obesity status were defined by the body mass index (BMI) according to Chinese criteria. Successful aging was defined following Rowe and Kahn’s multidimensional model. Multivariable logistic regression was used to estimate the relationship between obesity status and successful aging. Results The rate of successful aging in men and women was 18.87 and 9.48% respectively. For BMI, the proportion of population with underweight, overweight and obesity in men was 10.29, 23.04 and 29.63% respectively and that in women was 1.40, 11.69 and 9.47%. Men with obesity (OR = 1.587 95% CI 1.087 ~ 2.316) has an positive relationship with successful aging than normal weight men; Women with underweight (OR = 0.197 95% CI 0.058 ~ 0.824) has an negative relationship with successful aging than normal weight women; Meanwhile, no matter men and women, the relationship between obesity status and successful aging were not significant among oldest adults(≥75 years). Conclusion Obesity status was significantly association with successful aging in young older adults (60-74 years), and the components of successful aging differently were related with the obesity status of male and female.
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Affiliation(s)
- Huiqiang Luo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, No.17 Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Xiaohui Ren
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, No.17 Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Jijie Li
- Department of Medical Records, West China Secondary University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Kan Wu
- Department of Medical, West China School of Stomatology (West China Hospital of Stomatology), Chengdu, 610041, Sichuan, China
| | - Yixi Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, No.17 Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Qing Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, No.17 Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Ningxiu Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, No.17 Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China.
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Zhang L, Li JL, Guo LL, Li H, Li D, Xu G. The interaction between serum uric acid and triglycerides level on blood pressure in middle-aged and elderly individuals in China: result from a large national cohort study. BMC Cardiovasc Disord 2020; 20:174. [PMID: 32293295 PMCID: PMC7160924 DOI: 10.1186/s12872-020-01468-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 04/05/2020] [Indexed: 12/19/2022] Open
Abstract
Background The purpose of the research was to explore the extent of interaction between triglycerides (TG) and serum uric acid (SUA) level with blood pressure (BP) in middle-aged and elderly individuals in China. Methods Data were selected from the China Health and Retirement Longitudinal Study (CHARLS), a cross-sectional study. 3345(46.99%) men with average ages of 60.24 ± 9.24 years and 3774 (53.01%) women with average ages of 59.91 ± 9.95 years were included in the study. Differences between gender, or between categories of blood pressure levels were evaluated by t-test or chi-square test. The adjusted associations between various characteristics and BP status were first compared using linear regression models, as appropriate. Then, A general linear model adjusted for confounding factors (socio-demographic characteristics [age, educational levels, marital status, place of residence], health behaviors [cigarette smoking, alcohol drinking, eating habits, social and leisure activities, accidental injury, physical activities], medical history [history of cardiovascular diseases, hepatitis history, antidiabetic drugs, history of antilipidemic medication, anti-hypertensive therapy], metabolic measures [C-reactive protein (CRP), hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), estimated glomerular filtration rate (eGFR), body mass index (BMI)]) was used to examine the synergistic effect of SUA and TG level on BP in middle-aged and elderly individuals in China. Results Age-adjusted partial Pearson’s correlation coefficient showed that SUA and TG level positively correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in both men and women. Multiple linear regression analysis showed the TG level was significantly and positively associated with SBP and DBP in both men (SBP: β =0.068, P = 0.001; DBP: β =0.064, P = 0.002) and women (SBP: β =0.061, P = 0.002; DBP: β =0.084, P = 0.000), but SUA were significantly and positively associated with SBP in both men (SBP: β =0.047, P = 0.013) and women (SBP: β =0.040, P = 0.028), regardless of other confounding factors. After adjusting for related potential confounders, evidence of interaction between SUA and TG level on SBP (men: β = − 1.090, P = 0.726; women: β = − 0.692, P = 0.861) and DBP (men: β = − 1.026, P = 0.572; women: β = − 0.794, P = 0.842) was not observed. Conclusion The interaction effect of SUA and TG level on BP was not observed in our study. Moreover, high SUA level was significantly associated with SBP, while high TG level was strongly related to both DBP and SBP.
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Affiliation(s)
- Lin Zhang
- 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
| | - Jin-Long 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
| | - 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
| | - Hong Li
- 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
| | - Dan Li
- Experimental Center for Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Guang Xu
- Department of Radiotherapy, Third Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Heping Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China.
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Zhang L, Li JL, Zhang LL, Guo LL, Li H, Li D. Body mass index and serum uric acid level: Individual and combined effects on blood pressure in middle-aged and older individuals in China. Medicine (Baltimore) 2020; 99:e19418. [PMID: 32118796 PMCID: PMC7478523 DOI: 10.1097/md.0000000000019418] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Few studies on the individual and combined analysis between serum uric acid (SUA) and body mass index (BMI) and blood pressure (BP) were conducted in individuals aged ≥45 years. We aimed to assess the extent to which BMI and SUA and their interaction affect BP in Chinese middle-aged and older adults.Data were selected from the China Health and Retirement Longitudinal Study (CHARLS). A total of 5888 individuals aged 45 to 96 was included. Differences between BMI, or between categories of blood pressure were evaluated by t test or chi-square test. The trend of related variables according to four BMI categories was also tested using contrast analysis. The adjusted associations between various characteristics and BP status were first compared using linear regression models, as appropriate. Then, general linear models adjusting for related potential confounders were used to examine the synergistic effect of SUA and BMI level on BP for middle-aged and elderly individuals in China.Age-adjusted partial Pearson correlation coefficient showed that BMI was significantly and positively correlated with BP both in male and female, SUA positively correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in males with BMI <24.0 kg/m and females with BMI <24.0 kg/m. However, SUA level significantly and positively correlated with DBP, but not with SBP, in females with BMI ≥24.0 kg/m. Multiple linear regression analysis showed that BMI was independently associated with BP both in male and female, SUA significantly and positively associated with SBP in both males and females with BMI <24.0 kg/m, However, SUA level positively correlated with DBP in females with BMI <24.0 kg/m, but not with males with BMI <24.0 kg/m, independent of other confounding factors. A general linear model analysis adjusted for confounding factors did not reveal interaction between BMI, SUA levels and SBP (β=-1.404, P = .686 in males; β=-2.583, P = .575 in females) and DBP (β=-2.544, P = .263 in males; β=-2.619, P = .622 in females).No interaction between BMI, SUA levels, and BP was observed in either males or females; However, BMI was independently associated with BP both in male and female, SUA independently associated with SBP both in males and females with BMI <24.0 kg/m, and SUA independently associated with DBP in females with BMI ≥24.0 kg/m.
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Affiliation(s)
- Lin Zhang
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, Liaoning Province
| | - Jin-Long 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
| | - Li-Li Zhang
- Department of Surgery, Third Affiliated Hospital of Jinzhou Medical University, Chongqing Road, Linghe District, Jinzhou City, Liaoning Province
| | - Lei-Lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, Liaoning Province
| | - Hong Li
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, Liaoning Province
| | - Dan Li
- Experimental Center for Nursing, School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, Liaoning Province, P.R.China
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Song X, Wu J, Yu C, Dong W, Lv J, Guo Y, Bian Z, Yang L, Chen Y, Chen Z, Pan A, Li L. The distribution and correlates of self-rated health in elderly Chinese: the China Kadoorie Biobank study. BMC Geriatr 2019; 19:168. [PMID: 31200646 PMCID: PMC6570897 DOI: 10.1186/s12877-019-1183-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 06/05/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Self-rated health (SRH) have been widely used as a valid indicator of health status at the population and individual level. We aimed to investigate the distribution and correlates of global SRH and age-comparative SRH in elderly Chinese. METHODS Survey of 57,693 men and 67,089 women aged 60 years and above was conducted in five rural (Gansu, Sichuan, Hunan, Henan, Zhejiang) and five urban areas (Heilongjiang, Shandong, Jiangsu, Guangxi, Hainan) in China between 2004 and 2008. Logistic regression models were used to calculate the relations of different factors with global SRH and age-comparative SRH. RESULTS Among the participants, 38.33% reported their global SRH as good or excellent while 61.67% as fair or poor, and 17.70% reported better age-comparative SRH while 17.99% as worse. In the multivariate model, compared to women, men tended to report a good global SRH and better age-comparative SRH, urban residents tend to report good global SRH and better age-comparative SRH. The socioeconomic and health behavior factors that were associated with good global SRH and better age-comparative SRH (with varying strengths of association) included: high educational level, high household income, house ownership, quitting smoking by own choices, occasional and current alcohol drinking, overweight, and high physical activity level. The factors that were associated with poor global SRH and worse age-comparative SRH included: quitting smoking by illness, former drinking, underweight, and weight lost ≥2.5 kg in the previous year. CONCLUSIONS We found a moderate level of good global SRH and a low level of better age-comparative SRH among elderly Chinese. We identified a number of demographic, socioeconomic and health behavior factors that were related to SRH measures. Our study emphasizes the importance of incorporating both global and age-comparative SRH measures in future studies, and considering gender inequalities and urban/rural disparity, as well as socioeconomic status and health behaviors as important modifiers of health.
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Affiliation(s)
- Xingyue Song
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 China
| | - Jing Wu
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191 China
| | - Wenhong Dong
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191 China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - Ling Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - An Pan
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191 China
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - on behalf of the China Kadoorie Biobank Collaborative Group
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191 China
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
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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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Zhang L, Li JL, Zhang LL, Guo LL, Li H, Yan W, Li D. Relationship between adiposity parameters and cognition: the "fat and jolly" hypothesis in middle-aged and elderly people in China. Medicine (Baltimore) 2019; 98:e14747. [PMID: 30855469 PMCID: PMC6417533 DOI: 10.1097/md.0000000000014747] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The association between adiposity parameters and cognition is complex. The purpose of this study was to assess the relationship between adiposity parameters and cognition in middle-aged and elderly people in China.Data were obtained from a cross-sectional study. Cognitive function was evaluated in 5 domains, and adiposity parameters were measured. The association between adiposity parameters and cognition was analyzed using multiple linear and binary logistic regression analyses.After controlling for confounders, men with overweight and obesity had better scores in TICS-10 ([1] total, overweight vs normal: P = .006, β = 0.04; obesity vs normal: P = .005, β = 0.04. [2] stratification by age, with age ≥ 59 years, overweight vs normal: P = .006, β = 0.05; obesity vs normal: P = .014, β = 0.05. [3] stratification by educational levels, with less than elementary education, overweight vs normal: P = .011, β = 0.05; obesity vs normal: P = .005, β = 0.05), immediate word recall ([1] total, overweight vs normal: P = .015, β = 0.04. [2] stratification by age, with age 45-58 years, overweight vs normal: P = .036, β = 0.05. [3] stratification by educational levels, with less than elementary education, overweight vs normal: P = .044, β = 0.04; above high school, overweight vs normal: P = .041, β = 0.09), self-rated memory ([1] stratification by age, with age ≥ 59 years, overweight vs normal: P = .022, β = 0.05. [2] stratification by educational levels, with less than elementary education, overweight vs normal: P = .023, β = 0.04), and drawing a picture ([1] total, overweight vs normal: OR = 1.269, 95% CI = 1.05-1.53. [2] stratification by educational levels, with less than elementary education, overweight vs normal: OR = 1.312, 95% CI = 1.06-1.63); obesity vs normal: OR = 1.601, 95% CI = 1.11-2.31 than the normal weight; women with overweight and obesity had better measure scores in the TICS-10 ([1] total, overweight vs normal: P < .0001, β = 0.06; obesity vs normal: P < .0001, β = 0.05. [2] stratification by age, with age 45-58 years, obesity vs normal: P = .007, β = 0.05; with age ≥ 59 years: overweight vs normal: P < .0001, β = 0.07, obesity vs normal: P = .002, β = 0.06. [3] stratification by educational levels, with illiterate, overweight vs normal: P = .001, β = 0.08; obesity vs normal: P = .004, β = 0.06; with less than elementary education, overweight vs normal: P < .0001, β = 0.07; obesity vs normal: P = .010, β = 0.05), immediate word recall ([1] total, overweight vs normal: P = .011, β = 0.04; obesity vs normal: P = .002, β = 0.04. [2] stratification by age, with age 45-58 years, obesity vs normal: P = .021, β = 0.05; with age ≥ 59 years: overweight vs normal: P = .003, β = 0.06. [3] stratification by educational levels, with illiterate, obesity vs normal: P = .028, β = 0.05; with less than elementary education, obesity vs normal: P = .016, β = 0.05), delay word recall ([1] total, overweight vs normal: P = .015, β = 0.03; obesity vs normal: P = .031, β = 0.03. [2] stratification by age, with age ≥ 59 years: overweight vs normal: P = .004, β = 0.06. [3] stratification by educational levels, with less than elementary education, obesity vs normal: P = .043, β = 0.04), self-rated memory ([1] total, obesity vs normal: P = .026, β = 0.03. [2] stratification by age, with age ≥ 59 years, overweight vs normal: P = .044, β = 0.04; obesity vs normal: P = .018, β = 0.05), and drawing a picture ([1] total, overweight vs normal: OR = 1.226, 95% CI = 1.06-1.42. [2] stratification by age, with age 45-58 years: overweight vs normal: OR = 1.246, 95% CI = 1.02-1.53) than the normal weight. Regarding the association between WC and cognitive function, the obesity demonstrated better mental capacity ([1] total, men: P < .0001, β = 0.06; women: P < .0001, β = 0.05. [2] stratification by age, men with age 45-58 years: P < .0001, β = 0.08; men with ≥ 59 years: P = .006, β = 0.05. women with age 45-58 years: P = .001, β = 0.06; women with ≥ 59 years: P = .012, β = 0.04. [3] stratification by educational levels, men with illiterate: P = .045, β = 0.09; men with less than elementary education: P < .0001, β = 0.08; women with illiterate: P < .0001, β = 0.09), ability to recall immediately ([1] total, men: P = .030, β = 0.03; women: P = .001, β = 0.05. [2] stratification by age, women with age 45-58 years: P = .028, β = 0.04; women with ≥ 59 years: P = .007, β = 0.05. [3] stratification by educational levels, men with less than elementary education: P = .007, β = 0.05; women with illiterate: P = .027, β = 0.05; women with less than elementary education: P = .002, β = 0.06), delay word recall ([1] total, women: P = .044, β = 0.03. [2] stratification by educational levels, men with less than elementary education: P = .023, β = 0.04), self-rated memory (stratification by educational levels, women with less than elementary education: P = .030, β = 0.04), and draw a picture ([1] total, men: OR = 1.399, 95% CI = 1.17-1.67; women: OR = 1.273, 95% CI = 1.12-1.45. [2] stratification by age, men with age 45-58 years: OR = 1.527, 95% CI = 1.15-2.03; men with age ≥ 59 years: OR = 1.284, 95% CI = 1.02-1.61; women with age 45-58 years: OR = 1.320, 95% CI = 1.10-1.58; women with age ≥ 59 years: OR = 1.223, 95% CI = 1.01-1.49. [3] stratification by educational levels, men with less than elementary education: OR = 1.528, 95% CI = 1.25-1.87; women with illiterate: OR = 1.404, 95% CI = 1.14-1.73) than the participants with normal weight after the multivariate adjustment.Our study demonstrated a significant relationship between adiposity parameters and cognition that supports the "jolly fat" hypothesis.
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Affiliation(s)
- Lin Zhang
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District Jinzhou City, Liaoning Province
| | - Jin-Long 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
| | - Li-Li Zhang
- Department of Surgery, Third Affiliated Hospital of Jinzhou Medical University, No.28, Section 2, Chongqing Road
| | - Lei-Lei Guo
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District Jinzhou City, Liaoning Province
| | - Hong Li
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District Jinzhou City, Liaoning Province
| | - Wenzhu Yan
- Department of anatomy, School of Basic Medical Sciences, Jinzhou Medical University, No.40, Section 3, Songpo Road
| | - Dan Li
- Experimental Center for Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District Jinzhou City, Liaoning Province, PR China
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Zhang C, Xue Y, Zhao H, Zheng X, Zhu R, Du Y, Zheng J, Yang T. Prevalence and related influencing factors of depressive symptoms among empty-nest elderly in Shanxi, China. J Affect Disord 2019; 245:750-756. [PMID: 30448759 DOI: 10.1016/j.jad.2018.11.045] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/27/2018] [Accepted: 11/03/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND In China, aging has become a serious social problem, and the number of empty-nest elderly is on the rise. The aim of this study is to clarify the prevalence of depressive symptoms among empty-nest elderly in Shanxi province and evaluate the effects of sociodemographic factors and health-promoting lifestyles so as to provide a scientific reference for preventing and intervening their depression. METHODS A cross-sectional study, which used a multi-stage random cluster sampling way, was conducted among 4901 empty-nest elderly in Shanxi. An independent t-test and a chi square test were used to compare the sociodemographic factors, depression scores, and health-promoting lifestyle scores of the empty-nest elderly. Multinomial logistic regression was used to analyze the potential influencing factors for depression. RESULTS The prevalence of depressive symptoms in the population was 64.2%. Among all participants 1,776 (36.2%) had mild depression, 1,236 (25.2%) had moderate depression, and 135 (2.8%) had severe depression. The health-promoting lifestyle of the empty nesters in this study was at the medium level (2.51 ± 0.47). Gender, education level, old-age provision model, exercise frequency, chronic disease, relationships with children, self-care ability, and health-promoting lifestyles were found to be influencing factors of depression and all variables had different effects on different degrees of depression. LIMITATIONS This was a cross-sectional study, so the results cannot establish causal relationships among the study variables. CONCLUSIONS Depression was prevalent among the empty-nest elderly in Shanxi. Maintaining good interpersonal relationships, developing extensive interests, and maintaining healthy lifestyles including good nutrition habits and regular exercises can reduce the incidence of depression among empty nesters.
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Affiliation(s)
- Chichen Zhang
- School of Management, Center for Health Management and Policy, Shanxi Medical University, Taiyuan, Shanxi, China; Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Yaqing Xue
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Huining Zhao
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiao Zheng
- School of Management, Center for Health Management and Policy, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Ruifang Zhu
- School of Nursing, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yufeng Du
- The First School of Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jianzhong Zheng
- Center for Rural Health Research, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Tingzhong Yang
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Association and Interaction Analysis of Body Mass Index and Triglycerides Level with Blood Pressure in Elderly Individuals in China. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8934534. [PMID: 30596101 PMCID: PMC6282155 DOI: 10.1155/2018/8934534] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 09/11/2018] [Accepted: 10/04/2018] [Indexed: 01/18/2023]
Abstract
Objectives To assess the extent of interaction between body mass index (BMI) and triglyceride (TG) level and its effects on blood pressure (BP) in elderly individuals in China. Design Cross-sectional study. Setting Data were taken from a cross-sectional study called the China Health and Retirement Longitudinal Study. Participants The analytic sample included 3629 subjects aged 45 to 96 years. Main Outcome Measurements Data were obtained from the China Health and Retirement Longitudinal Study, which is a cross-sectional study. Age-adjusted partial Pearson's correlation test was used to compare various characteristics and BP. Adjusted associations were first used as linear regression models, as appropriate. Then, general linear models adjusted for related potential confounders were used to examine the synergistic effects of BMI and TG level on BP. Finally, a binary logistic regression model adjusted for confounding factors was used to examine the association between BMI or TG level and hypertension. Results Age-adjusted partial Pearson's correlation coefficient showed that the TG level was positively correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in both men and women with BMI < 24.0 kg/m2; however, TG level was positively correlated with DBP in women with BMI ≥ 24.0 kg/m2 but not with DBP in men with BMI ≥ 24.0 kg/m2. Multiple linear regression analysis showed that BMI level was significantly and positively associated with both SBP and DBP in men and women with BMI < 24.0 kg/m2, and TG level was significantly and positively associated with SBP in women with BMI < 24.0 kg/m2, independent of other confounding factors. A general linear model analysis with adjustment for confounding factors (age, educational level, marital status, current residence, smoking, eating habits, taking activities, antidiabetic medication, antihypertensive therapy, fasting plasma glucose [FPG], low-density lipoprotein cholesterol [LDL-C], estimated glomerular filtration rate [eGFR], and serum uric acid [SUA]) showed no interaction between BMI and TG level and SBP (men, β = 0.572, P = 0.845; women, β = 0.122, P = 0.923) and DBP (men, β = -0.373, P = 0.810; women, β = 0.272, P = 0.828). A binary logistic regression model analysis with adjustment for confounding factors (age, educational level, marital status, current residence, smoking, drinking, eating habits, taking activities, major accidental injury, physical activity, history of cardiovascular disease, history of liver disease, antilipidemic medication, antidiabetic medication, antihypertensive therapy, FPG, LDL-C, high-density lipoprotein cholesterol [HDL-C], eGFR, and SUA) showed that overweight and obese men and women were more likely to have hypertension (men: odds ratio [OR] = 1.781, 95% confidence interval [CI] = 1.393–2.277; women: OR = 1.653, 95% CI = 1.330–2.055) and women with high TG were more likely to have hypertension (OR = 1.558, 95% CI = 1.219–1.992). Conclusion An interactive effect of BMI and TG level on BP was not observed in either men or women; however, independent effects of BMI on BP were observed in both men and women, and an association between TG level and hypertension was observed in women.
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Zhou Q, Wang T, Basu K. Negative association between BMI and depressive symptoms in middle aged and elderly Chinese: Results from a national household survey. Psychiatry Res 2018; 269:571-578. [PMID: 30199699 DOI: 10.1016/j.psychres.2018.08.107] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 05/23/2018] [Accepted: 08/27/2018] [Indexed: 01/20/2023]
Abstract
The association between body size and mental health has been the focus of many studies. Results, however, varies between studies. This study aimed to investigate the association between BMI and depressive symptoms among Chinese adults. We also further explored childhood starvation as a potential mediator of this association. The China Health and Retirement Longitudinal Study data, a representative national survey of adults age 45 and older was used in this study. Results showed that the prevalence of overweight and obesity were 28.8% and 11.6%. There was a negative association between BMI and depressive symptoms for males. Obese male adults had the lowest CES-D scores, followed by overweight male adults, and underweight male adults had the highest CES-D scores. These associations also exist but are not significant for females. Furthermore, these associations were significant among males who had been exposed to food shortage during their childhood. Our results suggested a significant positive association between BMI and depression in middle aged and elderly males in China, while this association is weak in females. Childhood food shortage experience was a potential causative factor accounting for this association.
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Affiliation(s)
- Qin Zhou
- School of Public Administration, University of International Business and Economics, Ningyuan Building, No. 10 Huixin Dongjie, Chaoyang District, Beijing 100029, China.
| | - Tianyu Wang
- School of Labor and Human Resources, Renmin University of China, Qiushi Building, No. 59 Zhongguancun Street, Beijing 100871, China.
| | - Kisalaya Basu
- Health Canada, Brooke Claxton Building, AL-0908B, Tunney's Pasture, 70 Colu`mbine Driveway, Ottawa, Ontario K1A 0K9, Canada.
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Minkwitz J, Scheipl F, Cartwright L, Campbell IC, Chittka T, Thormann J, Hegerl U, Sander C, Himmerich H. Why some obese people become depressed whilst others do not: exploring links between cognitive reactivity, depression and obesity. PSYCHOL HEALTH MED 2018; 24:362-373. [PMID: 30252503 DOI: 10.1080/13548506.2018.1524153] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Obesity and depression are two major public health concerns, particularly when they co-occur. To date, mechanisms underlying this association have not been established and it is unclear why some obese people become depressed whilst others do not. However, considering the strong association between depression and cognitive reactivity (CR), the present study explores possible associations between obesity, depression and CR in light of the scarce and conflicting nature of past literature. 254 participants were included for measures of depression, CR and obesity. Multivariate analyses of covariance examined the effects of depression and obesity as well as interaction effects of depression x obesity controlling for age and gender. Directions of effects were analysed by means of regression analyses and group contrasts. Linear analyses revealed (1) a significant effect of obesity on the rumination (RUM) and control/perfectionism subscales of CR, (2) a significant effect of depression on CR and all of its subscales, and (3) a significant interaction effect between obesity x depression on RUM. Results may support the 'Jolly Fat Hypothesis' and the existence of a psychologically protected subgroup of obese patients characterised by a lower ruminative thinking style and fewer depressive symptoms. Thus, incorporating anti-rumination therapy into treatment for obese individuals may be beneficial to prevent the development of comorbid depression.
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Affiliation(s)
- Juliane Minkwitz
- a Department of Psychiatry and Psychotherapy , University Hospital Leipzig , Leipzig , Germany.,b IFB Adiposity Diseases , Leipzig University Medical Center , Leipzig , Germany
| | - Fabian Scheipl
- c Institute for Statistics , Ludwig-Maximilians-Universität München , München , Germany
| | - Lydia Cartwright
- d Department of Psychological Medicine , IoPPN, King´s College London , London , UK
| | - Iain C Campbell
- d Department of Psychological Medicine , IoPPN, King´s College London , London , UK
| | - Tobias Chittka
- b IFB Adiposity Diseases , Leipzig University Medical Center , Leipzig , Germany
| | - Julia Thormann
- a Department of Psychiatry and Psychotherapy , University Hospital Leipzig , Leipzig , Germany.,b IFB Adiposity Diseases , Leipzig University Medical Center , Leipzig , Germany
| | - Ulrich Hegerl
- a Department of Psychiatry and Psychotherapy , University Hospital Leipzig , Leipzig , Germany.,b IFB Adiposity Diseases , Leipzig University Medical Center , Leipzig , Germany
| | - Christian Sander
- a Department of Psychiatry and Psychotherapy , University Hospital Leipzig , Leipzig , Germany
| | - Hubertus Himmerich
- a Department of Psychiatry and Psychotherapy , University Hospital Leipzig , Leipzig , Germany.,b IFB Adiposity Diseases , Leipzig University Medical Center , Leipzig , Germany.,d Department of Psychological Medicine , IoPPN, King´s College London , London , UK
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Zhang L, Li JL, Zhang LL, Guo LL, Li H, Li D. No association between C-reactive protein and depressive symptoms among the middle-aged and elderly in China: Evidence from the China Health and Retirement Longitudinal Study. Medicine (Baltimore) 2018; 97:e12352. [PMID: 30235693 PMCID: PMC6160211 DOI: 10.1097/md.0000000000012352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The depressive symptoms have been associated with increased disabilities, and the depressive symptoms-related elevation of high C-reactive protein (CRP) has been proposed as a possible mechanism. We examined the relations between CRP and depressive symptoms among the middle-aged and elderly in China.A longitudinal sample of the middle-aged and elderly (4404 men and 5055 women) who were interviewed in the 2011 China Health and Retirement Longitudinal Study was used. A multivariate logistic regression analysis was used to examine the effects of sociodemographic characteristics, lifestyle, activity status, physical exercise, systolic blood pressure, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, body mass index (BMI), and CRP levels on depressive symptoms.The mean age in the study was 60.26 years [standard deviation (SD) ± 9.25; 46.56% men]. The mean CPR level was 2.79 mg/L (range, 0.01-178.10; SD ± 7.80). Depression scores ranged from 0 to 30 with a mean 8.65 (SD ± 6.33). The prevalence of depressive symptoms was 38.49% in the total population, 31.04% in men and 44.99% in men. Compared with baseline CRP levels (≤1.00 mg/L), the depressive symptoms are only weakly correlated with CRP levels among women [CRP 1.01-3.00 mg/L: odds ratio (OR) = 0.85, 95% confidence interval (CI) = 0.73-0.98; CRP 3.01-10.00 mg/L: OR = 1.25, 95% CI = 1.03-1.51; CRP >10 mg/L: OR = 1.41, 95% CI = 1.06-1.88]. After adjusting for age, education, marital status, hukou, residence, cigarette smoking, alcohol drinking, eating meals, activity status, major accidental injury, diseases, health status, physical exercise, systolic blood pressure, LDL, HDL, triglycerides, and BMI, depressive symptoms were not associated with subsequent high CPR levels among the middle-aged and elderly (CRP 1.01-3.00 mg/L: OR = 0.93, 95% CI = 0.83-1.03; CRP 3.01-10.00 mg/L: OR = 0.95, 95% CI = 0.82-1.10; CRP >10 mg/l: OR = 1.11, 95% CI = 0.88-1.39).Our data do not support an association between CRP and depressive symptoms in both middle-aged and elderly men and women among china.
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Affiliation(s)
- Lin Zhang
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province
| | - Jin-long 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
| | - Li-li Zhang
- Department of Surgery, Third Affiliated Hospital of Jinzhou Medical University
| | - Lei-lei Guo
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province
| | - Hong Li
- Department of Community Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province
| | - Dan Li
- Experimental Center for Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province, P.R. China
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Yu HJ, Li F, Hu YF, Li CF, Yang XH, Yuan S, Huang Y, Tang BW, Gong J, He QQ. Associations of physical activity and fruit and vegetable intake with well-being and depressive symptoms among obese schoolchildren in Wuhan, China: a cross-sectional study. BMC Public Health 2018; 18:986. [PMID: 30089451 PMCID: PMC6083616 DOI: 10.1186/s12889-018-5779-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 06/28/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of childhood obesity is increasing and psychological disorder is a common comorbidity of obesity. We investigated the associations of physical activity (PA) and fruit and vegetable (FV) intake with well-being and depressive symptoms among obese schoolchildren. METHODS Participants included 188 obese children aged 9.8 ± 0.7 years living in Wuhan, China. Self-administered questionnaires were used to collect the children's PA and FV intake information. PA was considered to be high if the child participated in sport and/or vigorous free play at least 3 days per week with 60 min per day, while sufficient FV intake was defined as consuming FV 5 times per day. Children's well-being and depressive symptoms were assessed by standard questionnaires. Multiple logistic regression was performed to determine the odds ratios (ORs) and 95% confidence intervals (CIs) of the relationships of PA and FV intake with well-being and depressive symptoms. RESULTS High PA and sufficient FV intake were independently associated with significantly decreased risks for depressive symptoms (for PA, OR: 0.39, 95% CI: 0.16-0.92; for FV, OR: 0.21, 95% CI: 0.08-0.55) and poor well-being (for PA, OR: 0.35, 95% CI: 0.16-0.74), respectively. Furthermore, interactive inverse associations were observed between combined high PA and sufficient FV intake with poor well-being and depressive symptoms. Compared to their counterparts, children with high PA and sufficient FV intake had significantly reduced risk for poor well-being (OR: 0.16, 95%CI: 0.05-0.55) and depressive symptoms (OR: 0.12, 95% CI: 0.03-0.48). CONCLUSIONS High PA and sufficient FV intake are inversely associated with the risks of poor well-being and depressive symptoms among obese Chinese schoolchildren.
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Affiliation(s)
- Hong-jie Yu
- School of Health Sciences, Wuhan University, Donghu Road 185#, Wuhan, People’s Republic of China
| | - Fang Li
- Wuhan Centers for Disease Prevention and Control, Hanbei Road 24#, Wuhan, People’s Republic of China
| | - Yong-feng Hu
- Xinzhou Centers for Disease Prevention and Control, Wuhan, People’s Republic of China
| | - Chang-feng Li
- Wuhan Centers for Disease Prevention and Control, Hanbei Road 24#, Wuhan, People’s Republic of China
| | - Xu-hao Yang
- School of Health Sciences, Wuhan University, Donghu Road 185#, Wuhan, People’s Republic of China
| | - Shuai Yuan
- School of Health Sciences, Wuhan University, Donghu Road 185#, Wuhan, People’s Republic of China
| | - Yao Huang
- School of Health Sciences, Wuhan University, Donghu Road 185#, Wuhan, People’s Republic of China
| | - Bo-wen Tang
- School of Health Sciences, Wuhan University, Donghu Road 185#, Wuhan, People’s Republic of China
| | - Jie Gong
- Wuhan Centers for Disease Prevention and Control, Hanbei Road 24#, Wuhan, People’s Republic of China
| | - Qi-qiang He
- School of Health Sciences, Wuhan University, Donghu Road 185#, Wuhan, People’s Republic of China
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Noh JW, Kim J, Yang Y, Park J, Cheon J, Kwon YD. Body mass index and self-rated health in East Asian countries: Comparison among South Korea, China, Japan, and Taiwan. PLoS One 2017; 12:e0183881. [PMID: 28846742 PMCID: PMC5573277 DOI: 10.1371/journal.pone.0183881] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 08/14/2017] [Indexed: 11/19/2022] Open
Abstract
There have been conflicting findings regarding the relationship between body mass index (BMI) and self-rated health (SRH) worldwide. The purpose of this study was to examine the association between BMI and SRH by comparing its relationship in four East Asian countries: South Korea, China, Japan, and Taiwan. Using data from the East Asian Social Survey, the relationship between weight status and SRH status was investigated and compared between four countries, China, Japan, South Korea, and Taiwan. An ordinal logit regression model was estimated for each country, and the results were compared. We found that the relationship between weight status and SRH status differed across the four countries. In China, people who were overweight reported better SRH scores than those of normal weight, whereas in Japan, obese and severely obese people reported poor scores. In contrast, South Koreans who were underweight, obese, or severely obese reported poor ratings of health status than those of normal weight. In Taiwan, however, no differences in respondents' weight status were found across SRH scores. There were notable differences in the relationship between BMI and SRH status in four East Asian countries. Individual countries should consider these relationships when designing and implementing obesity intervention programs.
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Affiliation(s)
- Jin-Won Noh
- Department of Healthcare Management, Eulji University, Seongnam, Korea
- Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Jinseok Kim
- Department of Social Welfare, Seoul Women's University, Seoul, Korea
| | - Youngmi Yang
- Department of Social Welfare, Seoul Women's University, Seoul, Korea
| | - Jumin Park
- National Institutes of Health Clinical Center, Bethesda, Maryland, United States of America
| | - Jooyoung Cheon
- Department of Nursing Science, Sungshin University, Seoul, Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul, Korea
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