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Liu H, Zhi J, Zhang C, Huang S, Ma Y, Luo D, Shi L. Association between Weight-Adjusted Waist Index and depressive symptoms: A nationally representative cross-sectional study from NHANES 2005 to 2018. J Affect Disord 2024; 350:49-57. [PMID: 38220117 DOI: 10.1016/j.jad.2024.01.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Depressive symptoms are strongly associated with the development of various diseases and are one of the leading causes of disability in the world. However, the relationship between weight-adjusted waist index (WWI) and depressive symptoms has not been studied. This study aimed to assess the relationship between depressive symptoms and WWI. METHODS This study took NHANES data from 2005 to 2018 with 32,374 participants. Depressive symptoms were measured by a questionnaire (PHQ-9).WWI was determined by dividing the square root of waist circumference (cm) by weight (kg). Multivariate logistic regression models, smoothed curve fitting, and weighted generalized additive model (GAM) regression were used to examine the relationship between depressive symptoms and WWI, BMI, and waist circumference. Subgroup analyses and interaction tests were also performed. RESULTS In fully adjusted models, the OR (95 % CI) for WWI and depressive symptoms with WWI, BMI, and waist circumference were 1.18 (1.05, 1.34), BMI 1.01 (1.00, 1.02, 1.01 (1.00, 1.01), respectively. Participants in the highest quartile (Q4) had a 49 % higher depressive symptoms compared to those in the lowest quartile (Q1) (OR = 1.49, 95 % CI:1.14-1.96). Subgroup analyses and interaction tests showed a stable relationship between depressive symptoms and WWI. LIMITATIONS It is difficult to determine a causal relationship between the two; questionnaire collection may be somewhat biased; CONCLUSIONS: WWI was positively associated with depressive symptoms. This association was stronger than BMI and waist circumference. However, this relationship was stable. This study emphasizes the potential utility of WWI in preventing depressive symptoms and improving prognosis in the population.
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Affiliation(s)
- Hangyu Liu
- The Second Affiliated Hospital of Shantou University Medical College, North Dongxia Road, Shantou 515041, Guangdong, China
| | - Jin Zhi
- Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqing Road, Shanghai 201100, China
| | - Chuzhao Zhang
- The Second Affiliated Hospital of Shantou University Medical College, North Dongxia Road, Shantou 515041, Guangdong, China
| | - Shiyi Huang
- Department of Plastic Surgery, Meizhou Clinical Institute of Shantou University Medical College, No.63 Huangtang Road, Meizhou 514031, Guangdong, China
| | - Yang Ma
- Department of Plastic Surgery, Meizhou Clinical Institute of Shantou University Medical College, No.63 Huangtang Road, Meizhou 514031, Guangdong, China
| | - Dandan Luo
- The Second Affiliated Hospital of Shantou University Medical College, North Dongxia Road, Shantou 515041, Guangdong, China
| | - Lungang Shi
- Department of Plastic Surgery, Meizhou Clinical Institute of Shantou University Medical College, No.63 Huangtang Road, Meizhou 514031, Guangdong, China.
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Lurz E, Patel H, Lebovic G, Quammie C, Woolfson JP, Perez M, Ricciuto A, Wales PW, Kamath BM, Chavhan GB, Jüni P, Ng VL. Paediatric reference values for total psoas muscle area. J Cachexia Sarcopenia Muscle 2020; 11:405-414. [PMID: 31920002 PMCID: PMC7113526 DOI: 10.1002/jcsm.12514] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/03/2019] [Accepted: 10/17/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Sarcopenia, the unintentional loss of skeletal muscle mass, is associated with poor outcomes in adult patient populations. In adults, sarcopenia is often ascertained by cross-sectional imaging of the psoas muscle area (PMA). Although children with chronic medical illnesses may be at increased risk for muscle loss because of nutritional deficiencies, physical deconditioning, endocrine anomalies, and systemic inflammation, consistent quantitative definitions for sarcopenia in children are lacking. We aimed to generate paediatric reference values for PMA at two intervertebral lumbar levels, L3-4 and L4-5. METHODS In this cross-sectional study, we analysed abdominal computed tomography scans of consecutive children presenting to the emergency department. Participants were children 1-16 years who required abdominal cross-sectional imaging after paediatric trauma between January 1, 2005 and December 31, 2015 in a large Canadian quaternary care centre. Children with a documented chronic medical illness or an acute spinal trauma at presentation were excluded. Total PMA (tPMA) at levels L3-4 and L4-5 were measured in square millimetres (mm2 ) as the sum of left and right PMA. Age-specific and sex-specific tPMA percentile curves were modelled using quantile regression. RESULTS Computed tomography images from 779 children were included. Values of tPMA at L4-5 were significantly larger than at L3-4 at all ages, but their correlation was high for both girls (r = 0.95) and boys (r = 0.98). Amongst girls, tPMA 50th percentile values ranged from 365 to 2336 mm2 at L3-4 and from 447 to 2704 mm2 for L4-5. Amongst boys, 50th percentile values for tPMA ranged between 394 and 3050 mm2 at L3-4 and from 498 to 3513 mm2 at L4-5. Intraclass correlation coefficients were excellent at L3-4 (0.97, 95% CI 0.94 to 0.981) and L4-5 (0.99, 95% CI 0.986 to 0.995). Weight and tPMA were correlated, stratified by sex for boys (L3-4 r = 0.90; L4-5 r = 0.90) and for girls (L3-4 r = 0.87; L4-5 r = 0.87). An online application was subsequently developed to easily calculate age-specific and sex-specific z-scores and percentiles. CONCLUSIONS We provide novel paediatric age-specific and sex-specific growth curves for tPMA at intervertebral L3-4 and L4-5 levels for children between the ages of 1-16 years. Together with an online tool (https://ahrc-apps.shinyapps.io/sarcopenia/), these tPMA curves should serve as a reference enabling earlier identification and targeted intervention of sarcopenia in children with chronic medical conditions.
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Affiliation(s)
- Eberhard Lurz
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Division of Gastroenterology, Hepatology and Nutrition, von Haunersches Kinderspital, LMU, Munich, Germany
| | - Hiten Patel
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Department of Radiology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Gerald Lebovic
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Claudia Quammie
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Jessica P Woolfson
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Manuela Perez
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Amanda Ricciuto
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Paul W Wales
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Department of Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Binita M Kamath
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Govind B Chavhan
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Peter Jüni
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.,Department of Medicine, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Vicky L Ng
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Baseline Body Mass Predicts Average Depressive Symptoms over the Next Two Decades for White but Not Black Older Adults. Geriatrics (Basel) 2019; 4:geriatrics4010014. [PMID: 31023982 PMCID: PMC6473455 DOI: 10.3390/geriatrics4010014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 01/11/2019] [Accepted: 01/16/2019] [Indexed: 12/26/2022] Open
Abstract
Background: Although obesity and depression have a bidirectional association, this link may vary based on race. The current study tested racial variation in bidirectional links between depressive symptoms and body mass index (BMI) over 24 years of follow-up in older adults over the age of 50 in the United States. We hypothesized weaker bidirectional links in Blacks compared to Whites. Methods: Data came from waves 1 to 12 (1990 to 2014) of the Health and Retirement Study (HRS), an ongoing state-of-the-art national cohort. The study followed a representative sample of Americans (n = 15,194; 2,200 Blacks and 12,994 Whites) over the age of 50. Dependent variables were average depressive symptoms and BMI over 24 years, based on measurements every other year, from 1990 to 2014. Independent variables included baseline depressive symptoms and BMI. Covariates included age, gender, marital status, veteran status, and activities of daily living. Structural equation models were fitted to the data for data analysis. Results: In the pooled sample, bidirectional associations were found between BMI and depressive symptoms as baseline BMI predicted average depressive symptoms over time and baseline depressive symptoms predicted average BMI over 24 years. Racial differences were found in the bidirectional association between BMI and depressive symptoms, with both directions of the associations being absent for Blacks. For Whites, baseline BMI predicted average depressive symptoms over the next 24 years. Conclusion: Reciprocal associations between BMI and depressive symptoms over a 24-year period among individuals over the age of 50 vary for Blacks and Whites. As these associations are stronger for Whites than Blacks, clinical and public health programs that simultaneously target comorbid obesity and depression may be more appropriate for Whites than Blacks.
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Venant V, Pouget M, Lahaye C, Gentes E, Pereira B, Lambert C, Debarges J, Domingues-Faria C, Palmier-Forestier C, Farigon N, Miolanne M, Boirie Y. Depression Severity as a Risk Factor of Sarcopenic Obesity in Morbidly Obese Patients. J Nutr Health Aging 2019; 23:761-767. [PMID: 31560036 DOI: 10.1007/s12603-019-1218-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
SETTING Etiopathogenic factors of physical disability in obesity are numerous, underestimated and not sought in the non-geriatric population. Amongst these factors, depression may favor the development of sarcopenic obesity by reducing strength and physical performance even in the absence of overt muscle loss. Objectives and participants: To study the link between depression status and muscle functional disorders (dynapenia) in a population of adult subjects with severe and morbid obesity. MEASUREMENTS Patients were assessed for body composition, grip strength, the Short Physical Performances Battery test (SPPB), for depression according to the Beck II score as well as for metabolic parameters through biological tests. RESULTS In 373 obese subjects (mean age 44 ± 13y and BMI 43 ± 6 kg/m²), the prevalence of depression was 53% with 18% having mild depression, 18% moderate depression and 16% severe depression. Depression was significantly related to dynapenia: 62% of dynapenic (D) patients suffered from depression compared to 50% of non-dynapenic (ND) patients (p = 0.036). The Beck questionnaire score for D patients was 20 ± 13 and 15 ± 10 for ND patients (p = 0.001). The depression intensity was significantly correlated with dynapenia with D patients having a higher severe depression degree than ND patients (30% versus 11%; p < 0.0001). Fat-free to fat mass ratio was also significantly correlated with dynapenia (p = 0.01). In multivariate analysis, the presence of depression was twice as likely to be associated with dynapenia. CONCLUSIONS Depression is associated with a reduction of muscle function in severe obesity in relation to its severity and to changes in fat to fat-free mass, suggesting that screening and prevention of sarcopenic obesity should be considered in adult obese patients with depression.
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Affiliation(s)
- V Venant
- Pr. Yves Boirie. Clermont-Ferrand University Hospital, Clinical Nutrition Department, 58 rue Montalembert, 63003 Clermont-Ferrand, France. Tel+33(0)473754937.
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Association between appendicular skeletal muscle mass and depressive symptoms: Review of the cardiovascular and metabolic diseases etiology research center cohort. J Affect Disord 2018; 238:8-15. [PMID: 29852344 DOI: 10.1016/j.jad.2018.05.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/27/2018] [Accepted: 05/13/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND The effects of skeletal muscle mass on depressive symptoms remain poorly understood, especially in the middle-aged population. We examined the relationship between skeletal muscle mass and depressive symptoms according to sex and menopausal status in the middle-aged Korean population. METHODS Herein, 1,151 men and 2,176 women aged 30-64 years completed questionnaires and underwent health examinations in the Cardiovascular and Metabolic Disease Etiology Research Center study. Appendicular skeletal muscle mass (ASM) was measured via bioelectrical impedance analysis and adjusted for height squared (ASM/Ht2). Both continuous values and tertile groups of ASM/Ht2 were used for analysis. Depressive symptoms were assessed using the Beck Depressive Inventory-II (BDI), and the prevalence of depressive symptoms was determined as a BDI score ≥ 20. RESULTS Multiple logistic regression analysis using a fully adjusted model showed that depressive symptoms were more frequently observed among men in the lower ASM/Ht2 tertile and middle ASM/Ht2 tertile than among those in the higher ASM/Ht2 tertile. Each 1-kg/m2 decrease in ASM/Ht2 was significantly associated with the presence of depressive symptoms in men. Such significant association was not observed among premenopausal and postmenopausal women. LIMITATIONS The cross-sectional nature of the study design, measurement of skeletal muscle mass and depressive symptoms only once, estimation of skeletal muscle mass using bioelectrical impedance analysis, assessing depressive symptoms by self-reported questionnaire, and potential unknown confounding variables constitute the limitations of our study. CONCLUSIONS The independent association between low skeletal muscle mass and depressive symptoms was observed in men but not in women.
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Kahl KG, Utanir F, Schweiger U, Krüger TH, Frieling H, Bleich S, Gutberlet M, Hartung D. Reduced muscle mass in middle-aged depressed patients is associated with male gender and chronicity. Prog Neuropsychopharmacol Biol Psychiatry 2017; 76:58-64. [PMID: 28132777 DOI: 10.1016/j.pnpbp.2017.01.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/05/2017] [Accepted: 01/22/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Reduced muscle mass is a characteristic finding in sarcopenia, the central element of physical frailty syndrome, and a major cause of physical function decay, morbidity and mortality in the elderly. Studies so far demonstrated reduced muscle mass in depressed patients with an average age over 60years. An open question is whether muscle mass reduction is already observed earlier. Therefore, muscle mass was assessed in middle-aged male and female depressive patients, and the findings were related to indicators of hypothalamus-pituitary adrenal axis activation, lifestyle factors, endocrine and immune measures. METHODS Sixty-seven depressed patients (mean age 38.6y; 58.2% female) and 26 healthy volunteers (mean age 40.5y; 61.5% female) were included. Muscle mass, adrenal gland volume, and intra-abdominal adipose tissue were assessed by magnetic resonance tomography. Laboratory parameters included fasting cortisol, pro-inflammatory cytokines, factors constituting the metabolic syndrome, and relative insulin resistance according to the homeostasis model assessment (HOMA-IR). RESULTS We found significant effects of depression (F=4.2; P=0.043) and gender (F=182; P<0.001) on muscle mass. Muscle mass was reduced in depressed men compared to healthy men (F=3.4; P=0.044), particularly in those with chronic depression. In contrast, no such association was observed in depressed females. Adrenal gland volume and intra-abdominal fat was increased in depressed men and women, although not significantly. Correlations were observed for muscle mass with the amount of self-reported exercise and depression severity, and for depression severity with self-reported exercise. Further findings comprised lower self-reported activity and higher cortisol concentrations in depressed male and female compared to healthy probands. CONCLUSIONS Muscle mass is reduced in middle-aged depressed men, particularly those with chronic disease course. This association is not observed in depressed females, possibly pointing to the role of female sex steroids in maintaining muscle mass. The increase of adrenal gland volume in depressed patients may point to the role of a dysregulated hypothalamus-pituitary-adrenal system. The inverse association of exercise with muscle mass demonstrates the importance of physical activity. Looking at the long term consequences of reduced muscle mass, interventions to preserve and rebuild muscle mass in depression - such as structured exercise interventions - should be recommended. SIGNIFICANT OUTCOMES Muscle mass is decreased in male patients with major depressive disorder, particular those with chronic disease course. This difference was not observed in female depressed patients. The extent of muscle mass reduction is correlated to depression severity and inversely to physical activity, pointing to the role of depression associated inactivity. Low muscle mass is a risk factor for physical frailty, therefore interventions aiming at improving physical fitness may be recommended. LIMITATIONS Sex steroids were not assessed in the study groups.
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Affiliation(s)
- Kai G Kahl
- Dep. of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany.
| | - Ferdi Utanir
- Dep. of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Ulrich Schweiger
- Dep. of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - Tillmann H Krüger
- Dep. of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Helge Frieling
- Dep. of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Stefan Bleich
- Dep. of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Marcel Gutberlet
- Dep. of Diagnostic and Interventional Radiology, Hannover Medical School, Germany
| | - Dagmar Hartung
- Dep. of Diagnostic and Interventional Radiology, Hannover Medical School, Germany
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