Herva A, Laitinen J, Miettunen J, Veijola J, Karvonen J T, Läksy K, Joukamaa M
Department of Psychiatry, Oulu University Hospital, PL 26, FIN-90029 Oys, Finland.
Int J Obes (Lond). 2006 Mar;30(3):520-7. doi: 10.1038/sj.ijo.0803174.
To examine the association between body size and depression in a longitudinal setting and to explore the connection between obesity and depression in young adults at the age of 31 years.
This study forms part of the longitudinal Northern Finland 1966 Birth Cohort Study (N = 12,058). The follow-up studies were performed at 14 and 31 years. Data were collected by postal inquiry at 14 years and by postal inquiry and clinical examination at 31 years.
A total of 8,451 subjects (4,029 men and 4,422 women) who gave a written informed consent and information on depression by three depression indicators at 31 years.
Body size at 14 (body mass index (BMI) and 31 (BMI and waist-to-hip ratio (WHR)) years and depression at 31 years by three different ways: depressive symptoms by the HSCL-25-depression questionnaire (HSCL-25), the use of antidepressants and self-reported physician-diagnosed depression.
Obesity at 14 years associated with depressive symptoms at 31 years; among male subjects using the cutoff point 2.01 in the HSCL-25 (adjusted odds ratio (OR) 1.97, 95% CI 1.06-3.68), among female subjects using the cutoff point 1.75 (adjusted OR 1.64, 95% CI 1.16-2.32). Female subjects who were obese both at baseline and follow-up had depressive symptoms relatively commonly (adjusted OR 1.40, 95% CI 1.06-1.85 at cutoff point 1.75); a similar association was not found among male subjects. The proportion of those who used antidepressants was 2.17-fold higher among female subjects who had gained weight compared to female subjects who had stayed normal-weighted (adjusted OR 2.17, 95% CI 1.28-3.68). In the cross-sectional analyses male subjects with abdominal obesity (WHR >or=85th percentile) had a 1.76-fold risk of depressive symptoms using the cutoff 2.01 in the HSCL-25 (adjusted OR 1.76, 95% CI 1.08-2.88). Abdominally obese male subjects had a 2.07-fold risk for physician-diagnosed depression (adjusted OR 2.07, 95% CI 1.23-3.47) and the proportion of those who used antidepressants was 2.63-fold higher among obese male subjects than among male subjects without abdominal obesity (adjusted OR 2.63, 95% CI 1.33-5.21). Abdominal obesity did not associate with depression in female subjects.
Obesity in adolescence may be associated with later depression in young adulthood, abdominal obesity among male subjects may be closely related to concomitant depression, and being overweight/obese both in adolescence and adulthood may be a risk for depression among female subjects.
在纵向研究中考察体型与抑郁之间的关联，并探究31岁年轻成年人中肥胖与抑郁的联系。
本研究是芬兰北部1966年出生队列纵向研究（N = 12,058）的一部分。随访研究分别在14岁和31岁时进行。14岁时通过邮寄问卷收集数据，31岁时通过邮寄问卷和临床检查收集数据。
共有8451名受试者（4029名男性和4422名女性），他们在31岁时签署了书面知情同意书，并通过三项抑郁指标提供了抑郁相关信息。
14岁时的体型（体重指数（BMI））以及31岁时的体型（BMI和腰臀比（WHR）），31岁时的抑郁情况通过三种不同方式评估：使用HSCL - 25抑郁问卷（HSCL - 25）评估抑郁症状、使用抗抑郁药情况以及自我报告的医生诊断的抑郁症。
14岁时肥胖与31岁时的抑郁症状相关；在男性受试者中，HSCL - 25中使用切点2.01时（调整优势比（OR）1.97，95%置信区间1.06 - 3.68），在女性受试者中，使用切点1.75时（调整OR 1.64，95%置信区间1.16 - 2.32）。基线和随访时均肥胖的女性受试者相对常见有抑郁症状（切点1.75时调整OR 1.40，95%置信区间1.06 - 1.85）；在男性受试者中未发现类似关联。体重增加的女性受试者中使用抗抑郁药的比例比体重保持正常的女性受试者高2.17倍（调整OR 2.17，95%置信区间1.28 - 3.68）。在横断面分析中，腹部肥胖（WHR≥第85百分位数）的男性受试者在HSCL - 25中使用切点2.01时出现抑郁症状的风险高1.76倍（调整OR 1.76，95%置信区间1.08 - 2.88）。腹部肥胖的男性受试者被医生诊断为抑郁症的风险高2.07倍（调整OR 2.07，95%置信区间1.23 - 3.47），肥胖男性受试者中使用抗抑郁药的比例比无腹部肥胖的男性受试者高2.63倍（调整OR 2.63，95%置信区间1.33 - 5.21）。腹部肥胖与女性受试者的抑郁无关。
青少年肥胖可能与成年早期后期的抑郁有关，男性受试者的腹部肥胖可能与并发抑郁密切相关，青少年和成年期均超重/肥胖可能是女性受试者抑郁的一个风险因素。
