Ho Roger C M, Niti Matthew, Kua Ee Heok, Ng Tze-Pin
Department of Psychological Medicine, National University of Singapore, Singapore.
Int J Geriatr Psychiatry. 2008 Apr;23(4):401-8. doi: 10.1002/gps.1893.
Studies that investigated the relationship between obesity and depressive symptoms in the elderly have generated conflicting findings, partly because of the use of body mass index (BMI) alone to measure obesity in the elderly. The use of BMI fails to account for varying proportions of muscle, fat and bone, and few studies have used other measures of central obesity, such as waist-hip ratio (WHR) and waist circumference (WC).
We examined whether individually BMI, WHR and WC were consistently associated with depressive symptoms in the elderly.
Analysis of cross-sectional data of 2604 community dwelling Chinese elderly aged 55 and above, including socio-emotional characteristics, self-rated health and functional status, anthropometric measurements and Geriatric Depression Scale (15 items, GDS-15).
There was a negative trend in the prevalence of depressive symptoms (GDS > or =5) across increasing BMI categories: 16.9% in low BMI, 14.2% in normal weight, 12.1% in moderate to high BMI. The associations for moderate to high BMI (OR, 0.77; p = 0.04) relative to normal BMI, were statistically significant after controlling for confounding variables. However, no consistent trends in the prevalence of depressive symptoms and OR's were observed for increasing WHR and WC categories.
Our results suggest that waist-hip and circumference measures of central obesity did not support an inverse relationship of obesity and depressive symptoms. An inverse relationship of BMI with depressive symptoms may indicate greater physiologic and functional reserve from greater muscle mass that protects against depressive symptoms.
调查老年人肥胖与抑郁症状之间关系的研究结果相互矛盾，部分原因是仅使用体重指数（BMI）来衡量老年人的肥胖情况。BMI未能考虑肌肉、脂肪和骨骼的不同比例，很少有研究使用其他中心性肥胖指标，如腰臀比（WHR）和腰围（WC）。
我们研究了BMI、WHR和WC是否分别与老年人的抑郁症状持续相关。
对2604名年龄在55岁及以上的中国社区老年人的横断面数据进行分析，包括社会情感特征、自评健康和功能状态、人体测量指标以及老年抑郁量表（15项，GDS - 15）。
随着BMI类别增加，抑郁症状（GDS≥5）的患病率呈下降趋势：低BMI组为16.9%，正常体重组为14.2%，中度至高度BMI组为12.1%。在控制混杂变量后，中度至高度BMI组相对于正常BMI组的关联（OR，0.77；p = 0.04）具有统计学意义。然而，随着WHR和WC类别增加，未观察到抑郁症状患病率和OR值的一致趋势。
我们的结果表明，中心性肥胖的腰臀比和腰围测量结果不支持肥胖与抑郁症状之间的负相关关系。BMI与抑郁症状之间的负相关关系可能表明，更多的肌肉量具有更大的生理和功能储备，从而预防抑郁症状。
