Everson-Rose Susan A, Lewis Tené T, Karavolos Kelly, Dugan Sheila A, Wesley Deidre, Powell Lynda H
Department of Medicine, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55414, USA.
Psychosom Med. 2009 May;71(4):410-6. doi: 10.1097/PSY.0b013e3181a20c9c. Epub 2009 Apr 27.
To examine whether depressive symptoms are differentially associated with visceral adipose tissue (VAT), which is more metabolically active and confers greater cardiovascular risk than subcutaneous fat (SAT). Prior research has shown an association between depression and central adiposity. Mechanisms underlying the association between depression and increased cardiovascular risk remain poorly understood. Central adiposity is one potential pathway.
We investigated the cross-sectional association between depressive symptoms, assessed by the Center for Epidemiological Studies Depression Scale (CES-D), and VAT and SAT, assessed by computed tomography, in a sample of 409 middle-aged women (44.7% African-Americans, 55.3% Whites; mean age = 50.4 years) participating in the Chicago site of the Study of Women's Health Across the Nation (SWAN).
With adjustments for age, race, total percent fat, and sex hormone binding globulin (SHBG), each 1-point higher score on the CES-D was associated with 1.03-cm(2) greater VAT (p < .001). Women with a CES-D score of >or=16, indicative of clinically relevant depressive symptomatology, had 24.5% more VAT than women with lower CES-D scores (p < .001). Further adjustment for Framingham Risk Score and physical activity did not alter the findings, and associations did not vary by race. Associations were strongest in obese and overweight women. Depressive symptoms were unrelated to SAT.
Increased visceral fat may be one pathway by which depression contributes to excess risk for cardiovascular disease and diabetes. Further research is needed to examine whether depressive symptoms influence accumulation of VAT over time.
研究抑郁症状与内脏脂肪组织（VAT）之间是否存在差异关联，内脏脂肪组织的代谢活性更高，相比皮下脂肪（SAT）会带来更大的心血管疾病风险。先前的研究已表明抑郁与中心性肥胖之间存在关联。抑郁与心血管疾病风险增加之间关联的潜在机制仍知之甚少。中心性肥胖是一种潜在途径。
我们在参与全国女性健康研究（SWAN）芝加哥站点研究的409名中年女性样本（44.7%为非裔美国人，55.3%为白人；平均年龄 = 50.4岁）中，调查了通过流行病学研究中心抑郁量表（CES-D）评估的抑郁症状与通过计算机断层扫描评估的VAT和SAT之间的横断面关联。
在对年龄、种族、总脂肪百分比和性激素结合球蛋白（SHBG）进行调整后，CES-D量表上每高出1分，VAT就增加1.03平方厘米（p < 0.001）。CES-D得分≥16分（表明存在临床相关抑郁症状）的女性比CES-D得分较低的女性VAT多24.5%（p < 0.001）。进一步对弗雷明汉风险评分和身体活动进行调整并没有改变研究结果，且关联在不同种族间没有差异。这种关联在肥胖和超重女性中最为强烈。抑郁症状与SAT无关。
内脏脂肪增加可能是抑郁导致心血管疾病和糖尿病额外风险增加的一种途径。需要进一步研究以检验抑郁症状是否会随着时间影响VAT的积累。
