Hawkins Misty A W, Goldstein Carly M, Dolansky Mary A, Gunstad John, Redle Joseph D, Josephson Richard, Hughes Joel W
Department of Psychological Sciences, Kent State University, USA
Department of Psychological Sciences, Kent State University, USA Department of Cardiopulmonary Research, Summa Health System, Akron, USA.
Eur J Cardiovasc Nurs. 2015 Dec;14(6):516-24. doi: 10.1177/1474515114542558. Epub 2014 Jul 16.
Depression is a predictor and consequence of obesity in the general population. Up to 50% of patients with heart failure exhibit elevated depressive symptoms or depressive disorders; however, research on the depression-obesity relationship in heart failure populations is limited, especially in regard to gender differences.
To conduct total-sample and gender-stratified analyses to determine whether depressive symptoms are associated with body mass index (BMI) in a sample of patients with heart failure.
Participants were 348 (39% female, 26% non-White) patients with heart failure (aged 68.7±9.7 years) recruited from urban medical centers. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9). Height and weight were used to compute BMI (kg/m(2)). Regressions were performed for total sample and both genders. Regressions for BMI were run with demographic, medical, and psychological covariates in Step 1 and the PHQ-9 in Step 2.
Regression results (total sample) revealed that the PHQ-9 was associated with BMI after adjusting for covariates (β=.22, p=.004). For males, the relationship between PHQ-9 and BMI remained (β=.23, p=.024) and was driven by those with severe obesity (BMI ≥ 40 kg/m(2)). A trend between PHQ-9 and BMI was detected among females (β=.19, p=.091).
BMI is related to depressive symptoms in adults with heart failure even after adjusting for demographic and medical covariates. Depressive symptoms were associated with BMI in males, whereas a trend was detected among females. These findings could ultimately be used to improve heart failure outcomes for depressed, obese individuals with heart failure.
在普通人群中,抑郁症是肥胖的一个预测因素和后果。高达50%的心力衰竭患者表现出抑郁症状加重或患有抑郁症;然而,关于心力衰竭人群中抑郁症与肥胖关系的研究有限,尤其是在性别差异方面。
进行全样本和性别分层分析,以确定在心力衰竭患者样本中,抑郁症状是否与体重指数(BMI)相关。
研究对象为从城市医疗中心招募的348例心力衰竭患者(女性占39%,非白人占26%),年龄为68.7±9.7岁。使用患者健康问卷-9(PHQ-9)测量抑郁症状。通过身高和体重计算BMI(kg/m²)。对全样本和男女两性分别进行回归分析。BMI的回归分析在第1步纳入人口统计学、医学和心理协变量,在第2步纳入PHQ-9。
回归结果(全样本)显示,在调整协变量后,PHQ-9与BMI相关(β = 0.22,p = 0.004)。对于男性,PHQ-9与BMI之间的关系依然存在(β = 0.23,p = 0.024),且由重度肥胖者(BMI≥40 kg/m²)驱动。在女性中检测到PHQ-9与BMI之间存在一种趋势(β = 0.19,p = 0.091)。
即使在调整人口统计学和医学协变量后,BMI仍与成年心力衰竭患者的抑郁症状相关。抑郁症状在男性中与BMI相关,而在女性中检测到一种趋势。这些发现最终可用于改善患有抑郁症的肥胖心力衰竭患者的心力衰竭预后。