Shimanoe Chisato, Hara Megumi, Nishida Yuichiro, Nanri Hinako, Otsuka Yasuko, Nakamura Kazuyo, Higaki Yasuki, Imaizumi Takeshi, Taguchi Naoto, Sakamoto Tatsuhiko, Horita Mikako, Shinchi Koichi, Tanaka Keitaro
Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan.
Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan; Department of Public Health, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan.
PLoS One. 2015 Feb 12;10(2):e0118105. doi: 10.1371/journal.pone.0118105. eCollection 2015.
Accumulated evidence suggests a weak positive relationship between psychosocial stress and body mass index (BMI), but little is known about stress coping strategies and BMI.
We aimed to examine if perceived stress and coping strategies are related to BMI, with any of their mutual interactions on BMI.
This cross-sectional study included 5,063 men and 6,982 women aged 40-69 years. A self-administered questionnaire ascertained perceived stress and 5 items of coping strategies (emotion expression, emotional support seeking, positive reappraisal, problem solving, and disengagement). Analyses were performed by gender with adjustment for age, socioeconomic status, and lifestyle factors.
No significant associations were detected between perceived stress and BMI in either men (P(trend) = 0.09) or women (P(trend) = 0.58). In men, however, 'disengagement' showed an inverse association with BMI (P(trend) < 0.001), and 'positive reappraisal' and 'problem solving' revealed a positive association with BMI (P(trend) = 0.04 and 0.007, respectively) even after controlling for perceived stress. A possible interaction between perceived stress and 'disengagement' on BMI was found in men (P(interaction) = 0.027); the inverse association between 'disengagement' and BMI was more evident in higher levels of stress (β = -0.13, P(trend) = 0.21 in low; β = -0.22, P(trend) = 0.01 in medium; and β = -0.24, P(trend) = 0.06 in high). In men, 'disengagement' was inversely associated with overweight/obesity (odds ratio 0.79, 95% confidential interval 0.67-0.95), and "positive reappraisal" was positively associated with it (1.25, 1.02-1.54).
Coping strategies may have an important role in developing overweight/obesity, particularly in men.
越来越多的证据表明心理社会压力与体重指数（BMI）之间存在微弱的正相关关系，但对于压力应对策略与BMI之间的关系却知之甚少。
我们旨在研究感知到的压力和应对策略是否与BMI相关，以及它们之间对BMI是否存在相互作用。
这项横断面研究纳入了5063名年龄在40至69岁之间的男性和6982名女性。通过一份自填式问卷确定感知到的压力以及5项应对策略（情绪表达、寻求情感支持、积极重新评价、解决问题和脱离）。按性别进行分析，并对年龄、社会经济地位和生活方式因素进行调整。
在男性（P趋势=0.09）或女性（P趋势=0.58）中，均未检测到感知到的压力与BMI之间存在显著关联。然而，在男性中，即使在控制了感知到的压力后，“脱离”与BMI呈负相关（P趋势<0.001），“积极重新评价”和“解决问题”与BMI呈正相关（P趋势分别为0.04和0.007）。在男性中发现感知到的压力与“脱离”对BMI可能存在相互作用（P相互作用=0.027）；在较高压力水平下，“脱离”与BMI之间的负相关更为明显（低压力时β=-0.13，P趋势=0.21；中等压力时β=-0.22，P趋势=0.01；高压力时β=-0.24，P趋势=0.06）。在男性中，“脱离”与超重/肥胖呈负相关（比值比0.79，95%置信区间0.67-0.95），而“积极重新评价”与超重/肥胖呈正相关（1.25，1.02-1.54）。
应对策略可能在超重/肥胖的发生发展中起重要作用，尤其是在男性中。
