Olvera Rene L, Williamson Douglas E, Fisher-Hoch Susan P, Vatcheva Kristina P, McCormick Joseph B
Department of Psychiatry, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229
J Clin Psychiatry. 2015 Oct;76(10):e1300-5. doi: 10.4088/JCP.14m09118.
We examined the prevalence of depression, obesity, and metabolic syndrome and associations between them in a population-based representative cohort of Mexican Americans living on the United States-Mexico border.
The sample in this cross-sectional analysis consisted of 1,768 Mexican American adults (≥ 18 years of age) assessed between the years 2004 and 2010, with whom we tested our central hypothesis of a significant relationship between obesity and depression. Depression was measured using the Center for Epidemiologic Studies-Depression scale (CES-D) with a cutoff score of ≥ 16 for depression and a cutoff score of ≥ 27 for severe depression. We categorized body mass index (BMI) values as obese (≥ 30kg/m(2)) and later subdivided the obese subjects into obese (30-39 kg/m(2)[inclusive]) and morbidly obese (≥ 40 kg/m(2)). Metabolic syndrome was defined using the American Heart Association definition requiring at least 3 of the following: increased waist circumference, elevated triglycerides, reduced high-density lipoprotein (HDL) cholesterol, elevated blood pressure, and elevated fasting glucose. Weighted data were analyzed to establish prevalence of depression, obesity, and metabolic syndrome. Univariate and multivariable weighted regression models were used to test potential associations between these disorders.
Using weighted prevalence, we observed high rates of depression (30%), obesity (52%), and metabolic syndrome (45%). Univariate models revealed female gender (P = .0004), low education (P = .003), low HDL level (P = .009), and increased waist circumference (P = .03) were associated with depression. Female gender (P = .01), low education (P = .003), and morbid obesity (P = .002) were risk factors for severe depression and remained significant in multivariable models.
In this large cohort of Mexican Americans, obesity, female gender, and low education were identified risk factors for depression. These indicators may serve as targets for early detection, prevention, and intervention in this population.
我们在美国 - 墨西哥边境的墨西哥裔美国人这一具有代表性的人群队列中，研究了抑郁症、肥胖症和代谢综合征的患病率及其之间的关联。
本横断面分析的样本包括2004年至2010年间评估的1768名墨西哥裔美国成年人（≥18岁），我们对肥胖与抑郁症之间存在显著关系这一核心假设进行了检验。使用流行病学研究中心抑郁量表（CES - D）测量抑郁症，抑郁的临界值为≥16分，重度抑郁的临界值为≥27分。我们将体重指数（BMI）值分类为肥胖（≥30kg/m²），随后将肥胖受试者进一步细分为肥胖（30 - 39kg/m²[含]）和病态肥胖（≥40kg/m²）。代谢综合征采用美国心脏协会的定义，即至少具备以下3项：腰围增加、甘油三酯升高、高密度脂蛋白（HDL）胆固醇降低、血压升高和空腹血糖升高。对加权数据进行分析以确定抑郁症、肥胖症和代谢综合征的患病率。使用单变量和多变量加权回归模型来检验这些疾病之间的潜在关联。
通过加权患病率，我们观察到抑郁症（30%）、肥胖症（52%）和代谢综合征（45%）的发生率较高。单变量模型显示，女性（P = 0.0004）、低教育程度（P = 0.003）、低HDL水平（P = 0.009）和腰围增加（P = 0.03）与抑郁症相关。女性（P = 0.01）、低教育程度（P = 0.003）和病态肥胖（P = 0.00）是重度抑郁症的危险因素，在多变量模型中仍然显著。
在这个庞大的墨西哥裔美国人队列中，肥胖、女性性别和低教育程度是已确定的抑郁症危险因素。这些指标可作为该人群早期检测、预防和干预的目标。
