Knüppel Anika, Shipley Martin J, Llewellyn Clare H, Brunner Eric J
Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
Psychol Med. 2019 Nov;49(15):2505-2514. doi: 10.1017/S0033291718003379. Epub 2018 Nov 20.
Mood disorders and adiposity are major public health challenges. Few studies have investigated the bidirectional association of weight and waist circumference (WC) change with psychological distress in middle age, while taking into account the potential U-shape of the association. The aim of this study was to examine the bidirectional association between psychological distress and categorical change in objectively measured weight and WC.
We analysed repeated measures (up to 17 522 person-observations in adjusted analyses) of psychological distress, weight and WC from the Whitehall II cohort. Participants were recruited at age 35-55 and 67% male. Psychological distress was assessed using the General Health Questionnaire. We used random-effects regressions to model the association between weight and WC changes and psychological distress, with and without a 5-year lag period.
Psychological distress was associated with weight and WC gain over the subsequent 5 years but not the second 5-year period. Weight gain and loss were associated with increased odds for incident psychological distress in models with and without time-lag [odds ratio (OR) for incident psychological distress after 5-year time-lag: loss 1.20, 95% confidence interval (CI) 1.00-1.43; gain>5% 1.20, 95% CI 1.02-1.40]. WC changes were only associated with psychological distress in models without time-lag (OR for incident psychological distress: loss 1.29, 95% CI 1.02-1.64; gain>5% 1.33, 95% CI 1.11-1.58).
Weight gain and loss increase the odds for psychological distress compared with stable weight over subsequent 10 years. In contrast, the association between psychological distress and subsequent weight and WC changes was limited to the first 5 years of follow-up.
情绪障碍和肥胖是重大的公共卫生挑战。很少有研究在考虑到这种关联可能呈U形的情况下，调查中年时期体重和腰围（WC）变化与心理困扰之间的双向关联。本研究的目的是检验心理困扰与客观测量的体重和WC分类变化之间的双向关联。
我们分析了白厅II队列中关于心理困扰、体重和WC的重复测量数据（在调整分析中多达17522人次观察）。参与者在35 - 55岁时招募，男性占67%。使用一般健康问卷评估心理困扰。我们使用随机效应回归来模拟体重和WC变化与心理困扰之间的关联，包括有和没有5年滞后期的情况。
心理困扰与随后5年的体重和WC增加有关，但与第二个5年期间无关。在有和没有时间滞后的模型中，体重增加和减少都与新发心理困扰的几率增加有关[5年时间滞后后新发心理困扰的优势比（OR）：减少1.20，95%置信区间（CI）1.00 - 1.43；增加>5% 1.20，95% CI 1.02 - 1.40]。WC变化仅在没有时间滞后的模型中与心理困扰有关（新发心理困扰的OR：减少1.29，95% CI 1.02 - 1.64；增加>5% 1.33，95% CI 1.11 - 1.58）。
与随后10年体重稳定相比，体重增加和减少都会增加心理困扰的几率。相比之下，心理困扰与随后体重和WC变化之间的关联仅限于随访的前5年。
