Stanikova Daniela, Luck Tobias, Pabst Alexander, Bae Yoon Ju, Hinz Andreas, Glaesmer Heide, Stanik Juraj, Sacher Julia, Engel Christoph, Enzenbach Cornelia, Wirkner Kerstin, Ceglarek Uta, Thiery Joachim, Kratzsch Juergen, Riedel-Heller Steffi G
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia.
Front Psychiatry. 2019 Jul 4;10:479. doi: 10.3389/fpsyt.2019.00479. eCollection 2019.
Several studies have shown a positive association between anxiety and obesity, particularly in women. We aimed to study whether sex hormone alterations related to obesity might play a role in this association. Data for this study were obtained from a population-based cohort study (the LIFE-Adult-Study). A total of 3,124 adult women (970 premenopausal and 2,154 postmenopausal) were included into the analyses. The anxiety symptomatology was assessed using the GAD-7 questionnaire (cut-off ≥ 10 points). Sex hormones were measured from fasting serum samples. We did not find significant differences in anxiety prevalence in premenopausal obese women compared with normal-weight controls (4.8% vs. 5.5%). Both obesity and anxiety symptomatology were separately associated with the same sex hormone alteration in premenopausal women: higher total testosterone level (0.97 ± 0.50 in obese vs. 0.86 ± 0.49 nmol/L in normal-weight women, = 0.026 and 1.04 ± 0.59 in women with vs. 0.88 ± 0.49 nmol/L in women without anxiety symptomatology, = 0.023). However, women with anxiety symptomatology had non-significantly higher estradiol levels than women without anxiety symptomatology (548.0 ± 507.6 vs. 426.2 ± 474.0 pmol/L), whereas obesity was associated with lower estradiol levels compared with those in normal-weight group (332.7 ± 386.5 vs. 470.8 ± 616.0 pmol/L). Women with anxiety symptomatology had also significantly higher testosterone and estradiol composition ( = 0.006). No associations of sex hormone levels and BMI with anxiety symptomatology in postmenopausal women were found. Although both obesity and anxiety symptomatology were separately associated with higher testosterone level, there was an opposite impact of anxiety and obesity on estradiol levels in premenopausal women. We did not find an evidence that the sex hormone alterations related to obesity are playing a significant role in anxiety symptomatology in premenopausal women. This could be the explanation why we did not find an association between obesity and anxiety. In postmenopausal women, other mechanisms seem to work than in the premenopausal group.
多项研究表明焦虑与肥胖之间存在正相关，尤其是在女性中。我们旨在研究与肥胖相关的性激素改变是否可能在这种关联中起作用。本研究的数据来自一项基于人群的队列研究（LIFE-成人研究）。共有3124名成年女性（970名绝经前女性和2154名绝经后女性）纳入分析。使用GAD-7问卷（临界值≥10分）评估焦虑症状。从空腹血清样本中测量性激素。我们发现绝经前肥胖女性与正常体重对照组相比，焦虑患病率没有显著差异（4.8%对5.5%）。在绝经前女性中，肥胖和焦虑症状分别与相同的性激素改变有关：总睾酮水平较高（肥胖女性为0.97±0.50，正常体重女性为0.86±0.49nmol/L，P = 0.026；有焦虑症状的女性为1.04±0.59，无焦虑症状的女性为0.88±0.49nmol/L，P = 0.023）。然而，有焦虑症状的女性雌二醇水平比无焦虑症状的女性略高（548.0±507.6对426.2±474.0pmol/L），而与正常体重组相比，肥胖与较低的雌二醇水平相关（332.7±386.5对470.8±616.0pmol/L）。有焦虑症状的女性睾酮和雌二醇组成也显著更高（P = 0.006）。未发现绝经后女性性激素水平和BMI与焦虑症状之间存在关联。虽然肥胖和焦虑症状都分别与较高的睾酮水平相关，但在绝经前女性中，焦虑和肥胖对雌二醇水平有相反的影响。我们没有发现证据表明与肥胖相关的性激素改变在绝经前女性的焦虑症状中起重要作用。这可能是我们未发现肥胖与焦虑之间存在关联的原因。在绝经后女性中，似乎起作用的机制与绝经前组不同。
