School of Public Health, University Vita-Salute San Raffaele, Milan, Italy; CARIM School for Cardiovascular Diseases, Maastricht University, Medical Center+, Maastricht, the Netherlands; CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.
CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.
J Affect Disord. 2021 Jan 15;279:484-490. doi: 10.1016/j.jad.2020.09.090. Epub 2020 Sep 29.
Moderate to vigorous physical activity (MVPA) can help to prevent depression, but identification of the most important psycho-biological pathways involved is unclear. The improvement of cardio-respiratory fitness (CRF) in response to MVPA can vary markedly, we therefore examined the association between CRF and the incidence of depressive symptoms.
We used data from The Maastricht Study, a large population-based prospective-cohort study. CRF was estimated at baseline from a graded submaximal exercise protocol and MVPA was measured with accelerometry. Depressive symptoms were assessed using the validated Dutch version of the 9-item Patient Health Questionnaire, both at baseline and during annual follow-up over five years. Cox proportional hazards models were used.
A total of 1,730 individuals without depressive symptoms at baseline were included in the analysis. During the 5-year follow-up, n = 166 (9.6%) of individuals developed depressive symptoms. Compared to individuals with a low CRF, those with a moderate-to-high CRF had a significantly lower risk of developing depressive symptoms, independent of MVPA (medium CRF: HR = 0.49 (95%CI = 0.33-0.72); high CRF: HR = 0.48 (95% CI = 0.30-0.75). These associations were adjusted for age, sex, level of education, diabetes status, smoking status, alcohol use, energy intake, waist circumferences and antidepressant medications.
PHQ-9 is a validated screening instrument, but it is not a diagnostic tool of depression.
Higher CRF was strongly associated with a lower risk of incident depressive symptoms over 5-year follow-up, independent of the level of MVPA at baseline, suggesting that interventions aimed at improving CRF could reduce the risk of depression.
中等到剧烈的身体活动（MVPA）有助于预防抑郁症，但尚不清楚涉及的最重要的心理生物学途径。MVPA 引起的心肺功能（CRF）改善差异很大，因此我们研究了 CRF 与抑郁症状发生之间的关联。
我们使用了 Maastricht 研究的数据，这是一项大型基于人群的前瞻性队列研究。在基线时，使用分级次最大运动方案估计 CRF，并用加速度计测量 MVPA。使用经过验证的荷兰版 9 项患者健康问卷评估抑郁症状，均在基线和五年期间每年随访时进行评估。使用 Cox 比例风险模型进行分析。
共有 1730 名在基线时没有抑郁症状的个体纳入了分析。在 5 年的随访期间，有 166 名（9.6%）个体出现了抑郁症状。与 CRF 较低的个体相比，CRF 中等至较高的个体发生抑郁症状的风险显著降低，与 MVPA 无关（中等 CRF：HR=0.49（95%CI=0.33-0.72）；高 CRF：HR=0.48（95%CI=0.30-0.75）。这些关联是在调整了年龄、性别、教育水平、糖尿病状况、吸烟状况、饮酒量、能量摄入、腰围和抗抑郁药物使用的情况下进行的。
PHQ-9 是一种经过验证的筛选工具，但它不是抑郁症的诊断工具。
在 5 年的随访期间，较高的 CRF 与抑郁症状的发生风险降低密切相关，与基线时的 MVPA 水平无关，这表明旨在提高 CRF 的干预措施可能会降低患抑郁症的风险。
