Huang Baoying, Huang Zhenhui, Tan Jianyi, Xu Huafu, Deng Kaisheng, Cheng Jinqun, Ren Zhiqiang, Gong Xiao, Gao Yanhui
Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510315, China; Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510315, China.
Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510315, China.
J Diabetes Complications. 2021 Jan;35(1):107764. doi: 10.1016/j.jdiacomp.2020.107764. Epub 2020 Oct 7.
Sufficient physical activity (PA) and less sedentary behavior (SB) have antidepressant effects, however the amount of PA varies according to weight status in adults with diabetes. Given that depression is a common complication of diabetes, we aimed to quantify to what extent the effects of diabetes on the risk of depression were explained by SB or insufficient PA in adults with and without obesity.
Data were collected from the 2007-2016 National Health and Nutrition Examination Survey (NHANES), which included 22,304 participants aged 20 years or older. The mediation and interaction were evaluated by the four-way effect decomposition method.
In individuals suffering from obesity, diabetes, SB, and insufficient moderate and vigorous intensity recreational activity were associated with an increased risk of depression. The increased relative risk of diabetes on depression could be decomposed into a reference interaction (96.78%), a mediated interaction (5.07%), and a pure indirect effect (2.48%), with insufficient moderate-intensity recreational activity as a potential mediator. SB attributed a proportion of 89.21% for the controlled direct effect and 3.64% for pure indirect effect.
Adults with obesity and diabetes are encouraged to increase moderate-intensity recreational activity and reduce SB, which can greatly prevent the occurrence of depression.
充足的体力活动（PA）和较少的久坐行为（SB）具有抗抑郁作用，然而在成年糖尿病患者中，PA的量因体重状况而异。鉴于抑郁症是糖尿病的常见并发症，我们旨在量化在有肥胖和无肥胖的成年人中，SB或不足的PA在多大程度上解释了糖尿病对抑郁症风险的影响。
数据来自2007 - 2016年国家健康和营养检查调查（NHANES），其中包括22304名20岁及以上的参与者。采用四向效应分解法评估中介作用和交互作用。
在肥胖、患糖尿病、有久坐行为以及中度和剧烈强度休闲活动不足的个体中，抑郁症风险增加。糖尿病对抑郁症相对风险的增加可分解为参考交互作用（96.78%）、中介交互作用（5.07%）和纯间接效应（2.48%），其中中度强度休闲活动不足作为潜在中介。久坐行为对控制直接效应的贡献率为89.21%，对纯间接效应的贡献率为3.64%。
鼓励肥胖和糖尿病成年人增加中度强度休闲活动并减少久坐行为，这可极大地预防抑郁症的发生。
