Kim Hyewon, Yoo Juhwan, Han Kyungdo, Fava Maurizio, Mischoulon David, Park Mi Jin, Jeon Hong Jin
Department of Psychiatry, Hanyang University Hospital, Seoul, South Korea.
Department of Biomedicine and Health Science, The Catholic University of Korea, Seoul, South Korea.
Front Psychiatry. 2021 Dec 23;12:761761. doi: 10.3389/fpsyt.2021.761761. eCollection 2021.
Changes in lifestyle factors are known to affect mood. However, there is insufficient evidence supporting the association between smoking, alcohol consumption, physical activity and depression in middle-aged women who are likely to experience rapid hormonal changes. We used a nationwide database of medical records in South Korea. 901,721 premenopausal and 943,710 postmenopausal women aged 40 years or older included in this study. Information on smoking, alcohol consumption, physical activity was identified from health examination data and followed up for the occurrence of depression using claims data. Compared with never-smokers, ex-smokers and current smokers among premenopausal and postmenopausal women showed an increased risk of depression in a dose-dependent manner (aHR 1.13 for ex-smokers; aHR 1.23 for current smokers). Compared with non-drinkers, mild drinkers showed a decreased risk of depression (aHR 0.98 for premenopausal women; aHR 0.95 for postmenopausal women), and heavy drinkers showed an increased risk of depression both among premenopausal (aHR 1.20) and postmenopausal women (aHR 1.05). The risk of depression due to smoking and heavy alcohol consumption was higher in premenopausal women than in postmenopausal women. Compared with those who had not engaged in regular physical activity, those who had engaged showed a decreased risk of depression both among premenopausal (aHR 0.96) and postmenopausal women (aHR 0.95). Smoking and heavy alcohol consumption increased the risk of depression, and the increased risk was prominent in premenopausal than in postmenopausal women. Regular physical activity decreased the risk of depression both in premenopausal and postmenopausal women.
已知生活方式因素的变化会影响情绪。然而，对于可能经历快速激素变化的中年女性，吸烟、饮酒、身体活动与抑郁症之间的关联，证据并不充分。我们使用了韩国全国范围的医疗记录数据库。本研究纳入了901,721名40岁及以上的绝经前女性和943,710名绝经后女性。从健康检查数据中获取吸烟、饮酒、身体活动的信息，并使用理赔数据对抑郁症的发生情况进行随访。与从不吸烟者相比，绝经前和绝经后女性中的既往吸烟者和当前吸烟者患抑郁症的风险呈剂量依赖性增加（既往吸烟者的风险比为1.13；当前吸烟者的风险比为1.23）。与不饮酒者相比，轻度饮酒者患抑郁症的风险降低（绝经前女性的风险比为0.98；绝经后女性的风险比为0.95），而重度饮酒者在绝经前（风险比为1.20）和绝经后女性（风险比为1.05）中患抑郁症的风险均增加。绝经前女性因吸烟和大量饮酒导致抑郁症的风险高于绝经后女性。与未进行规律身体活动的女性相比，进行规律身体活动的女性在绝经前（风险比为0.96）和绝经后女性（风险比为0.95）中患抑郁症的风险均降低。吸烟和大量饮酒会增加患抑郁症的风险，且这种增加的风险在绝经前女性中比在绝经后女性中更为显著。规律的身体活动会降低绝经前和绝经后女性患抑郁症的风险。
