Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 6BT London, UK; Research Department of Behavioural Science and Health, University College, London, 1-19 Torrington Place, WC1E 7HB London, UK.
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, Helsinki 00290, Finland.
Brain Behav Immun. 2022 Oct;105:192-200. doi: 10.1016/j.bbi.2022.07.009. Epub 2022 Jul 16.
Obesity is associated with increased risk of depression, but the extent to which this association is symptom-specific is unknown. We examined the associations of overweight and obesity with individual depressive symptoms.
We pooled data from 15 population-based cohorts comprising 57,532 individuals aged 18 to 100 years at study entry. Primary analyses were replicated in an independent cohort, the UK Biobank study (n = 122,341, age range 38 to 72). Height and weight were assessed at baseline and body mass index (BMI) was computed. Using validated self-report measures, 24 depressive symptoms were ascertained once in 16 cross-sectional, and twice in 7 prospective cohort studies (mean follow-up 3.2 years).
In the pooled analysis of the primary cohorts, 22,045 (38.3 %) participants were overweight (BMI between 25 and 29.9 kg/m), 12,025 (20.9 %) class I obese (BMI between 30 and 34.9 kg/m), 7,467 (13.0 %) class II-III obese (BMI ≥ 35 kg/m); and 7,046 (12.3 %) were classified as depressed. After multivariable adjustment, obesity class I was cross-sectionally associated with 1.11-fold (95 % confidence interval 1.01-1.22), and obesity class II-III with 1.31-fold (1.16-1.49) higher odds of overall depression. In symptom-specific analyses, robust associations were apparent for 4 of the 24 depressive symptoms ('could not get going/lack of energy', 'little interest in doing things', 'feeling bad about yourself, and 'feeling depressed'), with confounder-adjusted odds ratios of having 3 or 4 of these symptoms being 1.32 (1.10-1.57) for individuals with obesity class I, and 1.70 (1.34-2.14) for those with obesity class II-III. Elevated C-reactive protein and 21 obesity-related diseases explained 23 %-31 % of these associations. Symptom-specific associations were confirmed in longitudinal analyses where obesity preceded symptom onset, were stronger in women compared with men, and were replicated in UK Biobank.
Obesity is associated with a distinct set of depressive symptoms. These associations are partially explained by systemic inflammation and obesity-related morbidity. Awareness of this obesity-related symptom profile and its underlying biological correlates may inform better targeted treatments for comorbid obesity and depression.
肥胖与抑郁风险增加相关，但这种关联在多大程度上与特定症状相关尚不清楚。本研究旨在探讨超重和肥胖与个体抑郁症状的关联。
我们对 15 项基于人群的队列研究进行了数据汇总，这些研究共纳入了 57532 名年龄在 18 至 100 岁的个体。主要分析结果在英国生物银行研究（n=122341，年龄范围 38 至 72 岁）中进行了复制。在基线时评估身高和体重，并计算体重指数（BMI）。使用经过验证的自我报告量表，在 16 项横断面研究和 7 项前瞻性队列研究中（平均随访 3.2 年），单次评估了 24 项抑郁症状，两次评估了其中 7 项。
在主要队列的汇总分析中，22045 名（38.3%）参与者为超重（BMI 为 25 至 29.9kg/m²），12025 名（20.9%）为 I 级肥胖（BMI 为 30 至 34.9kg/m²），7467 名（13.0%）为 II 级-III 级肥胖（BMI≥35kg/m²），7046 名（12.3%）被诊断为抑郁。在多变量调整后，I 级肥胖与总体抑郁的发生风险呈正相关（比值比 1.11，95%置信区间 1.01-1.22），II 级-III 级肥胖与总体抑郁的发生风险呈正相关（比值比 1.31，95%置信区间 1.16-1.49）。在特定症状分析中，与 24 项抑郁症状中的 4 项（“提不起劲/缺乏活力”“对做事缺乏兴趣”“自我感觉不好”和“感到抑郁”）存在显著关联，肥胖 I 级和肥胖 II 级-III 级个体中，出现这 4 种症状的比值比为 1.32（1.10-1.57）和 1.70（1.34-2.14）。调整混杂因素后，C 反应蛋白升高和 21 种肥胖相关疾病可解释这些关联的 23%-31%。在肥胖先于症状出现的纵向分析中证实了特定症状的关联，且这种关联在女性中比男性更强，在英国生物银行研究中也得到了复制。
肥胖与一系列特定的抑郁症状相关。这些关联部分可通过系统性炎症和肥胖相关疾病来解释。了解这种肥胖相关的症状特征及其潜在的生物学相关性，可能有助于为肥胖和抑郁的共病提供更有针对性的治疗。
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