Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China.
Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China.
J Am Med Dir Assoc. 2023 Nov;24(11):1669-1676.e2. doi: 10.1016/j.jamda.2023.06.019. Epub 2023 Jul 27.
The aim of this study was to investigate the association between changes in depressive symptoms and sarcopenia by repeated measures of depressive symptoms at a follow-up visit every 2 years.
Cross-sectional design and longitudinal design.
We conducted a cross-sectional and longitudinal study using data from the China Health and Retirement Longitudinal Study, which is a representative national survey. A total of 12,287 participants were included in Wave 1 (2011-2012) for the cross-sectional analysis, followed by a total of 5285 participants in Wave 2 (2013-2014) and Wave 3 (2015-2016) for the longitudinal analysis based on the cross-sectional analysis.
Depressive symptoms were measured by the 10-item Center for the Epidemiological Studies of Depression Short Form. Sarcopenia was defined according to the Asian Sarcopenia Working Group criteria (AWGS 2019). Changes in depressive symptoms in Wave 1 and Wave 2 were used as exposure, and sarcopenia in Wave 3 was used as outcome. Cox proportional hazards regression model was used to test the relationship between changes in depressive symptoms and sarcopenia.
In cross-sectional analysis, depression was significantly associated with sarcopenia (odds ratio, 1.27; 95% CI, 1.10-1.48). In subsequent longitudinal analyses, a total of 174 sarcopenia events occurred, and those with increased depressive symptoms and persistent depressive symptoms were at higher risk for sarcopenia than those without depressive symptoms, with multivariable-adjusted hazard ratios of 1.65 (95% CI, 1.00-2.73) and 1.68 (95% CI, 1.06-2.68), respectively.
People with increased depressive symptoms and persistent depressive symptoms may have a higher risk of developing sarcopenia over time. In the future, more research is needed to confirm the mechanism by which long-term changes in depression contribute to the risk of sarcopenia, and to propose preventive measures accordingly.
本研究旨在通过在随访中每 2 年重复测量抑郁症状，来探讨抑郁症状变化与肌少症之间的关联。
横断面设计和纵向设计。
我们使用中国健康与退休纵向研究的数据进行了横断面和纵向研究，该研究是一项具有代表性的全国性调查。共有 12287 名参与者纳入了横断面分析的第 1 波（2011-2012 年），其中 5285 名参与者根据第 1 波纳入了第 2 波（2013-2014 年）和第 3 波（2015-2016 年）的纵向分析。
抑郁症状通过 10 项中心流行病学研究抑郁量表（Center for the Epidemiological Studies of Depression Short Form）进行测量。肌少症根据亚洲肌少症工作组（AWGS）标准（AWGS 2019）定义。第 1 波和第 2 波的抑郁症状变化作为暴露因素，第 3 波的肌少症作为结局。采用 Cox 比例风险回归模型检验抑郁症状变化与肌少症之间的关系。
在横断面分析中，抑郁与肌少症显著相关（优势比，1.27；95%置信区间，1.10-1.48）。在随后的纵向分析中，共发生 174 例肌少症事件，与无抑郁症状者相比，抑郁症状增加和持续性抑郁症状者发生肌少症的风险更高，多变量调整后的风险比分别为 1.65（95%置信区间，1.00-2.73）和 1.68（95%置信区间，1.06-2.68）。
抑郁症状增加和持续性抑郁症状者随着时间的推移，发生肌少症的风险可能更高。未来需要进一步研究来确认长期抑郁变化导致肌少症风险的机制，并相应地提出预防措施。
