Zeng Na, Li Chao, Mei Huan, Wu Shuilin, Liu Chang, Wang Xiaokun, Shi Jie, Lu Lin, Bao Yanping
School of Public Health, Peking University, Beijing 100191, China.
National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China.
Brain Sci. 2024 Jun 11;14(6):593. doi: 10.3390/brainsci14060593.
The study aimed to examine the bidirectional relationship between sarcopenia and depressive symptoms in a national, community-based cohort study, despite the unclear temporal sequence demonstrated previously.
Data were derived from four waves (2011 baseline and 2013, 2015, and 2018 follow-ups) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 17,708 participants aged 45 years or older who had baseline data on both sarcopenia status and depressive symptoms in 2011 were included in the study. For the two cohort analyses, a total of 8092 adults without depressive symptoms and 11,292 participants without sarcopenia in 2011 were included. Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Depressive symptoms were defined as a score of 20 or higher on the 10-item Center for Epidemiologic Studies Depressive Scale (CES-D-10). Cox proportional hazard regression models were conducted to examine the risk of depressive symptoms and sarcopenia risk, while cross-lagged panel models were used to examine the temporal sequence between depressive symptoms and sarcopenia over time.
During a total of 48,305.1 person-years follow-up, 1262 cases of incident depressive symptoms were identified. Sarcopenia exhibited a dose-response relationship with a higher risk of depressive symptoms (HR = 1.7, 95%CI: 1.2-2.3 for sarcopenia, and HR = 1.5, 95%CI: 1.2-1.8 for possible sarcopenia, trend < 0.001). In the second cohort analysis, 240 incident sarcopenia cases were identified over 39,621.1 person-years. Depressive symptoms (HR = 1.5, 95%CI: 1.2-2.0) are significantly associated with a higher risk of developing sarcopenia after multivariable adjustment ( < 0.001, Cross-lagged panel analyses demonstrated that depressive symptoms were associated with subsequent sarcopenia (β = 0.003, < 0.001). Simultaneously, baseline sarcopenia was also associated with subsequent depressive symptoms (β = 0.428, < 0.001).
This study identified a bidirectional relationship between depressive symptoms and sarcopenia. It seems more probable that baseline sarcopenia is associated with subsequent depressive symptoms in a stronger pattern than the reverse pathway. The interlinkage indicated that maintaining normal muscle mass and strength may serve as a crucial intervention strategy for alleviating mood disorders.
本研究旨在通过一项基于全国社区的队列研究，探讨肌肉减少症与抑郁症状之间的双向关系，尽管此前两者的时间顺序尚不清楚。
数据来源于中国健康与养老追踪调查（CHARLS）的四个波次（2011年基线以及2013年、2015年和2018年随访）。本研究纳入了2011年共有17708名年龄在45岁及以上且有肌肉减少症状态和抑郁症状基线数据的参与者。在两项队列分析中，纳入了2011年共有8092名无抑郁症状的成年人以及11292名无肌肉减少症的参与者。肌肉减少症状态根据亚洲肌肉减少症工作组2019年（AWGS 2019）标准定义。抑郁症状定义为在10项流行病学研究中心抑郁量表（CES-D-10）上得分20分及以上。采用Cox比例风险回归模型来检验抑郁症状风险和肌肉减少症风险，同时使用交叉滞后面板模型来检验抑郁症状和肌肉减少症随时间的时间顺序。
在总共48305.1人年的随访期间，共识别出1262例新发抑郁症状病例。肌肉减少症与更高的抑郁症状风险呈现剂量反应关系（肌肉减少症的HR = 1.7，95%CI：1.2 - 2.3；可能的肌肉减少症的HR = 1.5，95%CI：1.2 - 1.8，趋势<0.001）。在第二项队列分析中，在39621.1人年期间共识别出240例新发肌肉减少症病例。多变量调整后，抑郁症状（HR = 1.5，95%CI：1.2 - 2.0）与发生肌肉减少症的较高风险显著相关（<0.001）。交叉滞后面板分析表明，抑郁症状与随后的肌肉减少症相关（β = 0.003，<0.001）。同时，基线肌肉减少症也与随后的抑郁症状相关（β = 0.428，<0.001）。
本研究确定了抑郁症状与肌肉减少症之间的双向关系。基线肌肉减少症与随后的抑郁症状之间的关联模式似乎比相反途径更强。这种相互联系表明，维持正常的肌肉质量和力量可能是缓解情绪障碍的关键干预策略。
