Liu Shilin, Huang Yu, Liu Aixin, Li Xiaoxuan, Fu Yifan, Wang Wei, Wen Yuechun, Jiang Tao, Zhang Xiangyang
Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230001, China.
Anhui Public Health Clinical Center, Hefei, Anhui 230001, China.
Depress Anxiety. 2025 May 10;2025:6648190. doi: 10.1155/da/6648190. eCollection 2025.
There is limited evidence regarding the relationship between body mass index (BMI) and anxiety symptoms in individuals with major depressive disorder (MDD), and the findings are controversial. This study aimed to explore the association between BMI and anxiety symptoms in patients with first-episode drug-naïve (FEDN) MDD. A total of 1718 FEDN MDD patients were included in this study, gathering information on their sociodemographic attributes and physical measurements. BMI was classified into three categories (normal, overweight, and obese) based on the standards of the Working Group on Obesity in China (WGOC). Logistic regression and double robust estimation were used to assess the association between anxiety symptoms and BMI. Additionally, a restricted cubic spline (RCS) analysis was used to examine the relationship between anxiety symptoms and BMI. If nonlinear associations existed, threshold effects were analyzed using a two-piecewise logistic regression model. The subgroup analysis was performed to validate the robustness of the findings. Among 1718 patients, 12.7% (218) exhibited anxiety symptoms. After adjusting for confounding variables, multivariable logistic regression analysis revealed a positive association between BMI and the risk of experiencing anxiety symptoms (OR = 1.13, 95% CI: 1.039-1.229, =0.004). These findings were further confirmed using a doubly robust estimation. Additionally, RCS analysis revealed a nonlinear correlation between BMI and anxiety symptoms, with a turning point of 26.9 kg/m. On the left side of the inflection point, a positive association between BMI and anxiety symptoms was detected (OR = 1.167, 95% CI: 1.055-1.296, =0.003), while no significant association was observed on the right side of the inflection point (OR = 1.01, 95% CI: 0.685-1.341, =0.972). Subgroup analyses revealed significant variations in the association between gender and education level. This study demonstrated that a higher BMI was associated with an increased risk of experiencing anxiety symptoms in Chinese patients with FEDN MDD, particularly among those with a BMI below 26.9 kg/m.
关于重度抑郁症（MDD）患者体重指数（BMI）与焦虑症状之间的关系，证据有限，且研究结果存在争议。本研究旨在探讨首发未用药（FEDN）的MDD患者中BMI与焦虑症状之间的关联。本研究共纳入1718例FEDN的MDD患者，收集其社会人口学特征和身体测量信息。根据中国肥胖问题工作组（WGOC）的标准，BMI分为三类（正常、超重和肥胖）。采用逻辑回归和双重稳健估计来评估焦虑症状与BMI之间的关联。此外，使用受限立方样条（RCS）分析来检验焦虑症状与BMI之间的关系。如果存在非线性关联，则使用两段式逻辑回归模型分析阈值效应。进行亚组分析以验证研究结果的稳健性。在1718例患者中，12.7%（218例）表现出焦虑症状。在调整混杂变量后，多变量逻辑回归分析显示BMI与出现焦虑症状的风险呈正相关（OR = 1.13，95%CI：1.039 - 1.229，P = 0.004）。这些结果通过双重稳健估计得到进一步证实。此外，RCS分析显示BMI与焦虑症状之间存在非线性相关性，转折点为26.9kg/m²。在拐点左侧，检测到BMI与焦虑症状呈正相关（OR = 1.167，95%CI：1.055 - 1.296，P = 0.003），而在拐点右侧未观察到显著关联（OR = 1.01，95%CI：0.685 - 1.341，P = 0.972）。亚组分析显示性别和教育水平之间的关联存在显著差异。本研究表明，较高的BMI与中国FEDN的MDD患者出现焦虑症状的风险增加相关，尤其是BMI低于26.9kg/m²的患者。
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