Depression With Atypical Features and Increase in Obesity, Body Mass Index, Waist Circumference, and Fat Mass A Prospective, Population-Based Study
Depression With Atypical Features and Increase in Obesity, Body Mass Index, Waist Circumference, and Fat Mass A Prospective, Population-Based Study
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DOI：
10.1001/jamapsychiatry.2014.411
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发表时间：
2014-08-01
期刊：
影响因子：
25.8
通讯作者：
Preisig, Martin
中科院分区：
文献类型：
--
作者：
Lasserre, Aurelie M.;Glaus, Jennifer;Preisig, Martin
抑郁症和肥胖症是两种普遍存在的疾病，已被反复证明是相关的。然而，这种关联的机制和时间顺序尚不清楚。目的探讨抑郁症的亚型之间是否存在相关性，（M DD;肥胖、非典型、合并或未指明）在肥胖发生率和体重指数变化方面可预测肥胖（计算方法为体重（千克）除以身高（米）的平方）、腰围和脂肪量。设计、设置和参与者这项前瞻性的基于人群的队列研究，科劳斯（Cohorte Lausannoise）/PsyCoLaus（CoLaus研究的精神病学分支），随访5.5年，包括3054名随机选择的居民（平均年龄497岁;瑞士洛桑市妇女占53.1%（根据民事登记），年龄在35 - 66岁之间（2003年），接受了身体和精神基线和身体随访评估。基线和随访时的诊断标准，以及社会皮肤特征、生活方式（酒精和烟草的使用和身体活动）和药物治疗，使用半结构化的遗传研究诊断访谈进行。主要结果和指标随访期间体重指数、腰围和脂肪量的变化，以百分比表示基线值，以及随访期间基线时非肥胖患者的肥胖发生率。体重，身高，腰围，和体脂（生物阻抗）进行了测量，在基线和后续由训练有素的现场interviewers.Results只有参与者的非典型亚型的MDD在基线显示肥胖的增加在后续比没有MDD的参与者。这种MDD亚型与体重指数之间的关系（β = 3.19; 95% CI，1.50-4.88），肥胖发生率（比值比，3.75; 95% CI，1.24-11.35），两种性别的腰围（β = 2.44; 95%CI，0.21-4.66），和脂肪量在男性（β = 16.36; 95%CI，4.81-27.92）仍然显着调整后，广泛的可能cofounding.CONCLUSIONS和相关性MDD的非典型亚型是一个强有力的预测肥胖。这强调了在临床和研究环境中识别这种MDD亚型的个体的必要性。主张采取治疗措施，以减少非典型特征的抑郁发作期间食欲增加的后果。
IMPORTANCE Depression and obesity are 2 prevalent disorders that have been repeatedly shown to be associated. However, the mechanisms and temporal sequence underlying this association are poorly understood.OBJECTIVE To determine whether the subtypes of major depressive disorder (M DD; melancholic, atypical, combined, or unspecified) are predictive of adiposity in terms of the incidence of obesity and changes in body mass index (calculated as weight in kilograms divided by height in meters squared), waist circumference, and fat mass.DESIGN, SETTING, AND PARTICIPANTS This prospective population-based cohort study, CoLaus (Cohorte Lausannoise)/PsyCoLaus (Psychiatric arm of the CoLaus Study), with 5.5 years of follow-up included 3054 randomly selected residents (mean age, 497 years; 53.1% were women) of the city of Lausanne, Switzerland (according to the civil register), aged 35 to 66 years in 2003, who accepted the physical and psychiatric baseline and physical follow-up evaluations.EXPOSURES Depression subtypes according to the DSM-IV. Diagnostic criteria at baseline and follow-up, as well as sociodernographic characteristics, lifestyle (alcohol and tobacco use and physical activity), and medication, were elicited using the semistructured Diagnostic Interview for Genetic Studies.MAIN OUTCOMES AND MEASURES Changes in body mass index, waist circumference, and fat mass during the follow-up period, in percentage of the baseline value, and the incidence of obesity during the follow-up period among nonobese paritcipants at baseline. Weight, height, waist circumference, and body fat (bioimpedance) were measured at baseline and follow-up by trained field interviewers.RESULTS Only participants with the atypical subtype of MDD at baseline revealed a higher increase in adiposity during follow-up than participants without MDD. The associations between this MDD subtype and body mass index (beta = 3.19; 95% CI, 1.50-4.88), incidence of obesity (odds ratio, 3.75; 95% CI, 1.24-11.35), waist circumference in both sexes (beta = 2.44; 95% Cl, 0.21-4.66), and fat mass in men (beta = 16.36; 95% CI, 4.81-27.92) remained significant after adjustments for a wide range of possible cofounding.CONCLUSIONS AND RELEVANCE The atypical subtype of MDD is a strong predictor of obesity. This emphasizes the need to identify individuals with this subtype of MDD in both clinical and research settings. Therapeutic measures to diminish the consequences of increased appetite during depressive episodes with atypical features are advocated.