Obesity and Metabolic Syndrome Increase the Risk of Incident Depression in Older Men: The Health in Men Study
Obesity and Metabolic Syndrome Increase the Risk of Incident Depression in Older Men: The Health in Men Study
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肥胖和代谢综合征会增加老年男性患抑郁症的风险：男性健康研究
DOI：
10.1097/jgp.0b013e3181b047e3
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发表时间：
2009-10-01
影响因子：
7.2
通讯作者：
Flicker, Leon
中科院分区：
文献类型：
--
作者：
Almeida, Osvaldo P.;Calver, Janine;Flicker, Leon
背景资料：肥胖与年轻人和中年人普遍抑郁症的风险增加有关，但肥胖（及其各种措施，包括代谢综合征[MetS]）和老年人抑郁症之间的关系尚未得到充分研究。目的：这项研究评估了10年来在一个大型社区老年男性队列中各种肥胖指标与抑郁症事件之间的关联。研究方法：作者招募了12,216名年龄在65-84岁之间的男性，他们在1996年至1998年期间居住在澳大利亚的珀斯，并测量了他们的身高，体重，腰围和臀围以及血压。参与者还完成了一份问卷，其中包括有关糖尿病，高血压和高胆固醇或甘油三酯的临床诊断和治疗信息。然后，作者使用西澳大利亚关联数据系统检索了1966年1月1日至2006年12月31日期间有关以下ICD-10诊断的信息：抑郁发作，复发性抑郁障碍和心境恶劣。结果：作者从这些分析中排除了150名男性，因为他们有抑郁症病史或数据缺失。我们的12，066名参与者在招募时的平均年龄为72 +/- 4岁，他们平均随访8 +/- 2年。随访期间有3,623人死亡，481人被诊断为抑郁症。抑郁症的发病率为每1,000人年5例。校正后的考克斯比例风险模型显示，与非肥胖男性（BMI < 30）相比，体重指数（BMI）≥ 30的男性患抑郁症的风险增加31%（95%置信区间[CI] = 5%-64%）。抑郁与腰围>= 102 cm和腰/臀>= 1之间的关联没有达到统计学显著性。在招募时患有代谢综合征的男性，调整后的抑郁事件风险增加了137%（95%CI = 60%-251%）。结论：我们的研究结果表明，肥胖和代谢综合征与老年男性抑郁症发病风险的增加有关。如果这种关联确实是因果关系，那么降低肥胖和代谢综合征的患病率可能会导致晚年抑郁症的患病率和发病率下降。(Am J Geriatr Psychiatry 2009; 17：889-898）
Background: Obesity has been associated with increased risk of prevalent depression among young and middle-aged adults, but the association between obesity (and its various measures, including the metabolic syndrome [MetS]) and incident depression has not been examined adequately in the elderly. Objectives: This study evaluated the association between various measures of obesity and incident depression over a 10-year period in a large cohort of community-based older men. Methods: The authors recruited 12,216 men aged 65-84 years living in Perth, Australia, between 1996 and 1998, and measured their height, weight, waist and hip circumference, and blood pressure. Participants also completed a questionnaire that included information about the clinical diagnosis and treatment for diabetes, hypertension, and high cholesterol or triglycerides. The authors then used the Western Australian Linked Data System to retrieve information about the following ICD-10 diagnoses between January 1, 1966, and December 31, 2006: depressive episode, recurrent depressive disorder, and dysthymia. Results: The authors excluded 150 men from these analyses because of prior history of depression or missing data. The mean age of our 12,066 participants was 72 +/- 4 years at the time of recruitment, and they were followed up for an average of 8 +/- 2 years. There were 3,623 deaths during follow-up, and 481 men received the diagnosis of depression. The incidence of depression was 5 per 1,000 person-years. Adjusted Cox proportional hazard models showed that men with body mass index (BMI) >= 30 had a 31% (95% confidence interval [CI] = 5%-64%) increase in the risk of depression compared with that of nonobese men (BMI < 30). The association between depression and waist circumference >= 102 cm and waist/hip >= 1 did not reach statistical significance. Men with MetS at the time of recruitment had a 137% (95% CI = 60%-251%) increase in the adjusted risk of incident depression. Conclusions: Our results indicate that obesity and MetS are associated with an increase in the risk of incident depression among older men. If this association is truly causal, reducing the prevalence of obesity and MetS could potentially lead to a decline in the prevalence and incidence of depression in later life. (Am J Geriatr Psychiatry 2009; 17:889-898)