Depressive symptoms and objectively measured physical activity and sedentary behaviour throughout adolescence: a prospective cohort study
Depressive symptoms and objectively measured physical activity and sedentary behaviour throughout adolescence: a prospective cohort study
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DOI：
10.1016/s2215-0366(20)30034-1
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发表时间：
2020-03-01
影响因子：
64.3
通讯作者：
Hayes, Joseph F.
中科院分区：
文献类型：
--
作者：
Kandola, Aaron;Lewis, Gemma;Hayes, Joseph F.
背景识别可改变的危险因素对降低青少年抑郁症的患病率至关重要。自我报告的数据表明，体力活动和久坐行为可能与青少年的抑郁症状。我们研究了青少年抑郁症状与客观测量的体力活动和久坐行为之间的关系，从一个以人群为基础的青少年队列中，他们的母亲被邀请参加雅芳父母和儿童纵向研究（ALSPAC）研究，我们纳入了17.8岁时至少有一个加速度计记录和临床访谈修订版（CIS-R）抑郁评分的参与者（此后报告为18岁）。在大约12岁、14岁和16岁时，用加速度计测量了久坐行为和体力活动（轻度或中度到剧烈）所花费的时间。总身体活动还记录为每分钟计数（CPM），原始加速度计计数平均超过60秒。体力活动和久坐不动的行为变量和抑郁症（CIS-R）在18岁的分数之间的关联进行了分析与回归和基于组的轨迹modeling.Findings 4257青少年从14 901参加了ALSPAC研究有一个CIS-R抑郁症评分在18岁。纵向分析包括2486名12岁的参与者，1938名14岁的参与者和1220名16岁的参与者。总随访时间为6年。12岁至16岁之间的总体力活动减少，这是由于轻度活动持续时间减少（12岁时平均325.66分钟/天[SD 58.09]; 16岁时平均244.94分钟/天[55.08]）和久坐行为增加（430.99分钟/天[65.80]; 523.02分钟/天[65.25]）。18岁时抑郁评分较高与12岁（发病率比[IRR] 1.111 [95% CI 1.051-1.176]）、14岁（1.080 [1.012-1.152]）和16岁（1.107 [1.015-1.208]）时久坐行为增加60分钟/天相关。在12岁（0.904 [0.850-0.961]）、14岁（0.922 [0.857-0.992]）和16岁（0.889 [0.809-0.974]）时，轻度活动每增加60分钟/天，18岁时的抑郁评分较低。12-16岁年龄段基于群体的轨迹建模确定了久坐行为和活动水平的三个潜在亚组。抑郁得分在那些持续高的人中更高（IRR 1.282 [95% CI 1.061-1.548]）和持续平均值（1.249 [1.078-1.446]）久坐行为与那些久坐行为持续较低的人相比，而持续高水平光活动的受试者（0.804 [0.652-0.990]）则低于持续低水平光活动的受试者。中度至剧烈的体力活动12岁时（每增加15分钟/天）（0.910 [0.857-0.966]）和总体力活动12岁时（每增加100 CPM）（0.941 [0.910-0.972]）和14年（0.965 [0.932-0.999]），与抑郁症状呈负相关。解释久坐行为取代了整个青春期的轻度活动，并且与18岁时出现抑郁症状的风险更大有关。在青春期增加轻度活动和减少久坐行为可能是旨在减少抑郁症患病率的公共卫生干预措施的一个重要目标。
Background Identifying modifiable risk factors is essential to reduce the prevalence adolescent depression. Self-report data suggest that physical activity and sedentary behaviour might be associated with depressive symptoms in adolescents. We examined associations between depressive symptoms and objectively measured physical activity and sedentary behaviour in adolescents.Methods From a population-based cohort of adolescents whose mothers were invited to participate in the Avon Longitudinal Study of Parents and Children (ALSPAC) study, we included participants with at least one accelerometer recording and a Clinical Interview Schedule-Revised (CIS-R) depression score at age 17.8 years (reported as age 18 years hereafter). Amounts of time spent in sedentary behaviour and physical activity (light or moderate-to-vigorous) were measured with accelerometers at around 12 years, 14 years, and 16 years of age. Total physical activity was also recorded as count per minute (CPM), with raw accelerometer counts averaged over 60 s epochs. Associations between the physical activity and sedentary behaviour variables and depression (CIS-R) scores at age 18 years were analysed with regression and group-based trajectory modelling.Findings 4257 adolescents from the 14 901 enrolled in the ALSPAC study had a CIS-R depression score at age 18 years. Longitudinal analyses included 2486 participants at age 12 years, 1938 at age 14 years, and 1220 at age 16 years. Total follow-up time was 6 years. Total physical activity decreased between 12 years and 16 years of age, driven by decreasing durations of light activity (mean 325.66 min/day [SD 58.09] at 12 years; 244.94 min/day [55.08] at 16 years) and increasing sedentary behaviour (430.99 min/day [65.80]; 523.02 min/day [65.25]). Higher depression scores at 18 years were associated with a 60 min/day increase in sedentary behaviour at 12 years (incidence rate ratio [IRR] 1.111 [95% CI 1.051-1.176]), 14 years (1.080 [1.012-1.152]), and 16 years of age (1.107 [1.015-1.208]). Depression scores at 18 years were lower for every additional 60 min/day of light activity at 12 years (0.904 [0.850-0.961]), 14 years (0.922 [0.857-0.992]), and 16 years of age (0.889 [0.809-0.974]). Group-based trajectory modelling across 12-16 years of age identified three latent subgroups of sedentary behaviour and activity levels. Depression scores were higher in those with persistently high (IRR 1.282 [95% CI 1.061-1.548]) and persistently average (1.249 [1.078-1.446]) sedentary behaviour compared with those with persistently low sedentary behaviour, and were lower in those with persistently high levels of light activity (0.804 [0.652-0.990]) compared with those with persistently low levels of light activity. Moderate-to-vigorous physical activity (per 15 min/day increase) at age 12 years (0.910 [0.857-0.966]) and total physical activity (per 100 CPM increase) at ages 12 years (0.941 [0.910-0.972]) and 14 years (0.965 [0.932-0.999]), were negatively associated with depressive symptoms.Interpretation Sedentary behaviour displaces light activity throughout adolescence, and is associated with a greater risk of depressive symptoms at 18 years of age. Increasing light activity and decreasing sedentary behaviour during adolescence could be an important target for public health interventions aimed at reducing the prevalence of depression.