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Results from the Health, Aging, and Body Composition Study Nicole Vogelzangs 1 , Brenda Penninx 1 , Aartjan Beekman 1 ,

Longitudinal Associations between Abdominal Obesity and Depression. Results from the Health, Aging, and Body Composition Study Nicole Vogelzangs 1 , Brenda Penninx 1 , Aartjan Beekman 1 , Gretchen Brenes 2 , Anne Newman 3 , Tamara Harris 4 ,

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Results from the Health, Aging, and Body Composition Study Nicole Vogelzangs 1 , Brenda Penninx 1 , Aartjan Beekman 1 ,

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  1. Longitudinal Associations between Abdominal Obesity and Depression Results from the Health, Aging, and Body Composition Study Nicole Vogelzangs1, Brenda Penninx1, Aartjan Beekman1, Gretchen Brenes2, Anne Newman3, Tamara Harris4, Suzanne Satterfield5, Kristine Yaffe6, Stephen Kritchevsky2 1Psychiatry and EMGO institute, VU University Medical Center, Amsterdam, The Netherlands 2Wake Forest University, NC, 3University of Pittsburgh, PA, 4NIA, Bethesda, MD, 5University of Tennessee, TN, 6University of California, CA

  2. Background • Studies show a link between obesity and depression (e.g. Roberts et al, Am J Epidemiol, 2000; Lincinio, Rev Bras Psiquiatr, 2003) • Abdominal obesity is associated with poorer health outcome than overall obesity (e.g. Goodpaster et al, Diabetes Care, 2003; Nicklas et al, Am J Epidemiol, 2004) • This may be due to specific properties of visceral fat (e.g. Bjorntorp, GH & IGF Res, 1998; Park et al, Diab Res Clin Prac, 2005) • These mechanisms also play a role in depression (e.g. Bjorntorp, Obesity Rev, 2001; Kahl et al, Psychosom Med, 2005) => depression might be specifically associated with abdominal obesity, independent of overall obesity

  3. Background Cross-sectional studies show an association between abdominal obesity and depression (e.g. Thakore et al, Biol Psychiatry, 1997;Weber-Hamann et al, Psychosom Med, 2002; Lee et al, Obesity Res, 2005) life-style behaviors, self-image, co-morbid diseases, inflammation ? Abdominal obesity Depression life-style behaviors, sex steroid hormones, cortisol

  4. Research questions • Is abdominal obesity associated with depressed mood, independent of overall obesity? • What is the direction of such a link: • Does abdominal obesity predict the incidence of depressed mood in non-depressed persons at baseline? • Does depressed mood at baseline predict an increase in abdominal visceral fat over time?

  5. Health ABC Study • Population-based prospective cohort study with 5 years of annual follow-up • 3075 well-functioning black and white older men and women, aged 70-79 years

  6. Depressed mood • Center for Epidemiological Studies-Depression Scale (CES-D-20 and CES-D-10) • Depressed mood at baseline: CES-D-20 ≥ 16 • Incident depressed mood: CES-D-10 ≥ 10 on any of the annual follow-up assessments in persons without baseline depressed mood • Mean follow-up: 4.4 ± 1.0 years

  7. Obesity Baseline and 5-year follow-up • Overall obesity: • Body Mass Index: weight / height2 (kg/m2) • % body fat (dual X-ray absorptiometry scan) • Abdominal obesity: • Waist circumference (cm) • Sagittal diameter (cm) • Abdominal visceral fat (CT scan at L4-L5 level; cm2)

  8. Statistical analyses • Cox regression: N=2528 baseline abdominal obesity incident depressed mood • Linear regression: N=1733 baseline depressed mood 5-year change in abdominal obesity Covariates: age, sex, race, site, education, smoking, alcohol use, physical activity, cardiovascular disease, diabetes Additional adjustment: overall obesity (BMI)

  9. Sample characteristics (mean (SD) or %) a among non-depressed at baseline

  10. Risk of incident depressed mood (21.6%) a Adjusted for sociodemographics, life-style behaviors and diseases b Additionally adjusted for BMI

  11. Riska of incident depressed mood by abdominal visceral fat HR Quintiles of abdominal visceral fat a Adjusted for sociodemographics, life-style behaviors, diseases, and BMI

  12. Depressed mood and 5-year change in obesity a Adjusted for sociodemographics, life-style behaviors, diseases, and BMI (for abdominal obesity measures) b A sex interaction was observed for CES-D≥16: p=.02

  13. No depressed mood Depressed mood Adjusteda mean 5-year change in abdominal visceral fat Men p=.001 Women p=.14 cm2 a Adjusted for sociodemographics, life-style behaviors, diseases, and BMI

  14. Conclusions • In an older population, abdominal visceral obesity is independently and more strongly associated with depressed mood than overall obesity • The association between abdominal obesity and depressed mood is bidirectional: • Abdominal obesity predicts the onset of depressed mood • In older men only, depressed mood predicts an increase in abdominal visceral fat over time

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