Evaluation of the disparities in the association between depressive symptoms and body composition in the Multi-ethnic Study of Atherosclerosis

INTRODUCTION: Although race/ethnicity and sex have been shown to modify the association between depressive symptoms and adiposity, contradictory results exist. Further, interaction by neighborhood-level factors has yet to be examined for this relationship. Previous studies have also been limited in the use of body mass index (BMI) and waist circumference (WC) to measure adiposity. Examination of more specific body composition such as visceral adipose tissue (VAT) and lean muscle mass may be necessary to fully understand the mechanism through which elevated depressive symptoms (EDS) and body composition are related.;METHODS: Using data of men and women (45-84 years) from the Multi-ethnic Study of Atherosclerosis (MESA) and the MESA Neighborhood and Body Composition, Inflammation and Cardiovascular Ancillary Studies, we examined the longitudinal association between (1) baseline EDS (defined as a Center for Epidemiologic Studies for Depression Scale ≥ 16) and change in WC and BMI, and (2) baseline WC- and BMI-defined overweight/obesity and change in depressive symptoms using multi-level mixed-effects linear regression, as well as the cross-sectional relationship between EDS and CT-measured VAT and lean muscle. Interaction by race/ethnicity, sex, physical environment and social environment were also assessed.;RESULTS: Among normal weight individuals and those residing in poorly-rated physical environment, there was a 024 (C1=0.08, 0.30) and 0.18 (CI=0.03, 0.33) cm greater increase in WC, respectively, among those with EDS compared to those without. For either longitudinal study, interaction by race/ethnicity, sex and social environment was not found.;EDS and VAT was not significantly associated, nor were there interaction by race/ethnicity, sex, and neighborhood-level factors. EDS, however, was significantly associated with lower lean muscle mass for locomotion. Further, race/ethnicity modified this relationship. Blacks with EDS had about a 9% lower lean muscle for locomotion compared to Blacks without EDS. This difference was significantly different from that of the White population. There were no significant interaction by sex, or neighborhood-level factors.;CONCLUSION: EDS is associated with increases in WC and BMI among individuals of normal weight individuals or residing in poorly-rated physical environments. EDS was not associated with VAT, but was negatively associated with lean muscle for locomotion, notably among Blacks.