Association Between Hypertriglyceridaemia Waist Phenotype And Depressive Symptoms In The Middle-aged And Elderly Chinese Population

Background and objectiveThe incidence of obesity and depression is increasing year by year,which brings a heavy medical burden to the society.Previous studies have shown that the relationship between obesity and depression is inconclusive,and obesity may improve depressive symptoms.To further clarify the relationship between obesity and depression,hypertriglyceridaemia waist(HTGW)phenotype,which is able to better evaluate visceral fat and abdominal obesity,is introduced to analyze its impact on depressive symptoms and their evolution.As such,this study aims to provide reference for the physical and mental health of the middle-aged and elderly Chinese population.MethodsThis study used baseline and follow-up data from the China Health and Retirement Longitudinal Study(CHARLS),and a total of 7344 subjects aged 45 years and above were finally selected for analysis according to the inclusion and exclusion criteria.According to the waist circumference and serum triglyceride levels,the subjects were divided into the normal waist-normal triglycerides(NWNT)group,the enlarged waist-normal triglycerides(EWNT)group,the normal waist-elevated triglycerides(NWET)group and the hypertriglyceridaemia waist(HTGW)group.Depressive symptoms were evaluated using the 10-item version of Center for Epidemiologic Studies Depression Scale(CES-D-10).The baseline data were analyzed using chi-square test and ANOVA.The cross-sectional study of HTGW phenotype and baseline depressive symptoms was used binary logistic regression analysis.The follow-up study of HTGW phenotype and the evolution of depressive symptoms was used ordered logistic regression analysis.Results1.Prevalence of depressive symptoms is lower in the HTGW group compared to the NWNT group.There were statistically significant differences between groups in ages,genders,educational levels,residence,smoking status,drinking status,and history of diabetes,hypertension,heart diseases,and stroke.2.Compared to the NWNT group,after adjusting confounding factors,the EWNT group(OR=0.823,95%CI:0.728-0.931,P=0.002;OR=0.867,95%CI:0.775-0.969,P=0.012)and HTGW group(OR=0.671,95%CI:0.573-0.787,P<0.001;OR=0.771,95%CI:0.669-0.887,P<0.001)were negatively associated with depressive symptoms in both cross-sectional and follow-up studies.No statistically significant differences were found among the NWET group.3.In subgroup analysis,the HTGW group(OR=0.711,95%CI:0.586-0.863,P=0.001)was significantly negatively associated with depressive symptoms in females,and the effect of waist circumference(OR=0.706,95%CI:0.571-0.873,P=0.001)was more prominent in males than in females.The HTGW group of adults aged 45-59 years(OR=0.688,95%CI:0.554-0.853,P=0.001),the EWNT group(OR=0.730,95%CI:0.606-0.879,P=0.001)and the HTGW group(OR=0.645,95%CI:0.509-0.818,P<0.001)of adults aged 60 years and above were negatively associated with depressive symptoms.The EWNT group(OR=0.785,95%CI:0.688-0.895,P<0.001)and HTGW group(OR=0.648,95%CI:0.547-0.768,P<0.001)in the married population were negatively associated with depressive symptoms,and no statistical significance was shown in other marital status.The EWNT group(OR=0.816,95%CI:0.702-0.949,P=0.008)and HTGW group(OR=0.665,95%CI:0.544-0.813,P<0.001)were associated with depressive symptoms in the rural population,but in urban population,only the HTGW group(OR=0.678,95%CI:0.521-0.883,P=0.004)was associated with depressive symptoms.In the educational levels at illiterate,the EWNT group(OR=0.756,95%CI:0.607-0.941,P=0.012)and HTGW group(OR=0.711,95%CI:0.532-0.950,P=0.021)were associated with depressive symptoms.The HTGW group(OR=0.740,95%CI:0.580-0.943,P=0.015)in the educational levels at primary school was associated with depressive symptoms.In the junior high school and above group,the NWET group(OR=0.689,95%CI:0.490-0.970,P=0.033)and HTGW group(OR=0.537,95%CI:0.392-0.763,P<0.001)were negatively associated with depressive symptoms.Most results of the subgroup analysis of the evolution of depressive symptoms were in accordance with the results of the cross-sectional study,except that in the subgroup of residence,no significant association was identified in urban groups,and in the subgroup of educational levels,no statistical significance was shown in primary school level group.Conclusion1.This study found that obese individuals were less likely to suffer from depressive symptoms,and hypertriglyceridaemia waist phenotype was negatively associated with the prevalence and evolution of depressive symptoms in middle-aged and elderly Chinese.Compared to the elevated triglyceride levels,the effect of abdominal obesity was more prominent.2.HTGW phenotype takes a different effect on the occurrence and development of depressive symptoms among people with different genders,ages,residence,marital status,and education levels.