北京大学学报(医学版) ›› 2026, Vol. 58 ›› Issue (2): 319-326. doi: 10.19723/j.issn.1671-167X.2026.02.015

• 论著 • 上一篇    下一篇

辅助生殖人群体脂率和体骨骼肌率与抑郁的相关性研究

宋晓欢1, 罗桂英2, 王婕妤2, 贾月迪1, 江飞3, 朱梦黎3, 王丹妮1,*()   

  1. 1. 安徽医科大学公共卫生学院健康促进与行为科学系, 合肥 230032
    2. 安徽医科大学附属第一医院生殖医学中心, 合肥 230000
    3. 安徽医科大学公共卫生学院营养与食品卫生学系, 合肥 230032
  • 收稿日期:2024-03-26 出版日期:2026-04-18 发布日期:2025-09-24
  • 通讯作者: 王丹妮
  • 基金资助:
    国家自然科学基金青年项目(72004001); 安徽省高校科研人文项目(2022AH050627)

Correlational research on body fat rate and skeletal muscle rate with depression in the population of assisted reproduction

Xiaohuan SONG1, Guiying LUO2, Jieyu WANG2, Yuedi JIA1, Fei JIANG3, Mengli ZHU3, Danni WANG1,*()   

  1. 1. Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University, Hefei 230032, China
    2. Centre for Reproductive Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei 230000, China
    3. Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei 230032, China
  • Received:2024-03-26 Online:2026-04-18 Published:2025-09-24
  • Contact: Danni WANG
  • Supported by:
    the Youth Program of the National Natural Science Foundation of China(72004001); the Anhui University Scientific Research Humanities Project(2022AH050627)

RICH HTML

  

摘要:

目的: 探讨辅助生殖人群体脂率和体骨骼肌率与抑郁的关系。方法: 采用便利抽样法选取2022年7—10月在安徽医科大学附属第一医院生殖医学中心行辅助生殖技术治疗的不孕不育患者885例, 采用患者健康问卷9项抑郁量表(patient health questionnaire-9, PHQ-9)调查患者抑郁情况, 采用生物电阻抗(bioelectrical impedance analysis, BIA)原理的InBody仪测量人群体脂率以及体骨骼肌率的数据, 使用多元线性回归、广义线性模型、趋势化检验探讨体脂率、体骨骼肌率与抑郁的关联, 采用限制性立方样条分析其剂量-反应关系。结果: 辅助生殖人群的抑郁检出率为52.0%, 体脂率平均值为28.01%, 体骨骼肌率平均值为39.73%。控制混杂因素后, 体脂率与抑郁呈正相关(β=0.07, 95%CI: 0.01, 0.14), 体骨骼肌率与抑郁呈负相关(β=-0.12, 95%CI: -0.24, -0.01), 且在男性、年龄>30岁的辅助生殖人群中相关性有统计学意义(P < 0.05)。辅助生殖人群的体脂率、体骨骼肌率与抑郁存在显著线性关联(Pnon-linear >0.05)。结论: 辅助生殖人群的体脂率、体骨骼肌率与抑郁风险存在关联, 采取相应的运动和饮食等干预以控制体重、减少体脂肪、增加骨骼肌, 可望降低辅助生殖人群的抑郁发生率。

关键词: 辅助生殖, 脂肪, 抑郁, 骨骼肌, 限制性立方样条

Abstract:

Objective: To investigate the relationship between body fat rates and skeletal muscle rates with depression among patients undergoing assisted reproductive technology (ART) treatments. Methods: A total of 885 infertility patients who underwent ART treatment at the Center for Reproductive Medicine of the First Affiliated Hospital of Anhui Medical University from July to October, 2022 were selected using the convenience sampling method. The basic information of the patients was investigated, depression was investigated using the patient health questionnaire-9 (PHQ-9), and human adiposity and body skeletal muscle rate data were measured using the InBody instrument with the principle of bioelectrical impedance analysis (BIA). Multiple linear regression, generalized linear model, and trend test were used to investigate the association between adiposity, skeletal muscle mass, and depression in the assisted reproduction population, as well as the dose-response relationship using restricted cubic spline (RCS) analysis. Results: The mean detection rate of depression in the ART population was 52.0%, with 55.5% in women and 45.5% in men. The average body fat rate was 28.01%, and the average body skeletal muscle rate was 39.73%. After correcting for confounders, the body fat rate was observed to be positively associated with depression (β=0.07, 95%CI: 0.01, 0.14), and the body skeletal muscle rate was negatively associated with depression (β=-0.12, 95%CI: -0.24, -0.01). Trend-based tests showed a highly significant monotonically increasing trend in depression with the increasing body fat rate and the decreasing body skeletal muscle rate. These associations were significant (P < 0.05) in the male population and in the assisted reproduction population aged >30 years. No significant non-linear associations were found between the body fat rate, the skeletal muscle rate and depression in the overall ART-treated population (Pnon-linear>0.05). Conclusion: The patients undergoing ART have a higher rate of depression detection, and their body fat and skeletal muscle rates are associated with the risk of depression in ART patients. Interventions, such as weight control, body fat reduction, and an exercise diet that increases skeletal muscle and other body components are expected to reduce the incidence of depression in assisted reproduction.

Key words: Assisted reproduction, Fat, Depression, Skeletal muscle, Restricted cubic spline

中图分类号: 

  • R715.3

表1

患者的基本情况"

Characteristic Total (n=885) Male (n=312) Female (n=573) t/χ2 P value
Age/years, ${\bar x}$±s 30.82±4.37 31.1±1.41 30.7±4.35 -1.337 0.181
Education level, n (%) 0.863 0.065
  Below junior high school 260 (9.4) 86 (27.6) 174 (30.4)
  High school or secondary school 335 (37.9) 123 (39.4) 212 (37.0)
  Bachelor’s degree and above 290 (32.8) 103 (33.0) 187 (32.6)
Annual income, n (%) 75.446 < 0.001
  Less than 30 000 yuan 341 (38.5) 81 (26.0) 260 (45.4)
  30 000-100 000 yuan 401 (45.3) 138 (44.2) 263 (45.9)
  More than 100 000 yuan 143 (16.2) 93 (29.8) 50 (8.7)
Type of marriage, n (%) 7.083 0.008
  First marriage family 796 (89.9) 292 (93.6) 504 (88.0)
  Reorganized family 89 (10.1) 20 (6.4) 69 (12.0)
Infertility causes, n (%) 9.448 0.024
  Male 142 (16.0) 59 (18.9) 83 (14.5)
  Female 329 (37.2) 97 (31.3) 232 (40.5)
  Both parties have 210 (23.7) 74 (23.7) 136 (23.7)
  Unknown cause 204 (23.1) 82 (26.3) 122 (21.3)
Families’ perceptions of ART, n (%) 3.365 0.067
  Supports 785 (88.7) 285 (91.3) 500 (87.3)
  Objection 100 (11.3) 27 (8.7) 73 (12.7)
Physical activity, n (%) 33.355 < 0.001
  Low 295 (33.3) 70 (22.4) 225 (39.3)
  Middle 295 (33.3) 105 (33.7) 190 (33.2)
  High 295 (33.3) 137 (43.9) 158 (27.6)
Height/cm, ${\bar x}$±s 164.38±8.04 171.78±6.23 160.34±5.71 -20.429 < 0.001
Weight/kg, ${\bar x}$±s 65.67±13.09 75.99±12.90 60.04±9.20 -17.349 < 0.001
BMI/(kg/m2), ${\bar x}$±s 24.19±3.78 25.71±3.87 23.37±3.47 -9.014 < 0.001
Total body fat rate/%, ${\bar x}$±s 28.01±7.06 24.37±6.75 29.99±6.41 -12.240 < 0.001
Total skeletal muscle rate/%, ${\bar x}$±s 39.73±4.22 42.74±3.82 38.10±3.47 18.356 < 0.001
Depression score, ${\bar x}$±s 5.16±3.99 4.44±3.98 5.54±3.95 -4.450 < 0.001

表2

辅助生殖人群体脂率、体骨骼肌率与抑郁的关联"

Variable Total (n=885)
β (95%CI)a P valuea β (95%CI)b P valueb
BF%
  Q1 (≤24.50), M=21.40 0 0
  Q2 (24.51-31.20), M=28.10 0.93 (0.29, 1.57) 0.004 1.30 (0.35, 2.25) 0.007
  Q3 (>31.21), M=34.70 1.24 (0.61, 0.88) < 0.001 0.82 (0.11, 1.54) 0.025
  Ptrend < 0.001
  BF% (continuous variable) 0.06 (0.02, 0.10) 0.002 0.07 (0.01, 0.14) 0.040
SM%
  Q1 (≤37.68), M=35.66 0 0
  Q2 (37.69-41.46), M=39.53 -0.13 (-0.77, 0.51) 0.688 -0.14 (-0.87, 0.59) 0.712
  Q3 (>41.47), M=43.89 -1.33 (-1.97, -0.69) < 0.001 -1.16 (-2.12, -0.20) 0.018
  Ptrend < 0.001
  SM% (continuous variable) -0.12 (-0.18, -0.06) < 0.001 -0.12 (-0.24, -0.01) 0.029

图1

辅助生殖人群体脂率、体骨骼肌率与抑郁的剂量-反应关系"

表3

按年龄、性别分层的辅助生殖人群体脂率、体骨骼肌率与抑郁的关联"

Variable Gender
Male (n=312) Female (n=573)
β (95%CI) P value β (95%CI) P valuea
BF%
  Q1 (≤24.50), M=21.40 0 0
  Q2 (24.51-31.20), M=28.10 1.26 (0.12, 2.40) 0.030 0.28 (-0.63, 1.20) 0.544
  Q3 (>31.21), M=34.70 2.05 (0.37, 3.72) 0.017 0.67 (-0.50, 1.83) 0.263
  Ptrend 0.020 0.136
  BF% (continuous variable) 0.08 (-0.03, 0.19) 0.144 0.05 (-0.04, 0.14) 0.302
SM%
  Q1 (≤37.68), M=35.66 0 0
  Q2 (37.69-41.46), M=39.53 0.87 (-0.90, 2.64) 0.332 -0.21 (-1.01, 0.60) 0.617
  Q3 (>41.47), M=43.89 -0.62 (-2.55, 1.31) 0.529 -0.67 (-1.83, 0.50) 0.262
  Ptrend 0.092 0.072
  SM% (continuous variable) -0.14 (-0.31, 0.04) 0.120 -0.09 (-0.23, 0.06) 0.249
Variable Age
≤30 years old (n=444) >30 years old (n=441)
β (95%CI) P value β (95%CI) P value
BF%
  Q1 (≤24.50), M=21.40 0 0
  Q2 (24.51-31.20), M=28.10 0.42 (-0.59, 1.44) 0.280 1.19 (0.18, 2.19) 0.008
  Q3 (>31.21), M=34.70 0.73 (-0.59, 2.05) 0.146 1.83 (0.48, 3.19) 0.020
  Ptrend < 0.001 0.089
  BF% (continuous variable) 0.02 (-0.08, 0.11) 0.764 0.12 (0.02, 0.22) 0.018
SM%
  Q1 (≤37.68), M=35.66 0 0
  Q2 (37.69-41.46), M=39.53 0.15 (-0.81, 1.11) 0.764 -0.61 (-1.71, 0.49) 0.270
  Q3 (>41.47), M=43.89 -0.66 (-1.98, 0.66) 0.326 -1.74 (-3.13, -0.34) 0.015
  Ptrend < 0.001 0.066
  SM% (continuous variable) -0.03 (-0.18, 0.13) 0.684 -0.19 (-0.35, -0.03) 0.013

图2

不同性别、年龄辅助生殖人群体脂率、体骨骼肌率与抑郁的剂量-反应关系"

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