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Journal of Peking University (Health Sciences) ›› 2023, Vol. 55 ›› Issue (3): 429-435. doi: 10.19723/j.issn.1671-167X.2023.03.007

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Association of body fat distribution with depression and social anxiety in children and adolescents: A cross-sectional study based on dual-energy X-ray detection

Wen YUAN1,Yi ZHANG1,Li CHEN1,Jia-nuo JIANG1,Man-man CHEN1,Jie-yu LIU1,Tao MA1,Qi MA1,Meng-jie CUI1,Tong-jun GUO1,Xin-xin WANG2,Yan-hui DONG1,Jun MA1,*()   

  1. 1. Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
    2. School of Public Health and Management, Ningxia Medical University, Yinchuan 750004, China
  • Received:2023-03-01 Online:2023-06-18 Published:2023-06-12
  • Contact: Jun MA E-mail:majunt@bjmu.edu.cn
  • Supported by:
    National Natural Science Foundation of China(81673192);Beijing Natural Science Foundation(7222244)

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Abstract:

Objective: To investigate the status of depression and social anxiety in children and adolescents, and to analyze the association between body fat distribution and depression, social anxiety in children and adolescents. Methods: A total of 1 412 children aged 7 to 18 years in Beijing were included by stratified cluster random sampling method. Body fat distribution, including total body fat percentage (total BF%), Android BF%, Gynoid BF% and Android-to-Gynoid fat ratio (AOI), were obtained by dual-energy X-ray absorption method. Depression and social anxiety were evaluated by Children Depression Inventory and Social Anxiety Scale for Children. Multivariate linear regression and restricted cubic spline analysis were used to estimate the linear and non-linear correlation between body fat distribution and depression and social anxiety. Results: 13.1% and 31.1% of the children and adolescents had depressive symptoms and social anxiety symptoms respectively, and the detection rate of depression and social anxiety in the boys and young groups was significantly lower than those in the girls and old groups. There was no significant linear correlation between total BF%, Android BF%, Gynoid BF%, AOI and depression and social anxiety in the children and adolescents. However, total BF% and Gynoid BF% had significant nonlinear correlation with depression, showing an inverted U-shaped curve relationship with the tangent points of 26.8% and 30.9%, respectively. In terms of the nonlinear association of total BF%, Android BF%, Gynoid BF% and AOI with depression and social anxiety, the change trends of the boys and girls, low age group and high age group were consistent. The overall anxiety risk HR of body fat distribution in the boys was significantly higher than that in the girls, and the risk HR of depression and social anxiety were significantly higher in the high age group than those in the low age group. Conclusion: There was no significant linear correlation between body fat distribution and depression and social anxiety in children and adolescents. Total BF% and depression showed an inverted U-shaped curve, mainly manifested in Gynoid BF%, and this trend was consistent in different genders and different age groups. Maintaining children and adolescents' body fat distribution at an appropriate level is the future direction of the prevention and control of depression and social anxiety in children and adolescents.

Key words: Depression, Social anxiety, Body fat distribution, Restrictive cubic splines

CLC Number: 

  • R179

Table 1

Baseline characteristics of included population"

Items TotalGender Age group
Boys Girls t P 7-12 years 13-18 years t P
Sample size 1 412 716 696 688 724
Age/years 11.93±3.60 12.43±3.35 12.35±3.29 9.46±1.7 15.18±1.66
Height/cm 152.77±17.57 158.24±17.09 152.33±13.27 7.26 < 0.001 142.49±11.07 167.53±7.26 -49.97 < 0.001
Weight/kg 49.33±19.09 53.98±19.99 43.60±16.15 5.57 < 0.001 38.63±11.82 63.39±15.06 -34.45 < 0.001
BMI/(kg/m2) 20.34±4.72 20.85±4.78 20.42±4.65 1.71 0.088 18.67±3.79 22.51±4.76 -16.80 < 0.001
Body composition
  BF% 0.29±0.08 0.26±0.09 0.32±0.07 -12.92 < 0.001 0.30±0.07 0.28±0.09 4.62 < 0.001
  Android BF% 0.28±0.12 0.26±0.13 0.30±0.11 -7.03 < 0.001 0.28±0.11 0.28±0.12 -0.56 0.573
  Gynoid BF% 0.32±0.09 0.28±0.09 0.36±0.06 -17.40 < 0.001 0.34±0.08 0.30±0.10 7.34 < 0.001
  AOI 0.34±0.11 0.36±0.12 0.32±0.09 7.08 < 0.001 0.33±0.10 0.35±0.11 -4.41 < 0.001
CDI score 10.80±6.92 10.54±6.39 11.06±7.40 -1.40 0.163 8.77±5.74 12.73±7.38 -11.29 < 0.001
SAS-C score 5.66±4.16 5.14±3.89 6.20±4.39 -4.82 < 0.001 4.85±3.79 6.43±4.36 -7.29 < 0.001
Depression 199 (13.1) 87 (11.2) 112 (15.0) 4.53 0.033 58 (8.4) 141 (19.5) 35.54 < 0.001
Social anxiety 439 (31.1) 153 (26.2) 286 (36.1) 15.84 < 0.001 188 (22.2) 251 (39.5) 40.08 < 0.001

Table 2

Association between fat distribution, depression and social anxiety (standardized regression coefficient, β) among children and adolescents"

ItemsTotal Boys Girls
β (95%CI) P β (95%CI) P β (95%CI) P
Depression
  BF% -0.36 (-0.13, 0.52) 0.421 -0.02 (-0.14, 0.09) 0.713 -0.05 (-0.20, 0.10) 0.520
  Android BF% -0.12 (-0.51, 0.27) 0.536 -0.46 (-1.01, 0.1) 0.109 -0.20 (-0.78, 0.38) 0.501
  Gynoid BF% 0.07 (-0.19, 0.32) 0.621 0.30 (-0.09, 0.68) 0.128 0.07 (-0.32, 0.46) 0.720
  AOI 0.02 (-0.17, 0.21) 0.862 0.17 (-0.08, 0.43) 0.182 0.17 (-0.16, 0.49) 0.319
Social anxiety
  BF% -0.02 (-0.11, 0.07) 0.695 -0.02 (-0.13, 0.10) 0.129 -0.03 (-0.19, 0.12) 0.120
  Android BF% -0.18 (-0.57, 0.22) 0.385 -0.52 (-1.10, 0.05) 0.073 -0.08 (-0.68, 0.51) 0.788
  Gynoid BF% 0.10 (-0.17, 0.36) 0.469 0.33 (-0.06, 0.72) 0.098 0.003 (-0.40, 0.39) 0.982
  AOI 0.06 (-0.13, 0.26) 0.527 0.22 (-0.05, 0.48) 0.105 0.09 (-0.24, 0.42) 0.601
Items6-12 years 13-18 years
β (95%CI) P β (95%CI) P
Depression
  BF% -0.08 (-0.19, 0.04) 0.141 0.004 (-0.14, 0.15) 0.153
  Android BF% -0.50 (-0.98, -0.02) 0.040 0.06 (-0.57, 0.70) 0.845
  Gynoid BF% 0.26 (-0.06, 0.57) 0.110 -0.04 (-0.47, 0.39) 0.865
  AOI 0.23 (-0.03, 0.49) 0.082 0.01 (-0.28, 0.31) 0.926
Social anxiety
  BF% -0.11 (-0.23, 0.02) 0.085 -0.07 (-0.08, 0.21) 0.211
  Android BF% -0.72 (-1.24, -0.20) 0.007 0.27 (-0.35, 0.88) 0.395
  Gynoid BF% 0.36 (0.02, 0.71) 0.037 -0.14 (-0.56, 0.27) 0.499
  AOI 0.31 (0.02, 0.59) 0.034 -0.03 (-0.32, 0.26) 0.824

Figure 1

Nonlinear association of Android BF%, Gynoid BF%, AOI, BF% and depression (A-D), social anxiety (E-H) HR, hazard ratio; CI, confidence interval; BF%, total body fat precent; AOI, Android-to-Gynoid fat ratio."

Figure 2

Nonlinear association of Android BF%, Gynoid BF%, AOI, BF% and depression (A-D), social anxiety (E-H) in different gender Abbreviations as in Figure 1."

Figure 3

Nonlinear association of Android BF%, Gynoid BF%, AOI, BF% and depression (A-D), social anxiety (E-H) in different age groups Abbreviations as in Figure 1."

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