Email Alert | RSS

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

Previous Articles     Next Articles

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)

RICH HTML

   

PDF (PC)

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."

1 Charlson F , van Ommeren M , Flaxman A , et al.New WHO pre-valence estimates of mental disorders in conflict settings: Asyste- matic review and meta-analysis[J].Lancet,2019,394(10194):240-248.
doi: 10.1016/S0140-6736(19)30934-1
2 Lu J , Xu XF , Huang YQ , et al.Prevalence of depressive disorders and treatment in China: A cross-sectional epidemiological study[J].Lancet Psychiat,2021,8(11):981-990.
doi: 10.1016/S2215-0366(21)00251-0
3 Clarke DM , Currie KC .Depression, anxiety and their relationship with chronic diseases: A review of the epidemiology, risk and treatment evidence[J].Med J Australia,2009,190(7):S54-S60.
4 Blaine B .Does depression cause obesity? A meta-analysis of longitudinal studies of depression and weight control[J].J Health Psychol,2008,13(8):1190-1197.
doi: 10.1177/1359105308095977
5 Dixon JB , Dixon ME , O'Brien PE .Depression in association with severe obesity: Changes with weight loss[J].Arch Intern Med,2003,163(17):2058-2065.
doi: 10.1001/archinte.163.17.2058
6 Quek YH , Tam WWS , Zhang MWB , et al.Exploring the association between childhood and adolescent obesity and depression: A meta-analysis[J].Obes Rev,2017,18(7):742-754.
doi: 10.1111/obr.12535
7 Rao WW , Zong QQ , Zhang JW , et al.Obesity increases the risk of depression in children and adolescents: Results from a systema-tic review and meta-analysis[J].J Affect Disorders,2020,267,78-85.
doi: 10.1016/j.jad.2020.01.154
8 Cole TJ , Bellizzi MC , Flegal KM , et al.Establishing a standard definition for child overweight and obesity worldwide: International survey[J].BMJ,2000,320(7244):1240-1243.
doi: 10.1136/bmj.320.7244.1240
9 国家卫生和计划生育委员会. 学龄儿童青少年超重与肥胖筛查[S]. (2018-08-01)[2023-01-05]. https://www.chinacdc.cn/jkzt/yyhspws/xzdc/201804/P020180418380884895984.pdf.
10 Javed A , Jumean M , Murad MH , et al.Diagnostic performance of body mass index to identify obesity as defined by body adiposity in children and adolescents: A systematic review and meta-analysis[J].Pediatr Obes,2015,10(3):234-244.
doi: 10.1111/ijpo.242
11 Romero-Corral A , Somers VK , Sierra-Johnson J , et al.Accuracy of body mass index in diagnosing obesity in the adult general population[J].Int J Obesity,2008,32(6):959-966.
doi: 10.1038/ijo.2008.11
12 Zhou Y , Hoglund P , Clyne N .Comparison of DEXA and bioimpedance for body composition measurements in nondialysis patients with CKD[J].J Ren Nutr,2019,29(1):33-38.
doi: 10.1053/j.jrn.2018.05.003
13 Liu XJ , Zhang DD , Liu Y , et al.Dose response association between physical activity and incident hypertension: A systematic review and meta-analysis of cohort studies[J].Hypertension,2017,69(5):813-820.
doi: 10.1161/HYPERTENSIONAHA.116.08994
14 Ye SY , Zhu CN , Wei C , et al.Associations of body composition with blood pressure and hypertension[J].Obesity,2018,26(10):1644-1650.
doi: 10.1002/oby.22291
15 Kovacs M .The childrens depression inventory (CDI)[J].Psychopharmacol Bull,1985,21(4):995-998.
16 Helsel WJ , Matson JL .The assessment of depression in children: The internal structure of the child depression inventory (CDI)[J].Behav Res Ther,1984,22(3):289-298.
doi: 10.1016/0005-7967(84)90009-3
17 Lagreca AM , Dandes SK , Wick P , et al.Development of the social anxiety scale for children: Reliability and concurrent validity[J].J Clin Child Psychol,1988,17(1):84-91.
doi: 10.1207/s15374424jccp1701_11
18 Zhao G , Ford ES , Dhingra S , et al.Depression and anxiety among US adults: Associations with body mass index[J].Int J Obesity,2009,33(2):257-266.
doi: 10.1038/ijo.2008.268
19 陈曼曼, 马莹, 苏彬彬, 等.北京市7~18岁儿童青少年体成分百分位值变化特征[J].中国学校卫生,2021,42(11):1703-1707.
20 He W , James S A , Merli MG , et al.An increasing socioeconomic gap in childhood overweight and obesity in China[J].Am J Public Health,2014,104(1):E14-E22.
doi: 10.2105/AJPH.2013.301669
21 Chung KH , Chiou HY , Chen YH .Psychological and physiological correlates of childhood obesity in Taiwan[J].Sci Rep,2015,5,17439.
doi: 10.1038/srep17439
22 Merikangas AK , Mendola P , Pastor PN , et al.The association between major depressive disorder and obesity in US adolescents: Results from the 2001-2004 National Health and Nutrition Exa-mination Survey[J].J Behav Med,2012,35(2):149-154.
doi: 10.1007/s10865-011-9340-x
23 陆迪菲, 袁振芳, 杨丽华, 等.肥胖人群焦虑抑郁情况与肥胖程度相关性的调查分析[J].中国糖尿病杂志,2019,27(8):592-596.
24 Chung S .Body composition analysis and references in children: Clinical usefulness and limitations[J].Eur J Clin Nutr,2019,73(2):236-242.
doi: 10.1038/s41430-018-0322-8
25 Rapuano KM , Laurent JS , Hagler DJ , et al.Nucleus accumbens cytoarchitecture predicts weight gain in children[J].Proc Natl Acad Sci USA,2020,117(43):26977-26984.
doi: 10.1073/pnas.2007918117
26 Dionysopoulou S , Charmandari E , Bargiota A , et al.The role of hypothalamic inflammation in diet-induced obesity and its association with cognitive and mood disorders[J].Nutrients,2021,13(2):498.
doi: 10.3390/nu13020498
27 Zhang JH , Lam SP , Li SX , et al.A community-based study on the association between insomnia and hypothalamic-pituitary-adrenal axis: Sex and pubertal influences[J].J Clin Endocr Metab,2014,99(6):2277-2287.
doi: 10.1210/jc.2013-3728
28 Kohler CA , Freitas TH , Maes M , et al.Peripheral cytokine and chemokine alterations in depression: A meta-analysis of 82 studies[J].Acta Psychiat Scand,2017,135(5):373-387.
doi: 10.1111/acps.12698
29 Jantaratnotai N , Mosikanon K , Lee Y , et al.The interface of depression and obesity[J].Obes Res Clin Pract,2017,11(1):1-10.
30 Pierce GL , Kalil GZ , Ajibewa T , et al.Anxiety independently contributes to elevated inflammation in humans with obesity[J].Obesity,2017,25(2):286-289.
31 Dos Santos RRG , Forte GC , Mundstock E , et al.Body composition parameters can better predict body size dissatisfaction than body mass index in children and adolescents[J].Eat Weight Disord,2020,25(5):1197-1203.
[1] Min WANG, Qian LI. Path analysis of influencing factors of mental resilience in adolescents with depression [J]. Journal of Peking University (Health Sciences), 2024, 56(5): 809-814.
[2] Huameng TANG,Dianqi YUAN,Mingxing WANG,Hanbing YANG,Chao GUO. Sequential mediating role of digital participation and health lifestyle in the relationship between socioeconomic status and depression of older adults [J]. Journal of Peking University (Health Sciences), 2024, 56(2): 230-238.
[3] Jin-hui LAI,Qi WANG,Jia-xiang JI,Ming-rui WANG,Xin-wei TANG,Ke-xin XU,Tao XU,Hao HU. Effects of delayed ureteral stents removal during the COVID-19 pandemic on the quality of life and psychological status of postoperative patients with urinary calculi [J]. Journal of Peking University (Health Sciences), 2023, 55(5): 857-864.
[4] FAN Li-shi,GAO Min,Edwin B. FISHER,SUN Xin-ying. Factors associated with quality of life in 747 patients with type 2 diabetes in Tongzhou District and Shunyi District of Beijing [J]. Journal of Peking University (Health Sciences), 2021, 53(3): 523-529.
[5] Yi-fan WANG,Zhen FAN,Yao-bin CHENG,Yue-bo JIN,Yang HUO,Jing HE. Investigation of sleep disturbance and related factors in patients with primary Sjögren’s syndrome [J]. Journal of Peking University (Health Sciences), 2020, 52(6): 1063-1068.
[6] Yan GENG,Zhi-bo SONG,Xiao-hui ZHANG,Xue-rong DENG,Yu WANG,Zhuo-li ZHANG. Depression and anxiety in patients with psoriatic arthritis: Prevalence and associated factors [J]. Journal of Peking University (Health Sciences), 2020, 52(6): 1048-1055.
[7] Duan YI,Wei ZHU,Xiu-li MENG,Xiao-guang LIU,Shui-qing LI,Bin ZHU,Dong-lin JIA. Analysis of anxiety, depression and related factors in patients with chronic lumbocrural pain before minimally invasive surgery [J]. Journal of Peking University (Health Sciences), 2020, 52(2): 285-289.
[8] LEI Jie，LIU Mu-qing，FU Kai-yuan. Disturbedsleep, anxiety and stress are possible risk indicators for temporomandibular disorders with myofascialpain [J]. Journal of Peking University(Health Sciences), 2016, 48(4): 692-696.
[9] LIU Yi-Xuan, ZHANG Yong-Shen, DUAN Li-Ping, ZHANG Lu, YANG Chang-Qing. Effect of inherent depression on chronic visceral hypersensitivity induced by colon acetate stimulation in neonatal rats [J]. Journal of Peking University(Health Sciences), 2015, 47(2): 289-294.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd