Metabolically healthy obesity and depressive symptoms: 16-year follow-up of the Gazel cohort study

Guy-Marino Hinnouho, Archana Singh-Manoux, Alice Gueguen, Joane Matta, Cedric Lemogne, Marcel Goldberg, Marie Zins and Sébastien Czernichow

PLOS ONE, 2017, vol. 12, issue 4, 1-10

Abstract: Aims: The health correlates of the metabolically healthy obese (MHO) phenotype, particularly in relation to depressive symptoms remains unclear. Accordingly, we examined the risk of depressive symptoms in this phenotype using a 16-year follow-up prospective study. Methods: A sample of 14 475 participants (75% men), aged 44–59 years in 1996, was drawn from the Gazel cohort. Obesity was defined as body mass index (BMI) ≥ 30 kg/m2 and metabolic health as having none of the self-reported following cardiovascular risk factors: hypertension, type 2 diabetes and dyslipidemia. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression (CES-D) scale in 1996, 1999, 2002, 2005, 2008 and 2012. Generalized Estimating Equations (GEE) were used to estimate the risk of depressive symptoms during a follow-up of 16 years. Results: In multivariate analyses, metabolically unhealthy normal weight [Odds Ratio (OR) = 1.37; 95% Confidence Interval (CI): 1.25–1.51], overweight [1.44 (1.31–1.59)] and obese [1.30 (1.10–1.54)] but not MHO participants [1.04 (0.81–1.32)] had higher risk of depressive symptoms at the start of follow-up compared to metabolically healthy normal weight individuals. Depressive symptoms decreased over time in metabolically healthy normal weight individuals [0.52 (0.50–0.55)], this decrease was less marked only in metabolically unhealthy obese participants [1.22 (1.07–1.40)]. Compared to MHO participants, metabolically unhealthy obese individuals were at increased risk of depression at the start of follow-up, but with a similar reduction of this risk over time. Conclusion: Poor metabolic health, irrespective of BMI was associated with greater depressive symptoms at the start of follow-up, whereas a poorer course of depressive symptoms over time was observed only in those with both obesity and poor metabolic health.

Date: 2017
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0174678

DOI: 10.1371/journal.pone.0174678

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