Psychother Psychosom Med Psychol 2014; 64(03/04): 128-135
DOI: 10.1055/s-0033-1349097
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Adipositas und Depressions- und Angstsymptome ­bei prä- und post-menopausalen Frauen: Ein Vergleich verschiedener Adipositasmaße

Obesity and Symptoms of Depression and Anxiety in Pre- and Postmenopausal Women: A Comparison of Different Obesity Indicators
Birk Zedler*
1   Forschungs- und Lehreinheit Medizinische Psychologie, Medizinische Hochschule Hannover
,
Thomas von Lengerke*
1   Forschungs- und Lehreinheit Medizinische Psychologie, Medizinische Hochschule Hannover
,
Rebecca Emeny
2   Helmholtz Zentrum München – Deutsches Forschungszentrum für Gesundheit und Umwelt, Institut für Epidemiologie II, Neuherberg
,
Margit Heier
2   Helmholtz Zentrum München – Deutsches Forschungszentrum für Gesundheit und Umwelt, Institut für Epidemiologie II, Neuherberg
,
Maria Elena Lacruz
2   Helmholtz Zentrum München – Deutsches Forschungszentrum für Gesundheit und Umwelt, Institut für Epidemiologie II, Neuherberg
,
Karl-Heinz Ladwig
2   Helmholtz Zentrum München – Deutsches Forschungszentrum für Gesundheit und Umwelt, Institut für Epidemiologie II, Neuherberg
› Author Affiliations
Further Information

Publication History

eingereicht 11 December 2012

akzeptiert 03 May 2013

Publication Date:
21 August 2013 (online)

Zusammenfassung

Die Studie untersucht Unterschiede in der Auftretensrate depressiver und ängstlicher Symptome zwischen über- und normalgewichtigen Frauen vor bzw. nach der Menopause. Bei einer Bevölkerungsstichprobe von 1 416 Teilnehmerinnen des KORA-Survey F3 2004–2005 (35–74 Jahre) wurden Körpermassenindex (BMI), Taillenumfang (WC), Taille-Hüft-Verhältnis (WHR) und Taille-Größe-Verhältnis (WHtR) in einer körperlichen Untersuchung gemessen. Depression und Angst wurden mit der Hospital Anxiety and Depression Scale erhoben. Im Vergleich zu Normalgewicht war Adipositas mit Depression bei prämenopausalen Frauen assoziiert. Dies galt für erhöhte BMI-, WC- und WHtR-Werte (OR=3,7, 4,2 bzw. 2,8), was die Relevanz allgemeiner und abdomineller Adipositas unterstreicht. Der Menopausenstatus könnte ein Moderator für die Assoziation von Adipositas und Depression darstellen, was angesichts der Interaktion dieser Risikofaktoren auch präventiv bei der Entstehung kardiovaskulärer Outcomes wie der koronaren Herzkrankheit bedeutsam sein könnte.

Abstract

This study examines differences in the rates of depression and anxiety symptoms in overweight vs. normal weight women before and after the menopause. In a population sample of 1 416 participants of the KORA-Survey F3 2004–2005 (age 35–74 years), body mass index (BMI), waist circumference (WC), waist-to-hip-ratio (WHR) und waist-to-height-ratio (WHtR) were measured via physical examination. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale. Compared with normal weight, obesity was associated with depression in premenopausal women. This held for elevated BMI-, WC- and WHtR-scores (OR=3.7, 4.2, and 2.8), underlining the relevance of both general and abdominal obesity. Menopausal status may be a moderator for the association of obesity and depression, which – given the interaction between these 2 risk factors – may be of preven­tive importance in regard to the development of cardiovascular outcomes such as coronary heart disease.

* Gleichwertiger Beitrag/geteilte Erstautorenschaft.


Ergänzendes Material

 
  • Literatur

  • 1 Atlantis E, Baker M. Obesity effects on depression: systematic review of epidemiological studies. Int J Obes 2008; 32: 881-891
  • 2 Faith MS, Butryn M, Wadden TA et al. Evidence for prospective associations among depression and obesity in population-based studies. Obes Rev 2011; 12: e438-e453
  • 3 Luppino FS, de Wit LM, Bouvy PF et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010; 67: 220-229
  • 4 Gariepy G, Nitka D, Schmitz N. The association between obesity and anxiety disorders in the population: a systematic review and meta-analysis. Int J Obes 2010; 34: 407-419
  • 5 Stunkard AJ, Faith MS, Allison KC. Depression and obesity. Biol Psychiatry 2003; 54: 330-337
  • 6 Hilbert A, Rief W, Braehler E. Stigmatizing attitudes toward obesity in a representative population-based sample. Obesity (Silver Spring) 2008; 16: 1529-1534
  • 7 Bornstein SR, Schuppenies A, Wong ML et al. Approaching the shared biology of obesity and depression: the stress axis as the locus of gene-environment interactions. Mol Psychiatry 2006; 11: 892-902
  • 8 Rivenes AC, Harvey SB, Mykletun A. The relationship between abdominal fat, obesity, and common mental disorders: results from the HUNT study. J Psychosom Res 2009; 66: 269-275
  • 9 Genazzani AR, Gambacciani M. Effect of climacteric transition and hormone replacement therapy on body weight and body fat distribution. Gynecol Endocrinol 2006; 22: 145-150
  • 10 Bromberger JT, Schott LL, Kravitz HM et al. Longitudinal change in reproductive hormones and depressive symptoms across the menopausal transition: results from the Study of Women’s Health Across the Nation (SWAN). Arch Gen Psychiatry 2010; 67: 598-607
  • 11 Jones GL, Sutton A. Quality of life in obese postmenopausal women. Menopause Int 2008; 14: 26-32
  • 12 Lee CM, Huxley RR, Wildman RP et al. Indices of abdominal ­obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol 2008; 61: 646-653
  • 13 Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev 2012; 13: 275-286
  • 14 Towfighi A, Zheng L, Ovbiagele B. Weight of the obesity epidemic: rising stroke rates among middle-aged women in the United States. Stroke 2010; 41: 1371-1375
  • 15 Schneider HJ, Friedrich N, Klotsche J et al. The predictive value of different measures of obesity for incident cardiovascular events and mortality. J Clin Endocrinol Metab 2010; 95: 1777-1785
  • 16 Ashwell M, Hsieh SD. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr 2005; 56: 303-307
  • 17 van Dijk SB, Takken T, Prinsen EC et al. Different anthropometric adiposity measures and their association with cardiovascular disease risk factors: a meta-analysis. Neth Heart J 2012; 20: 208-218
  • 18 Kodama S, Horikawa C, Fujihara K et al. Comparisons of the Strength of Associations With Future Type 2 Diabetes Risk Among Anthropometric Obesity Indicators, Including Waist-to-Height Ratio: A Meta-Analysis. Am J Epidemiol 2012; DOI: 10.1093/aje/kws172.
  • 19 von Lengerke T, Stehr M. Sind adipöse Erwachsene in ihrer psychischen gesundheitsbezogenen Lebensqualität eingeschränkt? Eine systematische Übersicht neuerer Studien. Adipositas 2011; 5: 30-36
  • 20 Kulzer B, Albus C, Herpertz S et al. Psychosoziales und Diabetes mellitus. Diabetologie 2012; 7: S136-S142
  • 21 Holle R, Happich M, Lowel H et al. KORA – a research platform for pop­ulation based health research. Gesundheitswesen 2005; 67: S19-S25
  • 22 Lowel H, Doring A, Schneider A et al. The MONICA Augsburg surveys – basis for prospective cohort studies. Gesundheitswesen 2005; 67: S13-S18
  • 23 McLaren L, Gauvin L. Neighbourhood level versus individual level correlates of women’s body dissatisfaction: toward a multilevel understanding of the role of affluence. J Epidemiol Community Health 2002; 56: 193-199
  • 24 McLaren L, Gauvin L. Does the ‘average size’ of women in the neighbourhood influence a woman’s likelihood of body dissatisfaction?. Health Place 2003; 9: 327-335
  • 25 Hermann-Lingen C, Buss U, Snaith RP. HADS-D: Hospital Anxiety and Depression Scale, Deutsche Version. Manual. Bern: Huber; 2011
  • 26 WHO . Obesity: Preventing and managing the global epidemic. Geneva: WHO; 2000
  • 27 Han TS, van Leer EM, Seidell JC et al. Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ 1995; 311: 1401-1405
  • 28 DGSP . S1-Leitlinie: Vorsorgeuntersuchung im Sport. Frankfurt/Main: DGSP; 2007
  • 29 Browning LM, Hsieh SD, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value. Nutr Res Rev 2010; 23: 247-269
  • 30 Schneider HJ, Glaesmer H, Klotsche J et al. Accuracy of anthropometric indicators of obesity to predict cardiovascular risk. J Clin Endocrinol Metab 2007; 92: 589-594
  • 31 [Anonym] . National Institutes of Health State-of-the-Science Conference statement: management of menopause-related symptoms. Ann Intern Med 2005; 142: 1003-1013
  • 32 Nocon M, Keil T, Willich SN. Education, income, occupational status and health risk behaviour. J Public Health 2007; 15: 401-405
  • 33 DGPPN BÄK KBV et al. S3-Leitlinie/Nationale VersorgungsLeitlinie Unipolare Depression-Kurzfassung. Berlin, Düsseldorf: DGPPN, ÄZQ, AWMF; 2009
  • 34 Walendzik A, Rabe-Menssenl C, Lux G et al. Erhebung zur ambulanten psychotherapeutischen Versorgung. 2010. Duisburg-Essen: Alfried Krupp von Bohlen und Halbach-Stiftungslehrstuhl für Medizinmanagement, Universität Duisburg-Essen; o. J.;
  • 35 Jacobi F, Wittchen HU, Holting C et al. Prevalence, co-morbidity and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey (GHS). Psychol Med 2004; 34: 597-611
  • 36 von Gruchalla B, Hahlweg-Widmoser B, Gugger B et al. Peri- and postmenopausal changes – body awareness, sexuality, and self-image of the middle-aged and older woman. Zentralbl Gynakol 2003; 125: 202-208
  • 37 Terauchi M, Hiramitsu S, Akiyoshi M et al. Associations between anxiety, depression and insomnia in peri- and post-menopausal women. Maturitas 2012; 72: 61-65
  • 38 Jasienska G, Ziomkiewicz A, Gorkiewicz M et al. Body mass, depressive symptoms and menopausal status: an examination of the “Jolly Fat” hypothesis. Womens Health Issues 2005; 15: 145-151
  • 39 Stuart MJ, Baune BT. Depression and type 2 diabetes: inflammatory mechanisms of a psychoneuroendocrine co-morbidity. Neurosci Biobehav Rev 2012; 36: 658-676
  • 40 Wu HY, Xu SY, Chen LL et al. Waist to height ratio as a predictor of abdominal fat distribution in men. Chin J Physiol 2009; 52: 441-445
  • 41 Klöting N, Stumvoll M, Blüher M. Biologie des viszeralen Fetts. Internist 2007; 48: 126-133
  • 42 Hoffmann W, Terschuren C, Holle R et al. The problem of response in epidemiologic studies in Germany (Part II). Gesundheitswesen 2004; 66: 482-491
  • 43 Treloar AE, Boynton RE, Behn BG et al. Variation of the human menstrual cycle through reproductive life. Int J Fertil 1967; 12: 77-126
  • 44 Speroff L. The perimenopausal transition. Ann N Y Acad Sci 2000; 900: 375-392
  • 45 Treloar AE. Menstrual cyclicity and the pre-menopause. Maturitas 1981; 3: 249-264
  • 46 McKinlay SM, Brambilla DJ, Posner JG. The normal menopause transition. Maturitas 1992; 14: 103-115
  • 47 Schisterman EF, Cole SR, Platt RW. Overadjustment bias and unnecessary adjustment in epidemiologic studies. Epidemiology 2009; 20: 488-495
  • 48 VanderWeele TJ. On the relative nature of overadjustment and un­necessary adjustment. Epidemiology 2009; 20: 496-499
  • 49 Heidelberg DA, Holle R, Lacruz ME et al. Do diabetes and depressed mood affect associations between obesity and quality of life in postmenopause? Results of the KORA-F3 Augsburg population study. Health Qual Life Outcomes 2011; 9: 97
  • 50 Hilbert A, Brahler E, de Zwaan M. Eating disturbances in the German population. Psychother Psychosom Med Psychol 2012; 62: 139-141
  • 51 Albohn-Kuhne C, Rief W. Shame, guilt and social anxiety in obesity with binge-eating disorder. Psychother Psychosom Med Psychol 2011; 61: 412-417
  • 52 Ladwig KH, Marten-Mittag B, Lowel H et al. Synergistic effects of depressed mood and obesity on long-term cardiovascular risks in 1510 obese men and women: results from the MONICA-KORA Augsburg Cohort Study 1984-1998. Int J Obes 2006; 30: 1408-1414
  • 53 Kuehner C. Gender differences in unipolar depression: an update of epidemiological findings and possible explanations. Acta psychiatrica Scandinavica 2003; 108: 163-174
  • 54 Wiltink J, Weber MM, Beutel ME. Mental co-morbidity, health care utilization and illness behaviour in overweight and obese subjects –results from a representative German community survey. Psychother Psychosom Med Psychol 2007; 57: 428-434
  • 55 Everson-Rose SA, Lewis TT, Karavolos K et al. Depressive symptoms and increased visceral fat in middle-aged women. Psychosom Med 2009; 71: 410-416
  • 56 Lee ES, Kim YH, Beck SH et al. Depressive mood and abdominal fat distribution in overweight premenopausal women. Obes Res 2005; 13: 320-325
  • 57 Cornelissen PL, Tovee MJ, Bateson M. Patterns of subcutaneous fat deposition and the relationship between body mass index and waist-to-hip ratio: implications for models of physical attractiveness. J Theor Biol 2009; 256: 343-350