Purpose: The purpose of this study was to investigate the gender differences in the association between body mass index (BMI) and depression status among middle-aged and elderly people living in the community in Taiwan.
Methods: This is a cross-sectional study in northern Taiwan. 243 males and 607 females, aged 50-80 years were eligible for analysis. The participants were categorized in different depression status base on questionnaire according to gender. We applied Center for Epidemiologic Studies Depression Scale 10-item version (CESD-10) questionnaire to evaluate participant’s depression status. The statistical methods of Chi-square test were used to explored the correlation between depression status and categorical variables, including education level, marital status, BMI, self-reported health status, current smoking, alcohol consumption, exercise, employment status, income, hypertension, diabetes, and hyperlipidemia. Furthermore, we also applied multivariate logistic regression analysis.
Results: A total of 850 participants, 243 men and 607 women, were included in the analysis. They were classified into 2 categories by CESD-10 score with cut-off point of 8 in male and female group respectively. There is a significant difference between BMI and depression status in women (p<0.01). However, no significant relationship (p=0.06) between BMI and depression status was found in male group. Multivariate logistic regression analysis indicated that BMI<18.5 subclass has a significant relationship (p=0.02, OR 3.76, 95% CI 1.23-11.46) with depression status in female group.
Conclusions: Our study suggests that BMI below 18.5 is an independent risk factor for depression in females. Thus, when we visit thin middle-aged and elderly female patient, performing depression screening method should be taken into account in our clinical practice, especially those BMI below 18.5.
(Taiwan J Fam Med 2024; 34: 144-158) DOI: 10.53106/168232812024093403004

Key words: BMI, depression, gender differences

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¹Department of Family Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
²College of Medicine, Chang Gung University, Taoyuan, Taiwan.
³Department of Health Management, Xiamen Chang-Gung Hospital, Xiamen, China
Received: April 3, 2024; Revised: May 9, 2024; Accepted: June 3, 2024.
^*Corresponding author: Jau-Yuan Chen, Department of Family Medicine, Linkou Chang Gung Memorial Hospital.
E-mail:welins@cgmh.org.tw

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身體質量指數與憂鬱狀態在台灣社區中老年居民中的關聯性及性別差異之探討

陳若瑄¹ 李文正^1,2 陳昭源^1,2,3＊

目的：本研究旨在探討台灣社區居住的中老年人群中身體質量指數(body mass index, BMI)與憂鬱狀態之間的性別差異。
方法：這是一個在台灣北部進行的橫斷面研究。年齡介於50至80歲的243名男性和607名女性納入統計。依照不同的性別，參與者根據問卷分數被分類為不同的憂鬱狀態。我們採用了流行病學研究中心憂鬱量表10項版本(CESD-10)問卷來評估參與者的憂鬱狀態。並探討了憂鬱症與教育水平、婚姻狀況、BMI、自覺健康量表、吸菸習慣、飲酒習慣、運動、就業、收入、高血壓、糖尿病和高血脂的相關性。我們使用卡方檢定來比較類別變項之間的關係，而多元邏輯斯迴歸分析則使用來探討BMI與憂鬱狀態(CESD-10 ≥ 8分)之間的關聯性。
結果：將參與者根據性別與CESD-10切點8分分析。結果在男性組中，BMI與憂鬱狀態之間沒有顯著關聯(p=0.06)在女性，BMI和自覺健康量表與憂鬱狀態則存在顯著相關性(p<0.01)。我們使用多元邏輯斯迴歸分析，發現在女性組中BMI<18.5的族群與憂鬱狀態有顯著關聯(p=0.02, OR 3.76, 95% CI 1.23-11.46)。
結論：研究表明BMI低於18.5是女性憂鬱症的一個獨立風險因素。因此，我們建議對於BMI低於18.5體型瘦弱的中老年女性應進行憂鬱症篩檢。也強調維持適當的體重有助於改善心理健康，尤其是中老年女性。
(台灣家醫誌2024; 34: 144-158) DOI: 10.53106/168232812024093403004
 
關鍵詞：憂鬱、身體質量指數、性別差異
 

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¹林口長庚醫院家庭醫學部
²長庚大學醫學系
³廈門長庚醫院
受理日期：113年4月3日 修改日期：113年5月9日 同意刊登：113年6月3日
^*通訊作者