title: Depressive symptoms are associated with visceral adiposity in a community-based sample of middle-aged women and men.
abstract: OBJECTIVE
  To examine the relation between measures of adiposity and depressive symptoms in a large well characterized community-based sample, we examined the relations of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) to depressive symptoms in 1,581 women (mean age 52.2 years) and 1,718 men (mean age 49.8 years) in the Framingham Heart Study.
  
  
  METHODS
  Depressive symptoms were measured using the Center for Epidemiologic Studies Depression (CES-D) scale. Regression models were created to examine the association between each fat depot (exposure) and depressive symptoms (outcome). Sex-specific models were adjusted for age, body mass index, smoking, alcohol consumption, diabetes, hypertension, total and HDL cholesterol, lipid lowering treatment, CVD, menopause, C-reactive protein, and physical activity.
  
  
  RESULTS
  Mean CES-D scores were 6.8 and 5.6 in women and men. High levels of depressive symptoms were present in 22.5% of women and 12.3% of men. In women, one standard deviation increase in VAT was associated with a 1.3 point higher CES-D score after adjusting for age and BMI (P < 0.01) and remained significant in the fully adjusted model (P = 0.03). The odds ratio of depressive symptoms per 1 standard deviation increase in VAT in women was 1.33 (P = 0.015); results were attenuated in fully adjusted models (OR 1.29, P = 0.055). In men, the association between VAT and CES-D score and depressive symptoms was not significant. SAT was not associated with CES-D score or depressive symptoms.
  
  
  CONCLUSIONS
  This study supports an association between VAT and depressive symptoms in women. Further work is needed to uncover the complex biologic mechanisms mediating the association.
authors.affiliation: Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA. murabito@bu.edu
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Murabito
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.forename: Brian
authors.initials: B
authors.lastname: Clifford
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
mesh_terms: D050154:Adiposity; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D008076:Cholesterol, HDL / Q000378:metabolism; D003430:Cross-Sectional Studies; D003863:Depression / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D008297:Male; D008593:Menopause; D008875:Middle Aged; D009043:Motor Activity; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000503:physiopathology*
chemical_list: D000928:Antidepressive Agents; D008076:Cholesterol, HDL; D002097:C-Reactive Protein