title: Association of metabolically healthy obesity with depressive symptoms: pooled analysis of eight studies.
abstract: The hypothesis of metabolically healthy obesity posits that adverse health effects of obesity are largely avoided when obesity is accompanied by a favorable metabolic profile. We tested this hypothesis with depressive symptoms as the outcome using cross-sectional data on obesity, metabolic health and depressive symptoms. Data were extracted from eight studies and pooled for individual-participant meta-analysis with 30,337 men and women aged 15-105 years (mean age=46.1). Clinic measures included height, weight and metabolic risk factors (high blood pressure, high triglycerides, low high-density lipoprotein cholesterol, high C-reactive protein and high glycated hemoglobin). Depressive symptoms were assessed using clinical interview or standardized rating scales. The pooled sample comprised 7673 (25%) obese participants (body mass index ⩾30 kg m(-2)). Compared to all non-obese individuals, the OR for depressive symptoms was higher in metabolically unhealthy obese individuals with two or more metabolic risk factors (1.45; 95% confidence interval (CI)=1.30, 1.61) and for metabolically healthy obese with ⩽1 metabolic risk factor (1.19; 95% CI=1.03, 1.37), adjusted for sex, age and race/ethnicity. Metabolically unhealthy obesity was associated with higher depression risk (OR=1.23; 95% CI=1.05, 1.45) compared with metabolically healthy obesity. These associations were consistent across studies with no evidence for heterogeneity in estimates (all I(2)-values<4%). In conclusion, obese persons with a favorable metabolic profile have a slightly increased risk of depressive symptoms compared with non-obese, but the risk is greater when obesity is combined with an adverse metabolic profile. These findings suggest that metabolically healthy obesity is not a completely benign condition in relation to depression risk.
authors.affiliation: Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Jokela
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Hamer
authors.affiliation: 1] Department of Epidemiology and Public Health, University College London, London, UK [2] INSERM, U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.
authors.forename: A
authors.initials: A
authors.lastname: Singh-Manoux
authors.affiliation: 1] Department of Epidemiology and Public Health, University College London, London, UK [2] Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK [3] Alzheimer Scotland Dementia Research Centre, Department of Psychology, University of Edinburgh, Edinburgh, UK.
authors.forename: G D
authors.initials: GD
authors.lastname: Batty
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Kivimäki
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D003863:Depression / Q000097:blood / Q000150:complications* / Q000378:metabolism / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006304:Health Status; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000378:metabolism* / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D008055:Lipids