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Abstract：
BACKGROUND: The study aimed to examine the bidirectional relationship between sarcopenia and depressive symptoms in a national, community-based cohort study, despite the unclear temporal sequence demonstrated previously.
METHODS: Data were derived from four waves (2011 baseline and 2013, 2015, and 2018 follow-ups) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 17,708 participants aged 45 years or older who had baseline data on both sarcopenia status and depressive symptoms in 2011 were included in the study. For the two cohort analyses, a total of 8092 adults without depressive symptoms and 11,292 participants without sarcopenia in 2011 were included. Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Depressive symptoms were defined as a score of 20 or higher on the 10-item Center for Epidemiologic Studies Depressive Scale (CES-D-10). Cox proportional hazard regression models were conducted to examine the risk of depressive symptoms and sarcopenia risk, while cross-lagged panel models were used to examine the temporal sequence between depressive symptoms and sarcopenia over time.
RESULTS: During a total of 48,305.1 person-years follow-up, 1262 cases of incident depressive symptoms were identified. Sarcopenia exhibited a dose-response relationship with a higher risk of depressive symptoms (HR = 1.7, 95%CI: 1.2-2.3 for sarcopenia, and HR = 1.5, 95%CI: 1.2-1.8 for possible sarcopenia, p trend < 0.001). In the second cohort analysis, 240 incident sarcopenia cases were identified over 39,621.1 person-years. Depressive symptoms (HR = 1.5, 95%CI: 1.2-2.0) are significantly associated with a higher risk of developing sarcopenia after multivariable adjustment (p < 0.001, Cross-lagged panel analyses demonstrated that depressive symptoms were associated with subsequent sarcopenia (β = 0.003, p < 0.001). Simultaneously, baseline sarcopenia was also associated with subsequent depressive symptoms (β = 0.428, p < 0.001).
CONCLUSIONS: This study identified a bidirectional relationship between depressive symptoms and sarcopenia. It seems more probable that baseline sarcopenia is associated with subsequent depressive symptoms in a stronger pattern than the reverse pathway. The interlinkage indicated that maintaining normal muscle mass and strength may serve as a crucial intervention strategy for alleviating mood disorders.
METHODS: Data were derived from four waves (2011 baseline and 2013, 2015, and 2018 follow-ups) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 17,708 participants aged 45 years or older who had baseline data on both sarcopenia status and depressive symptoms in 2011 were included in the study. For the two cohort analyses, a total of 8092 adults without depressive symptoms and 11,292 participants without sarcopenia in 2011 were included. Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Depressive symptoms were defined as a score of 20 or higher on the 10-item Center for Epidemiologic Studies Depressive Scale (CES-D-10). Cox proportional hazard regression models were conducted to examine the risk of depressive symptoms and sarcopenia risk, while cross-lagged panel models were used to examine the temporal sequence between depressive symptoms and sarcopenia over time.
RESULTS: During a total of 48,305.1 person-years follow-up, 1262 cases of incident depressive symptoms were identified. Sarcopenia exhibited a dose-response relationship with a higher risk of depressive symptoms (HR = 1.7, 95%CI: 1.2-2.3 for sarcopenia, and HR = 1.5, 95%CI: 1.2-1.8 for possible sarcopenia, p trend < 0.001). In the second cohort analysis, 240 incident sarcopenia cases were identified over 39,621.1 person-years. Depressive symptoms (HR = 1.5, 95%CI: 1.2-2.0) are significantly associated with a higher risk of developing sarcopenia after multivariable adjustment (p < 0.001, Cross-lagged panel analyses demonstrated that depressive symptoms were associated with subsequent sarcopenia (β = 0.003, p < 0.001). Simultaneously, baseline sarcopenia was also associated with subsequent depressive symptoms (β = 0.428, p < 0.001).
CONCLUSIONS: This study identified a bidirectional relationship between depressive symptoms and sarcopenia. It seems more probable that baseline sarcopenia is associated with subsequent depressive symptoms in a stronger pattern than the reverse pathway. The interlinkage indicated that maintaining normal muscle mass and strength may serve as a crucial intervention strategy for alleviating mood disorders.
摘要：
背景：该研究旨在研究全国范围内肌肉减少症与抑郁症状之间的双向关系，以社区为基础的队列研究，尽管先前显示的时间序列不清楚。
方法：数据来自中国健康与退休纵向研究（CHARLS）的四波（2011年基线和2013年、2015年和2018年随访）。2011年，共有17,708名年龄在45岁或以上的参与者有关于肌肉减少症状态和抑郁症状的基线数据。对于两个队列分析，2011年共有8092例无抑郁症状的成年人和11,292例无肌肉减少症的参与者被纳入.肌少症状态是根据亚洲工作组2019（AWGS2019）标准定义的。抑郁症状定义为10项流行病学研究中心抑郁量表（CES-D-10）上的20分或更高。进行Cox比例风险回归模型以检查抑郁症状和肌肉减少症的风险。而交叉滞后面板模型用于检查抑郁症状和肌肉减少症之间随时间的时间顺序。
结果：在总共48,305.1人年的随访中，发现1262例偶发抑郁症状。肌肉减少症表现出剂量反应关系，抑郁症状的风险更高（HR=1.7，95CI：肌肉减少症的1.2-2.3，对于可能的肌少症，HR=1.5，95CI：1.2-1.8，p趋势<0.001)。在第二个队列分析中，在39,621.1人年期间，发现了240例肌肉减少症事件。抑郁症状（HR=1.5，95CI：1.2-2.0）与多变量调整后发生肌肉减少症的风险显着相关（p<0.001，交叉滞后面板分析显示抑郁症状与随后的肌肉减少症相关（β=0.003，p<0.001）。同时,基线肌肉减少症也与随后的抑郁症状相关(β=0.428,p<0.001)。
结论：本研究确定了抑郁症状和少肌症之间的双向关系。与反向途径相比，基线肌肉减少症似乎更可能与随后的抑郁症状相关。相互联系表明，维持正常的肌肉质量和力量可能是缓解情绪障碍的关键干预策略。
方法：数据来自中国健康与退休纵向研究（CHARLS）的四波（2011年基线和2013年、2015年和2018年随访）。2011年，共有17,708名年龄在45岁或以上的参与者有关于肌肉减少症状态和抑郁症状的基线数据。对于两个队列分析，2011年共有8092例无抑郁症状的成年人和11,292例无肌肉减少症的参与者被纳入.肌少症状态是根据亚洲工作组2019（AWGS2019）标准定义的。抑郁症状定义为10项流行病学研究中心抑郁量表（CES-D-10）上的20分或更高。进行Cox比例风险回归模型以检查抑郁症状和肌肉减少症的风险。而交叉滞后面板模型用于检查抑郁症状和肌肉减少症之间随时间的时间顺序。
结果：在总共48,305.1人年的随访中，发现1262例偶发抑郁症状。肌肉减少症表现出剂量反应关系，抑郁症状的风险更高（HR=1.7，95CI：肌肉减少症的1.2-2.3，对于可能的肌少症，HR=1.5，95CI：1.2-1.8，p趋势<0.001)。在第二个队列分析中，在39,621.1人年期间，发现了240例肌肉减少症事件。抑郁症状（HR=1.5，95CI：1.2-2.0）与多变量调整后发生肌肉减少症的风险显着相关（p<0.001，交叉滞后面板分析显示抑郁症状与随后的肌肉减少症相关（β=0.003，p<0.001）。同时,基线肌肉减少症也与随后的抑郁症状相关(β=0.428,p<0.001)。
结论：本研究确定了抑郁症状和少肌症之间的双向关系。与反向途径相比，基线肌肉减少症似乎更可能与随后的抑郁症状相关。相互联系表明，维持正常的肌肉质量和力量可能是缓解情绪障碍的关键干预策略。
