한국 과체중 및 비만 여성에서 우울 및 스트레스와 비만지표와의 상관관계

Relationship between Depression, Stress and Obesity Indexes in Overweight and Obese Korean Women

  • 김은주 (경희대학교 한의과대학 한방재활의학교실) ;
  • 이아라 (경희대학교 한의과대학 한방재활의학교실) ;
  • 황미자 (경희대학교 한의과대학 한방재활의학교실) ;
  • 조재흥 (경희대학교 한의과대학 한방재활의학교실) ;
  • 송미연 (경희대학교 한의과대학 한방재활의학교실)
  • Kim, Eun-Joo (Dept. of Oriental Rehabilitaion Medicine, College of Oriental Medicine, KyungHee University) ;
  • Lee, A-Ra (Dept. of Oriental Rehabilitaion Medicine, College of Oriental Medicine, KyungHee University) ;
  • Hwang, Mi-Ja (Dept. of Oriental Rehabilitaion Medicine, College of Oriental Medicine, KyungHee University) ;
  • Cho, Jae-Heung (Dept. of Oriental Rehabilitaion Medicine, College of Oriental Medicine, KyungHee University) ;
  • Song, Mi-Yeon (Dept. of Oriental Rehabilitaion Medicine, College of Oriental Medicine, KyungHee University)
  • 투고 : 2011.06.14
  • 심사 : 2011.06.27
  • 발행 : 2011.07.01

초록

Objectives Our purpose of this study was to evaluate the association between depression, stress, and obesity indexes. Methods This study was performed in 110 healthy overweight and obese(BMI${\geq}23\;kg/m^2$) women in Korea. Subjects underwent abdominal CT(computed tomography) scanning and were asked to complete Beck depression inventory(BDI), social readjustment rating scale(SRRS), and stress response inventory(SRI) questionnaires. Weight, body-mass index(BMI), waist circumference(WC), and waist-hip ratio(WHR) were evaluated. Subjects were given written consent and this study was performed under permission of institutional review board of KyunHee University Hospital at Gangdong. Results 1. BDI and SRI were significantly correlated with VFA(visceral fat area)(p<0.05). However, other obesity indexes were not significantly correlated with BDI and SRI(p>0.05). 2. SRRS was not significantly correlated with all obesity indexes(p>0.05). Conclusions This study suggests that depression and stress might be correlated with visceral fat, and this result would be helpful for planning a treatment schedule of obese patients with depression or stress in the clinic.

키워드

참고문헌

  1. Haslam DW, James WP. "Obesity". Lancet. 2005;366(9492):1197-209.
  2. Brancati FL, Wang NY, Mead LA, Liang KY, Klag MJ. Body weight patterns from 20 to 49 years of age and subsequent risk for diabetes mellitus: the Johns Hopkins Precursors Study. Arch Intern Med. 1999;159(9):957-63.
  3. Pi-Sunyer FX. The medical risks of obesity. Obes Surg. 2002;12(1):6-11.
  4. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW Jr. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 1999;341(15):1097-105.
  5. Goodpaster BH, Krishnaswami S, Resnick H, Kelley DE, Haggerty C, Harris TB, Schwartz AV, Kritchevsky S, Newman AB. Association between regional adipose tissue distribution and both type 2 diabetes and impaired glucose tolerance in elderly men and women. Diabetes Care. 2003;26(2):372-9.
  6. Suk SH, Sacco RL, Boden-Albala B, Cheun JF, Pittman JG, Elkind MS, Paik MC. Abdominal obesity and risk of ischemic stroke. Stroke. 2003;34(7):1586-92.
  7. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):442.
  8. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020:Global Burden of Disease Study. Lancet. 1997;349(9064):1498-1504.
  9. Penninx BW, Beekman AT, Honig A, Deeg DJ, Schoevers RA, van Eijk JT, van Tilburg W. Depression and cardiac mortality: results from a community-based longitudinal study. Arch Gen Psychiatry. 2001;58(3):221-7.
  10. Faith MS, Matz PE, Jorge MA. Obesity-depression associations in the population. J Psychosom Res. 2002;53(4):935-42.
  11. Scott KM, McGee MA, Wells JE, Oakley Browne MA. Obesity and mental disorders in the adult general population. J Psychosom Res. 2008;64(1):97-105.
  12. Stunkard AJ, Faith MS, Allison KC. Depression and obesity. Biol Psychiatry. 2003;54:330-7.
  13. Sachs-Ericsson N, Burns AB, Gordon KH, Eckel LA, Wonderlich SA, Crosby RD, Blazer DG. Body mass index and depressive symptoms in older adults: the moderating roles of race, sex, and socioeconomic status. Am J Geriatr Psychiatry 2007;15:815-25.
  14. De Wit LM, van Straten A, van Herten M, Penninx BW, Cuijpers P. Depression and body mass index, a u-shaped association. BMC Public Health. 2009;1:9-14.
  15. Carpenter KM, Hasin DS, Allison DB, Faith MS. Relationships between obesity and DSMIV Major depressive disorder, suicide ideation and suicide attempts: Results from a general population study. Am J Public Health. 2000;90:251-7.
  16. Ho RC, Niti M, Kua EH, Ng TP. Body mass index, waist circumference, waist hip ratio and depressive symptoms in Chinese elderly: A population-based study. Int J Geriatr Psychiatry 2008;23:401-8.
  17. Weber-Hamann B, Werner M, Hentschel F, Bindeballe N, Lederbogen F, Deuschle M, Heuser I. Metabolic changes in elderly patients with major depression: Evidence for increased accumulation of visceral fat at follow-up. Phychoneuroendocrinology. 2006;31:347-54.
  18. Vogelzangs N, Kritchevsky SB, Beekman AT, Newman AB, Satterfield S, Simonsick EM, Yaffe K, Harris TB, Penninx BW. Depressive symptoms and change in abdominal obesity in older persons. Arch Gen Psychiatry. 2008;65:1386-93.
  19. 김상만, 김성수, 윤수진, 심경원, 최희정, 김광민, 이득주. 복부 내장지방량을 가장 잘 표현할 수 있는 단순 비만지표는?(체질량지수, 허리둘레, 허리엉덩이둘레비). 대한비만학회지. 1998;7(2):157-68.
  20. Yoshizumi T, Nakamura T, Yamane M, Islam AHMW, Menju M, Yamasaki K, Arai T, Kotani K, Funahashi T, Shizuya Y, Matsuzawa Y. Abdominal fat: standardized technique for measurement at CT. Radiology. 1999;211:283-6.
  21. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-71.
  22. 한홍무, 염태호, 신영우, 김교헌, 윤도준, 정근재. Beck Depression Inventory의 한국판 표준화 연구- 정상집단을 중심으로(I). 신경정신의학. 1986;25(3):487-502.
  23. 김창윤 외. 정신장애 평가 도구. 서울:하나의학사. 2001:72-5.
  24. Holmes TH, Rahe RH. The social readjustment rating scale. J Phychosomatic Res. 1967;11:213-8.
  25. Koh KB, Kim CH, Park KJ. Development of the stress response inventory. The Korean J of Neuropsychiatric Association. 2000;39(4):707-19.
  26. McElroy SL, Kotwal R, Malhortra S, Nelson EB, Keck PE, Nemeroff CB. Are mood disorders and obesity related? A review for the mental health professional. J Clin Psychiatry. 2004;65:634-51.
  27. Marijnissen RM, Bus BA, Holewijn S, Franke B, Purandare N, de Graaf J, den Heijer M, Buitelaar JK, Oude Voshaar RC.Depressive symptom clusters are differentially associated with general and visceral obesity. J Am Geriatr Soc. 2011;59(1):67-72.
  28. Everson-Rose SA, Lewis TT. Psychosocial factors and cardiovascular diseases. Annu Rev Public Health. 2005;26:469-500.
  29. Everson-Rose SA, Meyer PM, Powell LH, Pandey D, Torrens JI, Kravitz HM, Bromberger JT, Matthews KA. Depressive symptoms, insulin resistance, and risk of diabetes in women at midlife. Diabetes Care. 2004;27:2856-62.
  30. Knol MJ, Twisk JW, Beekman AT, Heine RJ, Snoek FJ, Pouwer F. Depression as a risk factor for the onset of type 2 diabetes mellutus. A meta-analysis Diabetologia. 2006;49:837-45.
  31. Everson-Rose SA, Lewis TT, Karavolos K, Dugan SA, Wesley D, Powell LH. Depressive symptoms and increased visceral fat in middle-aged women. Psychosom Med. 2009;71(4):410-6.
  32. Chrousos GP. The role of stress and the hypothalamic-pituitary-adrenal axis in the pathogenesis of the metabolic syndrome: neuroendocrine and target tissue-related causes. Int J Obes Relat Metab Disord. 2000;24(2):50-5.
  33. Kyrou I, Tsigos C. Stress mechanisms and metabolic complications. Horm Metab Res. 2007;39:430-8.
  34. McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med. 1998;338:171-9.
  35. Musselman DL, Evans DL, Nemeroff CB. The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. Arch Gen Psychiatry 1998;55:580-92.
  36. Bjorntorp P. The regulation of adipose tissue distribution in humans. Int J Obes Relat Metab Disord. 1996;20:291-302.
  37. Rebuffe-Scrive M, Walsh UA, McEwen B, Rodin J. Effect of chronic stress and exogenous glucocorticoids on regional fat distribution and metabolism. Physiol Behav. 1992;52:583-90.
  38. You T, Ryan AS, Nicklas BJ. The metabolic syndrome in obese postmenopausal women:relationship to body composition, visceral fat, and inflammtion. J Clin Endocrinol Metab. 2004;89:5517-22.