青少年身體質量指數軌跡與憂鬱情緒發展軌跡之關係

Abstract

目的：憂鬱及BMI異常是兩個重要的青少年健康議題，然而過去有關青少年BMI與憂鬱關係的研究結果相當不一致，且缺乏BMI變化對憂鬱變化的長期追蹤研究。本研究目的旨在釐清青少年BMI軌跡與憂鬱軌跡的關係。 方法：本研究取自「兒童與青少年行為之長期發展研究計畫」中第一世代資料庫，追蹤年代從2007年至2012年，經排除填答不完整個案後，共有1497人納入後續分析，佔原始樣本67.8%。本研究利用群體軌跡模型以及多元羅吉斯迴歸，分析控制人口學、個人、家庭以及同儕因素後，BMI軌跡與憂鬱軌跡之關係。 結果：以BMI軌跡而言，男性分成五組：肥胖上升(5.4%)、持續肥胖(10.5%)、正常偏重(22.9%)、持續正常(37.2%)及正常偏輕(24.0%)；女性分成三組：肥胖上升(9.3%)、持續正常(33.5%)及正常偏輕(57.1%)。以憂鬱軌跡而言，男性分成四組：持續憂鬱(12.1%)、中等憂鬱上升(38.6%)、持續中等(41.9%)及低度下降(7.3%)；女性分成五組：持續憂鬱(12.2%)、高憂鬱下降(4.4%)、中等憂鬱上升(36.0%)、持續中等(39.1%)及持續低度(8.3%)。多元羅吉斯迴歸分析發現，在控制其他變項後，大部分BMI軌跡組別與憂鬱軌跡組別之間的關係未達統計顯著水準。對男性而言，僅BMI軌跡為「持續肥胖組」，落入憂鬱軌跡為「低度下降組」(aOR=2.01, 95%CI: 1.15-3.51)的風險較大；對女性而言，僅BMI軌跡為「正常偏輕組」，落入憂鬱軌跡為「中等憂鬱上升組」(aOR=1.78, 95%CI: 1.41-2.24)、「持續憂鬱組」(aOR=3.82, 95%CI: 2.65-5.51)以及「高憂鬱下降組」(aOR=3.95, 95%CI: 2.28-6.82)的風險較大。 結論：本研究發現只有少部分BMI軌跡組別與憂鬱軌跡組別有顯著相關，包含男性持續肥胖則長期較不憂鬱，及女性持續偏輕則長期較憂鬱。

Objective: Depression and abnormal body mass index (BMI) are major health concerns among adolescents. However, studies on the relationship between adolescent BMI and depression have not attained consistent results and longitudinal follow-up studies on the relationship between BMI and depression variations are lacking. This study aimed to clarify the association between adolescent BMI trajectories and depression trajectories. Methods: This study collected data from the first-generation database of the Child and Adolescent Behaviors in Long-term Evolution. The follow-up period was between 2007 and 2012. After excluding incomplete responses, 1497 respondents (67.8%) were included in subsequent analysis. This study used group-based trajectory model and multiple logistic regression to analyze the association between BMI trajectories and depression trajectories after demographic, individual, family, and peer factors were controlled for. Results: BMI trajectories for boys consisted of 5 groups, namely, increase in obesity (5.4%), consistent obesity (10.5%), normal to slightly overweight (22.9%), consistent normal weight (37.2%), and normal to slightly underweight (24.0%). BMI trajectories for girls consisted of 3 groups, namely, increase in obesity (9.3%), consistent normal weight (33.5%), and normal to slightly underweight (57.1%). Depression trajectories for boys consisted of 4 groups, namely, consistent depression (12.1%), moderate increase in depression (38.6%), consistent moderate depression (41.9%), and mild decrease in depression (36.0%). Depression trajectories for girls consisted of 5 groups, namely, consistent depression (12.2%), severe decrease in depression (4.4%), moderately increase in depression (36.0%), consistent moderate (39.1%), and consistent mild depression (8.3%). The multiple logistic regression analysis results revealed that after other variables were controlled for, the association between most BMI trajectory groups and depression trajectory groups did not reach the statistical significance level. The consistent obesity group of boys had greater odds ratio of entering the mild decrease in depression trajectory group (aOR = 2.01, 95% CI: 1.15–3.51). The normal to slightly underweight group of girls had greater risks of entering the moderate increase in depression (aOR = 1.78, 95% CI: 1.41–2.24), consistent depression (aOR = 3.82, 95% CI: 2.65–5.51), and severe decrease in depression (aOR = 3.95, 95% CI: 2.28–6.82) trajectories. Conclusion: This study identified that significant correlation was only observed in a small number of the BMI trajectory groups and depression trajectory groups. Boys in the consistent obesity group had lower depression scores over a long term, whereas girls in the consistently slightly underweight had higher depression scores over a long term.