Abstract P088: Lean Locomotor Muscle Mass Associated With Elevated Depressive Symptoms: The Multi-Ethnic Study of Atherosclerosis
Authors: Remigio-Baker Rosemay A , Allison Matthew A , Schreiner Pamela J , Carnethon Mercedes R , Nettleton Jennifer A , Mujahid Mahasin S , Szklo Moyses , Crum Rosa M , Franco Manuel , Jensky Nicole , Golden Sherita H 
Published: July 2021

Lean Locomotor Muscle Mass Associated With Elevated Depressive Symptoms: The Multi-Ethnic Study of Atherosclerosis
Rosemay A Remigio-Baker, MPH, PhDc, Matthew A Allison, MD, MPH, PhD, MPH, Pamela J Schreiner, PhD, MS, MS, Mercedes R Carnethon, PhD, Jennifer A Nettleton, PhD, Mahasin J Mujahid, PhD, Moyses Szklo, MD, DrPH, Rosa M Crum, MD, MPH, Manuel Franco, MD, PhD, Nicole Jensky, PhD, Sherita Hill Golden, MD, MHS

BACKGROUND:
Physical activity reduces depressive symptoms but it is unclear whether one physiologic response to activity, higher lean muscle mass, is associated with depression.

METHODS:
Using data from 976 men and women (45-84 years) from the Multi-Ethnic Study of Atherosclerosis (MESA) Body Composition, Inflammation and Cardiovascular Disease and the MESA Neighborhood Ancillary Studies, we examined the cross-sectional association between elevated depressive symptoms (EDS, defined as a Center for Epidemiologic Studies for Depression Scale (CES-D) score > 16) and CT-measured lean muscle mass in the abdomen using multilevel mixed-effects linear regression models. Muscles were categorized by functionality (locomotion vs. stabilization/posture) and combined (see Table). Covariates included demographics, antidepressant use, inflammatory markers, health behaviors, social support, comorbidities, body mass index (BMI) and neighborhood factors: physical and social environment (see Table). Gender, physical environment and social environment were also assessed as potential modifiers.

RESULTS:
Lean mass of muscle for locomotion was 4.25% lower among participants with EDS compared to those without after adjustment for demographics and antidepressant use (95% CI=-8.20, -0.30; see Table). This association remained significant after additional adjustment for inflammatory markers, health behaviors, social support, comorbidities, neighborhood factors and BMI (see Table). Results were significant in the fully-adjusted model (see Table). No association was observed between EDS and muscle for stabilization/posture. There were no interactions by gender or neighborhood factors.

CONCLUSION:
Elevated depressive symptoms is associated with less lean muscle for locomotion independent of obesity and physical activity; however, further investigation is necessary in larger samples to confirm and determine the clinical relevance of this association.

TABLE

Percent Difference

a

in Lean Muscle Mass

b

, in cm
2
, (95% Confidence Interval) Between Individuals With Versus Without Elevated Depressive Symptoms By Muscle Category

c

MODEL
All Muscle

Locomotion

d

Stabilization/ Posture

e

MODEL 1: Univariate

−5.75 (-11.0, -0.49)+
−9.25 (-15.3, -3.25)+
−5.04 (-10.4, 0.28)

MODEL 2: Demographics

f

−1.96 (-4.94, 1.01)
−4.35 (-8.30, -0.45)+
−1.48 (-4.58, 1.62)

MODEL 3: Model 1 + Antidepressant Use

−1.88 (-4.88, 1.11)
−4.25 (-8.20, -0.30)+
−1.40 (-4.52, 1.72)

MODEL 4: Model 3 + Inflammatory Markers

g

−1.84 (-4.83, 1.15)
−4.20 (-8.15, -0.25)+
−1.38 (-4.49, 1.75)

MODEL 5: Model 3+ Health Behaviors

h

−2.28 (-5.26, 0.68)
−4.35 (-8.25, -0.45)+
−1.85 (-4.95, 1.25)

MODEL 6: Model 3+ Social Support

−1.75 (-4.83, 1.33)
−4.35 (-8.45, -0.30)+
−1.22 (-4.43, 1.98)

MODEL 7: Model 3 + Comorbidity

i

−1.89 (-4.88, 1.10)
−4.05 (-8.00, -0.10)+
−1.45 (-4.56, 1.66)

MODEL 8: Model 3 + Neighborhood Factors

j

−1.49 (-4.47, 1.48)
−4.20 (-8.15, -0.25)+
−0.99 (-4.09, 2.11)

MODEL 9: Model 3 + Body Mass Index

−2.46 (-5.36, 0.45)
−4.60 (-8.55, -0.70)+
−1.98 (-5.03, 1.05)

MODEL 10: Fully-Adjusted Model

−2.11 (-5.07, 0.85)
−4.55 (-8.55, -0.60)+
−1.66 (-4.76, 1.44)

a

Percent difference is calculated by diving the estimate by the mean of the muscle category (x100).

b

Mean (range): for all muscle mass [117.3 cm
2
(42.9-228.7 cm
2
)]; for locomotion muscle mass [20.0 cm
2
(4.7-40.7 cm
2
)]; for stabilization/posture muscle mass [97.3 cm
2
(36.9 - 198.3 cm
2
)]

c

There were no significant interaction by gender, physical environment or social environment

d

Muscle for locomotion: psoas

e

Muscle for stabilization and posture: rectus abdominus, obliques, paraspinal

f

Demographics: age, race, gender, marital status, study site, highest level of education attained, income level

g

Inflammatory Markers: Interleukin-6, C-reactive protein

h

Health Behaviors: Pack-years of smoking, alcohol intake/week, total intentional exercise, daily caloric intake, dietary patterns (1. High-fat and processed food; 2. Vegetables and fish; 3. Beans, tomatoes and refined grains; 4. Whole grain and fruits)

i

Comorbidity: Having at least one of the following: Cancer, Type II Diabetes and Hypertension

j

Neighborhood Factors: Median Income, % with High School education, Physical Environment (walking environment, availability of healthy foods), Social Environment (aesthetic quality, safety and social cohesion) + Significant p-value < 0.05