Abstract P088: Lean Locomotor Muscle Mass Associated With Elevated Depressive Symptoms: The Multi-Ethnic Study of Atherosclerosis
Authors: Rosemay A Remigio-Baker, Matthew A Allison, Pamela J Schreiner, Mercedes R Carnethon, Jennifer A Nettleton, Mahasin S Mujahid, Moyses Szklo, Rosa M Crum, Manuel Franco, Nicole Jensky, Sherita H Golden
Journal: Circulation (2012)

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 &gt; 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 &lt; 0.05