Difference by sex but not by race/ethnicity in the visceral adipose tissue-depressive symptoms association: The Multi-Ethnic Study of Atherosclerosis

Rosemay A. Remigio-Baker, Matthew A. Allison, Pamela J. Schreiner, Moyses Szklo, Rosa M. Crum, Jeannie Marie Leoutsakos, Manuel Franco, Mercedes R. Carnethon, Jennifer A. Nettleton, Mahasin S. Mujahid, Ana V. Diez Roux, Nicole Jensky, Sherita H. Golden

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background: Prior studies have investigated the association of clinical depression and depressive symptoms with body weight (i.e. body mass index (BMI) and waist circumference), but few have examined the association between depressive symptoms and intra-abdominal fat. Of these a limited number assessed the relationship in a multi-racial/ethnic population. Methods: Using data on 1017 men and women (45-84 years) from the Multi-Ethnic Study of Atherosclerosis (MESA) Body Composition, Inflammation and Cardiovascular Disease Study, we examined the cross-sectional association between elevated depressive symptoms (EDS) and CT-measured visceral fat mass at L2-L5 with multivariable linear regression models. EDS were defined as a Center for Epidemiological Studies Depression score ≥16 and/or anti-depressant use. Covariates included socio-demographics, inflammatory markers, health behaviors, comorbidities, and body mass index (BMI). Race/ethnicity (Whites [referent group], Chinese, Blacks and Hispanics) and sex were also assessed as potential modifiers. Results: The association between depressive symptoms and visceral fat differed significantly by sex (p=0.007), but not by race/ethnicity. Among men, compared to participants without EDS, those with EDS had greater visceral adiposity adjusted for BMI and age (difference=122.5cm2, 95% CI=34.3, 210.7, p=0.007). Estimates were attenuated but remained significant after further adjustment by socio-demographics, inflammatory markers, health behaviors and co-morbidities (difference=94.7cm2, 95% CI=10.5, 178.9, p=0.028). Among women, EDS was not significantly related to visceral adiposity in the fully adjusted model. Conclusions: Sex, but not race/ethnicity, was found to modify the relationship between EDS and visceral fat mass. Among men, a significant positive association was found between depressive symptoms and visceral adiposity. No significant relationship was found among women.

Original languageEnglish (US)
Pages (from-to)78-87
Number of pages10
StatePublished - Sep 2014

Bibliographical note

Funding Information:
This work was supported by training grants from the National Institute of Diabetes, Digestive, and Kidney Diseases ( T32 DK062707 ) and the National Heart, Lung, and Blood Institute (NHLBI, T32 HL079891 ). Partial support was also provided by R01 HL101161. MESA was supported by N01-HC-95159 through N01-HC-95169 from the NHLBI and UL1-RR-024156 and UL1-RR-025005 from the National Center for Research Resources . The MESA Abdominal Body Composition, Inflammation and Cardiovascular Disease Ancillary Study was funded through a grant from the National Institutes of Health ( RO1-HL088451 ).

Copyright 2014 Elsevier B.V., All rights reserved.


  • Antidepressant use
  • Elevated depressive symptoms
  • Race/ethnicity
  • Sex
  • Visceral adipose tissue
  • Visceral fat mass

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