Sex-Specific Association of Low Muscle Mass with Depression Status in Asymptomatic Adults: A Population-Based Study

The objective of this study was to examine the correlation between low muscle mass (LMM) and depression, with a specific focus on identifying the sex-specific relationship between LMM and depression in a large sample.

This population-based cross-sectional study involved 292,922 community-dwelling adults from 2012 to 2019. Measurements were taken using the Center for Epidemiological Studies Depression (CESD) scale and body composition analyses. Depression was defined as a CESD score ≥ 16, and severe depression as a CESD score ≥ 22. LMM was defined as an appendicular muscle mass/height² below 7.0 kg/m² in men and below 5.4 kg/m² in women. Sex-based multivariable logistic regression analyzed the LMM-depression association, adjusting for confounders, with depression status and severe depression status as dependent variables.

Both men and women in the LMM group had an increased odds of depression (men, adjusted odds ratio = 1.13 [95% confidence interval = 1.03-1.12]; women, 1.07 [1.03-1.23]) and severe depression (men, 1.20 [1.05-1.36]; women, 1.10 [1.04-1.15]) compared to those in the control group. Men showed a stronger association between LMM and the presence of depression (p for interaction = 0.025) and the presence of severe depression (p for interaction = 0.025) compared to women.

Decreased muscle mass was independently associated with increased chances of depression and severe depression in both sexes, with a significantly stronger association in men compared to women. This highlights the potential significance of LMM as a predictor of depression, particularly in men.