TABLE 3—

Association of Natural Log of BMI, Waist Circumference, Metabolic Measures, and Inflammatory Markers with Elevated Depressive Symptoms and Antidepressant Use: Women’s Health Initiative (WHI), United States, 1993–2005

	Unadjusted Model		Multivariate Adjusted Modela		Multivariate Adjusted Modelb
Variable	b (95% CI)	Pc	b (95% CI)	Pc	b (95% CI)	Pc
WHI-OS data from baseline and year 3 (n = 71 809)
Elevated depressive symptoms: BMI		≤ .001		≤ .001		≤ .001
Not at all (Ref)	1.00		1.00		1.00
Yes at baseline, no at year 3	0.03 (0.02, 0.03)		0.01 (0.003, 0.01)		0.01 (0.003, 0.01)
No at baseline, yes at year 3	0.03 (0.03, 0.04)		0.01 (0.01, 0.02)		0.01 (0.01, 0.02)
Yes at baseline, yes at year 3	0.05 (0.04, 0.06)		0.01 (0.01, 0.02)		0.01 (0.01, 0.02)
Antidepressant use: BMI		≤ .001		≤ .001		≤ .001
Not at all (Ref)	1.00		1.00		1.00
Yes at baseline, no at year 3	0.04 (0.03, 0.05)		0.03 (0.02, 0.04)		0.03 (0.02, 0.04)
No at baseline, yes at year 3	0.03 (0.02, 0.03)		0.02 (0.01, 0.02)		0.02 (0.01, 0.02)
Yes at baseline, yes at year 3	0.04 (0.04, 0.05)		0.03 (0.02, 0.04)		0.03.(0.03, 0.04)
Elevated depressive symptoms: waist circumference		≤ .001		≤ .001		≤ .001
Not at all (Ref)	1.00		1.00		1.00
Yes at baseline, no at year 3	0.02 (0.02, 0.02)		0.01 (0.001, 0.01)		0.01 (0.003, 0.01)
No at baseline, yes at year 3	0.02 (0.02, 0.03)		0.01 (0.01, 0.02)		0.01 (0.01, 0.02)
Yes at baseline, yes at year 3	0.04 (0.03, 0.04)		0.01 (0.01, 0.02)		0.02 (0.01, 0.02)
Antidepressant use: waist circumference		≤ .001		≤ .001		≤ .001
Not at all (Ref)
Yes at baseline, no at year 3	0.03 (0.02, 0.04)		0.02 (0.01, 0.03)		0.02 (0.02, 0.03)
No at baseline, yes at year 3	0.02 (0.02, 0.03)		0.01 (0.01, 0.02)		0.02 (0.01, 0.02)
Yes at baseline, yes at year 3	0.04 (0.04, 0.05)		0.03 (0.03, 0.04)		0.03 (0.03, 0.04)
WHI-CT data from baseline, year 1, and year 3 (n = 1950)
Elevated depressive symptoms: Insulin		.03		.01		.01
Yes	−0.04 (−0.08, −0.001)		−0.05 (−0.09, −0.01)		−0.05 (−0.10, −0.01)
No (Ref)	1.00		1.00		1.00
Antidepressant use: Insulin		.18		.55		.55
Yes	−0.03 (−0.10, 0.05)		−0.01 (−0.08, 0.07)		−0.01(−0.09, 0.07)
No (Ref)	1.00		1.00		1.00
Elevated depressive symptoms: HOMA-IR		.03		.01		.01
Yes	−0.05 (−0.09, −0.01)		−0.06 (−0.10, −0.01)		−0.06 (−0.10, −0.01)
No (Ref)	1.00		1.00		1.00
Antidepressant use: HOMA-IR		.25		.67		.67
Yes	−0.04 (−0.12, 0.05)		−0.01 (−0.10, 0.08)		−0.01 (−0.11, 0.07)
No (Ref)	1.00		1.00		1.00
WHI-OS data from baseline (n = 2242)d
Elevated depressive symptoms: CRP		.27		.02
Yes	0.07 (−0.05, 0.18)		−0.13 (−0.25, −0.02)
No (Ref)	1.00
Antidepressant use: CRP		≤ .001		.004
Yes	0.38 (0.20, 0.56)		0.23 (0.07, 0.40)
No (Ref)	1.00
Elevated depressive symptoms: TNF-α R2		.003		.07
Yes	0.05 (0.02, 0.09)		0.03 (−0.002, 0.07)
No (Ref)	1.00		1.00
Antidepressant use: TNF-α R2		.003		.13
Yes	0.08 (0.03, 0.13)		0.04 (−0.01, 0.09)
No (Ref)	1.00		1.00

Note. BMI = body mass index; CI = confidence interval; CRP =  C-reactive protein; CT = clinical trials; CVD = cardiovascular disease; HOMA-IR = homeostasis model assessment of insulin resistance; HRT = hormone replacement therapy; OS = observational study; TNF-α R2 = tumor-necrosis factor-α receptor 2.

^aMultivariate models included elevated depressive symptoms status, antidepressant use, age, race/ethnicity, education, smoking status, alcohol intake, family history of diabetes, HRT use, total physical activity and total caloric intake as independent variables.

^bMultivariate models included elevated depressive symptoms status, antidepressant use, age, race/ethnicity, education, smoking status, alcohol intake, HRT use, total physical activity, and total caloric intake as independent variables, and excluded family history of diabetes

^cP values from linear mixed models included association of elevated depressive symptoms and antidepressant use with BMI, insulin, HOMA-IR, high-sensitivity CRP and TNF-α R2, respectively.

^dMultivariate models included elevated depressive symptoms status, antidepressant use, age, race/ethnicity, BMI, statin use, education, sleep duration, saturated fat intake and physical activity, and family history of CVD as independent variables.