Depression Score Mediate the Association between A Body Shape Index and Infertility in Overweight and Obesity Females, NHANES 2013-2018

Background: Previous observational studies have associated infertility with fundamental physical parameters, including BMI, waist circumference, and excessive weight. Here, we introduced another convincing body shape parameter called A body shape index (ABSI), which can be calculated using waist circumference, weight, and height. To explore the association between ABSI and infertility in overweight and obese females, and the potential mediating factor in the association, we conducted this cross-sectional study. Methods: : 5431 adult female participants from NHANES 2013-2018 were included in this study. The definition of infertility was based on the interviewees' answers to the reproductive health questionnaire, which asked if they had visited a doctor because they had been unable to conceive or had tried to get pregnant for at least a year without success. ABSI was calculated as a continuous variable using an acknowledged equation. PHQ-9 score was assessed when face-to-face interviews for all participants, reflecting their depression symptoms. Results: : Among 5431 participants, 596 females (10.97% ) were diagnosed with infertility. Age, BMI, and ABSI were higher in infertile females. In multivariable logistic regression models, infertility status was positively related to increased ABSI (OR: 1.78e+15, 95% CI: 2.78e+5 to 1.15e+25), adjusted model by adjusting age, race/ethnicity, educational background, and family income. PHQ-9 score mediated 0.2% (p <0.05) of the link between ABSI and infertility in all individuals, but 13.5% (p <0.01) in overweight and obese adult females. Conclusion: Depression score might increase ABSI and induce infertility state among adult females with overweight and obesity.