Synergistic effects of a body shape index and depression on mortality in individuals with low sexual frequency

Abstract

Background

Individuals with low sexual frequency often experience comorbidities that exacerbate mortality. This article evaluates the predictive value of five body fat anthropometric indicators for all-cause mortality and explores the interaction between obesity and depression in mortality among young and middle-aged individuals with sexual frequency <12 times per year.

Methods

This study included participants with a sexual frequency of <12 times per year from the 2015–2016 National Health and Nutrition Examination Survey (NHANES). We assessed the impact of anthropometric indicators and depression on mortality, as well as their synergistic interactions, and further developed an accessible predictive survival model.

Results

A total of 4978 participants aged 20–59 were included, with 215 deaths (4.3 %) over 15 years of follow-up. A Body Shape Index (ABSI) showed the strongest association with all-cause mortality, with an AUC of 0.67. Participants with ABSI ≥0.082 had a significantly higher risk of death (HR: 1.87, 95%CI: 1.31–2.68), as did those with depression (HR: 1.86, 95%CI: 1.19–2.92). Interaction analysis revealed a synergistic effect between depression and ABSI, increasing death risk by 293 % when both were present. Significant survival differences were observed between men and women with these risk factors, with median survival rates of 76.3 % and 90.8 %, respectively. The model based on ABSI and depression provided valuable mortality predictions, with AUC of 0.78, 0.77, and 0.77 for 3-year, 5-year, and 10-year survival.

Conclusion

ABSI and depression are associated with all-cause mortality in individuals with low sexual frequency, potentially creating a synergistic effect on mortality risk.