维生素B12水平与 melancholic 抑郁症状之间的关联：一项基于芬兰人群的研究。
Association between vitamin b12 levels and melancholic depressive symptoms: a Finnish population-based study.
作者信息
Seppälä Jussi, Koponen Hannu, Kautiainen Hannu, Eriksson Johan G, Kampman Olli, Leiviskä Jaana, Männistö Satu, Mäntyselkä Pekka, Oksa Heikki, Ovaskainen Yrjö, Viikki Merja, Vanhala Mauno, Seppälä Jussi
出版信息
BMC Psychiatry. 2013 May 24;13:145. doi: 10.1186/1471-244X-13-145.
BACKGROUND
An association between vitamin B12 levels and depressive symptoms (DS) has been reported in several epidemiological studies. The purpose of this study was to evaluate vitamin B12 levels in population-based samples with melancholic or non-melancholic DS as the relationship between vitamin B12 levels and different subtypes of DS has not been evaluated in previous studies.
METHODS
Subjects without previously known type 2 diabetes, aged 45-74 years were randomly selected from the National Population Register as a part of the Finnish diabetes prevention programme (FIN-D2D). The study population (N = 2806, participation rate 62%) consisted of 1328 men and 1478 women. The health examinations were carried out between October and December 2007 according to the WHO MONICA protocol. The assessment of DS was based on the Beck Depression Inventory (BDI, cut-off ≥10 points). A DSM-IV- criteria based summary score of melancholic items in the BDI was used in dividing the participants with DS (N = 429) into melancholic (N = 138) and non-melancholic DS (N = 291) subgroups. In the statistical analysis we used chi-squared test, t-test, permutation test, analysis of covariance, multivariate logistic regression analysis and multinomial regression model.
RESULTS
The mean vitamin B12 level was 331±176 pmol/L in those without DS while the subjects with non-melancholic DS had a mean vitamin B12 level of 324 ± 135 pmol/L, and those with melancholic DS had the lowest mean vitamin B12 level of 292±112 pmol/L (p < 0.001 after adjusted for age, sex, use of antidepressive medication and chronic diseases sum index). The adjusted difference of vitamin B12 levels between the non-melancholic and the melancholic group was 33 pmol/L (95%CI 8 to 57, p = 0.008). Melancholic DS and vitamin B12 levels showed an independent linearly inverse association. The relative risk ratio (RRR) for melancholic DS was 2.75 (95%CI 1.66 to 4.56) in the lowest vitamin B12 level tertile versus the highest (p for linearity <0.001) when those without DS formed the reference group. The RRR in the non-melancholic subgroup was nonsignificant.
CONCLUSIONS
The vitamin B12 level was associated with melancholic DS but not with non-melancholic DS.
背景
多项流行病学研究报告了维生素B12水平与抑郁症状（DS）之间的关联。本研究的目的是评估以抑郁性或非抑郁性DS为特征的人群样本中的维生素B12水平，因为既往研究尚未评估维生素B12水平与DS不同亚型之间的关系。
方法
作为芬兰糖尿病预防计划（FIN-D2D）的一部分，从国家人口登记册中随机选取年龄在45-74岁、既往无2型糖尿病的受试者。研究人群（N = 2806，参与率62%）包括1328名男性和1478名女性。2007年10月至12月期间，根据世界卫生组织MONICA方案进行健康检查。DS的评估基于贝克抑郁量表（BDI，临界值≥10分）。使用基于《精神疾病诊断与统计手册》第四版标准的BDI中抑郁性项目的汇总评分，将DS患者（N = 429）分为抑郁性（N = 138）和非抑郁性DS（N = 291）亚组。在统计分析中，我们使用了卡方检验、t检验、置换检验、协方差分析、多因素逻辑回归分析和多项回归模型。
结果
无DS者的维生素B12平均水平为331±176 pmol/L，非抑郁性DS患者的维生素B12平均水平为324±135 pmol/L，而抑郁性DS患者的维生素B12平均水平最低，为292±112 pmol/L（在调整年龄、性别、抗抑郁药物使用和慢性病综合指数后，p < 0.001）。非抑郁性和抑郁性组之间维生素B12水平的调整差异为33 pmol/L（95%CI 8至57，p = 0.008）。抑郁性DS与维生素B12水平呈独立的线性负相关。当以无DS者为参照组时，维生素B12水平最低三分位数组与最高三分位数组相比，抑郁性DS的相对风险比（RRR）为2.75（95%CI 1.66至4.56）（线性p < 0.001）。非抑郁性亚组的RRR无统计学意义。
结论
维生素B12水平与抑郁性DS相关，但与非抑郁性DS无关。
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