Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, SMBH Université Paris 13, 74 rue Marcel Cachin, 93017, Bobigny, France.
Faculté de Médecine, Sorbonne Paris Cité, Université Paris Descartes, Paris, France.
Eur J Nutr. 2017 Oct;56(7):2289-2298. doi: 10.1007/s00394-016-1269-y. Epub 2016 Jul 27.
Depression is a major public health issue because it is a common cause of disability worldwide. It has been suggested that an optimal vitamin D status may be related to fewer depressive symptoms, but findings are inconsistent. We aimed to investigate the association between plasma vitamin D at midlife and recurrent depressive symptoms and to test for a modulating effect by overall dietary quality.
The relationship between plasma 25-hydroxyvitamin D (25(OH)D) and recurrent depressive symptoms was evaluated among 1196 participants of the Supplémentation en Vitamines et Minéraux Antioxydants cohort with available data on the Center for Epidemiologic Studies-Depression Scale (CES-D) at baseline (1996-1997) and follow-up (2007-2009). Recurrent depressive symptoms were defined as a CES-D score ≥16 at baseline and follow-up. Prevalence ratios (PR) and 95 % confidence intervals (95 %-CI) were estimated using extensively adjusted Poisson regression models. Dietary quality was estimated using an index measuring adherence to the French national recommendations.
Having 25(OH)D concentrations above 10 ng/mL was related to a lower probability of recurrent depressive symptoms: PR (95 %-CI) = 0.48 (0.33; 0.69); P < 0.0001). When comparing individuals with concentrations < versus ≥20 or < versus ≥30 ng/mL, no significant results were obtained. In contrast, among individuals with low dietary quality, a better vitamin D status was related to a lower probability of recurrent depressive symptoms independently of the applied cutoff.
Plasma vitamin D might have a preventive role against recurrent depressive symptoms, notably among individuals with poor dietary quality. Our findings are relevant for the development of depression prevention programs.
抑郁症是一个重大的公共卫生问题，因为它是全球范围内导致残疾的主要原因。有人提出，最佳的维生素 D 状态可能与较少的抑郁症状有关，但研究结果并不一致。我们旨在调查中年期血浆维生素 D 与复发性抑郁症状之间的关系，并检验整体饮食质量的调节作用。
在 Supplémentation en Vitamines et Minéraux Antioxydants 队列的 1196 名参与者中，根据基线（1996-1997 年）和随访（2007-2009 年）时的流行病学研究抑郁量表（CES-D）可用数据，评估血浆 25-羟维生素 D（25（OH）D）与复发性抑郁症状之间的关系。复发性抑郁症状定义为基线和随访时 CES-D 评分≥16。使用广泛调整的泊松回归模型估计患病率比（PR）和 95%置信区间（95%CI）。饮食质量用衡量对法国国家推荐的依从性的指数来估计。
25（OH）D 浓度高于 10ng/mL 与较低的复发性抑郁症状发生概率相关：PR（95%CI）=0.48（0.33；0.69）；P<0.0001）。当比较浓度<与≥20 或<与≥30ng/mL 的个体时，未得到显著结果。相比之下，在饮食质量较低的个体中，更好的维生素 D 状态与较低的复发性抑郁症状发生概率相关，与应用的切点无关。
血浆维生素 D 可能对复发性抑郁症状具有预防作用，尤其是在饮食质量较差的个体中。我们的研究结果与预防抑郁方案的制定有关。
