Wirth Michael D, Shivappa Nitin, Burch James B, Hurley Thomas G, Hébert James R
Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, University of South Carolina.
Cancer Prevention and Control Program, University of South Carolina.
Health Psychol. 2017 Aug;36(8):760-769. doi: 10.1037/hea0000514. Epub 2017 May 29.
Abnormal physiology (e.g., inflammation), brought on by environmental exposures (e.g., diet or shift work [SW]), can affect numerous bodily systems, including the brain, and may be associated with depressive symptomatology. The study examined the associations between SW and depressive symptoms and diet-related inflammation (estimated by the Dietary Inflammatory Index [DII]) and depressive symptoms. Additionally, diet was examined as a mediator between SW and depressive symptoms.
Data were obtained from the U.S. National Health and Nutrition Examination Survey (Centers for Disease Control and Prevention, 2013). SW data were based on self-report. Dietary data were collected using 24-hr dietary recalls for DII calculation. Depressive symptoms were defined using a cut-point of 10 (moderate) on the Patient Health Questionnaire-9 (PHQ-9). Logistic regression was used to estimate odds ratios and 95% confidence intervals (95% CI) for depressive symptoms by SW and DII quartiles.
DII scores were associated with depressive symptoms among women. Women in DII quartile 4 were 30% more likely to report depressive symptoms than women in quartile 1 (95% CI [1.00-1.68]). There was no association between symptoms and SW when using a PHQ-9 cut-point of 10. When using a cut-point of 5 (mild depressive symptoms), those working any form of SW were more likely to suffer from mild symptoms than day workers (odds ratio = 1.22; 95% CI [1.04-1.43]). There was some evidence for mediation by the DII between SW and depressive symptoms.
Future longitudinal studies should examine effects of reductions in inflammation through diet on depressive symptoms, especially among shift workers, to elucidate the role of diet on depression among these groups. (PsycINFO Database Record
由环境暴露（如饮食或轮班工作[SW]）引发的异常生理状况（如炎症）会影响包括大脑在内的众多身体系统，并可能与抑郁症状相关。本研究探讨了轮班工作与抑郁症状之间的关联，以及饮食相关炎症（通过饮食炎症指数[DII]估算）与抑郁症状之间的关联。此外，还研究了饮食在轮班工作与抑郁症状之间的中介作用。
数据来自美国国家健康与营养检查调查（疾病控制与预防中心，2013年）。轮班工作数据基于自我报告。饮食数据通过24小时饮食回顾收集，用于计算DII。抑郁症状通过患者健康问卷-9（PHQ-9）上的10分（中度）临界点来定义。采用逻辑回归来估计按轮班工作和DII四分位数划分的抑郁症状的比值比和95%置信区间（95%CI）。
DII评分与女性的抑郁症状相关。处于DII四分位数4的女性报告抑郁症状的可能性比处于四分位数1的女性高30%（95%CI[1.00 - 1.68]）。当使用PHQ-9临界点10时，症状与轮班工作之间没有关联。当使用临界点5（轻度抑郁症状）时，从事任何形式轮班工作的人比日班工作者更易出现轻度症状（比值比 = 1.22；95%CI[1.04 - 1.43]）。有一些证据表明DII在轮班工作和抑郁症状之间起中介作用。
未来的纵向研究应考察通过饮食减轻炎症对抑郁症状的影响，尤其是在轮班工作者中，以阐明饮食在这些人群抑郁症中的作用。（PsycINFO数据库记录）
