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维生素 D 水平与晚年抑郁症状之间的关联:来自英国老龄化纵向研究(ELSA)的证据。

Associations Between Vitamin D Levels and Depressive Symptoms in Later Life: Evidence From the English Longitudinal Study of Ageing (ELSA).

机构信息

Department of Epidemiology & Public Health, English Longitudinal Study of Ageing (ELSA), University College London (UCL), UK.

Nutrition and Dietetics Group, School of Life and Environmental Sciences Charles Perkins Centre, University of Sydney, New South Wales, Australia.

出版信息

J Gerontol A Biol Sci Med Sci. 2018 Sep 11;73(10):1377-1382. doi: 10.1093/gerona/glx130.

Abstract

BACKGROUND

A possible role of vitamin D in depression has received considerable attention, especially given the significant disability, mortality, and healthcare costs associated to depression and the high prevalence of vitamin D deficiency.

METHODS

We investigated the cross-sectional associations between serum 25-hydroxyvitamin D (25OHD) levels and depressive symptoms (CES-D) in 5,607 older adults from the English Longitudinal Study of Ageing (ELSA).

RESULTS

Overall, there was a significant association between low 25OHD levels and elevated depressive symptoms (odds ratio [OR] = 1.58, 95% confidence interval [CI] = 1.20-2.07 for the lowest quartile; OR = 1.45, 95% CI = 1.15-1.83 for <30 nmol/L cut-off and OR = 1.34, 95% CI = 1.10-1.62 for the ≤50 nmol/L cut-off) after adjustment for a wide range of covariates of clinical significance. Fully adjusted models showed that women in the lowest (OR = 1.67, 95% CI = 1.20-2.34) and second lowest (OR = 1.68, 95% CI = 1.20-2.35) quartiles of 25OHD as well as those with 25OHD levels <30 nmol/L (OR = 1.40, 95% CI = 1.06-1.86) and ≤50 nmol/L (OR = 1.35, 95% CI = 1.07-1.72) were more likely to report elevated depressive symptoms. For men, however, this association only remained significant for those with 25OHD levels of <30 nmol/L (OR = 1.60, 95% CI = 1.06-2.42) in the fully adjusted models.

CONCLUSIONS

The independent and inverse association found between low 25OHD levels and elevated depressive symptoms suggests that vitamin D deficiency may be a risk factor for late-life depression, particularly among women. Whether our findings have any clinical meaning or not, additional data are needed from well-designed randomized controlled trials of vitamin D for the prevention and treatment of late-life depression.

摘要

背景

维生素 D 可能在抑郁症中发挥作用,这一观点引起了广泛关注,尤其是考虑到抑郁症与显著的残疾、死亡率和医疗保健费用相关,以及维生素 D 缺乏症的高发病率。

方法

我们研究了英国老龄化纵向研究(ELSA)中 5607 名老年人的血清 25-羟维生素 D(25OHD)水平与抑郁症状(CES-D)之间的横断面关联。

结果

总体而言,低 25OHD 水平与抑郁症状升高之间存在显著关联(最低四分位数的比值比[OR] = 1.58,95%置信区间[CI] = 1.20-2.07;<30 nmol/L 截止值的 OR = 1.45,95% CI = 1.15-1.83;≤50 nmol/L 截止值的 OR = 1.34,95% CI = 1.10-1.62),调整了大量具有临床意义的协变量后。完全调整的模型显示,25OHD 最低(OR = 1.67,95% CI = 1.20-2.34)和第二低(OR = 1.68,95% CI = 1.20-2.35)四分位数的女性,以及 25OHD 水平<30 nmol/L(OR = 1.40,95% CI = 1.06-1.86)和≤50 nmol/L(OR = 1.35,95% CI = 1.07-1.72)的女性更有可能报告抑郁症状升高。然而,对于男性,只有 25OHD 水平<30 nmol/L 的男性(OR = 1.60,95% CI = 1.06-2.42)的相关性在完全调整的模型中仍具有统计学意义。

结论

低 25OHD 水平与抑郁症状升高之间独立且相反的关联表明,维生素 D 缺乏可能是老年抑郁症的一个危险因素,尤其是在女性中。无论我们的发现是否具有临床意义,都需要有维生素 D 预防和治疗老年抑郁症的设计良好的随机对照试验的更多数据。

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