Department of Epidemiology, University of Pittsburgh Graduate School of Public Health.
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health.
Nutr Res. 2018 Jun;54:23-32. doi: 10.1016/j.nutres.2018.03.004. Epub 2018 Mar 21.
Cardiovascular disease (CVD) may increase depression risk. Risk for future CVD, which can be estimated by the Framingham Risk Score (FRS), and depression risk are both linked to systemic inflammation. Dietary consumption of proinflammatory food can be measured using the Dietary Inflammatory Index (DII) score. We examined the potential impact of DII on depression and whether this effect is independent of FRS. We hypothesized that (1) both FRS and DII would be associated with depression (Patient Health Questionnaire-9 ≥ 10) and (2) associations between DII and depressive symptoms (continuous) would be mediated by FRS. Data were included from adults without CVD who were participants of the 2007-2012 National Health and Nutrition Examination Survey (n = 11 624). Using logistic regression, we tested cross-sectional associations of FRS, DII (adjusting for FRS), and joint effects of FRS and DII with depression. Finally, using the Sobel method, we tested whether FRS mediates the relationship between DII and depressive symptoms. Individuals with FRS or DII scores in the top 2 quartiles had higher odds of depressive symptoms than those in the bottom quartile. The association of DII with depressive symptoms remained after FRS adjustment. The joint effects of elevated DII and FRS were additive. There was no evidence for mediation by FRS between DII and depressive symptoms. Thus, higher DII remained associated with increased odds of depressive symptoms net CVD risk. Collectively, the joint effects of CVD risk and DII indicate that a proinflammatory diet could add to risk for depressive symptoms even in those with a high FRS.
心血管疾病 (CVD) 可能会增加抑郁风险。未来 CVD 的风险可以通过 Framingham 风险评分 (FRS) 来估计，而 CVD 风险和抑郁风险都与系统性炎症有关。可以使用膳食炎症指数 (DII) 评分来衡量促炎食物的饮食摄入。我们研究了 DII 对抑郁的潜在影响，以及这种影响是否独立于 FRS。我们假设：(1) FRS 和 DII 都与抑郁（PHQ-9≥10）有关，(2) DII 和抑郁症状（连续）之间的关联可以通过 FRS 来解释。数据来自于 2007-2012 年全国健康与营养调查（NHANES）中没有 CVD 的成年人，共纳入 11624 名参与者。我们使用逻辑回归检验了 FRS、DII（校正 FRS）以及 FRS 和 DII 的联合作用与抑郁的横断面关联。最后，我们使用 Sobel 法检验了 FRS 是否在 DII 和抑郁症状之间存在中介作用。FRS 或 DII 评分处于前 2 四分位的个体患抑郁症状的几率高于处于后 1 四分位的个体。校正 FRS 后，DII 与抑郁症状仍存在关联。DII 和 FRS 升高的联合作用是累加的。FRS 不能介导 DII 和抑郁症状之间的关系。因此，即使 CVD 风险高，DII 升高仍与抑郁症状的几率增加相关。总之，CVD 风险和 DII 的联合作用表明，促炎饮食可能会增加抑郁症状的风险，即使在 FRS 较高的人群中也是如此。
