Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
Eur Child Adolesc Psychiatry. 2021 Feb;30(2):261-269. doi: 10.1007/s00787-020-01511-w. Epub 2020 Mar 19.
Increasing evidence suggests that serum lipids are associated with depressive symptoms. However, previous studies have mostly employed a cross-sectional design and assessed middle-aged or older adult populations, making it difficult to discern the impact of lipid changes early in life on the development of depression. Accordingly, we sought to investigate changes in blood cholesterol levels during adolescence and the development of depressive symptoms in early adulthood. This prospective cohort study included participants aged 15-16 years from the JS High School Study (JSHS), with an average follow-up of 6 years. Participants had no diagnosed depression at baseline. Multivariable linear regression models were used to estimate associations between changes in total cholesterol during adolescence and depressive symptoms in adulthood. Changes in total cholesterol during adolescence were classified as "consistently low," "decreased," "moderate," "increased," or "consistently high". In men, depressive symptoms were higher in the consistently low (β = 3.20, p = 0.036) and increased total cholesterol groups (β = 3.48, p = 0.017), compared with the moderate group. In the consistently high group, although a positive linear association was observed, it lacked statistical significance (β = 2.71, p = 0.067). While similar tendencies were noted in women, the associations were not statistically significant. Consistently low or increased total cholesterol levels during adolescence may pose an increased risk of depressive symptoms in early adulthood. These findings suggest that different strategies should be adopted to manage the lipid risk factors with consideration of age and sex.
越来越多的证据表明，血清脂质与抑郁症状有关。然而，以前的研究大多采用横断面设计，评估的是中年或老年人群，因此很难确定生命早期脂质变化对抑郁症发展的影响。因此，我们试图研究青少年时期血液胆固醇水平的变化与成年早期抑郁症状的发展之间的关系。这项前瞻性队列研究包括来自 JSHS 的 15-16 岁的参与者，平均随访 6 年。参与者在基线时没有被诊断出患有抑郁症。多变量线性回归模型用于估计青少年时期总胆固醇变化与成年期抑郁症状之间的关联。青少年时期总胆固醇的变化被分为“持续低”、“降低”、“中等”、“增加”或“持续高”。在男性中，与中等组相比，持续低（β=3.20，p=0.036）和总胆固醇增加组（β=3.48，p=0.017）的抑郁症状更高。在持续高组中，尽管观察到了正线性关联，但缺乏统计学意义（β=2.71，p=0.067）。虽然在女性中也观察到了类似的趋势，但关联没有统计学意义。青少年时期持续低或总胆固醇升高可能会增加成年早期抑郁症状的风险。这些发现表明，应根据年龄和性别采取不同的策略来管理血脂危险因素。
