Department of Epidemiology, Janssen Research & Development, Titusville, NJ, USA.
Department of Epidemiology, Janssen Research & Development, Titusville, NJ, USA.
J Clin Lipidol. 2020 Jul-Aug;14(4):515-521. doi: 10.1016/j.jacl.2020.06.001. Epub 2020 Jun 6.
Reports suggest low levels of cholesterol are associated with depression. However, results have not been replicated, the direction of the associations among types of cholesterol levels is not consistent, there is large study heterogeneity, and many studies have small samples.
The objective of the study was to assess the association of cholesterol with depression.
This is a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES). The NHANES is a research program that collects health information from a representative U.S.
We included subjects aged ≥18 years who responded to NHANES surveys from 2009 to 2015. Subjects were classified as having major depression if the Patient Health Questionnaire scores were ≥10. Exposures were total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. We considered the age, body mass index, gender, smoking, alcohol use, health status, and exposure to statins and antipsychotics as potential confounders. To assess the association of the exposures with depression, we used decision tree and logistic regression models.
A total of 19,527 subjects were analyzed, and 8% had depression. Subjects with depression were more likely to be women and smokers, and to have higher body mass index, poor health, higher levels of total cholesterol and triglycerides and lower levels of high-density lipoprotein cholesterol than subjects with no depression. After adjustment, low levels of total cholesterol (<129 mg/dL) were associated with decreased risk of depression compared with higher levels, OR = 0.64 and 95% CI (0.42-0.98).
This large population-based study found no association of low cholesterol or any other lower type of cholesterol levels with increased risk of depression. These findings are generalizable to the U.S.
有报道称，胆固醇水平较低与抑郁症有关。然而，这些结果尚未得到证实，不同类型胆固醇水平之间的关联方向不一致，研究存在较大的异质性，而且许多研究的样本量较小。
本研究旨在评估胆固醇与抑郁症之间的关联。
这是一项使用国家健康和营养调查（NHANES）的横断面研究。NHANES 是一个从美国代表性人群中收集健康信息的研究计划。
我们纳入了 2009 年至 2015 年期间对 NHANES 调查做出回应且年龄≥18 岁的受试者。如果患者健康问卷评分≥10，则将受试者分类为患有重度抑郁症。暴露因素为总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯水平。我们将年龄、体重指数、性别、吸烟、饮酒、健康状况以及他汀类药物和抗精神病药物的使用情况视为潜在的混杂因素。为了评估暴露因素与抑郁症之间的关联，我们使用了决策树和逻辑回归模型。
共分析了 19527 名受试者，其中 8%患有抑郁症。与无抑郁症的受试者相比，患有抑郁症的受试者更可能为女性和吸烟者，且体重指数更高、健康状况更差、总胆固醇和甘油三酯水平更高、高密度脂蛋白胆固醇水平更低。调整混杂因素后，与较高水平相比，总胆固醇水平较低（<129mg/dL）与抑郁症风险降低相关，OR=0.64，95%CI（0.42-0.98）。
这项基于人群的大型研究未发现低胆固醇或任何其他较低类型的胆固醇水平与抑郁症风险增加之间存在关联。这些发现可推广至美国人群。
