Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
Nutr Neurosci. 2022 Jun;25(6):1209-1218. doi: 10.1080/1028415X.2020.1843892. Epub 2020 Dec 9.
Vitamin D deficiency has been suggested to contribute to the onset of depression, but published results are inconsistent. The aims of this study were 1) to compare serum 25-hydroxyvitamin D (25(OH)D) levels in patients with depression and non-depressed controls and 2) to examine whether distinct subtypes and symptom severity of depression may vary in their association with 25(OH)D. The study involved cross-sectional data of n=1169 participants from the BiDirect Study (n=639 patients with clinically diagnosed major depressive disorder (MDD), n=530 controls). Serum 25(OH)D was measured via LS-MS/MS. We performed analysis of covariance to evaluate adjusted means of 25(OH)D levels and multinomial logistic regression to assess the association of depression and its clinical characteristics, namely distinct subtypes and symptom severity, with 25(OH)D status (adjusted for age, sex, education, season of blood sample collection, and lifestyle factors). In total, 45.0% of the participants had adequate 25(OH)D levels (≥20 ng/ml), whereas 24.9% had a deficiency (<12 ng/ml). Patients with MDD had lower 25(OH)D levels than controls (16.7 vs. 19.6 ng/ml, <0.001). Patients with atypical depression had the lowest levels (14.6 ng/ml). Symptom severity was inversely related to 25(OH)D. Moreover, patients with MDD had a more than 2-times higher odds of 25(OH)D deficiency than controls. Atypical depression showed the highest odds of deficiency. The results support that patients with depression have lower 25(OH)D concentrations than non-depressed individuals. Distinct subtypes, particularly the atypical subtype, may play a special role in this context. Therefore, depression heterogeneity should be considered in future research.
维生素 D 缺乏被认为与抑郁症的发生有关，但已发表的研究结果并不一致。本研究的目的是：1）比较抑郁症患者和非抑郁对照组的血清 25-羟维生素 D（25(OH)D）水平；2）探讨不同类型和严重程度的抑郁症与 25(OH)D 的关系是否不同。该研究纳入了 BiDirect 研究的横断面数据，共 1169 名参与者（639 名患有临床诊断为重度抑郁症（MDD）的患者，530 名对照）。通过 LS-MS/MS 检测血清 25(OH)D。我们采用协方差分析评估 25(OH)D 水平的调整均值，采用多分类逻辑回归评估抑郁症及其临床特征（即不同类型和严重程度）与 25(OH)D 状态的关系（调整年龄、性别、教育程度、采血季节和生活方式因素）。总的来说，45.0%的参与者有足够的 25(OH)D 水平（≥20ng/ml），24.9%有缺乏症（<12ng/ml）。与对照组相比，MDD 患者的 25(OH)D 水平较低（16.7 比 19.6ng/ml，<0.001）。伴有非典型性抑郁的患者 25(OH)D 水平最低（14.6ng/ml）。症状严重程度与 25(OH)D 呈负相关。此外，与对照组相比，MDD 患者 25(OH)D 缺乏的几率高 2 倍以上。非典型性抑郁患者 25(OH)D 缺乏的几率最高。这些结果支持抑郁症患者的 25(OH)D 浓度低于非抑郁个体。不同的类型，特别是非典型性抑郁，在这种情况下可能起着特殊的作用。因此，未来的研究应考虑抑郁症的异质性。
