School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
Environ Sci Pollut Res Int. 2021 Jun;28(21):26794-26806. doi: 10.1007/s11356-021-12560-2. Epub 2021 Jan 26.
To examine the associations between urinary antibiotics from various sources and depression in the elderly using the biomonitoring method.
In the current study, we investigated 990 elderly individuals (≥ 60 years old) from a community-based elderly cohort in West Anhui, China. The participants were interviewed by the Geriatric Depression Scale and self-developed questionnaires. A total of 45 antibiotics belonging to nine categories were screened in urine samples by the developed liquid chromatography electrospray tandem mass spectrometry method. Creatinine-corrected concentrations of antibiotics in urines were used to assess their exposure. Logistic regression analysis was employed to test the relationships between exposure to antibiotics and depression.
Compared to the control group, the multinomial logistic regression analyses showed the elderly exposed to higher concentrations of azithromycin (OR = 1.81, 95% CI: 1.09-3.00) and sulfaclozine (OR = 1.54, 95% CI: 1.05-2.28) had increased risks of depression, respectively. After categorizing the detected antibiotics, tetracyclines (OR = 1.48, 95% CI: 1.02-2.16) and veterinary antibiotics (VAs) (OR = 1.53, 95% CI: 1.06-2.20) were positively correlated with increased risks of depression. After stratified by sex, the VAs (OR = 2.04, 95% CI: 1.13-3.71) at higher concentrations were associated with elevated risks of depression in males, while the associations between depression and antibiotic exposures were observed in tetracyclines (OR = 1.74, 95% CI: 1.04-2.85) and all antibiotics (OR = 2.24, 95% CI: 1.01-2.94) at higher levels in females, respectively. Notably, after the stratification by age, the significant associations were mainly present in the subjects under the age of 70.
Our findings reveal that azithromycin, sulfaclozine, tetracyclines, and the VAs were significantly associated with elevated risks of depression in the elderly. Importantly, sex- and age-specific differences were observed in the associations between antibiotic exposures and depression.
采用生物监测法研究不同来源的尿用抗生素与老年人抑郁之间的关联。
本研究纳入了来自中国皖南地区一个社区老年队列中的 990 名老年人（≥60 岁）。采用老年抑郁量表和自拟问卷对参与者进行访谈。通过建立的液相色谱-电喷雾串联质谱法检测尿液样本中的 45 种属于九大类的抗生素。采用肌酐校正后的抗生素尿液浓度来评估其暴露水平。采用 logistic 回归分析来检验抗生素暴露与抑郁之间的关系。
与对照组相比，多变量 logistic 回归分析显示，暴露于较高浓度阿奇霉素（OR=1.81，95%CI：1.09-3.00）和磺胺醋酰（OR=1.54，95%CI：1.05-2.28）的老年人患抑郁的风险增加。在对检测到的抗生素进行分类后，四环素（OR=1.48，95%CI：1.02-2.16）和兽用抗生素（VAs）（OR=1.53，95%CI：1.06-2.20）与抑郁风险增加呈正相关。按性别分层后，高浓度的 VAs（OR=2.04，95%CI：1.13-3.71）与男性抑郁风险升高相关，而在女性中，较高浓度的抗生素（OR=1.74，95%CI：1.04-2.85）和所有抗生素（OR=2.24，95%CI：1.01-2.94）与抑郁的相关性更强。值得注意的是，在按年龄分层后，这些显著的相关性主要存在于年龄小于 70 岁的人群中。
我们的研究结果表明，阿奇霉素、磺胺醋酰、四环素和 VAs 与老年人抑郁风险升高显著相关。重要的是，抗生素暴露与抑郁之间的关联存在性别和年龄特异性差异。
