Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea; Mind Health Clinic, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.
J Affect Disord. 2022 Sep 1;312:86-91. doi: 10.1016/j.jad.2022.06.015. Epub 2022 Jun 21.
Several studies have reported an association between anemia and depression. However, whether anemia is independently associated with depression remains controversial. The current study aimed to investigate the association between anemia and depression according to sex in a large national sample population.
Data from the 2014, 2016, and 2018 Korean National Health and Nutrition Examination Survey were analyzed, and 15,472 participants were included in this study. Anemia was defined as a hemoglobin level <13 g/dL in men and <12 g/dL in women. We defined a Patient Health Questionnaire-9 score ≥10 as depression and ≥5 as mild depressive symptoms.
The prevalence of depression was significantly higher in women with anemia than in women without anemia (8.9 % vs. 7.0 %, P = 0.036). In women, anemia was significantly associated with depression after adjusting all covariates in multilevel logistic regression analysis (odds ratio, 1.37; 95 % confidence interval, 1.08-1.75; P = 0.011). However, no significant association was observed in men.
There is a limit to explaining the causal direction, and several factors may not have been considered as confounders. Also, patients with severe diseases were excluded from data acquisition. A structured diagnostic interview, other than the self-report method, was not conducted.
The findings of this study suggest that anemia is associated with depression in women but not in men. A decrease in tissue oxygenation, deterioration of physical performance due to anemia, and altered monoamine synthesis due to malnutrition may have an effect on depression.
多项研究报告称贫血与抑郁之间存在关联。然而，贫血是否与抑郁独立相关仍存在争议。本研究旨在在一个大型全国样本人群中按性别探讨贫血与抑郁之间的关系。
分析了 2014 年、2016 年和 2018 年韩国国家健康和营养检查调查的数据，共纳入 15472 名参与者。贫血定义为男性血红蛋白水平<13g/dL 和女性<12g/dL。我们将患者健康问卷-9 得分≥10 定义为抑郁，≥5 定义为轻度抑郁症状。
贫血女性的抑郁发生率明显高于非贫血女性（8.9% vs. 7.0%，P=0.036）。在女性中，在校正多层次逻辑回归分析中的所有协变量后，贫血与抑郁显著相关（比值比，1.37；95%置信区间，1.08-1.75；P=0.011）。然而，在男性中未观察到显著关联。
解释因果方向存在局限性，并且可能未考虑到一些因素作为混杂因素。此外，数据采集排除了患有严重疾病的患者。未进行除自我报告方法之外的结构化诊断访谈。
本研究结果表明，贫血与女性抑郁相关，而与男性无关。组织缺氧减少、贫血导致的身体机能恶化以及营养不良导致的单胺合成改变可能对抑郁产生影响。
