Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
J Affect Disord. 2023 Mar 15;325:48-54. doi: 10.1016/j.jad.2022.12.104. Epub 2023 Jan 3.
Association between vitamin D levels and the occurrence of depression are not always consistent. The present cohort study aimed to determine this association in older adults, using a method for measuring vitamin D levels which is more accurate than those used in previous studies.
Participants were 3447 individuals aged 40-74 years without depressive symptoms at baseline who participated in the 5-year follow-up survey. The baseline investigation, including a self-administered questionnaire survey and blood collection, was conducted in 2011-2013. Plasma 25-hydroxyvitamin D (25[OH]D) levels were measured, and divided into overall quartiles summed up by sub-quartiles and stratified by age, sex, and season. The outcome was depressive symptoms determined by the CES-D (11-item, cut-off score of 6/7) 5 years later. Covariates were demographics, lifestyles, baseline CES-D score, and disease history.
Mean plasma 25(OH)D levels were 58.0 nmol/L in men and 45.7 in women (P < 0.0001), and cumulative incidences of depressive symptoms were 249/1577 (15.8 %) in men and 313/1870 (16.7 %) in women (P = 0.4526). The lower 25(OH)D quartile group had higher adjusted ORs in men and women combined (P for trend = 0.0107) and women (P for trend = 0.0003), but not in men. Adjusted ORs of the lowest quartile group were significantly higher than the highest group in men and women combined (OR = 1.39, 95 % CI: 1.06-1.81) and women (OR = 1.89, 95 % CI: 1.31-2.72).
Depressive symptoms were self-reported.
Low vitamin D levels were associated with a high risk of depressive symptoms, especially in women. Women are thus considered a major target for preventing vitamin D deficiency to address depression.
维生素 D 水平与抑郁症发生之间的关系并不总是一致的。本队列研究旨在使用一种比以往研究更准确的方法来确定老年人中这种关联。
本研究纳入了 3447 名年龄在 40-74 岁且基线时无抑郁症状的参与者，这些参与者参加了为期 5 年的随访调查。基线调查包括自填式问卷调查和血液采集，于 2011-2013 年进行。测量了血浆 25-羟维生素 D（25[OH]D）水平，并根据年龄、性别和季节对亚四分位数进行了总和，将其分为总体四分位数。5 年后用 CES-D（11 项，得分 6/7 为界值）来确定抑郁症状。协变量为人口统计学、生活方式、基线 CES-D 评分和疾病史。
男性的平均血浆 25(OH)D 水平为 58.0 nmol/L，女性为 45.7 nmol/L（P<0.0001），男性和女性中抑郁症状的累积发生率分别为 1577 例中的 249 例（15.8%）和 1870 例中的 313 例（16.7%）（P=0.4526）。男性和女性合并时，25(OH)D 四分位较低组的校正比值比（OR）较高（趋势检验 P 值=0.0107），女性则更高（趋势检验 P 值=0.0003），但男性无此关联。男性和女性合并时，最低四分位组的校正 OR 明显高于最高四分位组（OR=1.39，95%可信区间：1.06-1.81）和女性（OR=1.89，95%可信区间：1.31-2.72）。
抑郁症状是自我报告的。
低维生素 D 水平与抑郁症状风险增加相关，尤其是在女性中。因此，女性被认为是预防维生素 D 缺乏以解决抑郁问题的主要目标人群。
