Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Int J Geriatr Psychiatry. 2023 Aug;38(8):e5972. doi: 10.1002/gps.5972.
There is growing evidence that vitamin D may be related to mental health. The aim of the current study was to investigate the association of dietary and blood inflammatory factors with mental health disorders in subjects with vitamin D deficiency, shedding further light on the complex interplay of these conditions.
In this cross-sectional study, 306 subjects completed the validated Depression, Anxiety, and Stress Scale questionnaire to evaluate their depression, anxiety, and stress scores. Dietary inflammatory index (DII) and healthy eating index (HEI) were calculated using a validated 65-item food frequency questionnaire. Blood samples were taken and vitamin D, cytokine, and hs-CRP levels were measured using enzyme-linked immunosorbent assay kits. Platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) were calculated using standard laboratory methods.
The subjects were divided into two groups based on their vitamin D levels: a vitamin D < 20 μg/dl group (N = 257) and a vitamin D ≥ 20 μg/dl group (N = 49). Between group analysis revealed that only DII (p = 0.015), platelet (p = 0.04), and hs-CRP (p = 0.015) were significantly different. In adults with vitamin D levels below 20 μg/dl, NLR and DII were significantly higher in subjects with anxiety (p < 0.05), and this relationship remained significant only for NLR after adjusting for age and sex. Additionally, PLR and HEI were significantly different in depressed compared to non-depressed subjects, and this association remained significant only for HEI after adjusting for age and sex.
In subjects with vitamin D deficiency, increased levels of PLR, NLR, and DII were associated with depression and anxiety, while HEI was negatively associated with depression. These associations were not found in subjects with vitamin D levels ≥20 μg/dl.
越来越多的证据表明，维生素 D 可能与心理健康有关。本研究旨在探讨饮食和血液炎症因子与维生素 D 缺乏人群心理健康障碍之间的关系，进一步阐明这些情况之间的复杂相互作用。
在这项横断面研究中，306 名受试者完成了经过验证的抑郁、焦虑和压力量表问卷，以评估他们的抑郁、焦虑和压力评分。使用经过验证的 65 项食物频率问卷计算饮食炎症指数 (DII) 和健康饮食指数 (HEI)。采集血液样本，使用酶联免疫吸附试剂盒测量维生素 D、细胞因子和 hs-CRP 水平。使用标准实验室方法计算血小板与淋巴细胞比值 (PLR) 和中性粒细胞与淋巴细胞比值 (NLR)。
根据维生素 D 水平将受试者分为两组：维生素 D<20μg/dl 组 (N=257) 和维生素 D≥20μg/dl 组 (N=49)。组间分析显示，仅 DII(p=0.015)、血小板(p=0.04)和 hs-CRP(p=0.015)差异有统计学意义。在维生素 D 水平低于 20μg/dl 的成年人中，NLR 和 DII 在焦虑症患者中显著较高 (p<0.05)，且在调整年龄和性别后，这种相关性仅对 NLR 有统计学意义。此外，PLR 和 HEI 在抑郁症患者中与非抑郁症患者差异有统计学意义，且在调整年龄和性别后，这种相关性仅对 HEI 有统计学意义。
在维生素 D 缺乏的受试者中，PLR、NLR 和 DII 水平升高与抑郁和焦虑相关，而 HEI 与抑郁呈负相关。在维生素 D 水平≥20μg/dl 的受试者中未发现这些关联。
