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维生素 D 补充对原发性抑郁症的影响:一项荟萃分析。

The effect of vitamin D supplementation on primary depression: A meta-analysis.

机构信息

National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, 139 Middle Renmin Road, Changsha 410011, Hunan, China.

National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, 139 Middle Renmin Road, Changsha 410011, Hunan, China.

出版信息

J Affect Disord. 2024 Jan 1;344:653-661. doi: 10.1016/j.jad.2023.10.021. Epub 2023 Oct 16.

Abstract

BACKGROUND

Previous meta-analyses reported inconsistent results on the effect of vitamin D on depression because of different baseline concentrations of 25-hydroxyvitamin D [25(OH)D], highlighting the need for a more accurate subgroup analysis of previously published findings. The goal of the present study was to evaluate the effect of vitamin D supplementation on depression in adults.

METHODS

A systematic search in numerous databases including PubMed, Embase, and Web of Science was performed. Randomized-controlled trials comparing the effect of vitamin D on depression in adults were selected.

RESULTS

Eighteen studies met the inclusion criteria in the retrieved citations. The meta-analysis showed that vitamin D supplementation had a significant effect on overall reduction in depression symptom scores (SMD = -0.15, 95 % CI [-0.26, -0.04]). Sub-group analysis showed that vitamin D supplementation significantly reduced depressive symptom scores in patients with serum 25(OH)D levels higher than 50 nmol/L (SMD = -0.38, 95 % CI [-0.68, -0.08]).

CONCLUSIONS

Vitamin D supplementation has a benefit on improving depressive symptoms in adults with primary depression and 25(OH)D levels higher than 50 nmol/L but has no effect on improving depressive symptoms in adults with primary depression and 25(OH)D levels lower than 50 nmol/L. Relatively high levels of 25(OH)D maybe required for alleviating depression.

LIMITATIONS

The randomized studies included in this study were designed and completed at different times and countries, the variability in duration and dose of vitamin D supplementation may have introduced significant heterogeneity and have militated against observation of the effects of vitamin D supplementation on depression.

摘要

背景

之前的荟萃分析报告称,由于 25-羟维生素 D [25(OH)D] 的基线浓度不同,维生素 D 对抑郁症的影响结果不一致,这突出表明需要对之前发表的研究结果进行更准确的亚组分析。本研究旨在评估维生素 D 补充对成年人抑郁症的影响。

方法

在包括 PubMed、Embase 和 Web of Science 在内的多个数据库中进行系统检索。选择比较维生素 D 对成年人抑郁症影响的随机对照试验。

结果

从检索到的文献中纳入了 18 项符合标准的研究。荟萃分析表明,维生素 D 补充对整体降低抑郁症状评分有显著效果(SMD=-0.15,95%CI[-0.26,-0.04])。亚组分析表明,在血清 25(OH)D 水平高于 50nmol/L 的患者中,维生素 D 补充显著降低了抑郁症状评分(SMD=-0.38,95%CI[-0.68,-0.08])。

结论

维生素 D 补充对原发性抑郁症且血清 25(OH)D 水平高于 50nmol/L 的成年人的抑郁症状有改善作用,但对原发性抑郁症且血清 25(OH)D 水平低于 50nmol/L 的成年人的抑郁症状没有改善作用。需要相对较高水平的 25(OH)D 可能才能缓解抑郁。

局限性

本研究纳入的随机研究是在不同时间和国家设计和完成的,维生素 D 补充的持续时间和剂量的差异可能导致了显著的异质性,并阻碍了观察维生素 D 补充对抑郁症的影响。

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