Chen Mengyuan, Luo Haolong, Han Yan, Li Yuanhong, Zhou Li, Ren Xiangmei
Department of Nutrition, School of Public Health, Xuzhou Medical University, Xuzhou, China.
Key Laboratory of Human Genetics and Environmental Medicine, Key Lab of Environment and Health, Xuzhou Medical University, Xuzhou, China.
Front Nutr. 2024 Jan 26;11:1324835. doi: 10.3389/fnut.2024.1324835. eCollection 2024.
Recent studies have shown that a higher intake of ascorbic acid was associated with a lower prevalence of depression. Nevertheless, the recall bias was common in dietary surveys in these studies, and it was ignored that there were differences in the absorption and utilization of ascorbic acid in the body. Hence, we aim to investigate the association between serum ascorbic acid levels and the prevalence of depression in US adults.
A total of 3,404 participants from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) that underwent measurement of the Patient Health Questionnaire-9 (PHQ-9) scores and serum levels of ascorbic acid. Propensity Score Matching (PSM) successfully established a case-control study, comprising 299 participants diagnosed with depression and 1,107 as controls. We used binary logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to explore associated risk factors for depression. Restricted cubic splines (RCS) were used to show the nonlinear relationship between serum ascorbic acid levels and the prevalence of depression.
The prevalence of depression was approximately 8.8%, with a median serum ascorbic acid level of 49.9 (36.0, 67.0) μmol/L. Results revealed that the serum ascorbic acid levels of depressed patients were significantly lower than those of non-depressed individuals (42.97 VS 52.97 μmol/L). The baseline data indicated that as serum ascorbic acid levels increased from Quartile 1 (Q) to Quartile 4 (Q), the depression prevalence decreased from 12.0 to 5.4% ( < 0.05). The results of the chi-square test after PSM showed that serum ascorbic acid was still statistically significant ( < 0.001) with the prevalence of depression. Forest plot showed that compared with the Q of serum ascorbic acid level, the OR and 95%CI of depression prevalence in Q was 0.42 (0.30 ~ 0.61), and the adjusted OR and 95%CI of depressive prevalence was 0.49 (0.33 ~ 0.73). RCS models showed an L-shaped nonlinear relationship (P for nonlinearity <0.05) between serum ascorbic acid and depression.
Our results suggested that higher serum ascorbic acid levels are associated with a reduced prevalence of depression.
近期研究表明，较高的抗坏血酸摄入量与较低的抑郁症患病率相关。然而，这些研究中的饮食调查普遍存在回忆偏差，且忽略了抗坏血酸在体内吸收和利用的差异。因此，我们旨在调查美国成年人血清抗坏血酸水平与抑郁症患病率之间的关联。
共有3404名来自2017 - 2018年国家健康与营养检查调查（NHANES）的参与者接受了患者健康问卷-9（PHQ-9）评分测量和血清抗坏血酸水平检测。倾向得分匹配（PSM）成功建立了一项病例对照研究，包括299名被诊断为抑郁症的参与者和1107名作为对照的参与者。我们使用二元逻辑回归来估计比值比（OR）和95%置信区间（CI），以探索抑郁症的相关危险因素。使用受限立方样条（RCS）来显示血清抗坏血酸水平与抑郁症患病率之间的非线性关系。
抑郁症患病率约为8.8%，血清抗坏血酸水平中位数为49.9（36.0，67.0）μmol/L。结果显示，抑郁症患者的血清抗坏血酸水平显著低于非抑郁症患者（42.97对52.97μmol/L）。基线数据表明，随着血清抗坏血酸水平从第一四分位数（Q1）增加到第四四分位数（Q4），抑郁症患病率从12.0%降至5.4%（P<0.05）。PSM后的卡方检验结果表明，血清抗坏血酸与抑郁症患病率仍具有统计学意义（P<0.001）。森林图显示，与血清抗坏血酸水平的Q1相比，Q4中抑郁症患病率的OR和95%CI为0.42（0.300.61），抑郁症患病率的校正OR和95%CI为0.49（0.330.73）。RCS模型显示血清抗坏血酸与抑郁症之间呈L形非线性关系（非线性P<0.05）。
我们的结果表明，较高的血清抗坏血酸水平与较低的抑郁症患病率相关。
