Liu Mengqing, Wang Gang, Jiang Chongfei
College of Humanities and Management, Guilin Medical College, Guilin, China.
Department of Nephrology, The University of HongKong-ShenZhen Hospital, ShenZhen, Guangdong, China.
Front Nutr. 2024 Aug 9;11:1389480. doi: 10.3389/fnut.2024.1389480. eCollection 2024.
Depression is a widespread mental health condition that can impact both mental and physical well-being. Prior research has shown that high levels of copper in the blood and low levels of folate are linked to depression. This study aimed to explore whether serum folate levels, independently or in combination with serum copper levels, associated with the risk of depression.
Data from participants aged 18-80 years in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016 were analyzed to examine the role of trace elements. Depression was assessed using the nine-item Patient Health Questionnaire (PHQ-9). Logistic regression analyses were employed to evaluate the main effect of serum copper and folate levels on depression. Three indices, including the relative excess risk of interaction (RERI), attributable proportion of interaction (API), and synergy index (SI), were used to analyze the interaction effect.
Among the 4,847 participants selected for this study, 429 (8.9%) had PHQ-9 scores above 10, which we defined as having depressive symptoms. After adjusting for all confounding factors, higher serum copper levels [≥15.5 vs. <15.5 μmol/L, odds ratio (OR): 1.54; 95% confidence intervals (CI): 1.18-2.11] and folate deficiency (folate ≥53.7 vs. <53.7 μmol/L, OR: 1.44; 95% CI: 1.21-2.10) were associated with an increased risk of depression. Patients with both higher serum copper levels and folate deficiency (OR: 2.11; 95% CI: 1.43-3.14) had the highest risk of depression than other levels. High copper levels and low folate levels are associated with the occurrence of depression symptoms, and there may be a synergistic effect between them (SI: 1.65; 95% CI: 1.49-4.76), with this interaction accounting for 19% of depression cases (API: 0.19; 95% CI: 0.01-0.54).
There may be a synergistic interaction between high copper levels and low folate levels associated with increasing risk of depression. Further population-based interventional studies are needed to confirm whether folic acid supplementation is effective in preventing depression in individuals with high blood copper levels.
抑郁症是一种普遍存在的心理健康状况，会影响身心健康。先前的研究表明，血液中铜含量高和叶酸水平低与抑郁症有关。本研究旨在探讨血清叶酸水平单独或与血清铜水平联合是否与抑郁症风险相关。
分析了2011年至2016年美国国家健康与营养检查调查（NHANES）中18 - 80岁参与者的数据，以研究微量元素的作用。使用九项患者健康问卷（PHQ - 9）评估抑郁症。采用逻辑回归分析来评估血清铜和叶酸水平对抑郁症的主要影响。使用三个指标，包括交互作用的相对超额风险（RERI）、交互作用的归因比例（API）和协同指数（SI）来分析交互作用效应。
在本研究选取的4847名参与者中，429名（8.9%）的PHQ - 9得分高于10，我们将其定义为有抑郁症状。在调整所有混杂因素后，较高的血清铜水平[≥15.5 vs. <15.5 μmol/L，比值比（OR）：1.54；95%置信区间（CI）：1.18 - 2.11]和叶酸缺乏（叶酸≥53.7 vs. <53.7 μmol/L，OR：1.44；95% CI：1.21 - 2.10）与抑郁症风险增加相关。血清铜水平高且叶酸缺乏的患者（OR：2.11；95% CI：1.43 - 3.14）患抑郁症的风险高于其他水平。高铜水平和低叶酸水平与抑郁症状的发生有关，它们之间可能存在协同作用（SI：1.65；95% CI：1.49 - 4.76），这种交互作用占抑郁症病例的19%（API：0.19；95% CI：0.01 - 0.54）。
高铜水平和低叶酸水平之间可能存在协同交互作用，与抑郁症风险增加有关。需要进一步开展基于人群的干预研究，以确认补充叶酸是否能有效预防血铜水平高的个体患抑郁症。
