饮食中摄入活菌对成年人抑郁和自杀意念发生率和死亡率的影响：一项基于全国人群的研究证据。

Effect of dietary live microbe intake on the prevalence and mortality risks of depression and suicidal ideation in adults: Evidence from a nationwide population-based study.

机构信息

Department of Medical Psychology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China.

出版信息

J Affect Disord. 2025 Jan 1;368:847-856. doi: 10.1016/j.jad.2024.09.127. Epub 2024 Sep 18.

DOI:10.1016/j.jad.2024.09.127

PMID:39303884

Abstract

BACKGROUND

Gut microbial dysbiosis has been implicated in the pathogenesis of depression. Dietary interventions offer promising microbial-targeted therapeutics for depression. However, limited evidence exists regarding the associations between dietary live microbe intake and the prevalence of depression, as well as its impact on mortality risks.

METHODS

This study included 28,133 participants from the U.S. National Health and Nutrition Examination Survey (2005-2018), and ascertained their underlying causes of death. Weighted logistic regression was utilized to assess the relationships between live microbe intake and risks of depression and suicidal ideation. Independent and joint associations between live microbe and mortality outcomes were evaluated using multivariable Cox regression and Kaplan-Meier survival curves to calculate relative risks.

RESULTS

In the fully adjusted model, participants with high dietary live microbe intake had a significantly lower prevalence of depression (OR = 0.727, 95%CI: 0.627,0.844) and suicidal ideation (OR = 0.778, 95%CI: 0.648,0.935) than those with low intake. The multivariable-adjusted HRs for individuals in the G1 were 1.217 (95%CI, 1.081, 1.370) for all-cause mortality and 1.307 (95%CI, 1.029,1.661) for cardiovascular disease mortality, compared to participants in the G3. Kaplan-Meier survival analysis revealed that cumulative hazard of cardiovascular mortality was progressively lower among participants with depression in the G3 than those without depression.

CONCLUSIONS

Higher live microbe intake was associated with a lower prevalence of depression and suicidal ideation, and was linked to significantly decreased risks of all-cause and cardiovascular mortality. Further larger prospective studies are essential to verify the health effects of live microbes, and personalized dietary recommendations are necessary.

摘要

背景

肠道微生物失调与抑郁症的发病机制有关。饮食干预为抑郁症提供了有前景的靶向微生物治疗方法。然而，关于饮食中活菌摄入与抑郁症患病率的关系，以及其对死亡率风险的影响，证据有限。

方法

本研究纳入了美国国家健康和营养调查（2005-2018 年）的 28133 名参与者，并确定了他们的根本死因。采用加权逻辑回归评估活菌摄入与抑郁和自杀意念风险的关系。采用多变量 Cox 回归和 Kaplan-Meier 生存曲线评估活菌与死亡率结果的独立和联合关联，以计算相对风险。

结果

在完全调整模型中，高饮食活菌摄入的参与者患抑郁症（OR=0.727，95%CI：0.627，0.844）和自杀意念（OR=0.778，95%CI：0.648，0.935）的患病率明显低于低摄入者。G1 组个体的多变量调整 HR 为全因死亡率的 1.217（95%CI，1.081，1.370）和心血管疾病死亡率的 1.307（95%CI，1.029，1.661），与 G3 组参与者相比。Kaplan-Meier 生存分析显示，与无抑郁的参与者相比，G3 组中患有抑郁的参与者心血管死亡率的累积风险逐渐降低。