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补充维生素D对抑郁症的影响:一项随机对照试验的系统评价和剂量反应荟萃分析

The effect of vitamin D supplementation on depression: a systematic review and dose-response meta-analysis of randomized controlled trials.

作者信息

Ghaemi Shadi, Zeraattalab-Motlagh Sheida, Jayedi Ahmad, Shab-Bidar Sakineh

机构信息

Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Department of Health and Human Performance, University of Houston, Houston, Texas, USA.

出版信息

Psychol Med. 2024 Nov 18;54(15):1-10. doi: 10.1017/S0033291724001697.

Abstract

The impact of vitamin D supplementation on depressive symptoms remains uncertain. This study aimed to investigate the dose-dependent effects of vitamin D supplementation on depressive and anxiety symptoms in adults. We systematically searched PubMed, Scopus, and Web of Science up to December 2022 to identify randomized controlled trials evaluating the effects of vitamin D supplementation on depression and anxiety symptoms in adults. Using a random-effects model, we calculated the standardized mean difference (SMD) for each 1000 IU/day vitamin D supplementation. The GRADE tool assessed the certainty of evidence. Our analysis included 31 trials with 24189 participants. Each 1000 IU/day vitamin D supplementation slightly reduced depressive symptoms in individuals with and without depression (SMD: -0.32, 95% CI -0.43 to -0.22; GEADE = moderate). The effect was more pronounced in those with depressive symptoms (SMD: -0.57, 95% CI -0.69 to -0.44; = 15). The greatest reduction occurred at 8000 IU/day (SMD: -2.04, 95% CI -3.77 to -0.31). Trials with follow-up ⩽8 weeks (SMD: -0.45, 95% CI -0.70 to -0.20; = 8) and 8 to ⩽24 weeks (SMD: -0.47, 95% CI -0.70 to -0.24; = 15) showed stronger effects compared to those lasting 24 to ⩽52 weeks (SMD: -0.13, 95% CI -0.28 to 0.02; = 5) or longer than 52 weeks (SMD: 0.14, 95% CI -0.16 to 0.44; = 3) ( group difference <0.001). Vitamin D supplementation had no significant effects on anxiety symptoms. In summary, this study suggests that vitamin D supplementation may effectively reduce depressive symptoms in short term. Further high-quality trials are warranted for a conclusive assessment of its impact on anxiety.

摘要

补充维生素D对抑郁症状的影响仍不确定。本研究旨在调查补充维生素D对成年人抑郁和焦虑症状的剂量依赖性影响。我们系统检索了截至2022年12月的PubMed、Scopus和Web of Science,以确定评估补充维生素D对成年人抑郁和焦虑症状影响的随机对照试验。使用随机效应模型,我们计算了每补充1000 IU/天维生素D的标准化均数差(SMD)。GRADE工具评估了证据的确定性。我们的分析纳入了31项试验,共24189名参与者。每补充1000 IU/天维生素D,无论个体是否患有抑郁症,抑郁症状均略有减轻(SMD:-0.32,95%置信区间-0.43至-0.22;GEADE = 中等)。在有抑郁症状的人群中,这种效果更为明显(SMD:-0.57,95%置信区间-0.69至-0.44; = 15)。最大降幅出现在每天补充8000 IU时(SMD:-2.04,95%置信区间-3.77至-0.31)。随访时间≤8周的试验(SMD:-0.45,95%置信区间-0.70至-0.20; = 8)和8至≤24周的试验(SMD:-0.47,95%置信区间-0.70至-0.24; = 15),与持续24至≤52周的试验(SMD:-0.13,95%置信区间-0.28至0.02; = 5)或超过52周的试验(SMD:0.14,95%置信区间-0.16至0.44; = 3)相比,效果更强(组间差异<0.001)。补充维生素D对焦虑症状无显著影响。总之,本研究表明补充维生素D可能在短期内有效减轻抑郁症状。需要进一步开展高质量试验,以最终评估其对焦虑的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fead/11650176/8730c0d8e0b6/S0033291724001697_fig1.jpg

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