Yang Yunhong, Qi Huaqian, Zhang Jiahao, Jia Jie, Yang Yunsong, Zhao Hong
Department of Acupuncture and Moxibustion, Shanghai University of Traditional Chinese Medicine, Shenzhen Hospital, Shenzhen, China.
Guangzhou University of Chinese Medicine, Guangzhou, China.
Front Nutr. 2025 Feb 10;12:1505700. doi: 10.3389/fnut.2025.1505700. eCollection 2025.
To improve further the management of the nutritional status and dietary habits of depressed patients.
This study investigated the effect of different severity states of depressive symptoms on serum and erythrocyte folate levels using the Nutrition Examination Survey (NHANES) database from 2017 to 2020. We comprised a sample of 4,872 cases from NHANES database. We developed 3 linear regression models to assess the effect of depressive symptoms on erythrocyte folate and serum folate by collating and analyzing the data. The relationship between depression severity and erythrocyte folate as well as serum folate was also mutually validated by the results of multiple logistic regression. Finally, we made restricted cubic spline plots using the glm function of R.
Depression remained negatively correlated with serum folate levels with a OR value of -0.02, 95% CI of -0.05 ~ -0.00. Moderate depression was negatively correlated with folate, with a OR value of -0.03, 95% CI of -0.05 ~ -0.00. When exploring the association between different degrees of depressive symptoms and erythrocyte folate, it was unexpectedly found that major depression was negatively associated with erythrocyte folate with a OR value of -0.18, 95% CI of -0.31 ~ -0.04 after adjusting for all covariates.
Depression is associated with folate levels. The risk of serum folate insufficiency or erythrocyte folate insufficiency is higher after a positive depression. For different degrees of depressive symptoms, serum folate levels were significantly lower than normal in patients with moderate depression, while erythrocyte folate levels were lower than normal in patients with major depression. Therefore, attention should be paid to the dietary habits and nutritional status of patients with depression or depressive symptoms when they are undergoing long-term antidepressant treatment. Folic acid supplementation is recommended for patients with moderate or severe depression or for depressed patients who have developed unhealthy eating habits.
进一步改善抑郁症患者营养状况和饮食习惯的管理。
本研究利用2017年至2020年的营养检查调查（NHANES）数据库，调查抑郁症状的不同严重程度状态对血清和红细胞叶酸水平的影响。我们从NHANES数据库中选取了4872例样本。通过整理和分析数据，我们建立了3个线性回归模型来评估抑郁症状对红细胞叶酸和血清叶酸的影响。抑郁严重程度与红细胞叶酸以及血清叶酸之间的关系也通过多元逻辑回归结果进行了相互验证。最后，我们使用R语言的glm函数绘制了受限立方样条图。
抑郁症与血清叶酸水平仍呈负相关，优势比（OR）值为 -0.02，95%置信区间（CI）为 -0.05至 -0.00。中度抑郁症与叶酸呈负相关，OR值为 -0.03，95%CI为 -0.05至 -0.00。在探索不同程度抑郁症状与红细胞叶酸之间的关联时，意外发现，在调整所有协变量后，重度抑郁症与红细胞叶酸呈负相关，OR值为 -0.18，95%CI为 -0.31至 -0.04。
抑郁症与叶酸水平有关。抑郁呈阳性后，血清叶酸不足或红细胞叶酸不足的风险更高。对于不同程度的抑郁症状，中度抑郁症患者的血清叶酸水平显著低于正常水平，而重度抑郁症患者的红细胞叶酸水平低于正常水平。因此，在抑郁症患者或有抑郁症状的患者接受长期抗抑郁治疗时，应关注其饮食习惯和营养状况。建议对中度或重度抑郁症患者或已养成不健康饮食习惯的抑郁症患者补充叶酸。
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