Qiu Xichenhui, Xu Ting, Huang Yiqing, Wei Changning, Wang Lina, Wu Bei
Health Science Center, Shenzhen University, No.1066 Xueyuan Avenue, Nanshan District, Shenzhen, 518060, China.
Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY, 10010, USA.
BMC Oral Health. 2025 Jun 5;25(1):914. doi: 10.1186/s12903-025-06274-x.
While the association between the gut microbiome and depression is well studied, the association between the oral microbiome and depression is less well characterized.
This cross-sectional study analyzed the association between depression and diversity of oral microbiome using data from the 2009-2012 National Health and Nutrition Examination Survey (NHANES). The gene sequencing of 16S ribosomal RNA was adopted for the profiling of oral microbiome. Alpha diversity, quantified by the observed number of amplicon sequence variants (ASVs), and beta diversity, assessed using Bray-Curtis dissimilarity, were evaluated to represent oral microbiome diversity. Depressive symptoms were measured by the Patient Health Questionnaire-9 (PHQ-9) scale, with alpha diversity as the primary predictor. Weighted logistic regression was employed to examine the relationship between depression and microbial alpha diversity. Threshold effect analysis was performed to explore potential nonlinear relationships between the observed ASVs and depression. Subgroup analysis indicated that smoke, excessive alcohol consumption, and oral treatment influenced the association between oral microbiology and depression, with interaction effects observed across gender and racial groups. Beta diversity differences were evaluated using Bray-Curtis dissimilarity and visualized via non-metric multidimensional scaling (NMDS).
A total of 15,018 participants were included, with an average age of 42.25 ± 15.2 years. In the fully adjusted model, the alpha diversity of oral microbiome was significantly negatively correlated with depression (OR = -0.51, 95% CI: -0.79--0.23, P = 0.003). Threshold analysis also revealed a nonlinear association in this relationship, with a significant inflection point as Log10ASVs of 2.32. Furthermore, beta diversity of the oral microbiome differed significantly between the normal and depression groups (p = 0.001). Sensitivity analyses showed that the relationship between depression and oral microbial diversity observed in this research was particularly pronounced among non-Hispanic Whites (OR = 0.16, 95% CI: 0.07-0.35) and men (OR = 0.14, 95% CI: 0.06-0.30). Additionally, significant differences in oral microbiome beta diversity were observed between the normal and depression groups (p = 0.001).
The findings suggest that the diversity of oral microbiome is negatively correlated with depressive symptoms. Hence, oral dysbiosis may serve as a therapeutic target or biomarker of depression. However, the underlying mechanisms require further investigation.
虽然肠道微生物群与抑郁症之间的关联已得到充分研究，但口腔微生物群与抑郁症之间的关联特征尚不明确。
这项横断面研究利用2009 - 2012年美国国家健康与营养检查调查（NHANES）的数据，分析了抑郁症与口腔微生物群多样性之间的关联。采用16S核糖体RNA基因测序对口腔微生物群进行分析。通过观察到的扩增子序列变体（ASV）数量进行量化的α多样性，以及使用布雷 - 柯蒂斯差异度评估的β多样性，用于代表口腔微生物群的多样性。抑郁症状通过患者健康问卷 - 9（PHQ - 9）量表进行测量，以α多样性作为主要预测指标。采用加权逻辑回归分析抑郁症与微生物α多样性之间的关系。进行阈值效应分析以探索观察到的ASV与抑郁症之间潜在的非线性关系。亚组分析表明，吸烟、过量饮酒和口腔治疗会影响口腔微生物学与抑郁症之间的关联，在性别和种族群体中均观察到交互作用。使用布雷 - 柯蒂斯差异度评估β多样性差异，并通过非度量多维尺度分析（NMDS）进行可视化。
共纳入15018名参与者，平均年龄为42.25±15.2岁。在完全调整模型中，口腔微生物群的α多样性与抑郁症显著负相关（OR = -0.51，95%CI：-0.79--0.23，P = 0.003）。阈值分析还揭示了这种关系中的非线性关联，Log10ASV为2.32时存在显著拐点。此外，正常组和抑郁症组之间口腔微生物群的β多样性存在显著差异（p = 0.001）。敏感性分析表明，本研究中观察到的抑郁症与口腔微生物多样性之间的关系在非西班牙裔白人（OR = 0.16，95%CI：0.07 - 0.35）和男性（OR = 0.14，95%CI：0.06 - 0.30）中尤为明显。此外，正常组和抑郁症组之间口腔微生物群β多样性存在显著差异（p = 0.001）。
研究结果表明，口腔微生物群的多样性与抑郁症状呈负相关。因此，口腔生态失调可能是抑郁症的治疗靶点或生物标志物。然而，其潜在机制需要进一步研究。
