药物导致的镁缺乏评分与抑郁症状患病率增加相关，且独立于肾功能：来自1999 - 2018年美国国家健康与营养检查调查（NHANES）的证据。

A medication-driven magnesium deficiency score is associated with increased depressive symptoms prevalence independent of renal function: Evidence from NHANES 1999-2018.

作者信息

Lu Jian, Deng Zekai, Cui Wen, Shang Xinru, Jiang Shimin, Wang Shunwei, Li Wenge

机构信息

Department of Nephrology, Capital Medical University China-Japan Friendship School of Clinical Medicine, No. 2 East Yinghuayuan Street, Chaoyang District, Beijing, China; Department of Nephrology, China-Japan Friendship Hospital, No. 2 East Yinghuayuan Street, Chaoyang District, Beijing, China.

Department of Nephrology, Capital Medical University China-Japan Friendship School of Clinical Medicine, No. 2 East Yinghuayuan Street, Chaoyang District, Beijing, China.

出版信息

J Affect Disord. 2025 Dec 1;390:119801. doi: 10.1016/j.jad.2025.119801. Epub 2025 Jul 3.

DOI:10.1016/j.jad.2025.119801

PMID:40614976

Abstract

BACKGROUND

Magnesium deficit is considered to be a risk factor for depression. This study aimed to determine the relationship between Magnesium Depletion Score (MgDS) and depressive symptoms.

METHODS

A total of 20,893 participants were included from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2018. Depressive symptoms was defined using a 9-item Patient Health Questionnaire (PHQ-9) (categorized as ≥5 [mild], ≥10 [clinical], and ≥ 15 [moderate-to-severe]). Weighted linear regression examined MgDS association with continuous PHQ-9 scores (range 0-27), while weighted logistic regression analyzed categorical depressive symptoms. Restricted cubic splines (RCS) assessed nonlinear relationships in both models. Sensitivity analyses included severity-stratified and subgroup analyses.

RESULTS

For each one-point increase in MgDS, the PHQ-9 score increased by 0.23 points (95 % CI: 0.13-0.32) in the continuous analysis. Similarly, the odds of clinical depressive symptom were increased by 12 % (OR = 1.12, 95 % CI: 1.04-1.21). Use of diuretics and PPIs was independently associated with increased likelihood of having depressive symptoms (OR = 1.24, 95 % CI: 1.04-1.46; OR = 1.95, 95 % CI: 1.64-2.32). In sensitivity analyses, per-unit MgDS increases corresponded to 11 % (mild; OR = 1.11, 1.04-1.17) and 17 % (moderate-to-severe; OR = 1.17, 1.05-1.31) higher odds of depressive symptoms. RCS analysis showed that there was a linear dose-response relationship across the MgDS. The association remained significant in stratified analyses by age, sex, magnesium intake, and comorbidity status.

CONCLUSION

MgDS was independently associated with depressive symptoms in a dose-response manner. The use of diuretics and PPIs may contribute to this association through magnesium imbalance, necessitating mechanistic studies and clinical monitoring in high-risk patients.

摘要

背景

镁缺乏被认为是抑郁症的一个风险因素。本研究旨在确定镁消耗评分（MgDS）与抑郁症状之间的关系。

方法

纳入了1999年至2018年期间进行的美国国家健康与营养检查调查（NHANES）中的20893名参与者。抑郁症状采用9项患者健康问卷（PHQ-9）进行定义（分为≥5[轻度]、≥10[临床]和≥15[中度至重度]）。加权线性回归分析MgDS与连续PHQ-9评分（范围0-27）之间的关联，而加权逻辑回归分析分类的抑郁症状。受限立方样条（RCS）评估两个模型中的非线性关系。敏感性分析包括按严重程度分层和亚组分析。

结果

在连续分析中，MgDS每增加1分，PHQ-9评分增加0.23分（95%CI：0.13-0.32）。同样，临床抑郁症状的几率增加了12%（OR=1.12，95%CI：1.04-1.21）。使用利尿剂和质子泵抑制剂与出现抑郁症状的可能性增加独立相关（OR=1.24，95%CI：1.04-1.46；OR=1.95，95%CI：1.64-2.32）。在敏感性分析中，MgDS每增加一个单位，抑郁症状的几率分别增加11%（轻度；OR=1.11，1.04-1.17）和17%（中度至重度；OR=1.17，1.05-1.31）。RCS分析表明，MgDS之间存在线性剂量反应关系。在按年龄、性别、镁摄入量和合并症状态进行的分层分析中，该关联仍然显著。