Association between dietary intake of flavonoids and perimenopausal depression, and the mediating role of high-density lipoprotein cholesterol: Evidence from NHANES 2005-2018

Abstract

Background

Perimenopausal depression seriously harms women's physical and mental health, and there is currently no safe and effective prevention and treatment method. Flavonoids not only have antidepressant effects, but can also promote the synthesis and utilization of high-density lipoprotein cholesterol (HDL-c), which are closely associated with depression. This study aimed to explore the association between flavonoid intake and the risk of perimenopausal depression and the mediating role of HDL-c.

Methods

The data of this study were collected from the US National Health and Nutrition Examination Survey (NHANES) continuously from 2005 to 2018, and flavonoid intakes data were extracted from the Food and Nutrient Database for Dietary Studies. Multivariate logistic regression was used to estimate the association between flavonoid intake and the risk of perimenopausal depression, and the mediating effect model was constructed to explore the impact of HDL-c on the correlation.

Results

Total 4603 perimenopausal female participants were included in this study, results showed that flavonoid intake was inversely associated with the risk of perimenopausal depression, and positively associated with serum HDL-c levels. These associations persisted after adjustment for relevant covariates. Serum HDL-c mediated the association between flavonoid intake and the risk of perimenopausal depression.

Limitations

As a cross-sectional study, which cannot determine the causal relationship between flavonoid intake and perimenopausal depression.

Conclusion

Our research showed that flavonoid intake, perimenopausal depression, and serum HDL-c are pairwise correlated, revealing that higher flavonoid intake was associated with a lower risk of perimenopausal depression, which may be mediated in part by serum HDL-c.