认知功能障碍的抑郁老年人血清总叶酸和血清维生素 D 浓度与 W 型的关系：一项横断面观察研究。

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2024-11-23 DOI:10.1016/j.clnesp.2024.11.021

Qinghua Guo , Yong Wang , Libo Guo , Ke Xu , Shaomei Shang

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引用次数: 0

摘要

背景：抑郁症和认知功能障碍在老年人群中十分普遍，严重影响患者的生活质量和社会功能。本研究旨在阐明血清总叶酸和血清维生素 D 浓度与老年人抑郁症状和认知功能障碍之间的关系：利用2011-2014年美国国家健康与营养调查（NHANES）的数据，对2042名60岁及以上的参与者进行了分析。抑郁症状通过患者健康问卷（PHQ-9）进行评估，认知功能通过阿尔茨海默病登记协会（CERAD）动物流畅性测试和数字符号替换测试（DSST）进行评估。使用多变量逻辑回归模型分析了血清总叶酸和维生素D浓度与认知功能障碍抑郁之间的关系，并进行了分层和敏感性分析：血清维生素 D 浓度每增加 1 毫摩尔/升，老年人患抑郁症的风险就会降低 1%（OR=0.99 95% CI 0.98-0.99）。血清总叶酸与伴有认知功能障碍的抑郁症呈显著的W形关联：当血清总叶酸浓度低于33.00 nmol/L时，其浓度每增加1 nmol/L，抑郁症风险降低7.6%（OR=0.924 95% CI 0.89-0.959）；当浓度高于33.00 nmol/L时，这种关联不显著（OR=1.006 95% CI 0.998-1.013）：充足的维生素 D 和叶酸水平有助于预防和控制老年人的抑郁和认知功能障碍。血清总叶酸与这些疾病之间的 W 型关联表明，叶酸补充剂在特定范围内可能有效，值得通过临床研究进一步探索和验证。

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Association of serum total folate and serum vitamin D concentrations with W-shape in depressed older adults with cognitive dysfunction: A cross-sectional observational study

Background

Depression and cognitive dysfunction are prevalent in the elderly population and have a serious impact on patients' quality of life and social functioning. Nutritional factors play a key role in the prevention and management of these disorders, particularly folate and vitamin D. The aim of this study was to elucidate the association between serum total folate and serum vitamin D concentrations and depressive symptoms and cognitive dysfunction in older adults.

Methods

Using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014, 2042 participants aged 60 years and older were analyzed. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9) and cognitive function was assessed by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Animal Fluency test and the Digit Symbol Substitution Test (DSST). Associations between serum total folate and vitamin D concentrations and depression with cognitive dysfunction were analyzed using multivariate logistic regression models, incorporating stratification and sensitivity analyses.

Results

For every 1 nmol/L increase in serum vitamin D concentration, there was a 1 % reduction in the risk of depression in older adults (OR = 0.99 95 % CI 0.98–0.99). Serum total folate showed a significant W-shaped association with depression with cognitive dysfunction: when serum total folate concentration was below 33.00 nmol/L, the risk of depression was reduced by 7.6 % for every 1 nmol/L increase in its concentration (OR = 0.924 95 % CI 0.89–0.959); this association was not significant when the concentration was above 33.00 nmol/L (OR = 1.006 95 % CI 0.998–1.013).

Conclusions

Adequate levels of vitamin D and folate may help prevent and manage depression and cognitive dysfunction in older adults. The W-shaped association between serum total folate and these conditions suggests that folic acid supplementation could be effective within a specific range, warranting further exploration and validation through clinical studies.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.