Association Between Low Serum 25-Hydroxyvitamin D and Depression in a Large Sample of Healthy Adults: The Cooper Center Longitudinal Study

doi:10.4065/mcp.2011.0208

Mayo Clinic Proceedings

Volume 86, Issue 11, November 2011, Pages 1050-1055

https://doi.org/10.4065/mcp.2011.0208 Get rights and content

OBJECTIVE

To investigate the association between serum vitamin D levels and depression in a large database of patients from the Cooper Clinic.

PATIENTS AND METHODS

We conducted a cross-sectional study of 12,594 participants seen at the Cooper Clinic from November 27, 2006, to October 4, 2010. Serum 25-hydroxyvitamin D [25(OH)D] was analyzed, and depression was defined as a Center for Epidemiologic Studies Depression Scale (CES-D) score of 10 or more. Those with and those without a history of depression represented 2 distinct populations with respect to CES-D scores; accordingly, they were analyzed separately.

RESULTS

In the total sample, higher vitamin D levels were associated with a significantly decreased risk [odds ratio, 0.92 (95% confidence interval, 0.87-0.97)] of current depression based on CES-D scores. The finding was stronger in those with a prior history of depression [odds ratio, 0.90 (95% confidence interval, 0.82-0.98)] and not significant in those without a history of depression [odds ratio, 0.95 (95% confidence interval, 0.89-1.02)].

CONCLUSION

We found that low vitamin D levels are associated with depressive symptoms, especially in persons with a history of depression. These findings suggest that primary care patients with a history of depression may be an important target for assessment of vitamin D levels.

Section snippets

Participants

The Cooper Center Longitudinal Study (CCLS) is a prospective study of patients who have completed a preventive medical examination at the Cooper Clinic in Dallas, TX.²⁵ The Cooper Clinic is a fee-for-service preventive medicine clinic. Patients at the Cooper Clinic are generally well-educated and mostly non-Hispanic whites (95%) from middle to upper socioeconomic strata. We examined data from 12,594 patients seen from November 27, 2006, to October 4, 2010, who completed baseline examinations

RESULTS

Participant characteristics are shown in Table 1. The study sample included 4005 women (31.8%) and 8589 men (68.2%) with a mean age of 51.7±11.0 years. Exploratory analysis showed that those with and those without a history of depression represented 2 distinct populations with respect to the CES-D score. Accordingly, in addition to analysis of the total sample, the 2 groups were analyzed separately. There were significantly higher percentages of women and participants with a history of

DISCUSSION

The association between vitamin D level and depression was analyzed in the largest data set to date, comprising generally healthy persons ranging from 20 to 90 years of age. Although mean vitamin D levels did not differ significantly between those with and those without a history of depression, there was a significant association between vitamin D levels and current “depressive symptoms” based on CES-D scores in those with a history of depression. This subset analysis may shed light on why

CONCLUSION

Current depression as defined by the CES-D was associated with lower vitamin D levels in participants with prior history of depression by self-report in the largest sample investigated to date. The findings suggest that patients with a history of depression could be an important population to target for screening of vitamin D levels. Additional research is needed to determine the nature and direction of the association between vitamin D levels and depression.

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Previous meta-analyses reported inconsistent results on the effect of vitamin D on depression because of different baseline concentrations of 25-hydroxyvitamin D [25(OH)D], highlighting the need for a more accurate subgroup analysis of previously published findings. The goal of the present study was to evaluate the effect of vitamin D supplementation on depression in adults.
A systematic search in numerous databases including PubMed, Embase, and Web of Science was performed. Randomized-controlled trials comparing the effect of vitamin D on depression in adults were selected.
Eighteen studies met the inclusion criteria in the retrieved citations. The meta-analysis showed that vitamin D supplementation had a significant effect on overall reduction in depression symptom scores (SMD = −0.15, 95 % CI [−0.26, −0.04]). Sub-group analysis showed that vitamin D supplementation significantly reduced depressive symptom scores in patients with serum 25(OH)D levels higher than 50 nmol/L (SMD = −0.38, 95 % CI [−0.68, −0.08]).
Vitamin D supplementation has a benefit on improving depressive symptoms in adults with primary depression and 25(OH)D levels higher than 50 nmol/L but has no effect on improving depressive symptoms in adults with primary depression and 25(OH)D levels lower than 50 nmol/L. Relatively high levels of 25(OH)D maybe required for alleviating depression.
The randomized studies included in this study were designed and completed at different times and countries, the variability in duration and dose of vitamin D supplementation may have introduced significant heterogeneity and have militated against observation of the effects of vitamin D supplementation on depression.
Low plasma 25-hydroxyvitamin D levels are associated with an increased risk of depressive symptoms in community-dwelling Japanese people aged between 40 and 74 years: The Murakami cohort study.
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Adult vitamin D deficiency and adverse brain outcomes
2023, Feldman and Pike's Vitamin D: Volume One: Biochemistry, Physiology and Diagnostics
There is a broad understanding that vitamin D deficiency at various points across the life span is associated with a range of adverse health outcomes, including brain disorders. The mechanisms through which vitamin D deficiency impacts behavior and cognition, however, are yet to be fully elucidated. A better understanding of how vitamin D deficiency impacts the adult brain may allow the targeting of specific pathways to prevent or ameliorate cascading effects of low vitamin D. In this review, we examine the evidence from epidemiological and animal studies linking adult vitamin D deficiency with a wide range of neuropsychiatric disorders and neurodegenerative diseases. Although supplementation with vitamin D is readily available, recent clinical trials have had mixed results, highlighting the need for further research.
Cardiorespiratory fitness and depression symptoms among adults during the COVID-19 Pandemic: Cooper Center Longitudinal Study
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This study examined the relation between cardiorespiratory fitness (fitness) and depression symptoms prior to and during COVID-19 among adults seeking preventive medical care. Participants consisted of 967 patients attending the Cooper Clinic (Dallas, TX) pre-pandemic (March 2018-December 2019) and during the pandemic (March-December 2020). The outcome, depression symptoms, was based on the Center for Epidemiological Studies-Depression (CES-D). Maximal metabolic equivalents task (MET) levels for fitness were determined from the final treadmill speed and grade. Multiple linear regression models were computed by sex. Analysis revealed that mean fitness decreased from 11.4 METs (SD = 2.1) prior to the pandemic to 10.9 METs (SD = 2.3) during the pandemic (p-value < 0.001). The mean CES-D score increased from 2.8 (SD = 3.1) before to pandemic to 3.1 (SD = 3.2) during the pandemic (p-value = 0.003). Results from multiple linear regression indicate that increased fitness was associated with a statistically significant decrease in depression scores in men (−0.17 per MET; 95% CI −0.33, −0.02) but not women. This modest decrease may have been tempered by high fitness levels and low depression scores at baseline in this well-educated sample.
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Depression symptoms are a significant risk factor for prediabetes-related diabetes, and low vitamin D levels are connected with depression symptoms. The goal of this study is to examine the association between vitamin D and depression symptoms in prediabetic persons.
This cross-sectional survey was conducted in Tianjin, China, among 4051 individuals. Symptoms of depression were assessed using the Self-Rating Depression Scale (SDS) (cut-off point SDS ≥45). Serum 25 (OH) D concentrations were determined using an enzyme immunoassay (OCTEIA 25-hydroxy Vitamin D, IDS Ltd, UK) and classified into three levels: 50 nmol/L, 50–75 nmol/L, and >75 nmol/L. The link between serum 25 (OH) D concentrations and depression symptoms in prediabetes was investigated using multiple logistic regression analysis. The models were adjusted for a variety of potential confounders.
The prevalence of symptoms of depression in prediabetic adults was 14.2% (12.5% males and 16.4% females). After adjusting for potentially confounding variables, the odds ratios - ORs for symptoms of depression in women across serum 25 (OH) D levels were 1.00 (reference), 1.03 (0.57, 1.39), and 0.28 (0.12, 0.57), respectively (p = 0.0015). However, no statistically significant connection was discovered in males.
In women with prediabetes, we showed a substantial negative connection between serum 25 (OH) D levels and depressed symptoms. Vitamin D supplementation may be an effective way to decrease the risk of depression symptoms in women with prediabetes.
Epigenetic regulation of gene expression: an overview of classical and recently discovered novel players
2022, Perinatal and Developmental Epigenetics: Volume 32 in Translational Epigenetics
Cells in a human body are phenotypically heterogenous although genetically homogenous, owing to differential gene expression. Such differences are acquired during development and propagated through rounds of meiosis and mitosis and termed as “epigenetic.” Epigenetic processes, viz., DNA methylation, genomic imprinting, histone modifications, and noncoding RNAs by altering DNA accessibility and chromatin structure regulate gene expression. All these epigenetic mechanisms play a crucial role during embryonic development via gene regulation through various processes such as genomic imprinting, X-inactivation, chromatin remodeling of embryonic stem cells, and organ and body patterning. Aberrations in these epigenetic mechanisms result in the loss of cellular identity and development of various pathologies. Perinatal insults as well as lifestyle factors in terms of nutritional and environmental challenges are known to alter the epigenetic mechanisms and are associated with an increased susceptibility to several metabolic disorders and cancers. This chapter summarizes the implication of epigenetic mechanisms in both physiological and pathological conditions with special reference to developmental epigenetics.

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: individual reprints of this article are not available.

¹: Dr Brown has research support from the National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute on Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, the Stanley Medical Research institute, and AstraZeneca.

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ORIGINAL ARTICLEAssociation Between Low Serum 25-Hydroxyvitamin D and Depression in a Large Sample of Healthy Adults: The Cooper Center Longitudinal Study

OBJECTIVE

PATIENTS AND METHODS

RESULTS

CONCLUSION

Section snippets

Participants

RESULTS

DISCUSSION

CONCLUSION

Mol Aspects Med

J Chem Neuroanat

Prog Neuropsychopharmacol Biol Psychiatry

Brain Res Bull

Am J Geriatr Psychiatry

J Affect Disord

Am J Prev Med

Arch Gerontol Geriatr

Am J Clin Nutr

Am Heart J

Appl Nurs Res

Cross-national epidemiology of DSM-IV major depressive episode

BMC Med

The impact of depression on workplace functioning and disability costs

Am J Manag Care

Diagnosis and management of vitamin D deficiency

BMJ

Vitamin D deficiency

N Engl J Med

Vitamin D and risk of cognitive decline in elderly persons

Arch Intern Med

Serum vitamin D and the risk of Parkinson disease

Arch Neurol

ORIGINAL ARTICLE
Association Between Low Serum 25-Hydroxyvitamin D and Depression in a Large Sample of Healthy Adults: The Cooper Center Longitudinal Study