The Sex-Specific Role of Plasma Folate in Mediating the Association of Dietary Quality with Depressive Symptoms
The Sex-Specific Role of Plasma Folate in Mediating the Association of Dietary Quality with Depressive Symptoms
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DOI：
10.3945/jn.109.113878
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发表时间：
2010-02-01
影响因子：
4.2
通讯作者：
Zonderman, Alan B.
中科院分区：
文献类型：
--
作者：
Beydoun, May A.;Kuczmarski, Marie T. Fanelli;Zonderman, Alan B.
叶酸缺乏与单相抑郁症的病因有关。在这项研究中，我们试图在一个全面的框架内将血浆叶酸、抑郁症状和饮食质量（或叶酸的饮食摄入量）联系在一起，同时检查性别对这些关联的影响。这是一项针对1681名年龄在30-64岁之间的参与者的横断面、基于人群的研究（寿命研究中多样性社区的健康老龄化）。参与者接受流行病学研究中心抑郁量表（CES-D）。血浆叶酸和饮食摄入量（2 24小时召回）的措施，从2005年健康饮食指数（HEI）的计算是可用的。多因素Logistic回归和结构方程模型（SM）进行。与最低的三分位数相比，血浆叶酸水平的中间和最高的三分位数与女性中CES-D升高（>= 16）的几率降低39-40%相关[校正的比值比（T（3）vs. T（1））= 0.60（95% CI = 0.42-0.86）; P = 0.006]。在男性和女性中均观察到HEI（总）对这种关联的混淆，尽管膳食叶酸并没有明显混淆这种关联。在SM中，血浆叶酸仅在男性中完全介导了HEI（总）-CES-D的反向关联，特别是HEI（2）（整个水果的摄入量较高），HEI（3）（总蔬菜），HEI（5）（总谷物），HEI（6）（全谷物），HEI（7）（牛奶）和HEI（12）（较低的可自由支配能量）。在女性中，HEI（总）和4种成分对CES-D评分有反向直接影响，表明一种独立于血浆叶酸的机制。在我们的研究中，抑郁症状可以通过改善整体饮食质量来缓解，血浆叶酸仅在男性中发挥潜在的介导作用。J.营养140：338-347，2010.
Folate deficiency has been implicated in the etiology of unipolar depression. In this study, we attempted to cross-link plasma folate, depressive symptoms, and dietary quality (or dietary intake of folate) together in a comprehensive framework, while examining effect modification of those associations by sex. This was a cross-sectional, population-based study of 1681 participants aged 30-64 y (Healthy Aging in Neighborhoods of Diversity across the Lifespan Study). Participants were administered the Center for Epidemiologic Studies Depression scale (CES-D). Measures of plasma folate and dietary intakes (2 24-h recalls) from which the 2005-Healthy Eating Index (HEI) was computed were available. Multivariate logistic regression and structural equation modeling (SM) were conducted. Compared with the lowest tertile, the middle and uppermost tertiles of plasma folate were associated with a 39-40% reduced odds of elevated CES-D (>= 16) among women [adjusted odds ratio (T(3) vs. T(1)) = 0.60 (95% CI = 0.42-0.86); P = 0.006]. Confounding of this association by HEI(total) was noted among both men and women, although dietary folate did not confound this association appreciably. In SM, plasma folate completely mediated the inverse HEI(total)-CES-D association among men only, specifically for HEI(2) (higher intakes of whole fruits), HEI(3) (total vegetables), HEI(5) (total grains), HEI(6), (whole grains), HEI(7) (milk), and HEI(12) (lower discretionary energy). Among women, HEI(total) and 4 components had an inverse direct effect on CES-D score, suggesting a mechanism that is independent of plasma folate. Depressive symptoms in our study may be alleviated by improving overall dietary quality, with plasma folate playing a potential mediating role only among men. J. Nutr. 140: 338-347, 2010.