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Casertano M, Dekker M, Valentino V, De Filippis F, Fogliano V, Ercolini D. Gaba-producing lactobacilli boost cognitive reactivity to negative mood without improving cognitive performance: A human Double-Blind Placebo-Controlled Cross-Over study. Brain Behav Immun 2024; 122:256-265. [PMID: 39163908 DOI: 10.1016/j.bbi.2024.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 08/01/2024] [Accepted: 08/11/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Psychobiotic bacteria are probiotics able to influence stress-related behavior, sleep, and cognitive outcomes. Several in vitro and human studies were performed to assess their physiological potential, to find strains having psychotropic activity in humans, and to elucidate the metabolic pathways involved. In our previous in vitro study, we identified two strains Levilactobacillus brevis P30021 and Lactiplantibacillus plantarum P30025, able to produce GABA and acetylcholine, being promising candidates to provide an effect on mood and cognitive performance. AIM To investigate the effects of probiotics in the alleviation on the cognitive performance of moderately stressed healthy adults. Secondary outcomes were related to mood improvement, production of GABA, glutamate, acetylcholine, and choline and modification of the microbiota composition. METHODS A 12-week randomized, double-blind, placebo-controlled, cross-over study investigated the effects of a probiotic formulation (Levilactobacillus brevis P30021 and Lactiplantibacillus plantarum P30025) on psychological, memory, and cognition parameters in 44 (Probiotic = 44, Placebo = 43) adults with a mean age of 29 ± 5.7 years old by CogState Battery test. Subjects-inclusion criteria was a mild-moderate (18.7 ± 4.06) stress upon diagnosis using the DASS-42 questionnaire. RESULTS Probiotic treatment had no effect on subjective stress measures. The probiotic formulation showed a significant beneficial effect on depressive symptoms by reducing cognitive reactivity to sad mood (p = 0.034). Rumination significantly improved after intake of the probiotic (p = 0.006), suggesting a potential benefit in reducing the negative cognitive effects associated with depression and improving overall mental health. When stratifying the treated subjects according to the response, we found an increase in the abundance of the probiotic genera in the gut microbiota of positive responders (p = 0.009 for Lactiplantibacillus and p = 0.004 for L.brevis). No relevant correlations were observed between the neurotransmitter concentration in the faecal sample, scores of LEIDS, DASS-42, and cognitive tests. CONCLUSION We highlight the potential of this probiotic preparation to act as psycobiotics for the relief of negative mood feelings. The assessment of the psychotropic effects of dietary interventions in human participants has many challenges. Further interventional studies investigating the effect of these psychobiotic bacteria in populations with stressed-related disorders are required including longer period of intervention and larger sample size in order to verify the effects of the treatment on further stress-related indicators.
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Affiliation(s)
- Melania Casertano
- Food Quality & Design Group, Wageningen University & Research, NL-6708 WG, the Netherlands; Department of Agricultural Sciences of the University of Naples "Federico II", Università 100, 80055 Portici (NA), Italy
| | - Matthijs Dekker
- Food Quality & Design Group, Wageningen University & Research, NL-6708 WG, the Netherlands
| | - Vincenzo Valentino
- Department of Agricultural Sciences of the University of Naples "Federico II", Università 100, 80055 Portici (NA), Italy
| | - Francesca De Filippis
- Department of Agricultural Sciences of the University of Naples "Federico II", Università 100, 80055 Portici (NA), Italy
| | - Vincenzo Fogliano
- Food Quality & Design Group, Wageningen University & Research, NL-6708 WG, the Netherlands.
| | - Danilo Ercolini
- Department of Agricultural Sciences of the University of Naples "Federico II", Università 100, 80055 Portici (NA), Italy
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Gu H, Chen Z, Zhou R, Yang X, Zhang Q, Yang T, Chen X, Zhao L, Cheng S. Vitamin D deficiency may exacerbate the role of metal exposure in depression: A cross-sectional analysis of NHANES data from 2007 to 2018. J Affect Disord 2024:S0165-0327(24)01217-5. [PMID: 39142580 DOI: 10.1016/j.jad.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 06/26/2024] [Accepted: 08/09/2024] [Indexed: 08/16/2024]
Abstract
People are paying more and more attention to the effects of environmental factors such as heavy metals on depression, and heavy metals may destroy the homeostasis of vitamin D in the body by affecting human metabolism, and the lack of vitamin D will increase the risk of depression. There are few studies on vitamin D deficiency in depression caused by heavy metals, and it is not deep enough. Therefore, this study used logistic regression, restricted cubic spline curve, weighted quantile and Quantile g-computation model to analyze the effects of heavy metal exposure alone and in combination on vitamin D and depression, as well as the potential role of vitamin D deficiency in the process of heavy metal-induced depression. The results showed that cadmium exposure alone or in combination increased the risk of depression (P < 0.05). When Cd increased by 1 unit, the risk of depressive symptoms increased by 1.178 units. Arsenic and its compounds and lead affected vitamin D levels in the body and contributed the second highest or highest weight in the mixture (P < 0.05). It is worth noting that after grouping according to vitamin D deficiency, compared with the normal group, the mixed exposure of heavy metals in the vitamin D deficiency group had more types of metals related to depression and contributed more weight (P < 0.05). This study found that single metal or multi-metal mixed exposure is associated with depression. Vitamin D deficiency may increase the risk of depression. Vitamin D may be a potential factor in the treatment of depression caused by metal, and the specific mechanism of action needs further study.
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Affiliation(s)
- Huiwen Gu
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Zhongwen Chen
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Ruiqi Zhou
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Xiaohong Yang
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Qiuhao Zhang
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Tingting Yang
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Xieyi Chen
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Lingxiao Zhao
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Shuqun Cheng
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing 400016, People's Republic of China.
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Charoenporn V, Tungsukruthai P, Teacharushatakit P, Hanvivattanakul S, Sriyakul K, Sukprasert S, Kamalashiran C, Tungsukruthai S, Charernboon T. Effects of an 8-week high-dose vitamin D supplementation on fatigue and neuropsychiatric manifestations in post-COVID syndrome: A randomized controlled trial. Psychiatry Clin Neurosci 2024. [PMID: 39072958 DOI: 10.1111/pcn.13716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/17/2024] [Accepted: 06/27/2024] [Indexed: 07/30/2024]
Abstract
AIM This study evaluated the effectiveness of high-dose vitamin D supplementation in alleviating fatigue and neuropsychiatric symptoms in post-COVID syndrome. METHODS In an 8-week, double-blind, randomized, placebo-controlled trial, 80 patients with post-COVID fatigue or neuropsychiatric symptoms were enrolled. Participants were randomly assigned to receive either 60,000 IU of vitamin D weekly (n = 40) or a placebo (n = 40) for 8 weeks. Clinical outcomes were assessed using the 11-item Chalder Fatigue Scale (CFQ-11); 21-item Depression, Anxiety, and Stress Scale (DASS-21); Pittsburgh Sleep Quality Index (PSQI); Addenbrooke's Cognitive Examination III (ACE); and Trail Making Test A and B (TMT-A and TMT-B). Baseline and 8-week measurements of inflammatory markers, including interleukin 6 (IL-6) and C-reactive protein (CRP), were also collected. RESULTS Significant improvements were found in the vitamin D group for CFQ (coefficient -3.5, P = 0.024), DASS-anxiety (-2.0, P = 0.011), and ACE (2.1, P = 0.012). No significant differences were observed in PSQI, DASS-depression, TMT, IL-6, or CRP levels. The incidence of adverse events was comparable between groups, with no serious adverse events reported. CONCLUSION High-dose vitamin D supplementation may benefit patients with post-COVID syndrome by reducing fatigue, alleviating anxiety, and improving cognitive symptoms, with minimal side effects.
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Affiliation(s)
- Veevarin Charoenporn
- Faculty of Medicine, Thammasat University, Pathumthani, Thailand
- Department of Psychiatry, Thammasat University Hospital, Pathumthani, Thailand
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - Parunkul Tungsukruthai
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | | | | | - Kusuma Sriyakul
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - Sophida Sukprasert
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - Chuntida Kamalashiran
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - Sucharat Tungsukruthai
- Division of Health and Applied Sciences, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
| | - Thammanard Charernboon
- Faculty of Medicine, Thammasat University, Pathumthani, Thailand
- Center of Excellence in Applied Epidemiology, Thammasat University, Pathumthani, Thailand
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Kautz A, Meng Y, Yeh KL, Peck R, Brunner J, Best M, Fernandez ID, Miller RK, Barrett ES, Groth SW, O'Connor TG. Dietary Intake of Nutrients Involved in Serotonin and Melatonin Synthesis and Prenatal Maternal Sleep Quality and Affective Symptoms. J Nutr Metab 2024; 2024:6611169. [PMID: 39015539 PMCID: PMC11250910 DOI: 10.1155/2024/6611169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 03/15/2024] [Accepted: 06/11/2024] [Indexed: 07/18/2024] Open
Abstract
Poor sleep quality and psychological distress in pregnancy are important health concerns. Serotonin and melatonin levels may underlie variation in these adverse outcomes. In this study, we examined dietary nutrients involved in serotonin and melatonin synthesis in relation to maternal sleep quality and affective symptoms during pregnancy. Pregnant women at no greater than normal medical risk at enrollment completed 24-hour dietary recalls in mid-late pregnancy. Usual intakes of vitamin B6, vitamin D, eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA), and tryptophan were estimated from dietary intake of foods and supplements using the National Cancer Institute (NCI) method. Sleep quality, depression, and anxiety were measured using validated questionnaires. Associations between nutrient intakes, sleep quality, and affective symptoms were estimated using generalized estimating equation models adjusting for potential confounding factors. In minimally adjusted models, EPA + DHA and tryptophan intakes were associated with a lower score indicating better sleep quality (b: -1.07, 95% CI: -2.09, -0.05) and (b: -12.40, 95% CI: -24.60, -0.21), respectively. EPA + DHA and tryptophan intakes were also associated with a lower odds of shorter sleep duration and sleep disturbances. In addition, tryptophan was associated with a lower odds of higher sleep latency. However, associations were attenuated and nonsignificant after adjustment for demographic and lifestyle factors. In conclusion, intakes of EPA + DHA and tryptophan were associated with improved sleep quality, but these associations were confounded by maternal demographic and lifestyle characteristics. This study highlights the need to consider dietary intake and pregnancy health in the context of demographic characteristics and lifestyle behaviors.
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Affiliation(s)
- Amber Kautz
- Public Health SciencesUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Ying Meng
- School of NursingUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Kuan-Lin Yeh
- School of NursingUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Robin Peck
- Clinical Research CenterUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Jessica Brunner
- School of NursingUniversity of Rochester Medical Center, Rochester, NY, USA
- Obstetrics and GynecologyUniversity of Rochester Medical Center, Rochester, NY, USA
- PsychiatryUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Meghan Best
- Obstetrics and GynecologyUniversity of Rochester Medical Center, Rochester, NY, USA
| | - I. Diana Fernandez
- Public Health SciencesUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Richard K. Miller
- Obstetrics and GynecologyUniversity of Rochester Medical Center, Rochester, NY, USA
- PediatricsUniversity of Rochester Medical Center, Rochester, NY, USA
- Pathology and Clinical Laboratory MedicineUniversity of Rochester Medical Center, Rochester, NY, USA
- Environmental MedicineUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Emily S. Barrett
- Public Health SciencesUniversity of Rochester Medical Center, Rochester, NY, USA
- Obstetrics and GynecologyUniversity of Rochester Medical Center, Rochester, NY, USA
- Biostatistics and EpidemiologyRutgers School of Public Health, Piscataway, NJ, USA
- Environmental and Occupational Health Sciences InstituteRutgers University, Piscataway, NJ, USA
| | - Susan W. Groth
- School of NursingUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Thomas G. O'Connor
- Obstetrics and GynecologyUniversity of Rochester Medical Center, Rochester, NY, USA
- PsychiatryUniversity of Rochester Medical Center, Rochester, NY, USA
- NeuroscienceUniversity of Rochester Medical Center, Rochester, NY, USA
- PsychologyUniversity of Rochester, Rochester, NY, USA
- Wynne Center for Family ResearchUniversity of Rochester Medical Center, Rochester, NY, USA
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Satyanarayana PT, Suryanarayana R, Yesupatham ST, Varadapuram Ramalingareddy SR, Gopalli NA. Does Vitamin D3 Supplementation Improve Depression Scores among Rural Adolescents? A Randomized Controlled Trial. Nutrients 2024; 16:1828. [PMID: 38931184 PMCID: PMC11206973 DOI: 10.3390/nu16121828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Contemporary evidence has been established demonstrating that stunted vitamin D levels are associated with depression, poor mood, and other mental disorders. Individuals with normal vitamin D levels have a much lower probability of developing depression. Improving vitamin D levels by supplementation has shown betterment in depressive patients among different age groups. The objective of this study was to assess the effect of vitamin D supplementation on depression scores among rural adolescents. MATERIAL AND METHODS This study was a cluster randomized controlled trial carried out for a period of 3 years among adolescents from rural Kolar. The sample size was calculated based on previous research and was determined to be 150 for each group. The intervention arm received 2250 IU of vitamin D, and the control arm received a lower dose of 250 IU of vitamin D for 9 weeks. To assess sociodemographic status, a pretested, semi-structured questionnaire was used, and, to assess depression, the Beck Depression Inventory (BDI-II) was used. A baseline assessment was carried out for vitamin D status and depression status, followed by a post-intervention assessment. From the start of the trial, the participants were contacted every week by the pediatric team to investigate any side effects. RESULTS Out of 235 school students in the vitamin D supplementation arm, 129 (54.9%) belonged to the 15 years age group, 124 (52.8%) were boys, and 187 (79.6%) belonged to a nuclear family. Out of 216 school students in the calcium supplementation arm, 143 (66.2%) belonged to the 15 years age group, 116 (53.7%) were girls, and 136 (63%) belonged to a nuclear family. By comparing Beck depression scores before and after the intervention, it was found that the vitamin D intervention arm showed a statistically significant reduction in Beck depression scores. CONCLUSIONS The present study showed that vitamin D supplementation reduced depression scores, showing some evidence that nutritional interventions for mental health issues such as depression are an excellent option. Vitamin D supplementation in schools can have numerous beneficiary effects on health while mutually benefiting mental health.
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Affiliation(s)
- Pradeep Tarikere Satyanarayana
- Community Medicine, Sri Devaraj Urs Medical College (SDUMC) Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar 563103, India
| | - Ravishankar Suryanarayana
- Biostatistics, Sri Devaraj Urs Medical College (SDUMC) Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar 563103, India
| | - Susanna Theophilus Yesupatham
- Biochemistry, Sri Devaraj Urs Medical College (SDUMC) Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar 563103, India;
| | | | - Navya Aswathareddy Gopalli
- Psychiatry, Sri Devaraj Urs Medical College (SDUMC) Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar 563103, India
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Deng X, Launer LJ, Lawrence KG, Werder EJ, Buller ID, Jackson WB, Sandler DP. Association between solar radiation and mood disorders among Gulf Coast residents. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024:10.1038/s41370-024-00691-w. [PMID: 38831020 DOI: 10.1038/s41370-024-00691-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Climate factors such as solar radiation could contribute to mood disorders, but evidence of associations between exposure to solar radiation and mood disorders is mixed and varies by region. OBJECTIVE To evaluate the association of solar radiation with depression and distress among residents living in U.S. Gulf states. METHODS We enrolled home-visit participants in the Gulf Long-Term Follow-up Study who completed validated screening questionnaires for depression (Patient Health Questionnaire-9, N = 10,217) and distress (Kessler Psychological Distress Questionnaire, N = 8,765) for the previous 2 weeks. Solar radiation estimates from the Daymet database (1-km grid) were linked to residential addresses. Average solar radiation exposures in the seven (SRAD7), 14 (SRAD14), and 30 days (SRAD30) before the home visit were calculated and categorized into quartiles (Q1-Q4). We used generalized linear mixed models to estimate prevalence ratios (PR) and 95% confidence intervals (CI) for associations between solar radiation and depression/distress. RESULTS Higher levels of SRAD7 were non-monotonically inversely associated with depression [PRVs.Q1 (95%CI): Q2 = 0.81 (0.68, 0.97), Q3 = 0.80 (0.65, 0.99), Q4 = 0.88 (0.69, 1.15)] and distress [PRVs.Q1 (95%CI): Q2 = 0.76 (0.58, 0.99), Q3 = 0.77 (0.57, 1.06), Q4 = 0.84 (0.58, 1.22)]. Elevated SRAD14 and SRAD30 appeared to be associated with decreasing PRs of distress. For example, for SRAD14, PRs were 0.86 (0.63-1.19), 0.80 (0.55-1.18), and 0.75 (0.48-1.17) for Q2-4 versus Q1. Associations with SRAD7 varied somewhat, though not significantly, by season with increasing PRs of distress in spring and summer and decreasing PRs of depression and distress in fall. IMPACT STATEMENT Previous research suffered from exposure misclassification, which impacts the validity of their conclusions. By leveraging high-resolution datasets and Gulf Long-term Follow-up Cohort, our findings support an association between increased solar radiation and fewer symptoms of mood disorders.
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Affiliation(s)
- Xinlei Deng
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Emily J Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Ian D Buller
- Social & Scientific Systems, Inc., a DLH Holdings Company, Silver Spring, MD, USA
| | | | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA.
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Foscolou A, Papandreou P, Gioxari A, Skouroliakou M. Optimizing Dietary Habits in Adolescents with Polycystic Ovary Syndrome: Personalized Mediterranean Diet Intervention via Clinical Decision Support System-A Randomized Controlled Trial. CHILDREN (BASEL, SWITZERLAND) 2024; 11:635. [PMID: 38929215 PMCID: PMC11201884 DOI: 10.3390/children11060635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/14/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
The hypothesis of this randomized controlled trial was that a clinical decision support system (CDSS) would increase adherence to the Mediterranean diet (MD) among adolescent females with polycystic ovary syndrome (PCOS). The objective was to assess the impact of personalized MD plans delivered via a CDSS on nutritional status and psychological well-being. Forty adolescent females (15-17 years) with PCOS were randomly assigned to the MD group (n = 20) or the Control group (n = 20). The MD group received personalized MD plans every 15 days via a CDSS, while the Control group received general nutritional advice. Assessments were conducted at baseline and after 3 months. Results showed significantly increased MD adherence in the MD group compared to the Control group (p < 0.001). The MD group exhibited lower intakes of energy, total fat, saturated fat, and cholesterol, and higher intakes of monounsaturated fat and fiber (p < 0.05). Serum calcium and vitamin D status (p < 0.05), as well as anxiety (p < 0.05) were improved. In conclusion, tailored dietary interventions based on MD principles, delivered via a CDSS, effectively manage PCOS in adolescent females. These findings highlight the potential benefits of using technology to promote dietary adherence and improve health outcomes in this population. ClinicalTrials.gov registry: NCT06380010.
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Affiliation(s)
- Alexandra Foscolou
- Department of Nutritional Science and Dietetics, School of Health Sciences, 24100 Kalamata, Greece;
| | - Panos Papandreou
- Department of Nutrition, IASO Hospital, 37-39 Kifissias Ave., 15123 Athens, Greece
| | - Aristea Gioxari
- Department of Nutritional Science and Dietetics, School of Health Sciences, 24100 Kalamata, Greece;
| | - Maria Skouroliakou
- Department of Dietetics and Nutritional Science, School of Health Science and Education, Harokopio University, 70 El. Venizelou Ave., 17676 Athens, Greece;
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Chen Y, Guo JH, Chen YJ, Huang Y, Zhang C, Zhang Q, Gong YL, Chen J. 1,25-Dihydroxyvitamin D3 reduces early mortality post severe burn injury via alleviating endotoxemia, oxidative stress and inflammation. Burns 2024:S0305-4179(24)00151-7. [PMID: 38987082 DOI: 10.1016/j.burns.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 04/29/2024] [Accepted: 05/02/2024] [Indexed: 07/12/2024]
Abstract
Severe burn patients frequently suffer from 1,25-Dihydroxyvitamin D3 (1,25-[OH]2-D3) deficiency. In this study, we investigated the effect of 1,25-[OH]2-D3 on early mortality post severe burn and potential underlying mechanisms. Our results indicate that 1,25-[OH]2-D3 significantly reduced early mortality in mice post severe burn injury. A decrease in serum lipopolysaccharide levels and an increase in serum superoxide dismutase activity were found after administration of 1,25-[OH]2-D3. Furthermore, 1,25-[OH]2-D3 demonstrated protective effects on both intestinal and lung histology and ameliorated lung inflammation. Its anti-inflammatory effect was further confirmed in airway epithelial cells. In conclusion, our study provides evidence that 1,25-[OH]2-D3 has a significant impact on the reduction of early mortality post severe burn injury, possibly through its ability to alleviate endotoxemia, oxidative stress, and inflammation. Our findings highlight the potential of 1,25-[OH]2-D3 to protect the intestinal mucosal barrier in the early stage following major burn injury and opens up new avenues for clinical application of 1,25-[OH]2-D3 in burn patients.
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Affiliation(s)
- Yu Chen
- State Key Laboratory of Trauma and Chemical Poisoning of China, Institute of Burn Research, Southwest Hospital (the First Affiliated Hospital), Third Military Medical University, (Army Medical University), Gao Tan Yan Street, Chongqing 400038, China
| | - Jing Hui Guo
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Ya Jie Chen
- State Key Laboratory of Trauma and Chemical Poisoning of China, Institute of Burn Research, Southwest Hospital (the First Affiliated Hospital), Third Military Medical University, (Army Medical University), Gao Tan Yan Street, Chongqing 400038, China
| | - Yong Huang
- State Key Laboratory of Trauma and Chemical Poisoning of China, Institute of Burn Research, Southwest Hospital (the First Affiliated Hospital), Third Military Medical University, (Army Medical University), Gao Tan Yan Street, Chongqing 400038, China
| | - Cheng Zhang
- State Key Laboratory of Trauma and Chemical Poisoning of China, Institute of Burn Research, Southwest Hospital (the First Affiliated Hospital), Third Military Medical University, (Army Medical University), Gao Tan Yan Street, Chongqing 400038, China
| | - Qiong Zhang
- State Key Laboratory of Trauma and Chemical Poisoning of China, Institute of Burn Research, Southwest Hospital (the First Affiliated Hospital), Third Military Medical University, (Army Medical University), Gao Tan Yan Street, Chongqing 400038, China
| | - Ya Li Gong
- State Key Laboratory of Trauma and Chemical Poisoning of China, Institute of Burn Research, Southwest Hospital (the First Affiliated Hospital), Third Military Medical University, (Army Medical University), Gao Tan Yan Street, Chongqing 400038, China
| | - Jing Chen
- State Key Laboratory of Trauma and Chemical Poisoning of China, Institute of Burn Research, Southwest Hospital (the First Affiliated Hospital), Third Military Medical University, (Army Medical University), Gao Tan Yan Street, Chongqing 400038, China.
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Celikbilek A, Koysuren A, Konar NM. Role of vitamin D in the association between pre-stroke sleep quality and poststroke depression and anxiety. Sleep Breath 2024; 28:841-848. [PMID: 37542680 DOI: 10.1007/s11325-023-02894-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/12/2023] [Accepted: 07/26/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE Poor sleep quality, mood disorders, and vitamin D deficiency are common in stroke. We investigated the association between serum vitamin D levels and pre-stroke sleep quality and the occurrence of poststroke depression (PSD) and poststroke anxiety (PSA) in acute ischemic stroke (AIS). METHODS This prospective cross-sectional study included hospitalized patients with AIS and age- and sex-matched controls. Vitamin D levels were measured within 24 h of admission. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) at admission. The severity of depression and anxiety symptoms was evaluated according to Beck Depression Inventory and Beck Anxiety Inventory scores, respectively, within 72 h after admission. RESULTS Comparing 214 AIS patients with 103 controls, patients had significantly higher scores of Beck Depression Inventory, Beck Anxiety Inventory, and PSQI and lower vitamin D levels (p < 0.001). Among AIS patients, Beck Depression Inventory (p = 0.004) and Beck Anxiety Inventory (p = 0.018) scores were significantly higher in bad sleepers (PSQI score ≥ 6) than in good sleepers (PSQI score ≤ 5). Correlation analysis revealed negative correlations between serum vitamin D levels and Beck Depression Inventory (r = - 0.234; p < 0.001), Beck Anxiety Inventory (r = - 0.135; p = 0.016), and PSQI (r = - 0.218; p < 0.001) scores. CONCLUSION Decreased serum vitamin D levels at admission are associated with a high risk for PSD and PSA in patients with poor pre-stroke sleep quality during the early stages of AIS.
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Affiliation(s)
- Asuman Celikbilek
- Department of Neurology, Kirsehir Ahi Evran University Faculty of Medicine, Kirsehir, 40100, Turkey.
| | - Aydan Koysuren
- Department of Neurology, Kirsehir Ahi Evran University Faculty of Medicine, Kirsehir, 40100, Turkey
| | - Naime Meric Konar
- Department of Biostatistics and Medical Informatics, Kirsehir Ahi Evran University Faculty of Medicine, Kirsehir, Turkey
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Mavar M, Sorić T, Bagarić E, Sarić A, Matek Sarić M. The Power of Vitamin D: Is the Future in Precision Nutrition through Personalized Supplementation Plans? Nutrients 2024; 16:1176. [PMID: 38674867 PMCID: PMC11054101 DOI: 10.3390/nu16081176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
In the last few decades, vitamin D has undeniably been one of the most studied nutrients. Despite our ability to produce vitamin D through sunlight exposure, its presence in several natural food sources and fortified foods, and its widespread availability as a dietary supplement, vitamin D deficiency is a serious public health problem, affecting nearly 50% of the global population. Low serum levels of vitamin D are being associated with increased susceptibility to numerous health conditions, including respiratory infections, mental health, autoimmune diseases, and different cancer types. Although the association between vitamin D status and health is well-established, the exact beneficial effects of vitamin D are still inconclusive and indefinite, especially when considering the prevention and treatment of different health conditions and the determination of an appropriate dosage to exert those beneficial effects in various population groups. Therefore, further research is needed. With constant improvements in our understanding of individual variations in vitamin D metabolism and requirements, in the future, precision nutrition and personalized supplementation plans could prove beneficial.
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Affiliation(s)
- Mladen Mavar
- Psychiatric Hospital Ugljan, Otočkih Dragovoljaca 42, 23275 Ugljan, Croatia;
| | - Tamara Sorić
- Psychiatric Hospital Ugljan, Otočkih Dragovoljaca 42, 23275 Ugljan, Croatia;
| | - Ena Bagarić
- Almagea Ltd., Ulica Julija Knifera 4, 10020 Zagreb, Croatia;
| | - Ana Sarić
- School of Medicine, Catholic University of Croatia, Ilica 242, 10000 Zagreb, Croatia;
| | - Marijana Matek Sarić
- Department of Health Studies, University of Zadar, Splitska 1, 23000 Zadar, Croatia;
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11
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Shi L, Luo J, Wei X, Xu X, Tu L. The protective role of ginsenoside Rg3 in heart diseases and mental disorders. Front Pharmacol 2024; 15:1327033. [PMID: 38469409 PMCID: PMC10926849 DOI: 10.3389/fphar.2024.1327033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/07/2024] [Indexed: 03/13/2024] Open
Abstract
Ginsenoside Rg3, a compound derived from Panax ginseng C. A. Mey., is increasingly recognized for its wide range of pharmacological effects. Under the worldwide healthcare challenges posed by heart diseases, Rg3 stands out as a key subject in modern research on Chinese herbal medicine, offering a novel approach to therapy. Mental illnesses are significant contributors to global disease mortality, and there is a well-established correlation between cardiac and psychiatric conditions. This connection is primarily due to dysfunctions in the sympathetic-adrenomedullary system (SAM), the hypothalamic-pituitary-adrenal axis, inflammation, oxidative stress, and brain-derived neurotrophic factor impairment. This review provides an in-depth analysis of Rg3's therapeutic benefits and its pharmacological actions in treating cardiac and mental health disorders respectively. Highlighting its potential for the management of these conditions, Rg3 emerges as a promising, multifunctional therapeutic agent.
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Affiliation(s)
- Lili Shi
- Department of Geriatric Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Jinlan Luo
- Department of Geriatric Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Xiupan Wei
- Department of Rehabilitation Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Xizhen Xu
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
- Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ling Tu
- Department of Geriatric Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
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12
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El Toum Y, Costa T, El Toum E, Haddad T, Salameh P, El Karak F, Ghosn M, Nasr F, Chahine G, Kattan J, Kourie HR. Supplement use and its impact on daily life of cancer patients: a cross-sectional study. Support Care Cancer 2024; 32:172. [PMID: 38379082 DOI: 10.1007/s00520-024-08380-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE This cross-sectional study aimed to investigate the prevalence and characteristics of supplement usage among cancer patients and explore its potential associations with anxiety, excessive daytime sleepiness, and overall quality of life. METHODS Cancer patients receiving specific care at Hôtel Dieu de France University Hospital, Beirut, were enrolled between April and June 2023. In face-to-face interviews, participants were asked to complete a questionnaire consisting of sociodemographic information, supplement usage details, and cancer-related variables. Three validated surveys (Epworth Sleepiness Scale, GAD-7, and EORTC-QLQ-C15-PAL) were employed to assess excessive daytime sleepiness, anxiety, and overall quality of life. Statistical analyses, including chi-square tests, t-tests, and multiple regression models, were conducted to examine associations between supplement use and other variables. RESULTS A total of 202 participants were interviewed. Fifty-two percent reported regular use of supplements following their cancer diagnosis, with vitamin D being the most commonly used supplement. Using multivariate logistic regression, supplement use was associated with being female, having lower educational levels, having a longer duration since cancer diagnosis, and having a poor overall quality of life. The multivariate logistic regression showed no significant correlation between supplement use and excessive daytime sleepiness and anxiety. CONCLUSION This study highlights a high prevalence of supplement usage among cancer patients in Lebanon, indicating a rising interest in alternative therapies aimed at enhancing quality of life. Larger prospective studies are needed to assess the relation between supplement intake and excessive daytime sleepiness and anxiety and establish clear guidelines pertaining to supplement use in cancer patients.
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Affiliation(s)
- Youssef El Toum
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
| | - Tarek Costa
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Elissa El Toum
- Faculty of Medical Sciences, Lebanese University, Hadat, Lebanon
| | - Tina Haddad
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Pascale Salameh
- Faculty of Medical Sciences, Lebanese University, Hadat, Lebanon
| | - Fady El Karak
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Marwan Ghosn
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Fady Nasr
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Georges Chahine
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Joseph Kattan
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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Arabshahi V, Khoddami M, Milajerdi M, Moabedi M, Milajerdi A. Association between dietary intake of vitamin D and risk of depression, anxiety, and sleep disorders among physically active adults: a cross-sectional study. Front Nutr 2024; 11:1339152. [PMID: 38389792 PMCID: PMC10881758 DOI: 10.3389/fnut.2024.1339152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
Introduction Rare studies have been done to investigate the association between dietary intakes of vitamin D and the risk of mental health disorders among athletes. The current study aimed to investigate the association between this vitamin intake and the risk of depression, anxiety, and sleep disorders among a group of Iranian physically active adults. Methods This cross-sectional study was conducted among 690 healthy athletes (18-50 years, mean BMI between 20 and 30) in Kashan, Iran. The usual dietary intake of participants was assessed by a 147-item FFQ. Depression was assessed by the Beck Depression Inventory-II (21-item), anxiety by the Beck Anxiety Inventory (21-item), and sleep disorders by the Pittsburgh Sleep Quality Index questionnaires. Statistical analyses were done by using SPSS version 18. p values < 0.05 were considered significant. Results No significant association was found between vitamin D dietary intake and risk of depression in the full-adjusted model (OR: 0.96, 95% CI: 0.62, 1.51). In contrast, participants at the highest tertile of vitamin D consumption had a 49% lower risk of anxiety than those at the lowest tertile (OR: 0.51, 95%: 0.29, 0.87). Moreover, a significant 46% lower risk of sleep disorders was found among those with the highest intake of vitamin D in comparison to participants with the lowest intake (OR: 0.54, 95% CI: 0.37, 0.78). Conclusion We found a significant association between dietary vitamin D intake and reduced risk of anxiety and sleep disorders, but not with depression, in this study. Further prospective studies are recommended for future investigations.
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Affiliation(s)
- Vajiheh Arabshahi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrad Khoddami
- Institute for Basic Sciences, Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Maryam Milajerdi
- Department of Medical Sciences, Islamic Azad University, Kashan, Iran
| | - Mahdi Moabedi
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Milajerdi
- Institute for Basic Sciences, Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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Somoza-Moncada MM, Turrubiates-Hernández FJ, Muñoz-Valle JF, Gutiérrez-Brito JA, Díaz-Pérez SA, Aguayo-Arelis A, Hernández-Bello J. Vitamin D in Depression: A Potential Bioactive Agent to Reduce Suicide and Suicide Attempt Risk. Nutrients 2023; 15:nu15071765. [PMID: 37049606 PMCID: PMC10097210 DOI: 10.3390/nu15071765] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/01/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Suicide is one of the leading causes of death worldwide. According to the World Health Organization (WHO), every year, more than 700 thousand people die from this cause. Therefore, suicide is a public health issue. The complex interaction between different factors causes suicide; however, depression is one of the most frequent factors in people who have attempted suicide. Several studies have reported that vitamin D deficiency may be a relevant risk factor for depression, and vitamin D supplementation has shown promising effects in the adjunctive treatment of this mood disorder. Among the beneficial mechanisms of vitamin D, it has been proposed that it may enhance serotonin synthesis and modulate proinflammatory cytokines since low serotonin levels and systemic inflammation have been associated with depression and suicide. The present narrative review shows the potential pathogenic role of vitamin D deficiency in depression and suicide and the potential benefits of vitamin D supplementation to reduce their risk.
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Affiliation(s)
- María Montserrat Somoza-Moncada
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico
| | - Francisco Javier Turrubiates-Hernández
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico
- Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico
| | - José Francisco Muñoz-Valle
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico
| | - Jesús Alberto Gutiérrez-Brito
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico
| | - Saúl Alberto Díaz-Pérez
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico
| | - Adriana Aguayo-Arelis
- Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico
| | - Jorge Hernández-Bello
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico
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Prijadi SM, Kusuma CF, Puspitasari IM. The association between Vitamin D levels and postpartum depression: a review. PHARMACIA 2023. [DOI: 10.3897/pharmacia.70.e97300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
According to WHO, Postpartum Depression (PPD) occurs in 10–15% of women after giving birth. Several studies assumed that vitamin D deficiency might worsen PPD symptoms. However, the association between vitamin D levels and PPD is still conflicting. This article summarizes the association between vitamin D levels and PPD. A literature search about Vitamin D levels and PPD from Scopus and PubMed databases was performed in June 2022. Eleven studies were obtained out of 30 studies. Nine out of 11 studies showed that vitamin D levels were significantly associated with PPD. However, the two others showed no significant association. The difference in the blood sample taken and how to assess depression contributes to a different result. The association is related to the role of vitamin D in mood regulation, synthesis of neurotransmitters, stimulating brain receptors, and intercellular neuronal signaling systems.
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Hung KC, Wu JY, Illias AM, Chiu CC, Chang YJ, Liao SW, Wang KF, Chen IW, Sun CK. Association of a low vitamin D status with risk of post-stroke depression: A meta-analysis and systematic review. Front Nutr 2023; 10:1142035. [PMID: 36875853 PMCID: PMC9983120 DOI: 10.3389/fnut.2023.1142035] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/02/2023] [Indexed: 02/18/2023] Open
Abstract
Background Although post-stroke depression (PSD) affects one-third of patients following an acute stroke, pooled evidence addressing the correlation between a low vitamin D status and the risk of PSD remains inconclusive. Methods Comprehensive database search of Medline, EMBASE, Cochrane library, and Google Scholar was performed from inception to December 2022. The primary outcome was the association of PSD risk with a low vitamin D status, while the secondary outcomes included the relationship between PSD and other risk factors. Results Analysis of seven observational studies published between 2014 and 2022 with 1,580 patients showed pooled incidences of vitamin D deficiency (defined as 25[OH] D levels < 50 nmol/L) and PSD of 60.1 and 26.1%, respectively. Patients with PSD had a lower circulating vitamin D concentration compared to those without [mean difference (MD) =-13.94 nmol/L, 95% CI: -21.83 to -6.05, p = 0.0005, I 2 = 91%, six studies, 1,414 patients]. Meta-analysis also demonstrated a correlation between a low vitamin D level and an increased PSD risk [odd ratio (OR) = 3.25, 95% CI: 1.57-6.69, p = 0.001, I 2 = 78.7%, 1,108 patients], the heterogeneity of which was found to be associated with the incidence of vitamin D deficiency but not female proportion on meta-regression. Besides, female gender (OR = 1.78, 95% CI: 1.3-2.44, p = 0.003, I 2 = 31%, five studies, 1,220 patients), hyperlipidemia (OR = 1.55, 95% CI: 1.01-2.36, p = 0.04, I 2 = 0%, four studies, 976 patients), and high National Institutes of Health Stroke Scale (NIHSS) scores (MD = 1.45, 95% CI: 0.58-2.32, p = 0.001, I 2 = 82%, five studies, 1,220 patients) were potential risk factors for PSD. For the primary outcome, the certainty of evidence was very low. Regarding secondary outcomes, the certainty of evidence was low for BMI, female gender, hypertension, diabetes, and stroke history, and very low for age, level of education, hyperlipidemia, cardiovascular disease, and NIHSS scores. Conclusion The results suggested an association of a low circulating vitamin D level with an increased risk of PSD. Besides, female gender, hyperlipidemia, high NIHSS score were related to an increased risk or occurrence of PSD. The current study may imply the necessity of routine circulating vitamin D screening in this population. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022381580.
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Affiliation(s)
- Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.,School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan City, Taiwan
| | - Amina M Illias
- Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung City, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung City, Taiwan.,Department of Medical Education and Research, E-Da Cancer Hospital, Kaohsiung City, Taiwan
| | - Ying-Jen Chang
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
| | - Shu-Wei Liao
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
| | - Kuei-Fen Wang
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
| | - I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City, Taiwan
| | - Cheuk-Kwan Sun
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung City, Taiwan.,Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
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