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Wylenzek F, Bühling KJ, Laakmann E. A systematic review on the impact of nutrition and possible supplementation on the deficiency of vitamin complexes, iron, omega-3-fatty acids, and lycopene in relation to increased morbidity in women after menopause. Arch Gynecol Obstet 2024; 310:2235-2245. [PMID: 38935105 PMCID: PMC11393286 DOI: 10.1007/s00404-024-07555-6] [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: 10/08/2023] [Accepted: 05/14/2024] [Indexed: 06/28/2024]
Abstract
A balanced and healthy diet during the menopausal transition and after menopause is crucial for women to reduce the risk for morbidities and chronic diseases due to deficiency of essential nutrients. PURPOSE The objective of this study was to conduct a systematic review of studies that analyzed the impact of vitamin and nutrient deficiencies in postmenopausal women in relation to increased morbidities and chronic conditions. METHODS Observational studies were searched in the databases PubMed, UpToDate, and Google Scholar. RESULTS We searched 122 studies, of which 90 were included in our analysis. The meta-analysis of the data could not be performed because of the heterogeneity of the statistical methods in the included studies. In our study, we focused on the aspects of vitamin B6, vitamin B12, vitamin D, iron, omega-3-fatty acids, and lycopene, belonging to the family of carotenoids. Postmenopausal women with deficiencies of these nutrients are more vulnerable to comorbidities such as cardiovascular and cerebrovascular events, metabolic diseases, osteoporosis, obesity, cancer and neurodegenerative diseases such as Parkinson's disease, Alzheimer's disease, depression, cognitive decline, dementia, and stroke. We concluded that women after menopause tend to have a greater probability of suffering from deficiencies in various vitamins and nutrients, and consequently have an increased risk of developing morbidities and chronic diseases. CONCLUSION In conclusion, maintaining optimum serum levels of nutrients and vitamins, either through a balanced and healthy diet consuming fresh fruits, vegetables, and fats or by taking appropriate supplementation, is essential in maintaining optimal health-related quality of life and reducing the risk for women during the menopausal transition and after menopause. Nevertheless, more recent studies need to be assessed to formulate adequate recommendations to achieve positive clinical outcomes.
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Affiliation(s)
- Friederike Wylenzek
- Department of Gynecological Endocrinology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Kai J Bühling
- Department of Gynecological Endocrinology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Elena Laakmann
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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2
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Tobin D, Vuckovic A, Sarris J. Targeting Divergent Pathways in the Nutritional Management of Depression. Nutrients 2024; 16:2806. [PMID: 39203943 PMCID: PMC11357244 DOI: 10.3390/nu16162806] [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: 06/17/2024] [Revised: 07/17/2024] [Accepted: 07/24/2024] [Indexed: 09/03/2024] Open
Abstract
The nutritional management of depression has long been discussed, due to the perceived benefit of a nutritional product having less side effects than pharmaceutical agents. Candidate nutrients for managing depression include vitamin D, B vitamins, tryptophan, branch chain amino acids, probiotics, omega-3 fatty acids, folate/methylfolate (also known as vitamin B9), and s-adenosylmethionine. This paper provides a narrative review of three nutrients which have significant scientific support for the management of depression. A deficiency in each nutrient is associated with depression, and interventional studies indicate that the correction of the nutritional deficiency may provide clinical benefit. We present epidemiological evidence, a mechanistic explanation and a review of interventional studies for these nutrients. Finally, relevant nutritional guidelines are presented with their conclusion for the role of each nutrient in the management of depression.
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Affiliation(s)
| | | | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Westmead, NSW 2145, Australia
- The Florey Institute of Neuroscience and Mental Health, Melbourne University, Melbourne, VIC 3052, Australia
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC 3122, Australia
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3
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Cao B, Xiao Y, Liu D. Associations of methylmalonic acid and depressive symptoms with mortality: a population-based study. Transl Psychiatry 2024; 14:297. [PMID: 39030164 PMCID: PMC11271623 DOI: 10.1038/s41398-024-03015-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 06/30/2024] [Accepted: 07/08/2024] [Indexed: 07/21/2024] Open
Abstract
Methylmalonic acid (MMA), a biomarker of mitochondrial dysfunction, has been reported to be associated with depression in specific populations (i.e., older adults and postpartum women). Our study aimed to investigate to what extent MMA was associated with depressive symptoms and mortality in the general population, and assess whether depressive symptoms mediate the relationship between MMA and mortality. We analyzed cross-sectional data from 8343 participants from the US National Health and Nutrition Examination Survey. MMA was measured by liquid chromatography-tandem mass spectrometry, while depressive symptoms were measured by the Patient Health Questionnaire-9. Mortality data were obtained through linkage with National Death Index records. Linear regression models were performed to assess the association between MMA and depressive symptoms. The Cox proportional hazard regression model was utilized to assess the association of MMA and depressive symptoms with mortality. Mediation analysis was conducted within the counterfactual framework. In this general population, each SD (around 0.49 μmol/L) increase in MMA was associated with a 0.03 SD (approximately 0.15 score) increase in depressive symptoms (β = 0.033, 95% CI: 0.010, 0.055, p = 0.005). Notably, this association was more pronounced in men and participants over 60 years old. Higher levels of MMA and having more depressive symptoms were associated with a higher risk of mortality. However, depressive symptoms do not mediate the relationship between MMA and mortality. Elevated MMA levels were associated with depressive symptoms and an increased risk of mortality. These findings suggest that mitochondrial dysfunction may contribute to the multifactorial etiology of depression.
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Affiliation(s)
- Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, P. R. China
- National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, 400715, P. R. China
| | - Yefei Xiao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, P. R. China
| | - Dan Liu
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
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4
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Stein G, Aly JS, Manzolillo A, Lange L, Riege K, Hussain I, Heller EA, Cubillos S, Ernst T, Hübner CA, Turecki G, Hoffmann S, Engmann O. Transthyretin Orchestrates Vitamin B12-Induced Stress Resilience. Biol Psychiatry 2024:S0006-3223(24)01457-4. [PMID: 39029777 DOI: 10.1016/j.biopsych.2024.07.009] [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: 02/09/2024] [Revised: 06/24/2024] [Accepted: 07/06/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Chronic stress significantly contributes to mood and anxiety disorders. Previous data suggest a correlative connection between vitamin B12 supplementation, depression, and stress resilience. However, the underlying mechanisms are still poorly understood. METHODS Using the chronic variable stress mouse model coupled with RNA sequencing, we identified vitamin B12-induced transcriptional changes related to stress resilience. Using viral-mediated gene transfer and in vivo epigenome editing, we revealed a functional pathway linking vitamin B12, DNA methylation (DNAme), and depression-like symptoms. RESULTS We identified Ttr (transthyretin) as a key sex-specific target of vitamin B12 in chronic stress. Accordingly, TTR expression was increased postmortem in the prefrontal cortex of male but not female patients with depression. Virally altered Ttr in the prefrontal cortex functionally contributed to stress- and depression-related behaviors, changes in dendritic spine morphology, and gene expression. In stressed mice, vitamin B12 reduced DNAme in the Ttr promoter region. Importantly, using in vivo epigenome editing to alter DNAme in the brains of living mice for the first time, we established a direct causal link between DNAme and Ttr and stress-associated behaviors. CONCLUSIONS Using state-of-the-art techniques, this study uncovered a mechanistic link between vitamin B12 supplementation, Ttr, and markers of chronic stress and depression, encouraging further studies into dietary interventions for mood disorders.
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Affiliation(s)
- Gregor Stein
- Institute for Biochemistry and Biophysics, Friedrich Schiller University, Jena, Germany
| | - Janine S Aly
- Institute of Human Genetics, Jena University Hospital, Jena, Germany
| | | | - Lisa Lange
- Institute for Biochemistry and Biophysics, Friedrich Schiller University, Jena, Germany
| | - Konstantin Riege
- Computational Biology Group, Leibniz Institute on Aging, Fritz Lipmann Institute, Jena, Germany
| | - Iqra Hussain
- Institute for Biochemistry and Biophysics, Friedrich Schiller University, Jena, Germany
| | - Elisabeth A Heller
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Susana Cubillos
- Institute for Biochemistry and Biophysics, Friedrich Schiller University, Jena, Germany
| | - Thomas Ernst
- Clinic for Internal Medicine II, Jena University Hospital, Jena, Germany
| | | | - Gustavo Turecki
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Québec, Canada
| | - Steve Hoffmann
- Computational Biology Group, Leibniz Institute on Aging, Fritz Lipmann Institute, Jena, Germany
| | - Olivia Engmann
- Institute for Biochemistry and Biophysics, Friedrich Schiller University, Jena, Germany; Institute of Human Genetics, Jena University Hospital, Jena, Germany.
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5
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Hu Y, Yu M, Wang Y, Wu H, Yang X, Chen X, Wu J. Exploring the Association between Serum B Vitamins, Homocysteine and Mental Disorders: Insights from Mendelian Randomization. Nutrients 2024; 16:1986. [PMID: 38999734 PMCID: PMC11243542 DOI: 10.3390/nu16131986] [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: 05/23/2024] [Revised: 06/15/2024] [Accepted: 06/18/2024] [Indexed: 07/14/2024] Open
Abstract
Previous studies show that B vitamins and homocysteine (Hcy) may be associated with mental disorders, but the accurate causal relationship remains unclear. This study aimed to elucidate the potential causal relationship of serum B vitamins and Hcy levels with five common mental disorders through a two-sample Mendelian randomization (MR) study. In this MR analysis, 50 single-nucleotide polymorphisms (SNPs)-13 related to folate, 17 to vitamin B6, 8 to vitamin B12 and 12 to Hcy-were obtained from a large-scale Genome-Wide Association Studies (GWAS) database and employed as instrumental variables (IVs). The MR analyses were conducted using the inverse variance weighted (IVW), weighted median (WM), MR-Egger methods and sensitivity analyses were further performed to test the robustness. This MR study found a suggestive causal relationships between serum vitamin B12 levels and the risk of anxiety disorders (odds ratio (OR): 1.34, 95% confidence interval (CI): 1.01-1.78, p = 0.046) and bipolar affective disorders (OR: 1.85, 95% CI: 1.16-2.96, p = 0.010). However, folate, vitamin B6 and Hcy levels may not be causally associated with the risk of mental disorders. In conclusion, this study reveals that elevated serum vitamin B12 levels might suggestively increase the risk of anxiety and bipolar affective disorders, even though horizontal pleiotropy cannot be completely eliminated. The potential implications of our results warrant validation in larger GWAS based on diverse populations.
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Affiliation(s)
- Yiming Hu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Miao Yu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- School of Public Health, Inner Mongolia Medical University, Hohhot 010107, China
| | - Yaqiang Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- School of Public Health, China Medical University, Shenyang 110122, China
| | - Haotian Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- School of Public Health, Inner Mongolia Medical University, Hohhot 010107, China
| | - Xueqing Yang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Xiangxin Chen
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- School of Public Health, Baotou Medical College, Baotou 014010, China
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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6
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Harikaran S, Basu S, Mukherjee MP, Kar R, Nair S, Priyadarssini M. Vitamin B12 and homocysteine in patients with major depressive disorder. J Family Med Prim Care 2024; 13:2049-2053. [PMID: 38948631 PMCID: PMC11213426 DOI: 10.4103/jfmpc.jfmpc_1460_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 01/11/2024] [Accepted: 01/16/2024] [Indexed: 07/02/2024] Open
Abstract
Background Alterations in the level of neurotransmitters are evident in patients with major depressive disorder (MDD). Vitamin B12 mediates the synthesis of neurotransmitters, and hence, vitamin B12 deficiency could be associated with depression. Aims and Objectives To assess the levels of serum vitamin B12, homocysteine (Hcy), and haematological profiles in patients of MDD. Materials and Methods Fifty-nine patients with MDD were recruited based on ICD-10 criteria. Severity of depression was assessed by HAM-D scale. Vitamin B12, Hcy levels, and haematological profiles were analysed. Results Vitamin B12 was deficient or depleted in all patients with MDD. The median level of vitamin B12 in serum was 164.2 pg./ml and significantly lower in patients with severe MDD. The mean value of Hcy was 18.34 μmol/L, which was high compared to the normal reference range. The red cell distribution width (RDW-CV) varied significantly between the three groups of MDD patients. Patients consuming non-vegetarian food had a significantly higher median value of serum vitamin B12. Conclusion Vitamin B12 deficiency is found in patients with MDD and varies inversely with severity of MDD. Hcy is found to be higher in patients with MDD. The manifestation of depressive symptoms precedes the more commonly known haematological manifestations of vitamin B12 deficiency in this study.
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Affiliation(s)
- S Harikaran
- Department of Biochemistry, JIPMER, Puducherry, India
| | - Sharbari Basu
- Department of Biochemistry, JIPMER, Puducherry, India
| | | | - Rakhee Kar
- Department of Pathology, JIPMER, Puducherry, India
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7
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Ghanbarzadeh E, Dorosty Motlagh AR, Abbasi B. Association of healthy eating index (2015) with depression and anxiety symptoms among Iranian adolescent girls. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:44. [PMID: 38566258 PMCID: PMC10988820 DOI: 10.1186/s41043-024-00529-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 02/16/2024] [Indexed: 04/04/2024]
Abstract
Adolescence is a period of rapid growth, with changes in body composition and cognitive and psychosocial development. Teenagers who eat properly and participate in daily physical activities have a healthy lifestyle. Healthy living promotes optimal growth and performance at school and in the workplace and minimizes the risk of chronic nutrient-related diseases. Therefore, the present study was conducted to determine the relationship between the healthy eating index (2015) (HEI-2015) and depression and anxiety among Iranian adolescent girls. This cross-sectional study was designed based on the updated version of HEI-2015. The study population consisted of 412 high school girls aged 12-17 years old. Data were collected about the diet, sociodemographic, and anthropometric characteristics of the participants. HEI and anthropometric characteristics of the participants were measured. The depression, anxiety, and stress scale 42 (DASS-42) questionnaire was used to detect adolescents suffering from depression and anxiety. The relationships of the HEI and anthropometric measures with depression and anxiety were also assessed. The results showed that the HEI is inversely correlated with depression and anxiety in Iranian adolescent girls. HEI was greater in the healthy participants than in those suffering from depression and anxiety (P < 0.0001).
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Affiliation(s)
- Elham Ghanbarzadeh
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Ahmad Reza Dorosty Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnood Abbasi
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran.
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Lee SM, Baek JC. Serum Vitamin Levels, Cardiovascular Disease Risk Factors, and Their Association with Depression in Korean Women: A Cross-Sectional Study of a Nationally Representative Sample. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2183. [PMID: 38138286 PMCID: PMC10744936 DOI: 10.3390/medicina59122183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 11/23/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Serum vitamin levels, cardiovascular disease risk factors, and their association with depression is a complex issue that has been the subject of much research. Therefore, we investigated the relationship between vitamin A, B9, and E levels, cardiovascular risk factors, and depression in premenopausal and menopausal South Korean women. Materials and Methods: This cross-sectional study used the 2016-2018 Korea National Health and Nutrition Examination Survey data. Depression was assessed using a questionnaire to check for symptoms of depression or the Patient Health Questionnaire-9. Blood samples were collected from the antecubital vein in the morning after an overnight fast. Covariates were defined as self-reported physician diagnoses. Well-trained medical staff performed the standard procedures. Statistical analysis was performed using the complex sample analysis method of SPSS, using two separate logistic regression models (model 1: adjusted for age; model 2: adjusted for age, marital status, smoking, and alcohol consumption). Results: A total of 3313 women aged over 20 years were enrolled. The association between vitamin A levels and depression was as follows: lower levels of vitamin A were associated with an increased risk of depression in premenopausal women in model 1 and model 2. The levels of serum vitamins E and B9 were not correlated with depression in premenopausal and postmenopausal women. In the premenopausal group, depression increased in the obesity (model 1: p = 0.037; model 2: p = 0.047) and diabetes mellitus (model 1: p = 0.010; model 2: p = 0.009) groups. The menopausal group with depression had higher rates of stroke (model 1: p = 0.017; model 2: p = 0.039) and myocardial infarction (model 1: p = 0.004; model 2: p = 0.008) than the group without depression. Conclusions: Depression is correlated with lower blood levels of vitamin A in premenopausal women. Vitamin B9 and E levels were not associated with depression independent of menopausal status. Depression is associated with obesity and diabetes mellitus in premenopausal women and with stroke and myocardial infarction in postmenopausal women.
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Affiliation(s)
- Seon Mi Lee
- Department of Obstetrics and Gynecology, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea;
| | - Jong Chul Baek
- Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro, Seongsan-gu, Changwon-si 51472, Republic of Korea
- Department of Obstetrics and Gynecology, Gyeongsang National University School of Medicine, Jinju 52727, Republic of Korea
- Institute of Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea
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9
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Bharti A, Tevatia MS, Prakash J, Yadav AS, Bajaj S. Are vitamin D, B12, and folate deficiency associated with depressive disorder? A case-control study. Ind Psychiatry J 2023; 32:100-105. [PMID: 37274573 PMCID: PMC10236675 DOI: 10.4103/ipj.ipj_86_22] [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: 05/11/2022] [Revised: 08/16/2022] [Accepted: 08/27/2022] [Indexed: 02/19/2023] Open
Abstract
Background Depression is a global burden with complex etiopathogenesis. Some nutrients including vitamin D, B12, and folate deficiency have been considered risk factors for depression. Therefore, this study has been contemplated to find out the possible association of vitamin D, B12, and folate deficiency with depression. Method This study included 81 case subjects with depression and 95 control subjects without any International Classification of Diseases (ICD)-10 diagnosis. The sociodemographic details were collected from each subject. Beck's Depression Inventory (BDI) was administered to identify the severity of depression. The blood samples were collected and measured for vitamin D, B12, and folate along with other laboratory investigations as per exclusion criteria. The data were obtained and analyzed using descriptive and inferential statistics. Results The mean age ± standard deviation (SD) of the case and control subjects were 34.86 ± 9.25 and 33.49 ± 8.44, respectively, without any significant difference (P > 0.05). The subjects with vitamin D deficiency were found to have four times higher odds (OR 4.703; 95% CI = 2.378-9.300) for depression compared to subjects with sufficient vitamin D levels. In addition, there was a negative correlation between vitamin D levels and the severity of depression as per BDI scoring (r = -.384, P < 0.01). However, there was no significant association identified between the case and control group with respect to serum vitamin B12 and folate levels. Conclusion The results of the study revealed that vitamin D deficiency has an association with depression. However, further research studies are needed to validate its correlation to the etiopathogenesis of depression.
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Affiliation(s)
- Abhishek Bharti
- Department of Psychiatry, Command Hospital (SC), Pune, Maharashtra, India
| | | | - Jyoti Prakash
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Arun Singh Yadav
- Department of Psychiatry, Command Hospital (SC), Pune, Maharashtra, India
| | - Swati Bajaj
- Department of Social and Preventive Medicine, Armed Forces Medical College, Pune, Maharashtra, India
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Association of suicidal ideation and depression with the use of proton pump inhibitors in adults: a cross-sectional study. Sci Rep 2022; 12:19539. [PMID: 36376493 PMCID: PMC9663563 DOI: 10.1038/s41598-022-24244-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
Proton pump inhibitors (PPIs) were found to be associated with depression. This study aimed to find the cross-sectional association between recent PPI use and suicidal ideation. Item 9 of Patient Health Questionnaire-9 (PHQ-9) of the US National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018 was used to categorize whether or not the participants had suicidal ideation. The secondary outcome of this study was depression and the scores of the PHQ-9 were used as the depression diagnostic instrument. The study population included 16,881 participants who were over 20 years old. The bivariate Rao-Scott χ2 test showed a significant association between PPI use and suicidal ideation (P < 0.001) and a stronger association was observed between PPIs and depression (P < 0.001). Multiple logistic regression analysis of the education, gender, race and age-adjusted model revealed that the PPI users had a 2.34 (95% CI 1.66-3.31) greater risk of having suicidal ideation than the non-PPI users. Middle-aged participants (40-49 years) showed the greatest number of differences in suicidal ideation between PPI and non-PPI users (P < 0.001). Future research should continue to consider the psychiatric effects of taking PPIs.
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11
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Franzka P, Turecki G, Cubillos S, Kentache T, Steiner J, Walter M, Hübner CA, Engmann O. Altered mannose metabolism in chronic stress and depression is rapidly reversed by vitamin B12. Front Nutr 2022; 9:981511. [PMID: 36313076 PMCID: PMC9609420 DOI: 10.3389/fnut.2022.981511] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
GDP-Mannose Pyrophosphorylase B (GMPPB) is a key enzyme for glycosylation. Previous studies suggested a dysregulation of GMPBB and mannose in depression. Evidence, however, was sporadic and interventions to reverse these changes are unknown. Here, we show that GMPPB protein, but not RNA abundance is increased in the postmortem prefrontal cortex (PFC) of depressed patients and the chronic variable stress (CVS) mouse-model. This is accompanied by higher plasma mannose levels. Importantly, a single dose of intraperitoneally administered vitamin B12, which has previously been shown to rapidly reverse behavioral symptoms and molecular signatures of chronic stress in mice, normalized GMPPB plasma mannose levels and elevated GDP-mannose abundance. In summary, these data underline metabolic dysregulation in chronic stress and depression and provide further support for rapid effects of vitamin B12 on chronic stress.
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Affiliation(s)
- Patricia Franzka
- Institute of Human Genetics, University Hospital Jena, Friedrich Schiller University, Jena, Germany
| | - Gustavo Turecki
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Susana Cubillos
- Institute for Biochemistry and Biophysics, Friedrich-Schiller-University Jena, Jena, Germany
| | | | - Johann Steiner
- Clinic for Psychiatry and Psychotherapy, University Hospital of Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Christian A. Hübner
- Institute of Human Genetics, University Hospital Jena, Friedrich Schiller University, Jena, Germany
| | - Olivia Engmann
- Institute of Human Genetics, University Hospital Jena, Friedrich Schiller University, Jena, Germany,Institute for Biochemistry and Biophysics, Friedrich-Schiller-University Jena, Jena, Germany,*Correspondence: Olivia Engmann,
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12
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Jain R, Larsuphrom P, Degremont A, Latunde‐Dada GO, Philippou E. Association between vegetarian and vegan diets and depression: A systematic review. NUTR BULL 2022; 47:27-49. [DOI: 10.1111/nbu.12540] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/04/2022] [Accepted: 01/04/2022] [Indexed: 12/22/2022]
Affiliation(s)
- Rishika Jain
- Department of Nutrition and Dietetics School of Life Course and Population Sciences King's College London London UK
| | - Phureephat Larsuphrom
- Department of Nutrition and Dietetics School of Life Course and Population Sciences King's College London London UK
| | - Alexia Degremont
- Department of Nutrition and Dietetics School of Life Course and Population Sciences King's College London London UK
| | | | - Elena Philippou
- Department of Nutrition and Dietetics School of Life Course and Population Sciences King's College London London UK
- Department of Life and Health Sciences University of Nicosia Nicosia Cyprus
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13
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Plasma homocysteine concentrations and depression: A twin study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 4. [PMID: 34414386 PMCID: PMC8372975 DOI: 10.1016/j.jadr.2021.100087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Homocysteine is an amino acid formed during metabolism of the essential amino acid methionine that plays an important role in energy metabolism and neurotransmitter synthesis. High levels of homocysteine have been linked to both depression and cardiovascular disease, however studies of depression have not always been consistent, possibly related to differences in methodology among studies. The study of twins in clinical research can be useful in controlling for confounding factors. The purpose of this study was to assess the relationship between depression and plasma homocysteine in a study of twins. Methods Homocysteine concentration was assessed in twins (N = 202) from the Vietnam Era Twin Registry, including twin pairs discordant for the diagnosis of Major Depressive Disorder (MDD) and twin pairs without MDD. Self reported depressive symptom levels were also measured as a continous variable using the Beck Depression Inventory (BDI). Results The average homocysteine concentration was 7.9 μmol/L (2.1 μmol/L SD, range of 2.0-17.1 μmol/L). There were no within twin pair differences in homocysteine concentration within twin pairs discordant for MDD and within twin pairs that differed for BDI score. There was a significant pair-level relationship between depressive symptoms as measured by mean BDI score and homocysteine concentration, such that the higher the mean BDI score of the twin pair, the higher the mean homocystein of the pair (p < .001). Every 10 point increase in BDI score was associated with an 0.8 μmol/L increase in homocysteine concentration at the pair level. Conclusions These findings are not consistent with a causal role for elevated homocysteine in the development of depression, but rather point to familial confounding or other factors that are shared by twin brothers and that contribute to both depression and homocysteine levels.
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Moradi F, Lotfi K, Armin M, Clark CCT, Askari G, Rouhani MH. The association between serum homocysteine and depression: A systematic review and meta-analysis of observational studies. Eur J Clin Invest 2021; 51:e13486. [PMID: 33423269 DOI: 10.1111/eci.13486] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Hyperhomocysteinaemia is known to interfere with neurological functions; however, there is a controversy regarding the relationship between homocysteine and depression. MATERIALS AND METHODS Science Direct, MEDLINE and ISI Web of Science were searched to find relevant articles, published up to August 2020. Studies were included if they compared homocysteine levels in healthy subjects with subjects with depression. Also, articles that reported the association between hyperhomocysteinaemia and risk of depression were included. Odds ratios of depression and means of homocysteine were used to ascertain the overall effect size. RESULTS Homocysteine level was higher in subjects with depression in comparison with healthy controls (weight mean difference = 2.53 µmol/L, 95% confidence interval: 1.77, 3.30), and the depression diagnostic tool was a source of heterogeneity. Homocysteine level was significantly higher in subjects with depression in studies that used Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV), Geriatric Depression Scale (GDS), Zung Self-Rating Depression Scale (ZDRS) and Beck Depression Index II (BDI-II) as depression diagnostic tools. Also, participants with hyperhomocysteinaemia had a higher chance of depression (Pooled risk = 1.34, 95% confidence interval: 1.19, 1.52), where the depression diagnostic tool was a source of heterogeneity. In contrast to ZDRS and Patient Health Questionnaire (PHQ) subgroups, hyperhomocysteinaemia yielded a significantly higher risk of depression in DSM-IV, GDS and 'other' subgroups. CONCLUSION Homocysteinemia level is higher in individuals with depression. However, the depression diagnostic tool used is instrumental in influencing their association, and thus, future studies should focus on the tools for depression assessment.
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Affiliation(s)
- Fatemeh Moradi
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Armin
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Gholamreza Askari
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Rouhani
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Wu Y, Zhang L, Li S, Zhang D. Associations of dietary vitamin B1, vitamin B2, vitamin B6, and vitamin B12 with the risk of depression: a systematic review and meta-analysis. Nutr Rev 2021; 80:351-366. [PMID: 33912967 DOI: 10.1093/nutrit/nuab014] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/12/2021] [Accepted: 02/24/2021] [Indexed: 01/24/2023] Open
Abstract
CONTEXT The results from epidemiologic studies on the intake of dietary vitamin B1, B2, B6, and B12 and association with risk of developing depression have been inconsistent. OBJECTIVE The purpose of this systematic review and meta-analysis was to summarize the existing evidence and synthesize the results. DATA SOURCES The databases of Web of Science and PubMed were searched for relevant articles published in English until September 2020. STUDY SELECTION Observational studies that evaluated the associations between depression and dietary vitamin B1, B2, B6, and B12 were included in this study. DATA EXTRACTION The job of data extraction was undertaken by 2 authors, and the pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a fixed-effects model. RESULTS Thirteen articles related to 18 studies were eligible for inclusion in this systematic review and meta-analysis. The pooled RR (95% CI) of depression for the highest vs the lowest category of dietary vitamin B1, B2, B6, and B12 was 0.69 (0.55-0.87), 0.77 (0.67-0.89), 0.81 (0.71-0.93), and 0.86 (0.75-0.99), respectively. The pooled RR (95% CI) of depression for the highest vs the lowest category of dietary vitamin B2 was 0.80 (0.64-0.99) in females and 0.83 (0.67-1.02) in males, for dietary vitamin B6 was 0.71 (0.59-0.86) in females and 0.92 (0.76-1.12) in males, and for dietary vitamin B12 was 0.79 (0.65-0.97) in females and 0.94 (0.77-1.15) in males. CONCLUSION This study suggested that the intake of dietary vitamin B1, B2, B6, and B12 may be inversely associated with the risk of depression; the inverse associations observed between depression and intake of dietary vitamin B2, B6, and B12 were significant in females, but not in males. Further studies are needed to confirm these results.
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Affiliation(s)
- Yanjun Wu
- Y. Wu, L. Zhang, S. Li, and D. Zhang are with the Department of Epidemiology and Health Statistics, the College of Public Health of Qingdao University, Qingdao, People's Republic of China
| | - Liming Zhang
- Y. Wu, L. Zhang, S. Li, and D. Zhang are with the Department of Epidemiology and Health Statistics, the College of Public Health of Qingdao University, Qingdao, People's Republic of China
| | - Suyun Li
- Y. Wu, L. Zhang, S. Li, and D. Zhang are with the Department of Epidemiology and Health Statistics, the College of Public Health of Qingdao University, Qingdao, People's Republic of China
| | - Dongfeng Zhang
- Y. Wu, L. Zhang, S. Li, and D. Zhang are with the Department of Epidemiology and Health Statistics, the College of Public Health of Qingdao University, Qingdao, People's Republic of China
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Nava-Mesa MO, Aispuru Lanche GR. [Role of B vitamins, thiamine, pyridoxine, and cyanocobalamin in back pain and other musculoskeletal conditions: a narrative review]. Semergen 2021; 47:551-562. [PMID: 33865694 DOI: 10.1016/j.semerg.2021.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/12/2021] [Indexed: 12/25/2022]
Abstract
Low back pain, as well as other musculoskeletal disorders (neck pain, osteoarthritis, etc.), are a very frequent cause of consultation both in primary care and in other hospital specialties and are usually associated with high functional and work disability. Acute low back pain can present different nociceptive, neuropathic and nonciplastic components, which leads to consider it as a mixed type pain. The importance of the concept of mixed pain is due to the fact that the symptomatic relief of these pathologies requires a multimodal therapeutic approach to various pharmacological targets. The antinociceptive role of the B vitamin complex has been recognized for several decades, specifically the combination of Thiamine, Pyridoxine and Cyanocobalamin (TPC). Likewise, there is accumulated evidence that indicates an adjuvant analgesic action in low back pain. The aim of the present review is to present the existing evidence and the latest findings on the therapeutic effects of the TPC combination in low back pain. Likewise, some of the most relevant mechanisms of action involved that can explain these effects are analyzed. The reviewed evidence indicates that the combined use of PCT has an adjuvant analgesic effect in mixed pain, specifically in low back pain and other musculoskeletal disorders with nociceptive and neuropathic components. This effect can be explained by an anti-inflammatory, antinociceptive, neuroprotective and neuromodulatory action of the TPC combination on the descending pain system.
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Affiliation(s)
- M O Nava-Mesa
- Grupo de Investigación en Neurociencias (NEUROS), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - G R Aispuru Lanche
- Grupo de Trabajo Aparato Locomotor Semergen. Gerencia de Atención Primaria de Burgos, Castilla y León, España.
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Ayyildiz T, Dulkadiroglu R, Yilmaz M, Polat OA, Gunes A. Evaluation of macular, retinal nerve fiber layer and choroidal thickness by optical coherence tomography in children and adolescents with vitamin B 12 deficiency. Int Ophthalmol 2021; 41:2399-2404. [PMID: 33768408 DOI: 10.1007/s10792-021-01794-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 03/06/2021] [Indexed: 01/09/2023]
Abstract
PURPOSE To investigate macular, Retinal Nerve Fiber Layer (RNFL) and choroidal thickness in children and adolescents with vitamin B12 deficiency and no neurological examination finding. METHODS The study group includes of thirty-three children aged 8-17 years who were brought to the Pediatric outpatient clinic with the symptoms of fatigue and forgetfulness and whose Vitamin B12 levels were detected < 200 pg/ml. The control group was the 30 children and adolescents applied to the same policlinic with various symptoms and whose Vitamin B12 levels were found normal. Children and adolescents with chronic systemic/ocular disease history and myopia or hyperopia more than 4 diopters were not included in both groups. Spectral Domain-Optical Coherence Tomography (SD-OCT) was used for measurements. RESULTS Mean Macular thickness value was 261.2 ± 17.6 in the Vitamin B12 deficiency group and 267.7 ± 17.4 in the control group. Mean value of Retinal Nerve Fiber Layer (RNFL) thickness was 103.5 ± 7.5 in the Vitamin B12 deficiency group and 104.3 ± 8.9 in the control group. The mean values of Choroidal thickness were 360.1 ± 59.8 and 316.9 ± 95.4 in Vitamin B12 deficiency and control groups, respectively. There was a statistically significant increase in choroidal thickness in Vitamin B12 deficiency group compared to controls. CONCLUSION Statistically significant increase in the Choroidal thicknesses of children and adolescents with Vitamin B12 deficiency is important in terms of shedding light on studies that will contribute to a better understanding of the relationship between vitamin B12 and inflammation. CLINICAL TRIAL REGISTRATION This study is an observational study.
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Affiliation(s)
- Taha Ayyildiz
- Ophthalmology Department, Bursa City Hospital, Bursa, Turkey
| | - Ramazan Dulkadiroglu
- Department of Pediatrics, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey.
| | - Mevlüt Yilmaz
- Ophthalmology Department, Ulucanlar Eye Hospital, Ankara, Turkey
| | - Osman Ahmet Polat
- Ophthalmology Department, Faculty of Medicine, Kayseri Erciyes University, Kayseri, Turkey
| | - Ali Gunes
- Department of Pediatrics, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
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Cross-sectional association between vitamin B12 status and probable postpartum depression in Indian women. BMC Pregnancy Childbirth 2021; 21:146. [PMID: 33596868 PMCID: PMC7890831 DOI: 10.1186/s12884-021-03622-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 02/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vitamin B12 is an essential micronutrient for neurological function, as it leads to the regeneration of methionine from homocysteine, which is precursor of biologically active molecule S-Adenosyl Methionine (SAM). Pregnancy is a state of increased demand and delayed postpartum repletion of nutrients may predispose women to depression. METHODS We included women who visited the hospital at 6-weeks postpartum for a regular checkup. Inclusion criteria were age (18-50 years), and willingness to donate venous sample for analysis. Exclusion criteria included previous history of mood disorders or antidepressant medication use, and any systemic illness like hypothyroidism, epilepsy, diabetes, and hypertension. Based on EPDS score of 10 as a cutoff, 217 women with probable postpartum depression (PPD) and equal number of age and BMI matched controls were included. Plasma total vitamin B12, holotranscobalamin (holotc), homocysteine (hcy), methyl malonic acid (MMA), 5-methyl tetrahydrofolate (THF), SAM and serotonin levels were estimated using commercially available ELISA kits. Combined B12 (cB12) score was calculated from study parameters. Multivariate analysis was performed to assess the risk of probable postpartum depression. RESULTS Total vitamin B12 and combined B12 score were found to be significantly lower (p = 0.001) and MMA (p = 0.002) and 5-methyl THF (p < 0.001) levels were higher in women with probable depression than women without probable PPD. Women in the lowest vitamin B12 quartile had 4.53 times higher likelihood of probable postpartum depression (p < 0.001). Multivariate analysis demonstrated that decreasing vitamin B12 (OR = 0.394; 95% CI: 0.189-0.822) and cB12 (OR = 0.293; 95% CI: 0182-0.470) and increasing MMA (OR = 2.14; 95% CI: 1.63-2.83) and 5-methyl THF levels (OR = 3.29; 95% CI: 1.59-6.83) were significantly associated with the risk of probable PPD. CONCLUSION Low vitamin B12 may contribute to depressive symptoms in vulnerable postpartum period.
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Global cognition modifies the relationship between anemia and depression in old age: A longitudinal analysis of the IMIAS Study. Arch Gerontol Geriatr 2021; 94:104342. [PMID: 33508513 DOI: 10.1016/j.archger.2021.104342] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/26/2020] [Accepted: 01/12/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To examine the relationship between anemia and depression and whether sex and global cognition modify this relationship over a 4-year follow-up. DESIGN Longitudinal analysis of an international cohort study SETTINGS AND PARTICIPANTS: Older adults from the International Mobility in Aging Study (IMIAS) aged between 65 and 74 years at baseline. METHODS Participants were recruited in Natal (Brazil), Manizales (Colombia), Kingston (Ontario, Canada), and Saint-Hyacinthe (Quebec, Canada). The study outcome was depression, defined by a score of ≥16 in the Center for Epidemiologic Studies Depression Scale. Longitudinal associations over a 4-year follow-up were examined using generalized estimating equations. Cognition was ascertained with the Leganes Cognitive Test with scores ≤ 22 indicating poor cognition. Models were also adjusted for research sites, marital status, alcohol drinking status, body mass index, chronic conditions, activities of daily life disabilities, and polypharmacy. RESULTS Anemia and poor cognition at baseline were associated with an increased risk of depression at follow-up (OR = 5.73, 95% CI: 1.58-20.78). Global cognition was also an effect modifier of the longitudinal association between the severity of anemia and depression. CONCLUSIONS In international samples of older adults, anemia, as well as the severity of anemia, were independent risk factors for depression, and the effect of these associations was modified by global cognition. The findings highlight an important issue as to whether depression in old age may be at least partially preventable through public health interventions to correct low Hb levels.
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Shoffel-Havakuk H, Lava CX, Reuven Y, Moog D, Odell K, Reder LS, Hapner ER, Johns MM. Effect of Vitamin B12 Injection on the Vocal Performance of Professional Singers: A Randomized, Double-blind, Placebo-Controlled, Crossover Trial. JAMA Otolaryngol Head Neck Surg 2021; 147:9-15. [PMID: 33180098 PMCID: PMC7662483 DOI: 10.1001/jamaoto.2020.4026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 09/08/2020] [Indexed: 11/14/2022]
Abstract
Importance One-third of singers and vocal professionals report experiencing a benefit from empirical vitamin B12 injections for improvement of mild singing-related symptoms (eg, reduced stamina, vocal fatigue, and effort). However, there is no objective evidence to support or refute these claims. Objective To assess the presence and magnitude of the effect of empirical vitamin B12 injection on the vocal performance of singers. Design, Setting, and Participants A randomized, double-blind, placebo-controlled, crossover trial was conducted from November 7, 2017, to November 30, 2018, at an academic voice center among 20 active adult singers without dysphonia but with mild vocal symptoms. Individuals with known or suspected vitamin B12 deficiency or active or recent vitamin B12 treatment were excluded. Analysis was on a per-protocol basis. Interventions Participants were randomized to receive an intramuscular (deltoid) injection of either vitamin B12 (1000 μg of cyanocobalmin) or placebo (0.9% sodium chloride). After a washout period of at least 4 weeks, participants were crossed over to receive the opposite injection. Both the investigators and participants were blinded to the order of injections. Main Outcomes and Measures The participants completed the Singing Voice Handicap Index-10 (SVHI-10), the Voice Fatigue Index (VFI), and the Evaluation of the Ability to Sing Easily (EASE) before each injection and at intervals of 1 hour, 3 hours, 24 hours, 72 hours, and 1 week after the injection. The primary time point assessment was 72 hours after injection, and the SVHI-10 score was the primary outcome measure. Results Twenty singers (10 men; median age, 22 years [range, 19-42 years]) were enrolled. The improvements after either placebo or vitamin B12 injections were comparable to each other. At 72 hours after the vitamin B12 injection, the median difference in the SVHI-10 score was 1 (95% CI, -1 to 2) compared with 3 (95% CI, 0-4) after placebo. The median difference between differences at 72 hours between placebo and vitamin B12 injections were 1.5 (95% CI, -2 to 5) for the SVHI-10, 1 (95% CI, -9 to 9) for the VFI, and -1 (95% CI, -3 to 2) for the EASE. The improvements after both injections failed to reach the estimated minimal clinically important difference. Of the 20 participants, 4 (20%) reached the estimated minimal clinically important difference in their SVHI-10 score after 72 hours for both vitamin B12 and placebo injections. Conclusions and Relevance This randomized, double-blind, placebo-controlled, crossover trial found that after empirical vitamin B12 injection to improve mild voice-related symptoms, the improvement in self-reported voice measures in singers shows no meaningful difference compared with placebo. Trial Registration ClinicalTrials.gov Identifier: NCT03437824.
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Affiliation(s)
- Hagit Shoffel-Havakuk
- Department of Otolaryngology–Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Christian X. Lava
- USC Voice Center, Department of Otolaryngology–Head and Neck Surgery, University of Southern California, Los Angeles
| | - Yonatan Reuven
- Department of Otolaryngology–Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dominic Moog
- USC Voice Center, Department of Otolaryngology–Head and Neck Surgery, University of Southern California, Los Angeles
| | - Karla Odell
- USC Voice Center, Department of Otolaryngology–Head and Neck Surgery, University of Southern California, Los Angeles
| | - Lindsay S. Reder
- USC Voice Center, Department of Otolaryngology–Head and Neck Surgery, University of Southern California, Los Angeles
| | - Edie R. Hapner
- UAB Voice Center, Otolaryngology, University of Alabama, Birmingham
| | - Michael M. Johns
- USC Voice Center, Department of Otolaryngology–Head and Neck Surgery, University of Southern California, Los Angeles
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Associations between dietary intake of B-vitamins and psychological disorders among Iranian women: a cross-sectional study. Public Health Nutr 2020; 24:1787-1797. [PMID: 32933593 DOI: 10.1017/s1368980020002943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE B-vitamins affect brain function through multiple pathways. Given limited evidence on the relationship between dietary intake of these vitamins and psychological disorders, we examined dietary intake of vitamin B6-9-12 in relation to psychological disorders among Iranian women. DESIGN Cross-sectional study. Dietary intake was assessed using a valid and reliable FFQ. To assess psychological disorders, we used a version of the Depression Anxiety Stress Scale-21 validated in Iran. SETTING Ten public health centres in southern Tehran, Iran. PARTICIPANTS A total of 447 female participants aged 20-50 years. RESULTS The median values of vitamin B6 (pyridoxine), B9 (folate) and B12 (cobalamin) were 1·30 mg/d, 313·89 µg/d and 3·99 µg/d, respectively. After adjustment for potential confounders, dietary vitamin B6 intake was associated with lower odds of depression (OR: 0·54; 95 % CI: 0·31, 0·95; Ptrend: 0·03). However, there was a positive association between dietary vitamin B12 intake with the odds of depression (OR: 2·05; 95 % CI: 1·17, 3·60; Ptrend: 0·01) and psychological distress (OR: 2·00; 95 % CI: 1·17, 3·41; Ptrend: 0·01). No association was found between vitamin B9 with any psychological disorders. CONCLUSIONS Women with higher dietary intakes of vitamin B6 had lower likelihood of depression. However, women with higher dietary intake of vitamin B12 had higher odds of depression and psychological distress. Future prospective studies in different populations are needed to clarify whether B-vitamin deficiency is a cause or consequence of psychological disorders.
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Diet, Stress and Mental Health. Nutrients 2020; 12:nu12082428. [PMID: 32823562 PMCID: PMC7468813 DOI: 10.3390/nu12082428] [Citation(s) in RCA: 133] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/25/2020] [Accepted: 08/04/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction: There has long been an interest in the effects of diet on mental health, and the interaction of the two with stress; however, the nature of these relationships is not well understood. Although associations between diet, obesity and the related metabolic syndrome (MetS), stress, and mental disorders exist, causal pathways have not been established. Methods: We reviewed the literature on the relationship between diet, stress, obesity and psychiatric disorders related to stress. Results: Diet and obesity can affect mood through direct effects, or stress-related mental disorders could lead to changes in diet habits that affect weight. Alternatively, common factors such as stress or predisposition could lead to both obesity and stress-related mental disorders, such as depression and posttraumatic stress disorder (PTSD). Specific aspects of diet can lead to acute changes in mood as well as stimulate inflammation, which has led to efforts to assess polyunsaturated fats (PUFA) as a treatment for depression. Bidirectional relationships between these different factors are also likely. Finally, there has been increased attention recently on the relationship between the gut and the brain, with the realization that the gut microbiome has an influence on brain function and probably also mood and behavior, introducing another way diet can influence mental health and disorders. Brain areas and neurotransmitters and neuropeptides that are involved in both mood and appetite likely play a role in mediating this relationship. Conclusions: Understanding the relationship between diet, stress and mood and behavior could have important implications for the treatment of both stress-related mental disorders and obesity.
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Cobalamin Deficiency in the Elderly. Mediterr J Hematol Infect Dis 2020; 12:e2020043. [PMID: 32670521 PMCID: PMC7340236 DOI: 10.4084/mjhid.2020.043] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/30/2020] [Indexed: 12/16/2022] Open
Abstract
Older people are at risk for cobalamin (vitamin B12) deficiency because of a number of common disorders (e.g., autoimmune gastritis) and drugs (e.g., antacids) that may alter its absorption and utilization. The prevalence of cobalamin deficiency increases with age, resulting, particularly elevated, in frail and institutionalized subjects. At variance with common sense, the diagnosis is far from simple. It requires a high degree of suspicion, due to heterogeneity and non-specificity of the signs and symptoms, ranging from macrocytosis (with or without anemia) to neuropsychiatric manifestations, that characterize several other aging-related disorders, like hematological malignancies, diabetes, hypothyroidism or vasculopathy. Furthermore, the detection of low levels of serum vitamin B12 appears poorly sensitive and specific. Other biomarkers, like serum homocysteine or methylmalonic acid, have improved the diagnostic possibilities but are expensive, not widely available, and may be influenced by some confounders (e.g., folate deficiency, or chronic renal failure). Early recognition and treatment are crucial since a proportion of patients develop severe complications, such as bone marrow failure and irreversible neurological impairment. High-dose oral treatment has proven to be as effective as the parenteral route, even in subjects with malabsorption, ensuring the complete resolution in the majority of cases. In this review, we trace the essential role of cobalamin in humans, the possible causes and impact of deficiency, the diagnostic challenges and the therapeutic options, between old and emerging concepts, with a particular focus on the elderly.
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Trautmann C, Bock A, Urbach A, Hübner CA, Engmann O. Acute vitamin B12 supplementation evokes antidepressant response and alters Ntrk-2. Neuropharmacology 2020; 171:108112. [PMID: 32335151 DOI: 10.1016/j.neuropharm.2020.108112] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 02/07/2023]
Abstract
Depression is the leading cause of disability worldwide. Although most research into risk factors focuses on stress, dietary factors also have a strong link with depression. For instance, chronic vitamin B12-supplementation may reduce depression risk and helps to reverse the prodepressive effects of early life stress in animal models. However, it is still unclear whether a single acute dose of vitamin B12 is sufficient to induce antidepressant effects on molecular or behavioral levels. Based on pharmacological work and CRISPR-dCas9 epigenome editing in Neuro2A-cells we provide in vitro evidence for a link between vitamin B12, gene expression and DNA methylation of the antidepressant-associated gene Ntrk-2, which codes for the BDNF-receptor TRKB. Using stress-induction protocols in C57Bl/6 J mice combined with behavioral testing and subsequent molecular tissue analysis, we establish in vivo evidence for antidepressant effects of vitamin B12. Acute supplementation with vitamin B12, but not folic acid, selectively altered DNA methylation and gene expression of Ntrk-2 in vitro, albeit DNA methylation and Ntrk-2 gene expression do not correlate in vivo. Importantly, one acute vitamin B12 injection improved multiple behavioral measures in tests for antidepressant action and at the same time reversed the effects of chronic and acute stress on Ntrk-2 levels in vivo, however causality has not been proven at this stage. Taken together, acute vitamin B12 supplementation can reverse stress effects on Ntrk-2 gene expression and improve behaviors that are associated with depression-like behavior in mice. Our findings encourage further investigation of vitamin B12-supplementation as a novel model for antidepressant action.
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Affiliation(s)
- Charlotte Trautmann
- Institut für Humangenetik, Jena University Hospital, Am Klinikum 1, F4E20, 07747, Jena, Germany
| | - Andrea Bock
- Institut für Humangenetik, Jena University Hospital, Am Klinikum 1, F4E20, 07747, Jena, Germany
| | - Anja Urbach
- Institut für Neurologie, Jena University Hospital, Am Klinikum 1, F4E20, 07747, Jena, Germany
| | - Christian A Hübner
- Institut für Humangenetik, Jena University Hospital, Am Klinikum 1, F4E20, 07747, Jena, Germany
| | - Olivia Engmann
- Institut für Humangenetik, Jena University Hospital, Am Klinikum 1, F4E20, 07747, Jena, Germany; Laboratory of Neuroepigenetics, University of Zürich and ETH Zürich, Center for Neuroscience Zürich, Brain Research Institute, Winterthurerstrasse 190, CH-8057 Zürich, Switzerland.
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Abstract
OBJECTIVE This study aimed to investigate the relationship between waist circumference as a measure of abdominal obesity and brain responses to stress among patients with coronary artery disease (CAD). METHODS Patients with CAD (N = 151) underwent acute mental stress tasks in conjunction with high-resolution positron emission tomography and radiolabeled water imaging of the brain. Brain responses to mental stress were correlated with waist circumference. RESULTS Waist circumference was positively correlated with increased activation in the right and left frontal lobes (β values ranging from 2.81 to 3.75 in the paracentral, medial, and superior gyri), left temporal lobe, left hippocampal, left amygdala, left uncus, and left anterior and posterior cingulate gyri (β values ranging from 2.93 to 3.55). Waist circumference was also negatively associated with the left and right parietal lobes, right superior temporal gyrus, and right insula and precuneus (β values ranging from 2.82 to 5.20). CONCLUSION Increased brain activation in the brain regions involved in the stress response and autonomic regulation of the cardiovascular system during psychological stress may underlie stress-induced overeating and abdominal obesity in patients with CAD.
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Kwok T, Wu Y, Lee J, Lee R, Yung CY, Choi G, Lee V, Harrison J, Lam L, Mok V. A randomized placebo-controlled trial of using B vitamins to prevent cognitive decline in older mild cognitive impairment patients. Clin Nutr 2019; 39:2399-2405. [PMID: 31787369 DOI: 10.1016/j.clnu.2019.11.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 10/23/2019] [Accepted: 11/05/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND & AIMS Mild cognitive impairment (MCI) patients are at risk of cognitive decline, while elevated serum homocysteine is also associated with cognitive impairment. Thus, older people with MCI and hyperhomocysteinemia may be under greater risk of cognitive decline. We therefore performed a randomized trial of homocysteine-lowering by B vitamins supplementation to prevent cognitive decline in older MCI patients with elevated serum homocysteine. METHODS 279 MCI outpatients aged ≥65 years with serum homocysteine ≥10.0 μmol/L were randomly assigned to take either methylcobalamin 500 μg and folic acid 400 μg once daily, or two placebo tablets for 24 months. All subjects were followed up at 12 monthly intervals. The primary outcome was cognitive decline as defined by an increase in clinical dementia rating scale (CDR) sum of boxes (CDR_SOB). The secondary outcomes were global CDR, memory Z score, executive function Z score and Hamilton depression rating scale (HDRS) score. RESULTS The clinical characteristics between two groups were well matched, except that the supplement group had better executive function. The supplement effectively lowered serum homocysteine (mean 13.9 ± sd 3.5 μmol at baseline to 9.3 ± 2.4 μmol/L at month 24). At month 24, there was no significant group difference in CDR_SOB or any secondary outcomes (mean changes in CDR_SOB 0.36 versus 0.22 in supplement and placebo groups respectively). At month 12, the supplement group significantly improved in executive function and had lower HDRS score (P = 0.004 and 0.012 respectively). Group difference was significant for HDRS, but borderline significant for executive function. (P = 0.01; 0.06 respectively) These effects were not significant at month 24. Subgroup analysis showed that aspirin use had significant interaction with B supplements in CDR_SOB at month 24 (Beta 0.189, P = 0.005). CONCLUSIONS Vitamin B12 and folic acid supplementation did not reduce cognitive decline in older people with MCI and elevated serum homocysteine, though the cognitive decline over two years in placebo group was small. The supplement led to a significant reduction in depressive symptoms at month 12, though this effect was not sustained. Aspirin use had a negative interaction effect on cognitive functioning with B supplements. CLINICAL TRIAL REGISTRATION Centre for Clinical Research and Biostatistics (CCRB) Clinical Trials Registry: CUHK_CCT00373.
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Affiliation(s)
- Timothy Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
| | - Yuanyuan Wu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
| | - Jenny Lee
- Department of Medicine, Alice Ho Mui Ming Nethersole Hospital, Taipo, Hong Kong.
| | - Ruby Lee
- Department of Health, Hong Kong.
| | - Cho Yiu Yung
- Department of Medicine & Geriatrics, United Christian Hospital, Kowloon, Hong Kong.
| | - Grace Choi
- Department of Occupational Therapy, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
| | - Vivian Lee
- School of Pharmacy, The Chinese University of Hong Kong, Hong Kong.
| | - John Harrison
- Alzheimer Center, VU Medical Center, Amsterdam, the Netherlands.
| | - Linda Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Taipo Hospital, Taipo, Hong Kong.
| | - Vincent Mok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
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Linking What We Eat to Our Mood: A Review of Diet, Dietary Antioxidants, and Depression. Antioxidants (Basel) 2019; 8:antiox8090376. [PMID: 31491962 PMCID: PMC6769512 DOI: 10.3390/antiox8090376] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/26/2019] [Accepted: 08/31/2019] [Indexed: 12/12/2022] Open
Abstract
Studies have shown that diet and nutrition play significant roles in the prevention of depression and its clinical treatment. The present review aims to provide a clear understanding of the associations between diet patterns, specific foods, nutrients such as antioxidants, and depression. As a result, balanced dietary patterns such as the Mediterranean diet and certain foods such as fish, fresh vegetables, and fruits have been associated with a lower risk of depression or depressive symptoms, while high-fat Western diets and sugar-sweetened beverages have been associated with higher risk of depression or depressive symptoms. Dietary antioxidants such as green tea polyphenols or isoflavonoid intake have been negatively associated with depression or depressive symptoms. It is concluded that diet patterns, specific foods, and antioxidants play important roles in the prevention and clinical treatment of depression.
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Ribeiro RHT, Ribeiro FA, Silva RPM, Bortolini MJS, Garrote-Filho MDS, Penha-Silva N. Depression, Hematologic Parameters, and Blood Levels of Vitamin B 12 in Patients With Laryngopharyngeal Reflux Under Use of Proton Pump Inhibitors. CLINICAL MEDICINE INSIGHTS. EAR, NOSE AND THROAT 2019; 12:1179550619828683. [PMID: 30792587 PMCID: PMC6376512 DOI: 10.1177/1179550619828683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 12/28/2018] [Indexed: 12/15/2022]
Abstract
Objective The objective of this study was to evaluate and correlate hematologic indices, vitamin B12 levels, and depression in patients with suspected laryngopharyngeal reflux (LPR) treated with proton pump inhibitor (PPI). Methods This was a prospective study with a population (n = 23) consisted of patients with suspected LPR and treated with 2 daily doses of Omeprazole 40 mg (80 mg or full dose). The study volunteers performed a complete blood count and vitamin B12 dosage before and after 3 and 6 months of treatment, as well as depression screening using the Center of Epidemiologic Studies-Depression (CES-D) questionnaire before and after 6 months of treatment. Scores greater than 16 were considered as suggestive of depression. Results The mean score on the CES-D scale of study participants at baseline significantly decreased after 6 months of treatment. A significant decrease was observed in the red blood cells count (RBC) after 6 months in relation to 3 months. Significant increases in mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were observed from 3 months to 6 months in this study. Vitamin B12 levels increased significantly between baseline and after 6 months of treatment. Conclusion Decreased scores on the CES-D scale were associated with increased MCV values, with no association with vitamin B12 levels. However, vitamin B12 levels also increased significantly after 6 months of treatment with PPI.
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Affiliation(s)
| | | | | | | | | | - Nilson Penha-Silva
- Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, MG, Brazil
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Vahdat Shariatpanahi M, Velayati A, Jamalian SA, Babevaynejad M, Vahdat Shariatpanahi Z. The relationship between serum cobalamin, folic acid, and homocysteine and the risk of post-cardiac surgery delirium. Neuropsychiatr Dis Treat 2019; 15:1413-1419. [PMID: 31190843 PMCID: PMC6536132 DOI: 10.2147/ndt.s201620] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 03/25/2019] [Indexed: 12/04/2022] Open
Abstract
Purpose: It has been reported that cobalamin and folate deficiency is related to delirium in persons with dementia. We evaluated the association of admission serum levels of cobalamin, folic acid, and homocysteine with the occurrence of acute delirium after coronary artery bypass surgery. Methods: In this prospective cohort study, serum levels of cobalamin, folic acid, and homocysteine were measured for 296 patients upon admission. Delirium was defined by the confusion assessment method for the intensive care unit. Results: Postoperative delirium was detected in 23% (n=68) of patients. Cobalamin deficiency, folate deficiency, and hyperhomocysteinemia were observed in 29% (n=86), 6% (n=18), and 68% (n=200) of patients, respectively. The mean ± SD serum levels of folic acid were 10.77±5.39 ng/mL and 12.86±6.51 ng/mL in delirium and non-delirium patients, respectively (P=0.008). The median (interquartile range [IQR]) serum levels of cobalamin were 280 (216-351) and 247 (195.5-336) in delirium and non-delirium patients, respectively (P=0.09). The median (IQR) serum levels of homocysteine were 18.5 (14.5-22.1) µmol/L and 17.33 (14.2-23.2) µmol/L in delirium and non-delirium patients, respectively (P=0.94). Multivariate regression analysis adjusted by other risk factors indicated that serum homocysteine, folate, and cobalamin levels had no association with the occurrence of delirium. Conclusion: There was no relationship between the preoperative levels of cobalamin, folate, and homocysteine, and acute occurrence of delirium observed after cardiac surgery.
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Affiliation(s)
- Maryam Vahdat Shariatpanahi
- Department of Psychiatry, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Aynaz Velayati
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Jamalian
- Department of Cardiology, Shahid Lavasani Hospital, Islamic Azad University, Tehran, Iran
| | - Mehdi Babevaynejad
- Department of Cardiac Surgery, Shahid Lavasani Hospital, Islamic Azad University, Tehran, Iran
| | - Zahra Vahdat Shariatpanahi
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Allen LH, Miller JW, de Groot L, Rosenberg IH, Smith AD, Refsum H, Raiten DJ. Biomarkers of Nutrition for Development (BOND): Vitamin B-12 Review. J Nutr 2018; 148:1995S-2027S. [PMID: 30500928 PMCID: PMC6297555 DOI: 10.1093/jn/nxy201] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/06/2017] [Accepted: 08/02/2018] [Indexed: 12/31/2022] Open
Abstract
This report on vitamin B-12 (B12) is part of the Biomarkers of Nutrition for Development (BOND) Project, which provides state-of-the art information and advice on the selection, use, and interpretation of biomarkers of nutrient exposure, status, and function. As with the other 5 reports in this series, which focused on iodine, folate, zinc, iron, and vitamin A, this B12 report was developed with the assistance of an expert panel (BOND B12 EP) and other experts who provided information during a consultation. The experts reviewed the existing literature in depth in order to consolidate existing relevant information on the biology of B12, including known and possible effects of insufficiency, and available and potential biomarkers of status. Unlike the situation for the other 5 nutrients reviewed during the BOND project, there has been relatively little previous attention paid to B12 status and its biomarkers, so this report is a landmark in terms of the consolidation and interpretation of the available information on B12 nutrition. Historically, most focus has been on diagnosis and treatment of clinical symptoms of B12 deficiency, which result primarily from pernicious anemia or strict vegetarianism. More recently, we have become aware of the high prevalence of B12 insufficiency in populations consuming low amounts of animal-source foods, which can be detected with ≥1 serum biomarker but presents the new challenge of identifying functional consequences that may require public health interventions.
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Affiliation(s)
- Lindsay H Allen
- USDA, Agricultural Research Service Western Human Nutrition Research Center, University of California, Davis, CA
| | - Joshua W Miller
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ
| | - Lisette de Groot
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Irwin H Rosenberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - A David Smith
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom
| | - Helga Refsum
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Daniel J Raiten
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda, MD
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Kunutsor SK, Seidu S, Khunti K. Depression, antidepressant use, and risk of venous thromboembolism: systematic review and meta-analysis of published observational evidence. Ann Med 2018; 50:529-537. [PMID: 30001640 DOI: 10.1080/07853890.2018.1500703] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
PURPOSE Evidence on the association between depression, antidepressant use and venous thromboembolism (VTE) risk is conflicting. We conducted a systematic review and meta-analysis of published observational studies evaluating the associations of depression and antidepressant use with VTE risk. DESIGN Eligible studies were identified in a literature search of MEDLINE, Embase, Web of Science and reference list of relevant studies up to April 2018. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were aggregated using random effects models. RESULTS Eight observational studies with data on 960 113 nonoverlapping participants and 9027 VTE cases were included. The pooled RR (95% CI) for VTE comparing antidepressant use with no antidepressant use was 1.27 (1.06-1.51). Tricyclic antidepressants, selective serotonin reuptake inhibitors and other antidepressants were each associated with an increased VTE risk; 1.16 (1.06-1.27), 1.12 (1.02-1.23), and 1.59 (1.21-2.09), respectively. In pooled analysis of three studies that compared patients with depression versus individuals without depression, the RR for VTE was 1.31 (1.13-1.53). CONCLUSIONS Pooled observational evidence suggests that depression and use of antidepressants are each associated with an increased VTE risk. The effect of antidepressant drugs on VTE may be a class effect. The mechanistic pathways underlying these associations deserve further evaluation. Systematic review registration: PROSPERO 2018: CRD42018095595 Key messages Emerging evidence suggests that depression and antidepressant use may be associated with venous thromboembolism (VTE) risk, but the evidence is conflicting. This first systematic review and meta-analysis of observational studies shows that depression and use of antidepressants are each associated with an increased risk of VTE. There may be a class effect of antidepressant drugs on VTE.
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Affiliation(s)
- Setor K Kunutsor
- a National Institute for Health Research Bristol Biomedical Research Centre , University Hospitals Bristol NHS Foundation Trust and University of Bristol , Bristol , UK.,b Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit , University of Bristol, Learning & Research Building (Level 1) , Southmead Hospital , Bristol , UK
| | - Samuel Seidu
- c Leicester Diabetes Centre, Leicester General Hospital , Leicester , UK.,d Diabetes Research Centre , University of Leicester, Leicester General Hospital , Leicester , UK
| | - Kamlesh Khunti
- c Leicester Diabetes Centre, Leicester General Hospital , Leicester , UK.,d Diabetes Research Centre , University of Leicester, Leicester General Hospital , Leicester , UK
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Expression of TCN1 in Blood is Negatively Associated with Verbal Declarative Memory Performance. Sci Rep 2018; 8:12654. [PMID: 30139959 PMCID: PMC6107676 DOI: 10.1038/s41598-018-30898-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 08/01/2018] [Indexed: 12/29/2022] Open
Abstract
Memory is indispensable for normal cognitive functioning, and the ability to store and retrieve information is central to mental health and disease. The molecular mechanisms underlying complex memory functions are largely unknown, but multiple genome-wide association studies suggest that gene regulation may play a role in memory dysfunction. We performed a global gene expression analysis using a large and balanced case-control sample (n = 754) consisting of healthy controls and schizophrenia and bipolar disorder patients. Our aim was to discover genes that are differentially expressed in relation to memory performance. Gene expression in blood was measured using Illumina HumanHT-12 v4 Expression BeadChip and memory performance was assessed with the updated California Verbal Learning Test (CVLT-II). We found that elevated expression of the vitamin B12-related gene TCN1 (haptocorrin) was significantly associated with poorer memory performance after correcting for multiple testing (β = −1.50, p = 3.75e-08). This finding was validated by quantitative real-time PCR and followed up with additional analyses adjusting for confounding variables. We also attempted to replicate the finding in an independent case-control sample (n = 578). The relationship between TCN1 expression and memory impairment was comparable to that of important determinants of memory function such as age and sex, suggesting that TCN1 could be a clinically relevant marker of memory performance. Thus, we identify TCN1 as a novel genetic finding associated with poor memory function. This finding may have important implications for the diagnosis and treatment of vitamin B12-related conditions.
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Ortiz-Guerrero G, Amador-Muñoz D, Calderón-Ospina CA, López-Fuentes D, Nava Mesa MO. Proton Pump Inhibitors and Dementia: Physiopathological Mechanisms and Clinical Consequences. Neural Plast 2018; 2018:5257285. [PMID: 29755512 PMCID: PMC5883984 DOI: 10.1155/2018/5257285] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 02/14/2018] [Indexed: 12/11/2022] Open
Abstract
Alzheimer's disease (AD) is the most common type of dementia, mainly encompassing cognitive decline in subjects aged ≥65 years. Further, AD is characterized by selective synaptic and neuronal degeneration, vascular dysfunction, and two histopathological features: extracellular amyloid plaques composed of amyloid beta peptide (Aβ) and neurofibrillary tangles formed by hyperphosphorylated tau protein. Dementia and AD are chronic neurodegenerative conditions with a complex physiopathology involving both genetic and environmental factors. Recent clinical studies have shown that proton pump inhibitors (PPIs) are associated with risk of dementia, including AD. However, a recent case-control study reported decreased risk of dementia. PPIs are a widely indicated class of drugs for gastric acid-related disorders, although most older adult users are not treated for the correct indication. Although neurological side effects secondary to PPIs are rare, several preclinical reports indicate that PPIs might increase Aβ levels, interact with tau protein, and affect the neuronal microenvironment through several mechanisms. Considering the controversy between PPI use and dementia risk, as well as both cognitive and neuroprotective effects, the aim of this review is to examine the relationship between PPI use and brain effects from a neurobiological and clinical perspective.
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Affiliation(s)
- Gloria Ortiz-Guerrero
- Individualized Research Learner Program, Neuromuscular Research Division, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS 66160, USA
| | - Diana Amador-Muñoz
- Neuroscience (NEUROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 No. 63C–69, Bogotá 111221, Colombia
| | - Carlos Alberto Calderón-Ospina
- Unidad de Farmacología, School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 No. 63C–69, Bogotá 111221, Colombia
| | - Daniel López-Fuentes
- Medical Social Service, Hospital de San Francisco, Kra 8 No. 6A–121, Gacheta 251230, Colombia
| | - Mauricio Orlando Nava Mesa
- Neuroscience (NEUROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 No. 63C–69, Bogotá 111221, Colombia
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Mohn ES, Kern HJ, Saltzman E, Mitmesser SH, McKay DL. Evidence of Drug-Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update. Pharmaceutics 2018; 10:E36. [PMID: 29558445 PMCID: PMC5874849 DOI: 10.3390/pharmaceutics10010036] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/13/2018] [Accepted: 03/16/2018] [Indexed: 12/18/2022] Open
Abstract
The long-term use of prescription and over-the-counter drugs can induce subclinical and clinically relevant micronutrient deficiencies, which may develop gradually over months or even years. Given the large number of medications currently available, the number of research studies examining potential drug-nutrient interactions is quite limited. A comprehensive, updated review of the potential drug-nutrient interactions with chronic use of the most often prescribed medications for commonly diagnosed conditions among the general U.S. adult population is presented. For the majority of the interactions described in this paper, more high-quality intervention trials are needed to better understand their clinical importance and potential consequences. A number of these studies have identified potential risk factors that may make certain populations more susceptible, but guidelines on how to best manage and/or prevent drug-induced nutrient inadequacies are lacking. Although widespread supplementation is not currently recommended, it is important to ensure at-risk patients reach their recommended intakes for vitamins and minerals. In conjunction with an overall healthy diet, appropriate dietary supplementation may be a practical and efficacious way to maintain or improve micronutrient status in patients at risk of deficiencies, such as those taking medications known to compromise nutritional status. The summary evidence presented in this review will help inform future research efforts and, ultimately, guide recommendations for patient care.
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Affiliation(s)
- Emily S Mohn
- Jean Mayer USDA Human Nutrition Research Center on Aging, and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
| | - Hua J Kern
- Nutrition & Scientific Affairs, Nature's Bounty Co., Ronkonkoma, NY 11779, USA.
| | - Edward Saltzman
- Jean Mayer USDA Human Nutrition Research Center on Aging, and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
| | - Susan H Mitmesser
- Nutrition & Scientific Affairs, Nature's Bounty Co., Ronkonkoma, NY 11779, USA.
| | - Diane L McKay
- Jean Mayer USDA Human Nutrition Research Center on Aging, and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
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Selected B vitamins and their possible link to the aetiology of age-related sarcopenia: relevance of UK dietary recommendations. Nutr Res Rev 2018; 31:204-224. [DOI: 10.1017/s0954422418000045] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AbstractThe possible roles of selected B vitamins in the development and progression of sarcopenia are reviewed. Age-related declines in muscle mass and function are associated with huge and increasing costs to healthcare providers. Falls and loss of mobility and independence due to declining muscle mass/function are associated with poor clinical outcomes and their prevention and management are attractive research targets. Nutritional status appears a key modifiable and affordable intervention. There is emerging evidence of sarcopenia being the result not only of diminished anabolic activity but also of declining neurological integrity in older age, which is emerging as an important aspect of the development of age-related decline in muscle mass/function. In this connection, several B vitamins can be viewed as not only cofactors in muscle synthetic processes, but also as neurotrophic agents with involvements in both bioenergetic and trophic pathways. The B vitamins thus selected are examined with respect to their relevance to multiple aspects of neuromuscular function and evidence is considered that requirements, intakes or absorption may be altered in the elderly. In addition, the evidence base for recommended intakes (UK recommended daily allowance) is examined with particular reference to original datasets and their relevance to older individuals. It is possible that inconsistencies in the literature with respect to the nutritional management of sarcopenia may, in part at least, be the result of compromised micronutrient status in some study participants. It is suggested that in order, for example, for intervention with amino acids to be successful, underlying micronutrient deficiencies must first be addressed/eliminated.
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Shoffel-Havakuk H, Lava CX, Hapner ER, O'Dell K, Reder L, Johns MM. The Singer's and the Clinician's Perspective on Vitamin B 12 Treatment for Vocal Benefits. J Voice 2018; 33:352-356. [PMID: 29306524 DOI: 10.1016/j.jvoice.2017.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/26/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION There is a belief among vocalists that there are voice benefits from vitamin B12 treatment. Yet there are no previous reports regarding vitamin B12 effects on voice. OBJECTIVES To assess the prevalence of vitamin B12 use among singers and their beliefs regarding vitamin B12 therapy. METHODS Anonymous online survey administered to singers, singing-teachers, speech-language pathologists, and laryngologists. RESULTS A total of 192 participants completed the surveys; 128 singers (68 singing-teachers, 30 speech-language pathologists) and 64 laryngologists. Among singers, 12% have perceived voice benefits from vitamin B12 treatment taken for any reason. Four percent used vitamin B12 for voice benefits; all perceived voice benefits as a result. The leading voice benefits were improved stamina, reduced effort, confidence, and control. Nineteen percent of the singers would recommend vitamin B12 treatment to a friend; 15% of the singing-teachers would recommend it to a student. Among laryngologists, 33% been asked by a singer to prescribe vitamin B12 for voice benefits; 9% have prescribed it in the past. Yet only 3% would you recommend it to a patient. When asked "Do you believe vitamin B12 therapy improves vocal performance?" 31% of the singers responded "Yes," compared with none in the laryngologists. When asked "Do you think the singing community believes vitamin B12 therapy improves vocal performance?" 26% of the singers responded "Yes," compared with 53% of the laryngologists (P = 0.0002). CONCLUSIONS There is a discrepancy between the singers' and the laryngologists' beliefs regarding vocal benefits perceived by vitamin B12. Blinded randomized trials are required to verify or refute this belief.
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Affiliation(s)
- Hagit Shoffel-Havakuk
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California
| | | | - Edie R Hapner
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California
| | - Karla O'Dell
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California
| | - Lindsay Reder
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California
| | - Michael M Johns
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California.
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Hibbeln JR, Northstone K, Evans J, Golding J. Vegetarian diets and depressive symptoms among men. J Affect Disord 2018; 225:13-17. [PMID: 28777971 DOI: 10.1016/j.jad.2017.07.051] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 07/24/2017] [Accepted: 07/27/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vegetarian diets are associate with cardiovascular and other health benefits, but little is known about mental health benefits or risks. AIMS To determine whether self-identification of vegetarian dietary habits is associated with significant depressive symptoms in men. METHOD Self-report data from 9668 adult male partners of pregnant women in the Avon Longitudinal Study of Parents and Children (ALSPAC) included identification as vegetarian or vegan, dietary frequency data and the Edinburgh Post Natal Depression Scale (EPDS). Continuous and binary outcomes were assessed using multiple linear and logistic regression taking account of potential confounding variables including: age, marital status, employment status, housing tenure, number of children in the household, religion, family history of depression previous childhood psychiatric contact, cigarette and alcohol consumption. RESULTS Vegetarians [n = 350 (3.6% of sample)], had higher depression scores on average than non-vegetarians (mean difference 0.96 points [95%CI + 0.53, + 1.40]) and a greater risk for EPDS scores above 10 (adjusted OR = 1.67 [95% CI: 1.14,2.44]) than non-vegetarians after adjustment for potential confounding factors. CONCLUSIONS Vegetarian men have more depressive symptoms after adjustment for socio-demographic factors. Nutritional deficiencies (e.g. in cobalamin or iron) are a possible explanation for these findings, however reverse causation cannot be ruled out.
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Affiliation(s)
- Joseph R Hibbeln
- Section on Nutritional Neurosciences, National Institute on Alcohol Abuse and Alcoholism, NIH, Rockville, MD, USA.
| | - Kate Northstone
- School of Social and Community Medicine, University of Bristol, UK
| | - Jonathan Evans
- School of Social and Community Medicine, University of Bristol, UK
| | - Jean Golding
- School of Social and Community Medicine, University of Bristol, UK
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Bender A, Hagan KE, Kingston N. The association of folate and depression: A meta-analysis. J Psychiatr Res 2017; 95:9-18. [PMID: 28759846 DOI: 10.1016/j.jpsychires.2017.07.019] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/20/2017] [Accepted: 07/20/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Previous research suggested that folate levels play an important role in the etiology and course of depression. However, the literature has been inconsistent with regard to differences in folate level between individuals with and without depression. The present meta-analysis synthesized the results of previous studies to examine whether individuals with depression had lower levels of folate than individuals without depression. METHODS Meta-analytic procedures were conducted in accordance with PRISMA guidelines. Studies evaluating folate levels in individuals with and without depression via red blood cell folate, serum folate, or dietary intake of folate methods were identified via PsycINFO and PubMed. Random-effects meta-analysis was conducted using Hedge's g, and moderation analysis was used for both folate measurement method and population type. Study heterogeneity was assessed with I2 and publication bias was qualitatively assessed via funnel plot and quantitatively assessed with the trim-and-fill method and Begg's adjusted rank test. RESULTS We found a significant, small effect size, such that individuals with depression had lower folate levels than those without depression, Hedge's g = -0.24 (95% CI = -0.31, -0.16), p < 0.001. Study heterogeneity was high (I2 = 84.88%), and neither folate measurement method nor population accounted for study heterogeneity. CONCLUSIONS Individuals with depression have lower serum levels of folate and dietary folate intake than individuals without depression. Given that previous literature suggested folate supplementation improved the efficacy of traditional antidepressant medications, future research on folate supplementation in depression is warranted and clinicians may wish to consider folate supplementation for patients with depression.
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Schefft C, Kilarski LL, Bschor T, Köhler S. Efficacy of adding nutritional supplements in unipolar depression: A systematic review and meta-analysis. Eur Neuropsychopharmacol 2017; 27:1090-1109. [PMID: 28988944 DOI: 10.1016/j.euroneuro.2017.07.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/16/2017] [Accepted: 07/05/2017] [Indexed: 02/08/2023]
Abstract
In this article, we aimed to assess the efficacy of adjunctive administration of nutritional supplements to antidepressants by means of a systematic review and meta-analysis. The supplements included were inositol, vitamin D, folic acid, vitamin B12, S-adenosyl-L-methionine (SAMe), omega-3 polyunsaturated fatty acids (n-3 PUFA) and zinc. A structured database search (MEDLINE, EBSCO, CENTRAL, Web of Science) was performed using terms for the respective substances in conjunction with terms for depression and the mode of treatment ("add-on" OR "adjunctive" OR "augmentation"). Meta-analyses, randomized controlled trials (RCTs) and non-randomized comparative studies that investigated the supplements as an add-on in the treatment of clinically diagnosed MDD were included. Agents had to be added to an existing antidepressant regime (augmentation) or started simultaneously with the antidepressant (acceleration). For n-3 PUFAs, folic acid and zinc, new meta-analyses were performed as part of this work. Our meta-analyses of 10 articles on n-3 PUFAs and four on zinc support their efficacy. For folic acid, our meta-analysis does not support efficacy. For n-3 PUFAs, sensitivity analysis showed no difference between acceleration and augmentation designs, but significant differences between individuals with or without comorbidities. For the remaining substances, only a few RCTs were available. The preliminary data on inositol was negative, while one RCT for vitamin D demonstrated positive results. For vitamin B12 one and for SAMe two RCTs and a few open trials are available reporting positive and mixed results. To summarize, for most of the substances, the available data is not yet sufficient or inconclusive.
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Affiliation(s)
- Cora Schefft
- Charité Universitätsmedizin Berlin, Campus Mitte, Department for Psychiatry and Psychotherapy, Charitéplatz 1, 10117 Berlin, Germany
| | - Laura L Kilarski
- University Hospital of Cologne, Department of Psychosomatic Medicine and Psychotherapy, Cologne, Germany
| | - Tom Bschor
- Schlosspark-Klinik, Department of Psychiatry, Berlin, Germany and Department of Psychiatry and Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Stephan Köhler
- Charité Universitätsmedizin Berlin, Campus Mitte, Department for Psychiatry and Psychotherapy, Charitéplatz 1, 10117 Berlin, Germany.
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Eisenberg MD, Avery RJ, Cantor JH. Vitamin panacea: Is advertising fueling demand for products with uncertain scientific benefit? JOURNAL OF HEALTH ECONOMICS 2017; 55:30-44. [PMID: 28743536 PMCID: PMC5599169 DOI: 10.1016/j.jhealeco.2017.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 11/04/2016] [Accepted: 06/07/2017] [Indexed: 05/16/2023]
Abstract
This study examines the effect of advertising on demand for vitamins-products with spiraling sales despite little evidence of efficacy. We merge seven years (2003-2009) of advertising data from Kantar Media with the Simmons National Consumer Survey to estimate individual-level vitamin print and television ad exposure effects. Identification relies on exploiting exogenous variation in year-to-year advertising exposure by controlling for each individual's unique media consumption. We find that increasing advertising exposure from zero to the mean number of ads increases the probability of consumption by 1.2 and 0.8% points (or 2 and 1.4%) in print and television respectively. Stratifications by the presence of health conditions suggests that in print demand is being driven by both healthy and sick individuals.
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Affiliation(s)
- Matthew D Eisenberg
- Department of Health Policy and Management, Johns Hopkins University, United States.
| | - Rosemary J Avery
- Department of Policy Analysis and Management, Cornell University, United States
| | - Jonathan H Cantor
- Wagner School of Public Service, New York University, United States; Department of Population Health, New York University School of Medicine, New York, NY, United States
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Poudel-Tandukar K. Dietary B Vitamins and Depression in Persons with Human Immunodeficiency Virus Infection: The Positive Living with HIV (POLH) Study. J Nutr Sci Vitaminol (Tokyo) 2017; 62:388-396. [PMID: 28202843 DOI: 10.3177/jnsv.62.388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
B vitamins have beneficial roles in mental health functional impairments; however, research on the role of B vitamins in depression among HIV-infected persons is limited. This study assessed the association between dietary B vitamin intake and depressive symptoms in a cohort of HIV-infected persons. A cross-sectional survey was conducted among 314 HIV-infected persons (180 men and 134 women) aged 18 to 60 y residing in the Kathmandu, Nepal. The Beck Depression Inventory-I was used to measure depression, with a cutoff score of 20 or higher. Dietary intake was assessed using two nonconsecutive 24-h dietary recalls. The relationships between B vitamins and depressive symptoms were assessed using multiple logistic regression analysis. Twenty-six percent participants (men: 23%; women: 29%) were depressed. More than two thirds of participants' B vitamins intake were below the estimated average requirements (EAR) level. Low intake of riboflavin was associated with an increased risk of depression in women but not in men. Multivariate OR (95% CI) for depression in the first, second, and third tertiles of riboflavin in total participants were 1 (reference), 0.87 (0.46-1.64), and 0.49 (0.24-0.98), respectively (p for trend=0.048) and in women were 1 (reference), 0.94 (0.36-2.40), and 0.23 (0.07-0.77), respectively (p for trend=0.020). No clear associations were seen between other B vitamins and depressive symptoms in either sex. Low intake of riboflavin was independently associated with an increased risk of depressive symptoms in all participants and in HIV-infected women. Further prospective studies are warranted to confirm the role of vitamin B vitamins in depressive symptoms among HIV-infected persons.
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Plasma Homocysteine and Serum Folate and Vitamin B 12 Levels in Mild Cognitive Impairment and Alzheimer's Disease: A Case-Control Study. Nutrients 2017; 9:nu9070725. [PMID: 28698453 PMCID: PMC5537839 DOI: 10.3390/nu9070725] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 06/13/2017] [Accepted: 07/04/2017] [Indexed: 01/20/2023] Open
Abstract
Homocysteine (Hcy) is a risk factor for brain atrophy, cognitive impairment, and dementia. Vitamin B12 and folate are cofactors necessary for the methylation of Hcy. However, there is some debate regarding the differing levels of plasma Hcy and serum folate and vitamin B12 among healthy controls, patients with mild cognitive impairment (MCI), and patients with Alzheimer’s disease (AD). This study aimed to evaluate how the levels of plasma Hcy and its biological determinants, folate and vitamin B12, are related to MCI and AD in older Chinese adults. This is a case-control study including 112 subjects with MCI, 89 AD patients and 115 healthy controls. Diagnosis of AD was made according to the NINCDS-ADRDA and MCI with modified Petersen’s criteria. Serum folate and vitamin B12 concentrations were analyzed by radioimmunoassay, and plasma Hcy was assessed by a high-performance liquid chromatography-fluorescence method. Multivariate analysis of regression was used to examine the odds ratio (OR) of MCI or AD with Hcy or vitamin levels. Results have shown that serum folate and vitamin B12 levels were significantly lower, but the plasma Hcy level was higher, in patients with MCI and AD than in healthy controls. Multivariate regression analyses showed that subjects in the lowest folate tertile had significantly higher adjusted ORs for MCI (OR: 3.07; 95% confidence interval [CI]: 1.12, 8.07) and AD (3.42; 95% CI: 1.15, 8.34) compared to subjects in the highest tertile. The highest Hcy tertile was significantly associated with MCI (adjusted OR: 2.81; 95% CI: 1.15, 4.73) and AD (adjusted OR: 3.64; 95% CI: 1.13, 9.04) compared to the lowest tertile. No association existed between low vitamin B12 levels and AD or MCI (p > 0.05). Low blood levels of folate and vitamin B12 and elevated Hcy levels were associated with MCI and AD in older Chinese adults, and the association was stronger for AD.
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43
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Vitamin B12, homocysteine and depressive symptoms: a longitudinal study among older adults. Eur J Clin Nutr 2017; 71:468-475. [DOI: 10.1038/ejcn.2016.224] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 09/13/2016] [Accepted: 10/11/2016] [Indexed: 01/08/2023]
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Is there an association between diet and depression in children and adolescents? A systematic review. Br J Nutr 2017; 116:2097-2108. [PMID: 28093091 DOI: 10.1017/s0007114516004359] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This review critically evaluates previous studies investigating the association between dietary intake of children and young people and depression and related mental health problems. A systematic literature search was conducted using electronic databases such as PsycINFO, MEDLINE, PubMed and Cochrane. A total of twenty studies were identified that met inclusion criteria and were subsequently rated for quality. The studies used a range of methods to measure dietary intake and mental health. Important potential confounding variables (e.g. socio-economic status) were often not included or controlled. There were also inconsistencies in the use of key constructs, which made comparisons between studies difficult. Despite some contradictory results, overall there was support for an association between healthy dietary patterns or consumption of a high-quality diet and lower levels of depression or better mental health. Similarly, there was a relationship between unhealthy diet and consumption of low-quality diet and depression or poor mental health. However, where significant relationships were reported, effect sizes were small. Future research on the relationship between diet and mental health in young people should use more clearly defined constructs to define diet and include or control for important confounders.
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45
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Lökk J. Association of vitamin B12, folate, homocysteine and cognition in the elderly. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/11026480310000662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Johan Lökk
- Department of Clinical Neuroscience, Occupational Therapy, and Elderly Care Research, Karolinska Institute, Huddinge University Hospital, and Comprehensive Centre for Elderly Care, Älvsjö, Stockholm, Sweden
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Nedley N, Ramirez FE. Nedley Depression Hit Hypothesis: Identifying Depression and Its Causes. Am J Lifestyle Med 2016; 10:422-428. [PMID: 27885322 PMCID: PMC5103329 DOI: 10.1177/1559827614550779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 08/11/2014] [Accepted: 08/19/2014] [Indexed: 11/28/2022] Open
Abstract
Depression is often diagnosed using the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. We propose how certain lifestyle choices and non-modifiable factors can predict the development of depression. We identified 10 cause categories (hits or “blows” to the brain) and theorize that four or more active hits could trigger a depression episode. Methods. A sample of 4271 participants from our community-based program (70% female; ages 17-94 years) was assessed at baseline and at the eighth week of the program using a custom test. Ten cause categories were examined as predictors of depression are (1) Genetic, (2)Developmental, (3)Lifestyle, (4)Circadian Rhythm, (5)Addiction, (6)Nutrition, (7)Toxic, (8)Social/Complicated Grief, (9)Medical Condition, and (10)Frontal Lobe. Results. The relationship between the DSM-5 score and a person having four hits categories in the first program week showed a sensitivity of 89.98 % (95% CI: 89.20 % - 90.73%), specificity 48.84% (CI 45.94-51.75) and Matthew Correlation Coefficient (MCC) .41 . For the eight-week test, the results showed a sensitivity 83.6% (CI 81.9-85.5), specificity 53.7% (CI 51.7-55.6) and MCC .38. Overall, the hits that improved the most from baseline after the eighth week were: Nutrition (47%), Frontal lobe (36%), Addiction (24%), Circadian rhythm (24%), Lifestyle (20%), Social (12%) and Medical (10%). Conclusions. The Nedley four-hit hypothesis seems to predict a depressive episode and correlates well with the DSM-5 criteria with good sensitivity and MCC but less specificity. Identifying these factors and applying lifestyle therapies could play an important role in the treatment of depressed individuals.
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Affiliation(s)
- Neil Nedley
- Medical Director (NN), Nedley Clinic, Ardmore, Oklahoma
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47
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de Koning EJ, van der Zwaluw NL, van Wijngaarden JP, Sohl E, Brouwer-Brolsma EM, van Marwijk HWJ, Enneman AW, Swart KMA, van Dijk SC, Ham AC, van der Velde N, Uitterlinden AG, Penninx BWJH, Elders PJM, Lips P, Dhonukshe-Rutten RAM, van Schoor NM, de Groot LCPGM. Effects of Two-Year Vitamin B 12 and Folic Acid Supplementation on Depressive Symptoms and Quality of Life in Older Adults with Elevated Homocysteine Concentrations: Additional Results from the B-PROOF Study, an RCT. Nutrients 2016; 8:nu8110748. [PMID: 27886078 PMCID: PMC5133130 DOI: 10.3390/nu8110748] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 12/31/2022] Open
Abstract
Lowering elevated plasma homocysteine (Hcy) concentrations by supplementing vitamin B12 and folic acid may reduce depressive symptoms and improve health-related quality of life (HR-QoL) in older adults. This study aimed to test this hypothesis in a randomized controlled trial. Participants (N = 2919, ≥65 years, Hcy concentrations ≥12 µmol/L) received either 500 µg vitamin B12 and 400 µg folic acid daily or placebo for two years. Both tablets contained 15 µg vitamin D3. Depressive symptoms were measured with the Geriatric Depression Scale-15 (GDS-15). HR-QoL was assessed with the SF-12 Mental and Physical component summary scores and the EQ-5D Index score and Visual Analogue Scale. Differences in two-year change scores were analyzed with Analysis of Covariance (ANCOVA). Hcy concentrations decreased more in the intervention group, but two-year change scores of the GDS-15 and three of four HR-QoL measures did not differ between groups. The EQ-5D Index score declined less in the intervention group than in the placebo group (mean change 0.00 vs. −0.02, p = 0.004). In conclusion, two-year supplementation with vitamin B12 and folic acid in older adults with hyperhomocysteinemia showed that lowering Hcy concentrations does not reduce depressive symptoms, but it may have a small positive effect on HR-QoL.
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Affiliation(s)
- Elisa J de Koning
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Nikita L van der Zwaluw
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.
| | - Janneke P van Wijngaarden
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.
| | - Evelien Sohl
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Elske M Brouwer-Brolsma
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.
| | - Harm W J van Marwijk
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Primary Care Research Center, Institute of Population Health, University of Manchester, Oxford Road, M13 9PL Manchester, UK.
| | - Anke W Enneman
- Department of Internal Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Karin M A Swart
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Suzanne C van Dijk
- Department of Internal Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Annelies C Ham
- Department of Internal Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Nathalie van der Velde
- Department of Internal Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Brenda W J H Penninx
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of Psychiatry, VU University Medical Center/GGZ inGeest, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Petra J M Elders
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Paul Lips
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of Internal Medicine/Endocrinology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | | | - Natasja M van Schoor
- EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
- Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Lisette C P G M de Groot
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.
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Kadihasanoglu M, Kilciler M, Kilciler G, Yucetas U, Erkan E, Karabay E, Toktas MG, Kendirci M. Relation between blood vitamin B12 levels with premature ejaculation: case-control study. Andrologia 2016; 49. [PMID: 27681841 DOI: 10.1111/and.12657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to investigate whether vitamin B12 levels are associated with premature ejaculation (PE). A total of 109 subjects (56 PE and 53 controls) were included in this study. PE was defined as self-reported intravaginal ejaculatory latency time (IELT) based on the Diagnostic and Statistical Manual of Mental Disorders IV criteria and those who had had an IELT of <2 min was considered as PE. All participants were evaluated using premature ejaculation diagnostic tool (PEDT), International Index of Erectile Function (IIEF) and Beck Depression Inventory (BDI). The vitamin 12 levels were measured in all subjects. The mean age between the PE and controls was comparable (p = .084). Mean IIEF and BDI scores between the two groups did not statistically differ. The mean IELT values in the PE group were significantly lower than in the control group (p < .0001). PE patients reported significantly lower vitamin B12 levels compared with the controls (213.14 vs. 265.89 ng ml-1 ; p < .001). The ROC analysis showed a significant correlation between the diagnosis of PE and lower vitamin B12 levels. This study has demonstrated that lower vitamin B12 levels are associated with the presence of PE. This work also shows a strong correlation between vitamin B12 levels and the PEDT scores as well as the IELT values.
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Affiliation(s)
- M Kadihasanoglu
- Department of Urology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - M Kilciler
- Department of Urology, Bahcesehir University, Faculty of Medicine, Medical Park Bursa Hospital, Bursa, Turkey
| | - G Kilciler
- Gulhane Askeri Tıp Akademisi, Gastroenteroloji Bilim Dalı, Ankara, Turkey
| | - U Yucetas
- Department of Urology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - E Erkan
- Department of Urology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - E Karabay
- Department of Urology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - M G Toktas
- Department of Urology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - M Kendirci
- Department of Urology, Istinye University, Faculty of Medicine, Liv Hospital Ulus, Istanbul, Turkey
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Petridou ET, Kousoulis AA, Michelakos T, Papathoma P, Dessypris N, Papadopoulos FC, Stefanadis C. Folate and B12 serum levels in association with depression in the aged: a systematic review and meta-analysis. Aging Ment Health 2016; 20:965-73. [PMID: 26055921 DOI: 10.1080/13607863.2015.1049115] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To systematically review and meta-analyse existing evidence on the association between folate/B12, and depression among the aged people. METHODS Following PRISMA/STROBE guidelines, the Medline abstracts were retrieved using an algorithm comprising relevant MeSH terms. Publications on the association of folate/B12 serum measurements with depression were abstracted independently by two reviewers and included in both gender and gender-specific meta-analyses, following recarculations of published data as appropriate. The Newcastle-Ottawa scale was used to evaluate the quality of included studies. RESULTS Both gender data were contributed by 11 folate-related (7949 individuals) and 9 B12-related studies (6308 individuals), whereas gender-specific data by 4 folate-related (3409 individuals) and 3 B12-related studies (1934 individuals). A statistically significant overall association between both exposures of interest (low folate and B12 levels) and depression was observed (ORfolate:1.23, 95%CI:1.07-1.43, ORB12:1.20, 95%CI:1.02-1.42). Gender-specific estimates pointed to a statistically significant positive association between low B12 levels and depression only among women (OR:1.33, 95%CI:1.02-1.74); the gender specific associations of low folate levels with depression were, however, non-significant and of counter-direction (ORfemales:1.37, 95%CI:0.90-2.07; ORmales:0.84, 95%CI:0.57-1.25). CONCLUSION Low folate and B12 serum levels seem to be associated with depression in the aged. The gender-specific analyses are confined to a positive association of low B12 with depression among older women and call for further research in this direction.
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Affiliation(s)
- Eleni Th Petridou
- a Department of Hygiene , Epidemiology and Medical Statistics, Athens University Medical School , Athens , Greece
| | - Antonis A Kousoulis
- a Department of Hygiene , Epidemiology and Medical Statistics, Athens University Medical School , Athens , Greece
| | - Theodoros Michelakos
- a Department of Hygiene , Epidemiology and Medical Statistics, Athens University Medical School , Athens , Greece
| | - Paraskevi Papathoma
- a Department of Hygiene , Epidemiology and Medical Statistics, Athens University Medical School , Athens , Greece
| | - Nick Dessypris
- a Department of Hygiene , Epidemiology and Medical Statistics, Athens University Medical School , Athens , Greece
| | - Fotios C Papadopoulos
- b Department of Neuroscience , Psychiatry, Uppsala University Hospital, Uppsala University , Uppsala , Sweden
| | - Christodoulos Stefanadis
- c First Department of Cardiology , Athens University Medical School, Hippokration Hospital , Athens , Greece
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Penninx BWJH. Depression and cardiovascular disease: Epidemiological evidence on their linking mechanisms. Neurosci Biobehav Rev 2016; 74:277-286. [PMID: 27461915 DOI: 10.1016/j.neubiorev.2016.07.003] [Citation(s) in RCA: 308] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 05/22/2016] [Accepted: 07/06/2016] [Indexed: 12/17/2022]
Abstract
Depression's burden of disease goes beyond functioning and quality of life and extends to somatic health. Results from longitudinal cohort studies converge in illustrating that major depressive disorder (MDD) subsequently increases the risk of cardiovascular morbidity and mortality with about 80%. The impact of MDD on cardiovascular health may be partly explained by mediating mechanisms such as unhealthy lifestyle (smoking, excessive alcohol use, physical inactivity, unhealthy diet, therapy non-compliance) and unfavorable pathophysiological disturbances (autonomic, HPA-axis, metabolic and immuno-inflammatory dysregulations). A summary of the literature findings as well as relevant results from the large-scale Netherlands Study of Depression and Anxiety (N=2981) are presented. Persons with MDD have significantly worse lifestyles as well as more pathophysiological disturbances as compared to healthy controls. Some of these differences seem to be specific for (typical versus 'atypical', or antidepressant treated versus drug-naive) subgroups of MDD patients. Alternative explanations are also present, namely undetected confounding, iatrogenic effects or 'third factors' such as genetics.
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Affiliation(s)
- Brenda W J H Penninx
- Department of Psychiatry, EMGO+ Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
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