Investigating the Relationship of Vitamin D Deficiency and Certain Biochemical Parameters with Depression

Introductıon: Depression is the most common psychiatric disorder in the general population and is the most common mental health condition in primary care patients. Although theories involving biological, psychological, and environmental factors have been put forth, the underlying pathophysiology of depression is unknown, as several different mechanisms are likely involved. Identification of vitamin D receptors in brain regions active in depression has strengthened the link between vitamin D and depression. The aim of this study was to examine the relationship of depression with vitamin D and certain biochemical parameters. Methods: Patients who were admitted to Şanlıurfa Mehmet Akif İnan Training and Research Hospital Internal Medicine outpatient clinic who had no chronic diseases and whose vitamin D, ferritin, hemoglobin (Hb), thyroid stimulant hormone (Tsh), free thyroxine (T4), folate, magnesium and B12 levels were recorded were included in the study. Beck’s Depression Inventory was presented to the patients to examine the relationship of depression with the selected parameters. Results: A total of 352 cases were included in the study. Of the cases, 246 (69.9%) were female and 106 (30.1%) were male. There was no significant correlation between Beck’s Depression Inventory scores and magnesium, hemoglobin, ferritin, B12, Tsh and T4 levels (p>0.05). A significant correlation was found only between folate levels and Beck’s Depression Inventory scores (p=0.046). There was not a significant correlation between vitamin D levels and Beck’s Depression Inventory scores (p=0.727), although a weak negative correlation was discovered between them (r= -0.019). There was no significant correlation between vitamin D levels and depression severity (p=0.650). None of the patients who had normal vitamin D levels were found to have severe depression. Conclusion: Depression is a common psychiatric disease and its pathophysiology has not been fully elucidated. Further studies are need to better understand the relationship between biochemical parameters and depression. The evidence-based results of these studies should be used to prevent and treat depression, which is an important health problem.

Keywords:

Depression Vitamin D, Beck’s Depression Inventory,

PDF

___

1-Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999 Nov 10;282(18):1737-44.
2-Bertone-Johnson, Elizabeth R. "Vitamin D and the occurrence of depression: causal association or circumstantial evidence?." Nutrition reviews 67.8 (2009): 481-92.
3- Eyles DW, Smith S, Kinobe R, Hewison M, McGrath JJ. Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain. J Chem Neuroanat 2005; 29: 21–30.
4-Ginde AA, Liu MC, Camargo CA. Demographic differences and trends of vitamin D insufficiency in the US population, 1988–2004. Arch Intern Med 2009; 169: 626–32.
5-Cora McGreevy, Miriam Barry, Colin Davenport, et al. The effect of vitamin D supplementation on arterial stiffness in an elderly community-based population. J Am Soc Hypertens. 2015 Mar;9(3):176-83.
6-Eyles, D.W., Smith, S., Kinobe, R., Hewison, M,.& McGrath, J.J. Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain. Journal of Chemical Neuroanatomy (2005) 29(1):21-30.
7-Prüfer, K., Veenstra, T.D., Jirikowski, G.F., & Kumar, R. Distribution of 1,25- dihydroxyvitamin D3 receptor immuno reactivity in the rat brain and spinal cord. Journal of Chemical Neuroanatomy, (1999) 16(2):135-45.
8-Beck AT. An inventory for measuring depression. Arch Gen Psychiatry 1961;4(6):561-71.9-Guy W. Clinical Global Impressions: ECDEU Assessment Manual for Pharmacology, revised edition. National Institute of Mental Health, Dept. of Health, Education and Welfare Publication (ADM). 1976:218- 22.
10-Nisha Saji Parel, Parimi Vamsi Krishna, Anuradha Gupta, et al. Depression and Vitamin D: A Peculiar Relationship. Cureus. 2022 Apr 21;14(4):e24363.11-Geng C, Shaikh AS, Han W, et al. Vitamin D and depression: mechanisms, determination and application. Asia Pac J Clin Nutr. 2019;28:689–94.
12-Lars Libuda , Björn-Hergen Laabs , Christine Ludwig , et al. Vitamin D and the Risk of Depression: A Causal Relationship? Findings from a Mendelian Randomization Study, Nutrients. 2019 May 16;11(5):1085.
13-Leila Kamalzadeh , Malihe Saghafi , Seyede Salehe Mortazavi , Atefeh Ghanbari Jolfaei. Vitamin D deficiency and depression in obese adults: a comparative observational study, BMC Psychiatry. 2021 Nov 30;21(1):599.
14-Vikas Menon, Sujita Kumar Kar, Navratan Suthar, Naresh Nebhinani. Vitamin D and Depression: A Critical Appraisal of the Evidence and Future DirectionsIndian J Psychol Med 2020 Jan 6;42(1):11-21.
15-Ramos M.I., Allen L.H., Haan M.N., Green R., and Miller J.W. Plasma folate concentrations are associated with depressive symptoms in elderly Latina women despite folic acid fortification. Am. J. Clin. Nutr. 2004; 80: pp. 1024-28.
16-Sachdev P.S., Parslow R.A., Lux O., et al. Relationship of homocysteine, folic acid and vitamin B12 with depression in a middle-aged community sample. Psychol. Med. 2005; 35: pp. 529-38. 17-Reynolds E.H., Preece J.M., Bailey J., and Coppen A.: Folate deficiency in depressive illness. Br. J. Psychiatr. 1970; 117: pp. 287-92.
18-Papakostas G.I., Petersen T., Mischoulon D., et al. Serum folate, vitamin B12, and homocysteine in major depressive disorder, Part 2: predictors of relapse during the continuation phase of pharmacotherapy. J. Clin. Psychiatr. 2004; 65: pp. 1096-98.
19-Levitt A.J., and Joffe R.T. Folate, B12, and life course of depressive illness. Biol. Psychiatr. 1989; 25: pp. 867-72.
20-Ansley Bender, Kelsey E. Hagan and Neal Kingston. The association of folate and depression: A meta-analysis,. Journal of Psychiatric Research, 2017-12-01, Volume 95, 9-18.
21-P. Sangle, O. Sandhu, Z. Aftab, A.T. Anthony, S. Khan. Vitamin B12 supplementation: preventing onset and improving prognosis of depression. Cureus, 12 (10) (2020)
22-L.E.M. Elstgeest, I.A. Brouwer, B.W. Penninx, N.M. Van Schoor, M. Visser. Vitamin B12, homocysteine and depressive symptoms: a longitudinal study among older adults. Eur. J. Clin. Nutr., 71 (4) (2017), 468-75.
23-S. Markun, I. Gravestock, L. Jäger, et al. Effects of vitamin B12 supplementation on cognitive function, depressive symptoms, and fatigue: a systematic review, meta-analysis, and meta-regression. Nutrients, 13 (3) (2021), p. 923.
24-A. Rajizadeh, H. Mozaffari-Khosravi, M. Yassini-Ardakani, A. Dehghani. Effect of magnesium supplementation on depression status in depressed patients with magnesium deficiency: a randomized, double-blind, placebo-controlled trial. Nutrition, 35 (2017), 56-60.
25-E.K. Tarleton, A.G. Kennedy, G.L. Rose, A. Crocker, B. Littenberg. The association between serum magnesium levels and depression in an adult primary care population. Nutrients, 11 (7) (2019), 1475.
26-Anna Serefko , Aleksandra Szopa , Ewa Poleszak. Magnesium and depression. Magnes Res. 2016 Mar 1;29(3):112-19.
27-Shinsuke Hidese, Kenji Saito, Shinya Asano, Hiroshi Kunugi. Association between iron-deficiency anemia and depression: A web-based Japanese investigation. Psychiatry Clin Neurosci. 2018 Jul;72(7):513-21.
28-Ittermann T, Völzke H, Baumeister SE, Appel K, Grabe HJ. Diagnosed thyroid disorders are associated with depression and anxiety. Soc Psychiatry Psychiatr Epidemiol. 2015;50:1417–25