长期补充维生素D3并不能降低抑郁症或临床相关抑郁症状的风险 作者： 发布时间：/8/5 23:20:15 美国布列根和妇女医院和哈佛医学院JoAnn E. Manson联合马萨诸塞总医院和哈佛医学院Olivia I. Okereke团队，研究了长期补充维生素D3与安慰剂相比对抑郁或临床相关抑郁症状风险以及情绪评分变化的影响。8月4日，《美国医学会杂志》发表了该成果。
25-羟基维生素D水平较低与之后生活中抑郁风险较高有关，但长期、大剂量的大规模试验很少。
为了评估补充维生素D3对晚年抑郁症风险和情绪评分的影响，研究组在美国一项针对25871名成年人的心血管疾病和癌症预防的随机临床试验中进行了一项辅助试验，11月至3月，招募了18353名50岁及以上的参与者，其中16657名有发生抑郁症的风险，1696名有抑郁症复发的风险（既往有抑郁史，但过去两年内无治疗）。将其随机分组，其中9181名每日口服维生素D3，9172名服用相匹配的安慰剂。
18353名参与者的平均年龄为67.5岁，女性占49.2%，中位治疗5.3年后，有90.5%的参与者完成了试验。维生素D3组中有609例发生抑郁症或临床相关抑郁症状事件，发生率为每1000人年12.9例，安慰剂中有625例，发生率为每1000人年13.3例，两组间抑郁症发生率或复发率均无显著差异。两组间情绪评分随时间的变化无明显差异；8项患者健康问卷抑郁量表（PHQ-8）得分均未改善。
总之，对于在基线检查时没有临床相关抑郁症状的50岁及以上的成年人中，维生素D3治疗与安慰剂相比，在中位5.3年的随访中，抑郁症或临床相关抑郁症状的发生率和复发率，以及情绪评分的变化，均未显著改善。
附：英文原文
Title: Effect of Long-term Vitamin D3 Supplementation vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores: A Randomized Clinical Trial
Author: Olivia I. Okereke, Charles F. Reynolds, David Mischoulon, Grace Chang, Chirag M. Vyas, Nancy R. Cook, Alison Weinberg, Vadim Bubes, Trisha Copeland, Georgina Friedenberg, I-Min Lee, Julie E. Buring, JoAnn E. Manson
Issue Volume: /08/04
Abstract: Importance Low levels of 25-hydroxyvitamin D have been associated with higher risk for depression later in life, but there have been few long-term, high-dose large-scale trials.
Objective To test the effects of vitamin D3 supplementation on late-life depression risk and mood scores.
Design, Setting, and Participants There were 18353 men and women aged 50 years or older in the VITAL-DEP (Vitamin D and Omega-3 Trial-Depression Endpoint Prevention) ancillary study to VITAL, a randomized clinical trial of cardiovascular disease and cancer prevention among 25871 adults in the US. There were 16657 at risk for incident depression (ie, no depression history) and 1696 at risk for recurrent depression (ie, depression history but no treatment for depression within the past 2 years). Randomization occurred from November through March ; randomized treatment ended on December 31, , and this was the final date of follow-up.
Intervention Randomized assignment in a 2 2 factorial design to vitamin D3 (2000 IU/d of cholecalciferol) and fish oil or placebo; 9181 were randomized to vitamin D3 and 9172 were randomized to matching placebo.
Main Outcomes and Measures The primary outcomes were the risk of depression or clinically relevant depressive symptoms (total of incident and recurrent cases) and the mean difference in mood scores (8-item Patient Health Questionnaire depression scale [PHQ-8]; score range, 0 points [least symptoms] to 24 points [most symptoms]; the minimal clinically important difference for change in scores was 0.5 points).
Results Among the 18353 randomized participants (mean age, 67.5 [SD, 7.1] years; 49.2% women), the median treatment duration was 5.3 years and 90.5% completed the trial (93.5% among those alive at the end of the trial). Risk of depression or clinically relevant depressive symptoms was not significantly different between the vitamin D3 group (609 depression or clinically relevant depressive symptom events; 12.9/1000 person-years) and the placebo group (625 depression or clinically relevant depressive symptom events; 13.3/1000 person-years) (hazard ratio, 0.97 [95% CI, 0.87 to 1.09]; P=.62); there were no significant differences between groups in depression incidence or recurrence. No significant differences were observed between treatment groups for change in mood scores over time; mean change in PHQ-8 score was not significantly different from zero (mean difference for change in mood scores, 0.01 points [95% CI, 0.04 to 0.05 points]).
Conclusions and Relevance Among adults aged 50 years or older without clinically relevant depressive symptoms at baseline, treatment with vitamin D3 compared with placebo did not result in a statistically significant difference in the incidence and recurrence of depression or clinically relevant depressive symptoms or for change in mood scores over a median follow-up of 5.3 years. These findings do not support the use of vitamin D3 in adults to prevent depression.
DOI: 10.1001/jama..10224
Source:
期刊信息
JAMA-Journal of The American Medical Association：《美国医学会杂志》，创刊于1883年。隶属于美国医学协会，最新IF：51.273
官方网址：
投稿链接：
