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In patients with HF, low levels of vitamin D associated with depressive symptoms
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Patients with HF and low levels of vitamin D are more likely to have depressive symptoms, particularly in those with low levels of physical function, according to a new study.
Researchers investigated whether vitamin D levels, which are often low in patients with HF, are associated with depressive symptoms in patients with HF, and whether the relationship is mediated by physical function.
In 506 patients hospitalized for HF (mean age, 71 years; 38% women), the researchers measured vitamin D level by taking blood samples; assessed depressive symptoms by the Centre for Epidemiological Studies Depression Scale, with a score of more than 16 signifying presence of depressive symptoms; and assessed physical function by the RAND-36 physical function scale. Patients were stratified by whether their vitamin D levels was higher or lower than 50 nmol/L.
At baseline hospitalization, they found no relationship between vitamin D levels and depressive symptoms.
However, at 18-month follow-up, patients with vitamin D < 50 nmol/L were more likely to have depressive symptoms than patients with vitamin D > 50 nmol/L (29% vs. 19%; P < .05), Peter Johansson, PhD, from the department of cardiology, University Hospital of Linköping, Sweden, and colleagues wrote.
They found a correlation in patients with vitamin D < 50 nmol/L between vitamin D level and physical function (r = .29; P < .001) and between vitamin D level and depressive symptoms (r = .2; P < .001), but did not find such relationships in patients with vitamin D > 50 nmol/L.
When they performed structural equation modeling, the researchers found an indirect association between vitamin D and depressive symptoms, mediated by physical function (B = .2), in patients with vitamin D < 50 nmol/L but not in patients with vitamin D > 50 nmol/L.
“A vicious circle may be seen, where low levels of [vitamin D] further worsens physical impairment and decreases outdoor activities and hence increases the possibility to develop depressive symptoms, which also can cause physical inactivity,” Johansson and colleagues wrote. – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.
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