Age and Sex Differences in the Association between Serum Vitamin E Levels and Depressive Symptoms: Korea National Health and Nutrition Examination Survey

Abstract

Studies have reported inconsistent results regarding the relationship between serum vitamin E levels and depressive symptoms. Furthermore, the potential modulating role of age and sex has been underexplored. We conduct an age- and sex-stratified investigation of the association between serological vitamin E status and depressive symptoms in a large nationwide sample. Data from the Korean National Health and Nutrition Examination Survey were analyzed (n = 4448). The participants were stratified into four groups according to age (<65 vs. ≥65 years) and sex. Each group was divided into tertiles of vitamin E/total lipid ratio, and Patient Health Questionnaire-9 (PHQ-9) scores were compared among the tertiles via multivariable linear regression analyses. The relationship between dietary supplement use and the proportions of tertiles was assessed in each group. With the middle tertile as the reference group, the low tertile of vitamin E/total lipid ratio was associated with increased PHQ-9 scores in younger females and older males after adjusting for all covariates, while the high tertile showed no significant associations with PHQ-9 scores in any group. The low tertile was associated with increased adjusted mean PHQ-9 scores by 0.53 and 1.02 compared to the middle tertile in younger females and older males, respectively. Dietary supplement use was related to higher vitamin E/total lipid ratio in all four groups. In conclusion, younger females and older males with a low vitamin E status showed worse depressive symptoms. These individuals may benefit from dietary interventions to prevent depressive symptoms.

Serum Vitamin Levels, Cardiovascular Disease Risk Factors, and Their Association with Depression in Korean Women: A Cross-Sectional Study of a Nationally Representative Sample

“…Obesity and diabetes mellitus were positively associated with depression in premenopausal women, and stroke and myocardial infarction were positively associated with depression in menopausal women. Studies of the association between serum vitamins and depression in Asian subjects are rare [6,7]. Previous studies in Western populations have generally reported that vitamin A levels are positively associated with depression [5,[21][22][23] and that vitamin E and vitamin B9 levels are negatively association with depression [8,10,11,[24][25][26][27][28][29].…”

“…The link between oxidative stress and depression has been explored [6]. Folate is involved in the synthesis of neurotransmitters such as serotonin, which plays a key role in the regulation of mood [5,7]. Because the serum levels of vitamins A, E, and B9 were presented in the Korea National Health and Nutrition Examination Survey (KNHANES) data from 2016 to 2018, we selected vitamins A, E, and B9 among the several types of vitamins.…”