Association between Serum Ferritin Concentrations and Depressive Symptoms among Chinese Adults: A Population Study from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIHealth) Cohort Study

Abstract

Depressive symptoms have become the most important global public health issue. Iron plays an important role in brain function, cognition, and behavior, and its impacts on depressive symptoms may be multifactorial with both positive and negative effects. Previous observational studies focusing on the association between iron status and depressive symptoms showed inconsistent results. Ferritin is a ubiquitous intracellular protein that can store and release iron and is widely used as a clinical biomarker to evaluate iron status. We performed a cross-sectional study to examine the relationship between serum ferritin and depressive symptoms among 3,839 subjects who were from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIHealth) cohort. Depressive symptoms were assessed using the Chinese version of 20-item self-rating Depression Scale (SDS) with 4 cutoffs (40, 45, 48 and 50) to indicate elevated depressive symptoms (40 was the primary cut-off). The prevalence of depressive symptoms was 36.5%, 17.6%, 11.0% and 7.0% for SDS ≥40, ≥45, ≥48 and ≥50, respectively. With the primary cut-off point of 40, multiple potential confounding factors were adjusted and the odds ratios (95% confidence interval) of having elevated depressive symptoms by quartiles of serum ferritin concentrations were 1.00 (reference), 1.10 (0.91, 1.34), 0.81 (0.66, 1.01) and 1.02 (0.81, 1.28) for the first, second, third and fourth quartile, respectively (P for trend = 0.76). Similar relations were observed with the use of other cut-offs as a definition of depressive symptoms. In conclusion, there is no significant relationship between serum ferritin concentrations and depressive symptoms among Chinese adults.

Quantitative Susceptibility Mapping Reveals an Association between Brain Iron Load and Depression Severity

“…Some studies indicated that lower levels of serum ferritin concentrations had a higher prevalence of depressive symptoms and these depressive symptoms concomitantly occurred among patients with anemia (Yi et al, 2011 ). Interestingly, it was also reported that depressive symptoms were not correlated with ferritin levels and that there was no relationship between maternal iron status and postpartum depression (PPD; Stewart and Hirani, 2012 ; Su et al, 2016 ). Another study about PPD found that early iron supplementation in mothers with PPD significantly improves the iron stores and even causes a significant improvement in PPD (Sheikh et al, 2017 ).…”

Association of serum ferritin level and depression with respect to the body mass index in Korean male adults

“…In addition, elevated serum ferritin levels were discovered to be a risk factor for metabolic syndrome [26], and a predictive factor for obesity during the 5 year follow up of men [27]. A previous study showed that 3,839 subjects with higher serum ferritin concentrations were more likely to be male, and have a higher BMI and WBC count [28].…”

Relationship of morningness-eveningness questionnaire score to ferritin, gamma glutamyl-transpeptidase and alanine amino-transferase concentrations in a large cohort

“…Iron deficiency may promote fatigue but not depression nor ESS, although surveys assessing these correlations are scarce. [48][49][50][51] A great body of research indicates that eveningness is associated with negative psychological outcomes, including depressive mood. [52][53][54][55] Our data extend previous results by demonstrating evening type to have significantly higher Pichot fatigue ADA scores indicating a higher degree of fatigue complaint.…”