Correlation between Serum 25-Hydroxyvitamin D Level and Depression among Korean Women with Secondary Amenorrhea: A Cross-Sectional Observational Study

Abstract

Vitamin D deficiency is considered a major public health problem worldwide and has been reported as having an association with depression. However, studies on the association between vitamin D deficiency and depressive symptoms in secondary amenorrhea (SA) patients are still scarce. This study examined the relationship between serum 25-hydroxyvitamin D (25(OH)D) levels and depressive symptoms among Korean women with SA. In this cross-sectional observational study, 78 patients with SA were initially recruited. Clinical and biochemical parameters, including serum 25(OH)D level, were measured. Data from 63 SA patients who met the study inclusion criteria and completed psychiatric assessments were finally analyzed. We analyzed their association with depression using a hierarchical regression model. The average serum 25(OH)D level was 34.40 ± 24.02 ng/mL, and 41.3% of the women with SA were vitamin D-deficient (<20 ng/mL). The total score of the Korean version of the Hamilton Depression Rating Scale (K-HDRS) was negatively related to serum 25(OH)D levels, free testosterone, and serum anti-Müllerian hormone (AMH) after adjusting for age and BMI (r = −0.450, p < 0.001; r = −0.258, p = 0.045; and r = −0.339, p = 0.006, respectively). Serum 25(OH)D levels and AMH levels were the most powerful predictors of depressive severity when using the K-HDRS in SA patients (β = −0.39, p < 0.005; β = −0.42, p < 0.005, respectively). This study showed that low serum 25(OH)D levels were associated with the severity of depressive symptoms in SA patients. This observation suggests that the evaluation of vitamin D deficiency for the risk of depression may be necessary in patients with SA.

Association of a low vitamin D status with risk of post-stroke depression: A meta-analysis and systematic review

“…Although previous studies have linked a low vitamin D level to an increased risk of depression (36)(37)(38), the exact mechanisms underlying the correlation are not fully understood (39,40). One possibility is that vitamin D plays a role in the synthesis of neurotransmitters (e.g., serotonin, and norepinephrine, dopamine) associated with mood regulation (40).…”

The Effects of Latitude and Temperate Weather on Vitamin D Deficiency and Women's Reproductive Health: A Scoping Review

“…For example, administering vitamin D could reduce the frequency of migraine crises 58 or in schizophrenia; it has been observed that patients with schizophrenia have lower serum levels of 25(OH)D than people without schizophrenia 59 . Other recent studies have associated vitamin D deficiency with postpartum depression, 60,61 and low serum levels of vitamin D3 are associated with severity of depressive symptoms among women with secondary amenorrhea 62 . We recommend that future research investigate the relationship among vitamin D levels, female reproductive health across the life span, and comorbidities, to inform more individualized supplementation recommendations (Table 2).…”

“…59 Other recent studies have associated vitamin D deficiency with postpartum depression, 60,61 and low serum levels of vitamin D3 are associated with severity of depressive symptoms among women with secondary amenorrhea. 62 We recommend that future research investigate the relationship among vitamin D levels, female reproductive health across the life span, and comorbidities, to inform more individualized supplementation recommendations (Table 2).…”

The Associations of Vitamin D with Ovarian Reserve Markers and Depression: A Narrative Literature Review

“…However, there is still a lack of evidence regarding a causal relationship between vitamin D and depression in these patients. In our previous study, we showed that low levels of vitamin D and AMH were associated with depressive severity in patients with secondary amenorrhea, but the cross-sectional study could not suggest a causal relationship with depression [ 22 ]. Additionally, research results on the effects of vitamin D supplementation on depression in postmenopausal or PCOS women are still inconsistent [ 23 , 92 , 93 , 94 ].…”

“…In this context, several studies have been published on the relationship between vitamin D and ovarian reserve markers, BDNF, and neurotrophic factors [ 14 , 15 ], and there have also been many clinical reports that vitamin D deficiency is associated with reproductive hormonal decline or imbalances such as menopause, polycystic ovarian syndrome (PCOS), primary ovarian insufficiency (POI), and depression in women [ 16 , 17 , 18 , 19 ]. Meanwhile, the relationship between female reproductive hormone changes and depression is already well established [ 20 , 21 ], and several studies have shown that depression in female reproductive hormone-related diseases is also associated with low vitamin D levels and ovarian reserve markers [ 22 , 23 ]. In this regard, vitamin D, which is involved in both female hormones and depression, may be another key to explaining female reproductive depression.…”