肥胖人群膳食铁、铜摄入与抑郁症状的相关性研究

Relationship between Dietary Iron and Cop-per Intake and Depressive Symptoms in Obese Population

摘要: 目的：探究美国肥胖人群膳食铁、铜摄入与抑郁症状的关系，为肥胖人群改善抑郁症状提供饮食指导。方法：整合美国国家健康和营养调查(NHANES) 2015~2018年数据，采用病人健康问卷(PHQ-9)评估研究对象是否有抑郁症状，PHQ-9评分 ≥ 10的人群被纳入有抑郁症状组。组间比较采用2检验和Mann- Whitney U检验。采用单因素、多因素logistic回归以及限制性立方样条曲线分析膳食铁、铜摄入与抑郁症状之间的关联。结果：多因素logistic回归分析显示，与最低摄入组(Q1)相比，铁摄入量Q3、Q4的OR值和95%可信区间分别是0.573 (0.422~0.778)、0.698 (0.517~0.942)；铜摄入量Q2、Q3、Q4的OR值和95%可信区间分别是0.717 (0.543~0.947)、0.651 (0.486~0.873)、0.695 (0.516~0.937)。限制性立方样条模型结果显示，肥胖人群膳食铁、铜摄入量与抑郁症状之间存在非线性剂量–反应关系(P非线性 = 0.045，P非线性 = 0.006)。结论：肥胖人群摄入适量的膳食铁、铜能降低抑郁症状发生风险，且肥胖人群膳食铁、铜摄入量与抑郁症状之间存在非线性剂量–反应关系。

Abstract: Objective: To explore the relationship between dietary iron and copper intake and depressive symptoms in obese people in the United States, and to provide dietary guidance for improving de-pressive symptoms in obese people. Methods: Data from the NHANES from 2015 to 2018 were inte-grated, and PHQ-9 was used to assess whether the subjects had depressive symptoms. Patients with PHQ-9 score ≥ 10 were included in the group with depressive symptoms. 2 test and Mann- Whitney U test were used for comparison between groups. Univariate, multivariate logistic regression and restricted cubic spline curves were used to analyze the association between dietary iron and copper intake and depressive symptoms. Results: Multivariate logistic regression analysis showed that compared with the lowest intake group (Q1), the OR values and 95% confidence intervals of iron intake Q3 and Q4 were 0.573 (0.422~0.778) and 0.698 (0.517~0.942), respectively. The OR values and 95% confidence intervals of copper intake Q2, Q3 and Q4 were 0.717 (0.543~0.947), 0.651 (0.4866~0.873) and 0.695 (0.516~0.937), respectively. The results of the restricted cubic spline model showed that there was a nonlinear dose-response relationship between dietary iron and copper intake and depressive symptoms in obese people (Pnonlinear = 0.045, Pnonlinear = 0.006). Conclu-sion: Intake of adequate dietary iron and copper can reduce the risk of depressive symptoms in obese population, and there is a nonlinear dose-response relationship between dietary iron and copper intake and depressive symptoms in obese population.