Abstract 1125: Associations of Vitamin D Levels to Depression Among a General Healthcare Population With Cardiovascular Disease
BACKGROUND: Depression has increased dramatically over the last century. During that time, exposure to sunlight has also decreased via urbanization, industrialization, and health recommendations, thus contributing to the reduced exposure of 25(OH) vitamin (vit) D levels. It is well known that depression is associated with cardiovascular (CV) events. Therefore, it has been hypothesized that vit D deficiency may be associated with depression and be a contributing factor to excess CV events. To better elucidate this hypothesis, we evaluated whether there is an association with vit D and depression among a CV population.
METHODS: Patients (N=8,680), ≥50 yrs, with a CV diagnosis (CAD, MI, CHF, CVA, TIA, AF, PVD) and a measured vit D level were studied. Vit D was stratified into 3 categories: >30 (normal [N]; n=2,856), >15–30 (low [L]; n=4,063), and ≤15 (very low [VL]; n=1,761). Depression was defined as a hospitalization where a depression diagnosis was reported (ICD-9 codes: 296.2–296.36 and 311). Patients were followed (mean: 1.1±1.1 yrs) from baseline (vit D draw day) to depression diagnosis. Vit D categories were evaluated by Cox hazard regression with adjustment by standard CV risk factors.
RESULTS: Age averaged 72.2±10.4 yrs, 37.6% were male. A depression diagnosis prior to vit D draw was 32.1%, 25.2%, and 20.9% for VL, L, and N, respectively (p<0.0001). When compared to N, VL was associated with depression (hazard ratio [HR]=1.35, p<0.0001), but not to L (HR=1.05, p=0.38). Among those with no prior depression (n=6,493), the association between baseline vit D a new diagnosis of depression increased (VL vs. N: adjusted HR=1.42, p=0.03; L vs. N: adjusted HR=1.31, p=0.04). Winter (Dec-Feb) was found to enhance this association overall (n=2,415; VL vs. N: HR=1.30, p=0.17; L vs. N: HR=1.33, p=0.09) and among those without a prior depression diagnosis (n=1,811; VL vs. N: HR=1.46, p=0.28; L vs. N: HR=2.08, p=0.01).
CONCLUSION: Among a CV population that was ≥50 yrs, levels of vit D were shown to be associated with depression. This was particularly evident among those with no prior incidence of depression. Though future studies are needed to further adequately establish a relationship, this study strengthens the hypothesis of the association between vit D and depression.