Associations of major depressive disorder and related clinical characteristics with 25-hydroxyvitamin D levels in middle-aged adults.

Background: Vitamin D deficiency has been suggested to contribute to the onset of depression, but published results are inconsistent. The aims of this study were 1) to compare serum 25-hydroxyvitamin D (25(OH)D) levels in patients with depression and non-depressed controls and 2) to examine whether distinct subtypes and symptom severity of depression may vary in their association with 25(OH)D.Methods: The study involved cross-sectional data of n=1169 participants from the BiDirect Study (n=639 patients with clinically diagnosed major depressive disorder (MDD), n=530 controls). Serum 25(OH)D was measured via LS-MS/MS. We performed analysis of covariance to evaluate adjusted means of 25(OH)D levels and multinomial logistic regression to assess the association of depression and its clinical characteristics, namely distinct subtypes and symptom severity, with 25(OH)D status (adjusted for age, sex, education, season of blood sample collection, and lifestyle factors).Results: In total, 45.0% of the participants had adequate 25(OH)D levels (≥20 ng/ml), whereas 24.9% had a deficiency (<12 ng/ml). Patients with MDD had lower 25(OH)D levels than controls (16.7 vs. 19.6 ng/ml, p<0.001). Patients with atypical depression had the lowest levels (14.6 ng/ml). Symptom severity was inversely related to 25(OH)D. Moreover, patients with MDD had a more than 2-times higher odds of 25(OH)D deficiency than controls. Atypical depression showed the highest odds of deficiency.Conclusions: The results support that patients with depression have lower 25(OH)D concentrations than non-depressed individuals. Distinct subtypes, particularly the atypical subtype, may play a special role in this context. Therefore, depression heterogeneity should be considered in future research.

Walkability and its association with prevalent and incident diabetes among adults in different regions of Germany: results of pooled data from five German cohorts.

BACKGROUND: Highly walkable neighbourhoods may increase transport-related and leisure-time physical activity and thus decrease the risk for obesity and obesity-related diseases, such as type 2 diabetes (T2D). METHODS: We investigated the association between walkability and prevalent/incident T2D in a pooled sample from five German cohorts. Three walkability measures were assigned to participant's addresses: number of transit stations, points of interest, and impedance (restrictions to walking due to absence of intersections and physical barriers) within 640 m. We estimated associations between walkability and prevalent/incident T2D with modified Poisson regressions and adjusted for education, sex, age at baseline, and cohort. RESULTS: Of the baseline 16,008 participants, 1256 participants had prevalent T2D. Participants free from T2D at baseline were followed over a mean of 9.2 years (SD: 3.5, minimum: 1.6, maximum: 14.8 years). Of these, 1032 participants developed T2D. The three walkability measures were not associated with T2D. The estimates pointed toward a zero effect or were within 7% relative risk increase per 1 standard deviation with 95% confidence intervals including 1. CONCLUSION: In the studied German settings, walkability differences might not explain differences in T2D.

Childhood trauma and personality explain more variance in depression scores than sociodemographic and lifestyle factors - Results from the BiDirect Study.

OBJECTIVE: Sociodemographic and lifestyle factors, childhood adversities, and personality aspects have been identified as contributing to the onset and course of depression. However, only few studies examined all aspects concomitantly in different populations. This was the objective of the study presented here. METHODS: The BiDirect Study includes three distinct cohorts: Cross-sectional data for 670 patients with depression (DEP), 283 patients with cardiovascular disease (CVD), and 787 population controls (POP) were available for the present analysis. Participants answered interviews and filled in questionnaires assessing depression details, childhood trauma, the Big Five personality traits, trait resilience as well as socioeconomic and lifestyle factors. Descriptive statistics and hierarchical linear regression analyses were employed to identify those factors, which contributed significantly to the explanation of depression severity scores (assessed by the Center for Epidemiologic Studies Depression Scale, CESD). RESULTS: In all three cohorts, the psychological variables explained most variance in depression scores (35-44%), while sociodemographic and lifestyle factors explained only very little variance (1-2%). When all postulated predictors were entered in the same regression model, higher neuroticism and lower resilience scores were associated with higher depression severity levels in all three cohorts, while higher childhood trauma proved significant in the cardiovascular and population cohort. CONCLUSION: Childhood trauma, neuroticism, and low resilience are significantly associated with depression in different populations. Although a considerable part of the variance in depression severity levels was explained by the variables studied here, more research on the impact of lifestyle and social factors on depression is needed.

Walkability and its association with walking/cycling and body mass index among adults in different regions of Germany: a cross-sectional analysis of pooled data from five German cohorts.

OBJECTIVES: To examine three walkability measures (points of interest (POI), transit stations and impedance (restrictions to walking) within 640 m of participant's addresses) in different regions in Germany and assess the relationships between walkability, walking/cycling and body mass index (BMI) using generalised additive models. SETTING: Five different regions and cities of Germany using data from five cohort studies. PARTICIPANTS: For analysing walking/cycling behaviour, there were 6269 participants of a pooled sample from three cohorts with a mean age of 59.2 years (SD: 14.3) and of them 48.9% were male. For analysing BMI, there were 9441 participants of a pooled sample of five cohorts with a mean age of 62.3 years (SD: 12.8) and of them 48.5% were male. OUTCOMES: (1) Self-reported walking/cycling (dichotomised into more than 30 min and 30 min and less per day; (2) BMI calculated with anthropological measures from weight and height. RESULTS: Higher impedance was associated with lower prevalence of walking/cycling more than 30 min/day (prevalence ratio (PR): 0.95; 95% CI 0.93 to 0.97), while higher number of POI and transit stations were associated with higher prevalence (PR 1.03; 95% CI 1.02 to 1.05 for both measures). Higher impedance was associated with higher BMI (ß: 0.15; 95% CI 0.04 to 0.25) and a higher number of POI with lower BMI (ß: -0.14; 95% CI -0.24 to 0.04). No association was found between transit stations and BMI (ß: 0.005, 95% CI -0.11 to 0.12). Stratified by cohort we observed heterogeneous associations between BMI and transit stations and impedance. CONCLUSION: We found evidence for associations of walking/cycling with walkability measures. Associations for BMI differed across cohorts.