Age and Sex Differences in the Association between Serum Vitamin E Levels and Depressive Symptoms: Korea National Health and Nutrition Examination Survey.

Studies have reported inconsistent results regarding the relationship between serum vitamin E levels and depressive symptoms. Furthermore, the potential modulating role of age and sex has been underexplored. We conduct an age- and sex-stratified investigation of the association between serological vitamin E status and depressive symptoms in a large nationwide sample. Data from the Korean National Health and Nutrition Examination Survey were analyzed (n = 4448). The participants were stratified into four groups according to age (<65 vs. ≥65 years) and sex. Each group was divided into tertiles of vitamin E/total lipid ratio, and Patient Health Questionnaire-9 (PHQ-9) scores were compared among the tertiles via multivariable linear regression analyses. The relationship between dietary supplement use and the proportions of tertiles was assessed in each group. With the middle tertile as the reference group, the low tertile of vitamin E/total lipid ratio was associated with increased PHQ-9 scores in younger females and older males after adjusting for all covariates, while the high tertile showed no significant associations with PHQ-9 scores in any group. The low tertile was associated with increased adjusted mean PHQ-9 scores by 0.53 and 1.02 compared to the middle tertile in younger females and older males, respectively. Dietary supplement use was related to higher vitamin E/total lipid ratio in all four groups. In conclusion, younger females and older males with a low vitamin E status showed worse depressive symptoms. These individuals may benefit from dietary interventions to prevent depressive symptoms.

The electroanatomical remodelling of the left atrium is related to CHADS2/CHA2DS2VASc score and events of stroke in patients with atrial fibrillation.

BACKGROUND: Although atrial fibrillation (AF) increases the risk of stroke, its relationship with atrial remodelling has not yet been studied. We hypothesized that the degree of electroanatomical remodelling of the left atrium (LA) is related to CHADS2/CHA2DS2VASc score and events of stroke. METHODS AND RESULTS: We compared CHADS2/CHA2DS2VASc score (0, 1, ≥ 2) or events of stroke with mean and regional LA volume [by three-dimensional (3D) computed tomography images] or LA endocardial voltage (by 3D-electroanatomical map) in 348 patients who underwent catheter ablation of AF (78.4% male, 55.4 ± 11.0 years old, paroxysmal AF:persistent AF = 215:133). We graded LA volume index as Grade 1 (< 48.3 mL/m²; n= 80), grade 2 (48.3-63.0 mL/m², n= 82), grade 3 (63.0-99.0 mL/m²; n= 94), and grade 4 (≥ 99.0 mL/m²; n= 92). Results (i) The percentage volume of anterior portion of LA enlarged at the early stage of LA remodelling (Grade 1 vs. grade 2, P= 0.006) and the voltage of posterior venous LA was significantly reduced with the degree of LA remodelling (P= 0.001). (ii) Mean LA volume/body surface area (BSA), especially anterior portion of LA, was greater in patients with high CHADS2/CHA2DS2VASc score (P= 0.002). Mean LA voltage was significantly lower in patients with high CHA2DS2VASc score than low score (P= 0.007). (iii) In patients who experience stroke (n= 22), LA volume/BSA, especially anterior LA, was greater (P= 0.012), and LA endocardial voltage was lower (P= 0.039) than those without stroke. CONCLUSION: Electroanatomical remodelling of LA, estimated by LA volume and endocardial voltage, has significant relationship with the risk scores or events of stroke in patients with non-valvular AF.