Association between Serum Folate Levels and Depression in Reproductive Aged U.S. Women, NHANES (2011-2012) Open Access

Abstract

Background: Depression is the leading cause of disability and affects about a quarter of United States population. Some studies have shown that low serum folate levels are associated with an increased risk of depression, particularly pronounced among women; however, results varied by study size and design.

Objective: We examined, using latest data, the association between serum folate level and depression among non-pregnant U.S. women of reproductive age.

Methods: We used data from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). We compared serum folate levels between women with and without self-reported depression based on Patient Health Questionnaire-9 (PHQ-9) scores. We examined the association between serum folate and depression by controlling for potential co-variables using multivariable linear and logistic regression analysis. Crude and adjusted odds ratios (cORs and aORs) and 95% confidence intervals (CI) were estimated. Additionally, we examined effect modification by race and ethnicity.

Results: Among 1,324 non-pregnant women (age 20-44 years), 16.7% (n=221) were screened positive for depression. There was no statistical difference in the median serum folate concentrations between participants with and without depression (17.8 ng/ml and 17.2 ng/ml, respectively; P=0.5). The unadjusted association of serum folate concentration and depression was not significant (cOR: 1.02; 95% CI: 0.98, 1.07). After adjustments for potential co-variables, serum concentration of folate was weakly and positively associated with depression (aOR: 1.10; 95% CI: 1.02, 1.19).

Conclusions: Our study found a weak association between serum folate and depression among women of reproductive age in the United States. We recommend future studies to conduct prospective analyses to confirm the association between serum folate and depression women of reproductive age to demonstrate potential benefits from regular and adequate folic acid use.

Table of Contents

Introduction…………………………………………………………….…………….……..1

Review of Literature……………………………………………….……….……………...4

Materials and Methods…………………………………………………………….….....13

Results……………………………………………………………………………..…….…..17

Discussion………………………………………………………………………...…….…..19

References..………………………………………………………………………….…......23

Tables and Figures…………………………………………………………………....……32

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	Women Depression Reproductive Age Serum Folate NHANES
Committee Chair / Thesis Advisor	Kancherla, Vijaya, Emory University
Committee Members	Weiss, Paul, Emory University Beydoun, Hind, U.S. Food and Drug Administration

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