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Vitamin D and Depression

비타민 D와 우울증

  • Cho, Su Kyung (Department of Food and Nutrition, Yeungnam University) ;
  • Koo, Sle (Department of Food and Nutrition, Yeungnam University) ;
  • Park, Kyong (Department of Food and Nutrition, Yeungnam University)
  • 조수경 (영남대학교 식품영양학과) ;
  • 구슬 (영남대학교 식품영양학과) ;
  • 박경 (영남대학교 식품영양학과)
  • Received : 2014.06.20
  • Accepted : 2014.08.14
  • Published : 2014.10.31

Abstract

Recent studies have shown that insufficient or deficient vitamin D status may be linked to increased risk of depressive conditions or depression. The aim of this study was to review all available evidence on vitamin D, depression, and any association between them. Cross-sectional, case-control, and cohort studies have reported contradictory results. Some have reported that low levels of vitamin D may be associated with higher risk of depression or depressive symptoms while others reported that vitamin D status may not be related to depression. Recent clinical trials examining the effects of vitamin D supplementation on depression have also showed discrepant results. However, meta-analysis study results are consistent regarding the beneficial effects of vitamin D. Several mechanisms that account for these beneficial effects of vitamin D on depression have been reported but remain largely speculative. Vitamin D deficiency is very common, and prevalence of depression is increasing in the Asian population, especially females. However, limited literature is available on this population. Considering research results of a potential inverse association between vitamin D level and prevalence of depression, it is important to advance our understanding of the role of vitamin D in depression and conduct well-designed prospective trials in the Asian population.

본 연구에서는 비타민 D와 정신질환, 특히 전 세계적으로 높은 유병률 추이를 보이고 있는 우울증과의 연관성을 살펴보기 위해 비타민 D의 종류, 급원 식품, 비타민 D 영양상태 현황 및 이에 영향을 미치는 요인, 비타민 D와 우울증과의 연관성에 대한 국내외 문헌을 체계적으로 고찰하여 요약하였다. 그 결과 첫째, 비타민 D는 자연계에 주로 비타민 $D_2$(ergocalciferol)와 $D_3$(cholecalciferol) 두 가지 형태로 존재하며 주로 대구간유, 고등어, 정어리와 같은 지방이 많은 생선, 난황, 표고버섯 등이 주요 급원 식품이다. 둘째, 국내 외 다양한 인구 집단을 대상으로 비타민 D 수준을 고찰한 결과 비타민 D 결핍은 매우 높은 수준을 보이고 있다. 특히 한국인의 청소년을 대상으로 한 연구 결과 혈청 25(OH)D 20 ng/mL 미만인 남녀는 각각 89%, 99%로 매우 낮은 비타민 D 수준을 보였다. 셋째, 체내 비타민 D의 수준에 영향을 미칠 수 있는 요인으로는 인종, 거주 지역, 위도, 의복차림, 계절적 차이, 직업, 자외선 노출 정도, 보충제 복용 여부 등이 보고되었으며, 일반적으로 연령의 증가(한국인 및 일본인의 경우 반대 방향), 자외선 차단제의 사용, 어두운 피부색, 흡수 불량 및 비만은 비타민 D의 합성, 흡수 및 이용률에 영향을 주어 비타민 D 부족증의 원인이 될 수 있다고 보고되었다. 넷째, 최근 비타민 D 수준과 우울증과의 연관성을 분석한 국외 역학연구들은 꾸준히 보고되고 있으며 이에 대한 횡단 연구와 코호트 연구 결과는 불일치한 양상을 보이고 있다. 또한 최근 비타민 D 보충과의 관계를 규명하기 위해 임상시험연구도 일부 진행되었으나 이 또한 불일치한 결과를 보였지만 보충제로 얻는 비타민 D는 식이로부터 얻는 비타민 D와 다르다는 가능성을 제시하고 있다. 더 나아가 횡단 연구 및 코호트 연구를 메타 분석한 연구 결과 우울증에 대한 비타민 D의 이로운 효과에 대하여 비교적 일치하는 연구 결과를 제시하고 있다. 그러나 대부분의 연구 결과는 국외에서 진행된 연구이며 한국인을 대상으로 분석된 연구는 매우 제한적이다. 따라서 한국인을 대상으로 한 후속 연구가 요구된다.

Keywords

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