Association Of Total Zinc, Iron, Copper And Selenium Intakes With Depression In The US Adults

Objective:Zinc,iron,copper,and selenium as essential microelements,have essential roles in growth,development and regulating of neuromodulation.Epidemiological studies on the associations between zinc,iron,copper,and selenium intakes and depression are limited or controversial.The aim of present cross-sectional study was to examine the associations of total zinc,iron,copper and selenium intakes from diet and supplements with depression.Methods:Adults aged 18 years or older from the National Health and Nutrition Examination Survey?NHANES?2007-2008,2009-2010,2011-2012 and 2013-2014 were collected for the present cross-sectional study.Demographic,socioeconomic,lifestyle,physical information,and health-related were obtained through questionnaire and examination by highly trained medical personnel.Dietary data were obtained through two24-hour dietary recall interviews.Depression was assessed by a nine-item Patient Health Questionnaire?PHQ-9?.Student's t-tests were used to compare the mean levels of continuous variables between depression group and non-depression group if the variables conformed to the normal distribution.Otherwise Mann-Whitney U tests and chi-square tests were used to compare the averages of continuous variables and the percentages of categorical variables between groups,respectively.Appropriate sampling weights,primary sampling unit and strata information were included in the analyses.Univariate and multivariate logistic regression were conducted to examine the associations between total zinc,iron,copper and selenium intakes and risk of depression,and stratified by gender and total daily energy intake.Restricted cubic spline model was applied to further explore the shape of the relationship between total zinc,iron,copper and selenium intakes and depression.Results:A total of 17730 subjects?8622 men and 9108 women?were included in the present study.The prevalence of depression?PHQ-9 scale?10?was 9.22%.Total zinc,iron,copper and selenium intakes were inversely associated with depression in unadjusted model and age-and gender-adjusted model.Additional adjustment for BMI,race,educational level,smoking status,family income,work activity,recreational activity,hypertension,diabetes and total daily energy intake,total zinc,copper and selenium intakes were negatively associated with depression.The multivariate adjusted odds ratios?ORs?with 95%confidence intervals?CIs?of depression were 0.65?0.46,0.92?,0.58?0.43,0.78?and0.44?0.31,0.62?for the highest versus lowest quartile of zinc,copper and selenium intakes,respectively.The inverse associations of depression were statistically significant for the Q2?OR:0.73;95%CI:0.58-0.92?and Q3?OR:0.71;95%CI:0.55-0.91?versus lowest quartile of iron intake.Compared to those below the RDA?Recommended Dietary Allowance?,participants who met the RDA for zinc?OR:0.71;95%CI:0.55-0.93?,copper?OR:0.65;95%CI:0.53-0.80?and selenium?OR:0.52;95%CI:0.39,0.71?had significantly lower odds of depression.After adjustment for potential confounders,the results of the restricted cubic spline analyses found a linear dose-response relationship of zinc intake with depression(P _nonlinearity=0.07)and nonlinear dose-response relationship of iron,copper and selenium intakes with depression(P _nonlinearity?27?0.05).Conclusion:Total zinc,iron,copper and selenium intakes may be inversely associated with depression.Future prospective cohort studies and experimental studies are needed to confirm these findings.