In reply

Abstract

We thank O'Keefe et al for their interest in our report on the association between serum hydroxyvitamin D and current depressive symptoms.1Hoang M.T. Defina L.F. Willis B.L. Leonard D.S. Weiner M.F. Brown E.S. Association between low serum 25-hydroxyvitamin D and depression in a large sample of healthy adults: the Cooper Center Longitudinal Study.Mayo Clin Proc. 2011; 86: 1050-1055Abstract Full Text Full Text PDF PubMed Scopus (119) Google Scholar Lack of cardiorespiratory fitness (CRF) has been associated with depressive symptoms. For example, previous studies from the Aerobics Center Longitudinal Study found a significant inverse dose-response relationship between maximal CRF and depressive symptoms.2Sui X. Laditka J.N. Church T.S. et al.Prospective study of cardiorespiratory fitness and depressive symptoms in women and men.J Psychiatr Res. 2009; 43: 546-552Abstract Full Text Full Text PDF PubMed Scopus (98) Google Scholar, 3Galper D.I. Trivedi M.H. Barlow C.E. Dunn A.L. Kampert J.B. Inverse association between physical inactivity and mental health in men and women.Med Sci Sports Exerc. 2006; 38: 173-178Crossref PubMed Scopus (285) Google Scholar The current study focused on depressive symptoms and their relationship to serum hydroxyvitamin D from a psychiatric perspective. Physical activity has been used as a covariate by other similar studies exploring the relationship between vitamin D and depression.4Pan A. Lu L. Franco O.H. Yu Z. Li H. Lin X. Association between depressive symptoms and 25-hydroxyvitamin D in middle-aged and elderly Chinese.J Affect Disord. 2009; 118: 240-243Abstract Full Text Full Text PDF PubMed Scopus (126) Google Scholar, 5Nanri A. Mizoue T. Matsushita Y. et al.Association between serum 25-hydroxyvitamin D and depressive symptoms in Japanese: analysis by survey season.Eur J Clin Nutr. 2009; 63: 1444-1447Crossref PubMed Scopus (64) Google Scholar In our report, we controlled for physical activity, or exercise, which represents a modifiable behavior that was statistically significant in its inverse relationship to depressive symptoms in this study.1Hoang M.T. Defina L.F. Willis B.L. Leonard D.S. Weiner M.F. Brown E.S. Association between low serum 25-hydroxyvitamin D and depression in a large sample of healthy adults: the Cooper Center Longitudinal Study.Mayo Clin Proc. 2011; 86: 1050-1055Abstract Full Text Full Text PDF PubMed Scopus (119) Google Scholar In sensitivity analyses that included CRF in the model, the relationship between vitamin D and depression was essentially unchanged. We applaud O'Keefe et al's thoughtful review of the potential mechanisms linking depression, vitamin D, and cardiovascular disease. The idea that low vitamin D levels may be, in part, responsible for the association between depression and cardiovascular disorders is interesting and worthy of further investigation. Kolade noted that guidelines for vitamin D deficiency do not call for screening vitamin D levels in the setting of current or prior depression. The idea of using vitamin D screening and, when necessary, supplementation to prevent depression relapse is very interesting and warrants further study. Predicting Recurrent Depression Using Vitamin D Levels?Mayo Clinic ProceedingsVol. 87Issue 4PreviewI read the report of Hoang et al1 on low 25-hydroxyvitamin D and depression with great interest. Of note, recently published guidelines on evaluation of vitamin D deficiency do not call for screening of persons with prior or current depression.2 A plausible clinical application of the findings of this study—if confirmed, especially in multiracial cohorts—would be to obtain 25-hydroxyvitamin D levels in patients with a history of depression and treat when indicated, in hope of preventing new episodes of depression. Full-Text PDF Can Vitamin D Deficiency Break Your Heart?Mayo Clinic ProceedingsVol. 87Issue 4PreviewWe congratulate Hoang et al1 from the Cooper Center Longitudinal Study on their article reporting a significant association between low serum 25-hydroxyvitamin D [25(OH)D] levels and depression among the largest group of individuals in whom this potential link has been explored to date. The fact that this study was done as part of a medical student summer research program makes it even more impressive. In the same issue of Mayo Clinic Proceedings, Chamberlain et al2 report that among a cohort of patients with preexisting cardiovascular (CV) disease, depression independently predicted hospitalization and all-cause mortality over a 17-year follow-up period. Full-Text PDF