Abstract
Depression is known to be correlated with increased risk for chronic obstructive pulmonary disease (COPD) in middle-aged and older adults, but there is scarce evidence regarding its association with lung function among healthy adults. Thus, we aimed to assess this association by measuring the lung function and depression severity in Chinese college students. This cross-sectional study was conducted among 3,891 college students aged 16–24 years. Lung function was assessed by measuring the forced vital capacity (FVC) using a spirometer, and depression severity was evaluated using the 20-item Zung self-rating depression scale (SDS), with SDS scores of ≥40 and ≥45 indicating mild and moderate-to-severe depression, respectively. After adjusting for potential confounders, the geometric means of the FVC levels for the normal, mild depression, and moderate-to-severe depression groups were 3,446.1 (95% confidence interval [CI]: 3,418.6–3,470.3), 3,415.2 (95% CI: 3,357.7–3,473.8), and 3,351.0 (95% CI: 3271.5–3432.3), respectively (P for trend: 0.031). These results indicated that depression severity was independently correlated with lung function decline in Chinese college students. Future prospective cohort or interventional studies are needed to confirm the negative association between depressive symptoms and lung function and investigate its causality.
Highlights
Lung function has proved to be an effective and non-invasive measure of the respiratory health of individual patients and populations
We excluded 367 participants owing to missing data on sleep duration (n = 4) and forced vital capacity (FVC) (n = 363)
Participants with moderate-to-severe depression reported a higher frequency of occasional drinking and skipping breakfast, had lower physical activity (PA) levels, and lower proportion of good sleep quality
Summary
Lung function has proved to be an effective and non-invasive measure of the respiratory health of individual patients and populations. Its assessment helps to identify people with a potential risk for COPD, but may predict survival in asymptomatic adults who do not have chronic respiratory diseases or persistent respiratory symptoms (Burney and Hooper, 2011), as Abbreviations: ANCOVA, analysis of covariance; BMI, body mass index; COPD, chronic obstructive pulmonary disease; FVC, forced vital capacity; IPAQ, international physical activity questionnaire; MET, metabolic equivalents; PA, physical activity; SDS, self-rating depression scale. Oxidative stress occurs as a result of oxidant/antioxidant imbalance (Valko et al, 2007) It induces lipid peroxidation, protein oxidation, and DNA damage, which, in turn, results in the development of abnormalities in cell structures, eventually leading to cell death (Valko et al, 2007). Because the surface area for gas exchange is large, the respiratory system is susceptible to oxidative stress-induced injury, which subsequently exacerbates pulmonary dysfunction (Santus et al, 2014)
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