The associations between dietary flavonoids intake and risk of depressive symptom in diabetic patients: Data from NHANES 2007–2008, 2009–2010, and 2017–2018

Abstract

BackgroundThe increasing incidence of depressive symptoms in diabetic patients contributes to the global burden of disease, but few epidemiological studies have evaluated the relationship between dietary flavonoids intake and depressive symptoms in diabetic patients in American adults. ObjectiveThis study intended to evaluate the associations of dietary flavonoids intake and depressive symptoms in diabetic patients in American adults. MethodsWe conducted a cross-sectional analysis of 1993 adults aged ≥20 years old who participated in the 2007–2008, 2009–2010, and 2017–2018 National Health and Nutrition Examination Surveys (NHANES). Chi-square test and independent-sample t-test were used to compare subjects' characteristics. Logistic regression model was further used to analyze the relationship between dietary flavonoid intake and depressive symptoms in diabetic patients. Restricted cubic spline (RCS) analysis was used to investigate the non-linear relationship between dietary flavonoid intake and the prevalence of depressive symptoms in diabetic patients. The weighted quartile sum (WQS) regression was used to analyze the effect of 29 flavonoids monomers. ResultsThe results showed that the total flavonoid intake in the third quartile (OR, 0.635; 95 % CI,0.419–0.962; P, 0.032) was significantly associated with a reduced risk of depressive symptoms in diabetic patients compared with the lowest quartile. And there was a U-shaped association between dietary flavonoid intake and risk of depressive symptoms in diabetic patients. Top contributors of flavonoid monomers were eriodictyol, naringenin, and theaflavin-3′-gallate, accounting for a percentage of 30.83 %, 22.17 %, and 6.92 %, respectively. ConclusionModerate (56.07–207.12 mg/day) dietary flavonoid intake was associated with a reduced risk of depressive symptoms in diabetic patients. The important flavonoid monomers were eriodictyol, naringenin, and theaflavin-3′-gallate.