title: Vitamin D levels and depressive symptoms in patients with chronic heart failure.
abstract: BACKGROUND
  Vitamin D (Vit D) is suggested to play a role in the regulation of physical function as well as in depression. Since, Vit D deficiency is common in patients with heart failure (HF), this study aims to explore if Vit D levels are associated with depressive symptoms and if this association is mediated by the patients' physical function.
  
  
  METHODS
  506 HF patients (mean age 71, 38% women) were investigated. Depressive symptoms and physical function were measured with the Centre for Epidemiological Studies Depression Scale and the physical function scale from the RAND-36. Vit D was measured in blood samples
  
  
  RESULTS
  At baseline there was no relationship between depressive symptoms and Vit D levels. However, at 18months follow-up 29% of patients with Vit D <50nmol/l at baseline had depressive symptoms compared 19% of those with Vit D levels >50nmol/l (p<0.05). Only in patients with Vit D <50nmol/l, Vit D correlated significantly to physical function and depressive symptoms (r=.29, p<0.001 and r=.20, p<0.01). In structural equation modelling an indirect association between Vit D and depressive symptoms was found, mediated by physical function (B=0.20). This association was only found in patients with Vit D levels <50nmol/l.
  
  
  CONCLUSIONS
  In HF patients with Vit D <50nmol/l, Vit D is associated to depressive symptoms during follow-up and this association is mediated by physical function. This relationship is not found in patients with Vitamin D level >50nmol/l.
authors.affiliation: Department of Cardiology, Department of Medicine and Health Sciences, Linköping University, Sweden. Electronic address: peter.johansson@kindamail.se.
authors.forename: Peter
authors.initials: P
authors.lastname: Johansson
authors.affiliation: Department of Cardiology, Department of Medicine and Health Sciences, Linköping University, Sweden.
authors.forename: Urban
authors.initials: U
authors.lastname: Alehagen
authors.affiliation: Department of Social and Welfare studies, Faculty of Health Sciences, Linköping University, Sweden; Department of Cardiology, University Medical Centre Groningen, University of Groningen, The Netherlands.
authors.forename: Martje H L
authors.initials: MH
authors.lastname: van der Wal
authors.affiliation: Swedish Defense Research Agency, Linköping, Sweden.
authors.forename: Erland
authors.initials: E
authors.lastname: Svensson
authors.affiliation: Department of Social and Welfare studies, Faculty of Health Sciences, Linköping University, Sweden; Department of Cardiology, University Medical Centre Groningen, University of Groningen, The Netherlands.
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003863:Depression / Q000097:blood* / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000175:diagnosis / Q000523:psychology
chemical_list: D014807:Vitamin D
keywords: Depression; Heart failure; Physical exercise; Vitamin D