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BMI Modifies the Association Between Depression Symptoms and Serum Copper Levels

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Abstract

Depression is one of the most common mental disorders which dramatically threatens public health and wellness. Copper has been known to be involved in many biological processes that could help explaining the occurrence of depression. However, studies focusing on its effect have yielded mixed results. The present study aims to evaluate the association between serum copper levels and depression symptoms. It also investigates the effect of modification of BMI (body mass index) on depression symptoms. A total of 5419 US adults aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES) 2011–2016 participated in the cross-sectional study. Logistic regression models were applied using depression levels as the outcome and serum cooper/selenium/zinc categories as the main predictor, with the adjustments of gender, age, marital status, race, education, family income level, alcohol drinking, cigarette smoking, diabetes, pressure, stroke, and BMI. The interaction terms for copper levels and other covariates were further incorporated into the model to assess their roles in predicting depression symptoms. The prevalence of depression symptoms was significantly higher in samples with a high copper level. Among the levels of serum copper, selenium, and zinc, only the association between depression symptoms and serum copper levels was observed to be significant in the unadjusted model (P = 0.002). Individuals with a high copper level (114–134 μg/dL) and a very high copper level (≥ 134 μg/dL) had 1.85 (95% CI 1.24, 2.77)- and 1.72 (95% CI 1.21, 2.44)-fold higher odds ratio of depression symptoms, respectively, compared to those with a normal serum copper level. Although the association was not significant in the adjusted models, in which confounders were added, the interaction of copper level, including high and very high copper levels, and obesity (BMI ≥ 30 kg/m2) exhibited significantly higher odds ratio (4.12 (95% CI 1.38, 12.27) and 4.53 (95% CI 1.87, 10.96)) of having depression symptoms. The concentration of serum copper was positively associated with the prevalence of depression symptoms. Obesity exacerbated the risk of having depression symptoms in people with high serum copper levels.

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Data Availability

Data described in the manuscript, code book, and analytic code will be made available upon request pending application and approval from the corresponding author.

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Acknowledgements

We thank all individuals at the National Center for Health Statistics of the Centers for Disease Control and Prevention who planned and administered NHANES and made the datasets of NHANES available on their website.

Funding

This study was supported by the Scientific Research Fund of the Hunan Provincial Education Department (20C1605, 19B476).

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Author notes

  1. Wu Hongrong and Li Qingqi contributed equally to this work.

Authors and Affiliations

  1. Institute of Pathogenic Biology, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China

    Wu Hongrong & Tang Shuangyang

  2. Institute of Neuroscience, Hengyang Medical School, University of South China, 421001, Hengyang, People’s Republic of China

    Li Qingqi & Zhao Jianfeng

  3. Department of Physiology, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China

    Gao Rong, Zhang Kaifang & Zhao Jianfeng

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  1. Wu Hongrong
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  4. Tang Shuangyang
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Contributions

JZ conceptualized and designed the study. KZ, JZ, and ST participated in the investigation and the drafting of the paper. HW and QL analyzed and interpreted the data. RG and JZ revised the paper critically for intellectual content. JZ approved the final version of the paper to be published. All authors agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Zhao Jianfeng.

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Ethics Approval

The protocol of NHANES 2011–2016 (Protocol #2011–17) was approved by NCHS Research Ethics Review Board (ERB).

Informed Consent

There are no plans to disseminate the results of the research to individual study participants because all participants are de-identified. The results of this study will be disseminated as a medical manuscript and will be publicly available on PubMed Central.

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The authors declare no competing interests.

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Hongrong, W., Qingqi, L., Rong, G. et al. BMI Modifies the Association Between Depression Symptoms and Serum Copper Levels. Biol Trace Elem Res 201, 4216–4229 (2023). https://doi.org/10.1007/s12011-022-03505-y

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