Association between depression and COPD: results from the NHANES 2013–2018 and a bidirectional Mendelian randomization analysis

ABSTRACT

Background

Observational studies showed a bidirectional association between depression and chronic obstructive pulmonary disease (COPD). However, it is unclear whether the observed association is causal. Thus we estimated the relationship using observational studies combined with bidirectional Mendelian randomization [MR].

Materials and methods

The study included 9977 participants from the 2013–2018 National Health and Nutrition Examination Survey and used weighted logistic regression analysis to assess the association between depression and COPD, followed by a bidirectional Mendelian randomization analysis to verify their causality.

Results

Adjusted-weighted logistic regression in observational studies showed a significant association between COPD and mild depression (OR (95% CI): 1.81 (1.30, 2.52), P = 0.002) and COPD and depression (OR (95% CI): 1.93 (1.49, 2.50), P < 0.001). MR suggested depression may play a causal role in COPD risk (OR (95% CI): 1.45 (1.32, 1.60), P < 0.001), but more evidence for reverse causation is lacking (reverse MR OR (95% CI): 1.03 (0.99, 1.07), P = 0.151).

Conclusion

In conclusion, our study found depression may play a potential causal role in the morbidity of COPD suggesting depression might be the etiology of COPD. This finding needs to be validated in further prospective cohort studies with large sample sizes and adequate follow-up time.

KEYWORDS:

• chronic obstructive pulmonary disease
• depression
• NHANES
• Mendelian randomization
• genetics

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or mending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

BR and YZ: Planning the study. BR: Analysis of the data. BR and YZ: drafting. YW and FW: Revision of the article. All authors critically reviewed the manuscript, provided important intellectual input, approved the final version, and agree to be accountable for their contributions. All the authors have read and approved the final manuscript.

Acknowledgments

We express our gratitude to the staff members of the National Center for Disease Control (CDC) and the Center for Prevention’s National Center for Health Statistics (NCHS) in the U.S., as well as to the individuals who registered for the National Health and Nutrition Examination Survey. The 1•3•5 Excellent Discipline Project of West China Hospital at Sichuan University (ZYGD18006, ZYJC18012) and the National Natural Science Foundation of China (82100047) provided funding for this work.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17476348.2023.2282022

Additional information

Funding

This work was supported by the 1•3•5 Project for Disciplines of Excellence, West China Hospital of Sichuan University (ZYGD23009, ZYJC18012) and the National Natural Science Foundation of China (82100047). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.