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. 2025 Jun 13;44(3):495-506.
doi: 10.5937/jomb0-54015.

Vitamin D deficiency, fatigue, and persistent cough as independent predictors of depressive symptoms in sarcoidosis patients

Branislav S Gvozdenovic  1 , Violeta Mihailovic-Vucinic  2 , Mira Vukovic  3 , Maja Omcikus  4 , Jelena Cvejic  5 , Slobodan Belic  4 , Jelena Jankovic  4 , Natasa Đurđevic  4 , Mihailo Stjepanovic  4
Affiliations

Vitamin D deficiency, fatigue, and persistent cough as independent predictors of depressive symptoms in sarcoidosis patients

Branislav S Gvozdenovic et al. J Med Biochem. .

Abstract
in English, Serbian

Background: Depressive symptoms are frequent in sarcoidosis. We assessed the impact of sarcoidosis symptoms, pulmonary function, fatigue, radiographic findings, comorbidities, treatment, and serum levels of 25-hydroxyvitamin D (25(OH)D) on depressive symptoms in sarcoidosis patients.

Methods: In a cross-sectional study, we measured depressive symptoms using the Center for Epidemiologic Studies - Depression Scale (CES-D) and fatigue using the Fatigue Assessment Scale (FAS). Presence of depressive symptoms was defined with CES-D scores ≥16 and ≥20, respectively. Fatigue was defined as having an FAS score of ≥22.

Results: A total of 400 patients were included in the study. CES-D score ≥16 had 128 patients, while CES-D score ≥20 had 86 patients. In a multivariate binomial logistic regression model, the following independent predictors of CES-D score ≥16 were identified: female gender (odds ratio, OR 1.983), chronic sarcoidosis (OR 2.311), serum levels of 25(OH)D ≤20 ng/mL (OR 2.326), persistent dry cough (OR 2.173), FAS Scores ≥22 (OR 9.243), and chest X-ray stage 3 (8.851). Five variables were independent predictors of CES-D score ≥20: diplopia (OR 4.411), FEV1 <80% predicted associated with FVC <80% predicted (OR 2.311), serum levels of 25(OH)D ≤20 ng/mL (OR 2.278), persistent dry cough (OR 3.001), and FAS Scores ≥22 (OR 7.611).

Conclusions: Measuring the contribution of low serum 25-hydroxyvitamin D and the impact of persistent dry cough on depressive symptoms in patients with sarcoidosis may be crucial in deciding whether to use vitamin D3 alone or with antitussive therapy before the psychiatric diagnosis of depression with antidepressant therapy initiation.

Uvod: Simptomi depresije su česti kod sarkoidoze. Ispitivali smo uticaj simptoma sarkoidoze, plućne funkcije, zamora, radiografskih nalaza, komorbiditeta, lečenja i nivoa 25-hidrok si vitamina D (25(OH)D) u serumu na simptome depresije kod pacijenata sa sarkoidozom.

Metode: U okviru studije preseka, simptomi depresije su mereni pomoću Skale za procenu depresije Centra za epidemiološke studije (CES-D), a zamor pomoću Skale za procenu zamora (FAS). Prisustvo simptoma depresije definisano je CES-D skorovima ≥16 i ≥20, dok je zamor definisan FAS skorom od ≥22.

Rezultati: Ukupno 400 pacijenata je uključeno u studiju. CES-D skor ≥16 je imalo 128 pacijenata, dok je CES-D skor ≥20 imalo 86 pacijenata. U multivarijantnom binomi jalnom logističkom regresionom modelu identifikovani su sledeći nezavisni prediktori za CES-D skor ≥16: ženski pol (OR 1,983), hronična sarkoidoza (OR 2,311), serumski nivo 25(OH)D ≤20 ng/mL (OR 2,326), uporan suvi kašalj (OR 2,173), FAS skor ≥22 (OR 9,243) i stadijum 3 na rentgenu grudnog koša (OR 8,851). Pet varijabli su bili nezavisni prediktori za CES-D skor ≥20: diplopija (OR 4,411), FEV1 <80% od predvi|enog udružen sa FVC <80% od pred vi|enog (OR 2,311), serumski nivo 25(OH)D ≤20 ng/mL (OR 2,278), uporan suvi kašalj (OR 3,001) i FAS skor ≥22 (OR 7,611).

Zaključak: Merenje doprinosa niskog serumskog nivoa 25-hidroksivitamina D i uticaja upornog suvog kašlja na simp tome depresije kod pacijenata sa sarkoidozom može biti ključno u odlučivanju da li koristiti vitamin D3 samostalno ili u kombinaciji sa antitusivnom terapijom pre postavljanja psihijatrijske dijagnoze depresije i započinjanja terapije antidepresivima.

Keywords: cough; depressive symptoms; fatigue; multivariate analysis; sarcoidosis; vitamin D deficiency.

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Conflict of interest statement

All the authors declare that they have no conflict of interest in this work.Conflict of Interest: The authors stated that they have no conflicts of interest regarding the publication of this article.

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