Relationship between depression and oral microbiome diversity: analysis of NHANES data (2009–2012)

Background: While the association between the gut microbiome and depression is well studied, the association between the oral microbiome and depression is less well characterized. Methods: This cross-sectional study analyzed the association between depression and diversity of oral microbiome using data from the 2009–2012 National Health and Nutrition Examination Survey (NHANES). The gene sequencing of 16S ribosomal RNA was adopted for the profiling of oral microbiome. Alpha diversity, quantified by the observed number of amplicon sequence variants (ASVs), and beta diversity, assessed using Bray–Curtis dissimilarity, were evaluated to represent oral microbiome diversity. Depressive symptoms were measured by the Patient Health Questionnaire-9 (PHQ-9) scale, with alpha diversity as the primary predictor. Weighted logistic regression was employed to examine the relationship between depression and microbial alpha diversity. Threshold effect analysis was performed to explore potential nonlinear relationships between the observed ASVs and depression. Subgroup analysis indicated that smoke, excessive alcohol consumption, and oral treatment influenced the association between oral microbiology and depression, with interaction effects observed across gender and racial groups. Beta diversity differences were evaluated using Bray–Curtis dissimilarity and visualized via non-metric multidimensional scaling (NMDS). Results: A total of 15,018 participants were included, with an average age of 42.25 ± 15.2 years. In the fully adjusted model, the alpha diversity of oral microbiome was significantly negatively correlated with depression (OR = -0.51, 95% CI: -0.79—-0.23, P = 0.003). Threshold analysis also revealed a nonlinear association in this relationship, with a significant inflection point as Log10ASVs of 2.32. Furthermore, beta diversity of the oral microbiome differed significantly between the normal and depression groups (p = 0.001). Sensitivity analyses showed that the relationship between depression and oral microbial diversity observed in this research was particularly pronounced among non-Hispanic Whites (OR = 0.16, 95% CI: 0.07–0.35) and men (OR = 0.14, 95% CI: 0.06–0.30). Additionally, significant differences in oral microbiome beta diversity were observed between the normal and depression groups (p = 0.001). Conclusions: The findings suggest that the diversity of oral microbiome is negatively correlated with depressive symptoms. Hence, oral dysbiosis may serve as a therapeutic target or biomarker of depression. However, the underlying mechanisms require further investigation.