The association between depression and bone metabolism: a US nationally representative cross-sectional study,Archives of Osteoporosis

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The association between depression and bone metabolism: a US nationally representative cross-sectional study
Archives of Osteoporosis ( IF 3.1 ) Pub Date : 2022-08-13 , DOI: 10.1007/s11657-022-01154-1
Ming Ma _{1,

2,

3} , Xiaolong Liu _{1,

2,

3} , Gengxin Jia _{1,

2,

3} , Zhongcheng Liu _{1,

2,

3} , Kun Zhang _{1,

2,

3} , Liangzhi He _{1,

2,

3} , Bin Geng _{1,

2,

3} , Yayi Xia _{1,

2,

3}

Affiliation

Summary

This population-based study investigated the association between depression and bone mineral density (BMD), fractures, and osteoporosis in the US population. We found that participants with depression had lower BMD and were more likely to have fractures and osteoporosis.

Background

Depression, fractures, and osteoporosis are common in middle-aged and elderly, but their associations remained unclear.

Objective

To investigate the association between depression and bone mineral density (BMD), osteoporosis, and fracture in a middle-aged and elderly US population.

Methods

A nationally representative cross-sectional study used the National Health and Nutrition Examination Survey (NHANES) datasets. Depression was assessed and stratified using the Patient Health Questionnaire (PHQ-9). The multiple logistic regression models and the logistic binary regression models were used to analyze the association between depression and BMD, fractures, and osteoporosis. Gender, age, race, educational level, poverty ratio, body mass index (BMI), smoke, alcohol use, physical activity, and diabetes were included as covariates. Subgroup analysis was also conducted on gender, age, race, and education level.

Results

In total, 9766 participants were included after a series of exclusions, and 4179 (42.79%) had at least mild depressive symptoms. Compared to the participants without depression, those with depression had a lower total femur, femoral neck, and total spine BMD after adjusting multiple covariates. The multivariable-adjusted logistic binary regression models demonstrated that participants with depression more likely have hip fractures (OR = 1.518, 95% CI: 1.377–2.703, P = 0.000), spine fractures (OR = 1.311, 95% CI: 1.022–1.678, P = 0.030), and osteoporosis (OR = 1.621, 95% CI: 1.388–1.890, P = 0.000). Subgroup analysis revealed that depressed participants who were males, non-Hispanic White, ≤ 70 years, and not highly educated had a lower BMD and easily had osteoporosis.

Conclusion

Depression was associated with lower BMD, particularly in the spine, males, Hispanic-White, and not highly educated populations. Moreover, people with depression were more likely to have fractures and osteoporosis.

中文翻译：

抑郁症与骨代谢之间的关联：一项美国全国代表性横断面研究

概括

这项基于人群的研究调查了美国人群中抑郁症与骨密度 (BMD)、骨折和骨质疏松症之间的关系。我们发现抑郁症参与者的 BMD 较低，并且更容易发生骨折和骨质疏松症。

背景

抑郁、骨折和骨质疏松症在中年和老年人中很常见，但它们之间的关联仍不清楚。

客观的

旨在调查美国中老年人群中抑郁症与骨密度 (BMD)、骨质疏松症和骨折之间的关联。

方法

一项具有全国代表性的横断面研究使用了国家健康和营养检查调查 (NHANES) 数据集。使用患者健康问卷 (PHQ-9) 对抑郁症进行评估和分层。多元逻辑回归模型和逻辑二元回归模型用于分析抑郁症与 BMD、骨折和骨质疏松症之间的关联。性别、年龄、种族、教育水平、贫困率、体重指数 (BMI)、吸烟、饮酒、身体活动和糖尿病作为协变量。还对性别、年龄、种族和教育水平进行了亚组分析。

结果

经过一系列排除后，总共有 9766 名参与者被纳入，其中 4179 名 (42.79%) 至少有轻度抑郁症状。与没有抑郁症的参与者相比，在调整多个协变量后，抑郁症患者的总股骨、股骨颈和总脊柱 BMD 较低。多变量调整后的逻辑二元回归模型表明，患有抑郁症的参与者更有可能发生髋部骨折（OR = 1.518，95% CI：1.377–2.703，P = 0.000），脊柱骨折（OR = 1.311，95% CI：1.022–1.678 , P = 0.030), 和骨质疏松症 ( OR = 1.621, 95% CI : 1.388–1.890, P= 0.000）。亚组分析显示，男性、非西班牙裔白人、≤ 70 岁且受教育程度不高的抑郁症参与者 BMD 较低，并且容易患骨质疏松症。