Independent and joint influence of depression and advanced lung cancer inflammation index on mortality among individuals with chronic kidney disease.

IF 4 2区 农林科学 Q2 NUTRITION & DIETETICS
Frontiers in Nutrition Pub Date : 2024-10-23 eCollection Date: 2024-01-01 DOI:10.3389/fnut.2024.1453062
Jie Zhou, Wenjun Liu, Xiaoxin Liu, Jijun Wu, Ying Chen
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引用次数: 0

Abstract

Background: The combined effect of depression and nutritional-inflammatory status on mortality in the chronic kidney disease (CKD) population is unclear.

Methods: We prospectively analyzed 3,934 (weighted population: 22,611,423) CKD participants from the National Health and Nutrition Examination Survey (2007-2018). Depression and nutritional-inflammatory status were assessed with Patient Health Questionnaire 9 (PHQ-9) and Advanced Lung Cancer Inflammation Index (ALI), respectively. Weighted multivariate COX regression models, restricted cubic splines (RCS) models, and stratified analyses were used to investigate the association of PHQ-9 scores and ALI with all-cause mortality.

Results: During a median follow-up of 5.8 years (interquartile range 3.4-8.6 years), a total of 985 patients died (25.0%). Each point increase in a patient's PHQ-9 score increased the risk of all-cause mortality by 4% (HR, 1.04; 95% CI, 1.02-1.06; p < 0.001), in the full adjusted model. However, an increase in ALI levels was associated with a decreased risk. HRs (95% CI) of 0.76 (0.65-0.90), 0.70 (0.57-0.86), and 0.51 (0.41-0.64) in the Q2, Q3, and Q4 of ALI compared with the Q1 of ALI, respectively. In addition, the joint analysis showed that CKD patients without depression and with higher ALI were associated with a reduced risk of all-cause mortality. Namely, patients in the highest ALI group (Q4) without depression had the lowest risk (HR, 0.32; 95% CI, 0.21-0.48). Furthermore, this combined effect was consistent across all subgroups, and no significant interaction was found (p > 0.05 for interaction).

Conclusion: In a nationally representative sample of US patients with CKD, coexisting depression and poorer nutrition-inflammation were associated with a significantly increased risk of all-cause mortality.

抑郁症和晚期肺癌炎症指数对慢性肾病患者死亡率的独立和共同影响。
背景:抑郁症和营养炎症状态对慢性肾脏病(CKD)人群死亡率的综合影响尚不清楚:抑郁和营养-炎症状态对慢性肾脏病(CKD)人群死亡率的综合影响尚不明确:我们对全国健康与营养调查(2007-2018 年)中的 3,934 名(加权人口:22,611,423 人)CKD 参与者进行了前瞻性分析。抑郁和营养炎症状态分别通过患者健康问卷 9(PHQ-9)和晚期肺癌炎症指数(ALI)进行评估。采用加权多变量COX回归模型、限制性立方样条(RCS)模型和分层分析来研究PHQ-9评分和ALI与全因死亡率的关系:中位随访时间为 5.8 年(四分位间范围为 3.4-8.6 年),共有 985 名患者死亡(25.0%)。患者的PHQ-9得分每增加1分,全因死亡风险就会增加4%(HR,1.04;95% CI,1.02-1.06;交互作用P > 0.05):结论:在具有全国代表性的美国慢性肾脏病患者样本中,并发抑郁症和较差的营养-炎症与全因死亡风险显著增加有关。
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来源期刊
Frontiers in Nutrition
Frontiers in Nutrition Agricultural and Biological Sciences-Food Science
CiteScore
5.20
自引率
8.00%
发文量
2891
审稿时长
12 weeks
期刊介绍: No subject pertains more to human life than nutrition. The aim of Frontiers in Nutrition is to integrate major scientific disciplines in this vast field in order to address the most relevant and pertinent questions and developments. Our ambition is to create an integrated podium based on original research, clinical trials, and contemporary reviews to build a reputable knowledge forum in the domains of human health, dietary behaviors, agronomy & 21st century food science. Through the recognized open-access Frontiers platform we welcome manuscripts to our dedicated sections relating to different areas in the field of nutrition with a focus on human health. Specialty sections in Frontiers in Nutrition include, for example, Clinical Nutrition, Nutrition & Sustainable Diets, Nutrition and Food Science Technology, Nutrition Methodology, Sport & Exercise Nutrition, Food Chemistry, and Nutritional Immunology. Based on the publication of rigorous scientific research, we thrive to achieve a visible impact on the global nutrition agenda addressing the grand challenges of our time, including obesity, malnutrition, hunger, food waste, sustainability and consumer health.
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