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.
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.