Ming Ma1,2,3, Xiaolong Liu1,2,3, Gengxin Jia1,2,3, Zhongcheng Liu1,2,3, Kun Zhang1,2,3, Liangzhi He1,2,3, Bin Geng1,2,3, Yayi Xia4,5,6. 1. Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, China. 2. Orthopaedics Key Laboratory of Gansu Province, Lanzhou University Second Hospital, Lanzhou, China. 3. The Second School of Clinical Medical, Lanzhou University, Lanzhou, China. 4. Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, China. xiayy@lzu.edu.cn. 5. Orthopaedics Key Laboratory of Gansu Province, Lanzhou University Second Hospital, Lanzhou, China. xiayy@lzu.edu.cn. 6. The Second School of Clinical Medical, Lanzhou University, Lanzhou, China. xiayy@lzu.edu.cn.
Abstract
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.
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.
Authors: Nicole C Wright; Anne C Looker; Kenneth G Saag; Jeffrey R Curtis; Elizabeth S Delzell; Susan Randall; Bess Dawson-Hughes Journal: J Bone Miner Res Date: 2014-11 Impact factor: 6.741