Tian Maolu, Qian Zuping, Long Yanjun, Yu Fangfang, Yuan Jing, Zha Yan
Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, People's Republic of China.
NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People's Hospital, Guiyang, Guizhou, People's Republic of China.
Psychol Res Behav Manag. 2023 Oct 26;16:4367-4376. doi: 10.2147/PRBM.S436574. eCollection 2023.
Depression is a common psychiatric disorder and related to poor outcomes in patients undergoing maintenance hemodialysis (MHD). Previous studies have reported some associations between sarcopenia and depressive symptoms. Recently, intracellular water (ICW) and total body water (TBW) have been found to reflect muscle function and muscle mass. ICW/TBW ratio is a marker of sarcopenia that is simple to assess. However, the relationship between ICW/TBW ratio and depression has not been explored in MHD patients.
In our cross-sectional and multi-center study, 3300 adult MHD patients were included from June 1, 2021, to August 30, 2021. Depressive symptoms were evaluated using the Beck Depression Inventory-II (BDI-II). TBW and ICW were measured by Body Composition Monitor (BCM). Multivariable logistic regression, stratified analyses, and interactive analyses were conducted to assess the relationship between ICW/TBW ratio and depression.
About 16.5% of the 3300 MHD patients were found to have depressive symptoms. The prevalence of depression increased with decreasing quartiles of ICW/TBW ratios, and decreased ICW/TBW ratio was independently associated with depression after adjusting for potential confounders. Patients in Quartile 1 of ICW/TBW ratios were more likely to have depressive symptoms (odds ratio 1.55, 95% confidence interval 1.07-2.22; =0.002) than those in Quartile 4. History of diabetes and education status had interactive roles in the relationship between depression and ICW/TBW ratios ( < 0.05). The association of ICW/TBW ratios and depression existed in patients of both genders and different education levels, but only in non-diabetic patients.
In MHD patients, the decreased ratio of ICW/TBW was independently related to high depression rates.
抑郁症是一种常见的精神障碍，与维持性血液透析（MHD）患者的不良预后相关。先前的研究报道了肌肉减少症与抑郁症状之间的一些关联。最近，细胞内液（ICW）和总体液（TBW）已被发现可反映肌肉功能和肌肉量。ICW/TBW比值是一种易于评估的肌肉减少症标志物。然而，MHD患者中ICW/TBW比值与抑郁症之间的关系尚未得到探讨。
在我们的横断面多中心研究中，纳入了2021年6月1日至2021年8月30日期间的3300例成年MHD患者。使用贝克抑郁量表第二版（BDI-II）评估抑郁症状。通过人体成分监测仪（BCM）测量TBW和ICW。进行多变量逻辑回归、分层分析和交互分析，以评估ICW/TBW比值与抑郁症之间的关系。
在3300例MHD患者中，约16.5%被发现有抑郁症状。抑郁症的患病率随着ICW/TBW比值四分位数的降低而增加，在调整潜在混杂因素后，ICW/TBW比值降低与抑郁症独立相关。ICW/TBW比值处于第一四分位数的患者比第四四分位数的患者更有可能出现抑郁症状（优势比1.55，95%置信区间1.07-2.22；P=0.002）。糖尿病病史和教育程度在抑郁症与ICW/TBW比值之间的关系中具有交互作用（P<0.05）。ICW/TBW比值与抑郁症的关联在不同性别和不同教育水平的患者中均存在，但仅在非糖尿病患者中存在。
在MHD患者中，ICW/TBW比值降低与高抑郁症发生率独立相关。
