Liu Mingming, Li Yuxiao
Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Department of Brain Sciences, Centre for Vestibular Neurology, Imperial College London, Laboratory Block, Charing Cross Campus, London, W6 8RF, UK.
Osteoporos Int. 2025 Jun 23. doi: 10.1007/s00198-025-07573-3.
This longitudinal study examined the association between depressive symptom trajectories and the risk of hip fracture using a nationally representative dataset. The findings suggested that a high-increasing trajectory was a significant risk factor for hip fracture in females.
Depression has been associated with increased risk of hip fracture; however, no study has specifically examined how trajectories of depressive symptoms influence hip fracture incidence. This study aimed to investigate the association between long-term depressive symptom trajectories and the 5-year risk of hip fracture, and whether this association differs by gender.
We analyzed data from 8942 individuals aged 45 and older from the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptom trajectories (2011-2015) were identified using group-based trajectory modeling. Cox proportional hazards models were used to examine the association between these trajectories and the risk of hip fracture over the subsequent 5 years.
Three distinct depressive symptom trajectories were identified: low-stable, moderate-stable, and high-increasing. Compared to the low-stable group, females in the high-increasing trajectory had a significantly higher risk of hip fracture (HR = 2.37, 95% CI 1.29-4.35, P < 0.01), while no significant risk increase was observed for the moderate-stable group (HR = 1.05, 95% CI 0.63-1.73, P > 0.05). This association was not found among males. Sensitivity analyses supported these findings.
A high-increasing depressive symptom trajectory was significantly associated with an increased risk of hip fracture, particularly among females. Prioritizing targeted interventions for individuals with this trajectory is essential to mitigate their risk.
本纵向研究使用全国代表性数据集，考察了抑郁症状轨迹与髋部骨折风险之间的关联。研究结果表明，高增长轨迹是女性髋部骨折的一个重要风险因素。
抑郁症与髋部骨折风险增加有关；然而，尚无研究专门考察抑郁症状轨迹如何影响髋部骨折发生率。本研究旨在调查长期抑郁症状轨迹与5年髋部骨折风险之间的关联，以及这种关联是否因性别而异。
我们分析了来自中国健康与养老追踪调查（CHARLS）的8942名45岁及以上个体的数据。使用基于组的轨迹模型确定抑郁症状轨迹（2011 - 2015年）。采用Cox比例风险模型来考察这些轨迹与随后5年髋部骨折风险之间的关联。
确定了三种不同的抑郁症状轨迹：低稳定、中稳定和高增长。与低稳定组相比，高增长轨迹的女性髋部骨折风险显著更高（风险比[HR] = 2.37，95%置信区间[CI] 1.29 - 4.35，P < 0.01），而中稳定组未观察到显著的风险增加（HR = 1.05，95% CI 0.63 - 1.73，P > 0.05）。在男性中未发现这种关联。敏感性分析支持了这些发现。
高增长的抑郁症状轨迹与髋部骨折风险增加显著相关，尤其是在女性中。优先对具有这种轨迹的个体进行有针对性的干预对于降低其风险至关重要。
