Wang Baoping, Fan Yuxin, Tang Shaofang, Guo Weihong, Li Yin, Dai Chenlin
Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.
Medical School of Tianjin University, Tianjin University, Tianjin, China.
Front Nutr. 2025 Jul 1;12:1578954. doi: 10.3389/fnut.2025.1578954. eCollection 2025.
Lifestyle factors play a critical role in osteoporosis management and are closely linked to the development and progression of comorbid depression. This study examines lifestyle patterns and their association with depression in individuals with osteopenia or osteoporosis, while assessing the mediating role of the Dietary Inflammatory Index (DII).
Data from the National Health and Nutrition Examination Survey (NHANES) 2009-2020 were analyzed using latent class analysis (LCA) to classify 3,384 adults based on their lifestyle behaviors. A generalized linear model (GLM) evaluated the effects of lifestyle patterns on depression, and mediation analysis tested associations between these patterns, DII, and Patient Health Questionnaire-9 (PHQ-9) scores.
LCA identified three lifestyle groups: healthy but inactive (34.16%), unhealthy (8.78%), and sedentary (57.06%). The unhealthy (OR = 2.848, 95% CI = 1.550-5.234, = 0.001) and sedentary (OR = 1.600, 95% CI = 1.127-2.271, = 0.009) groups were associated with higher depression risk in women. DII partially mediated the relationships between unhealthy lifestyle and PHQ-9 (effect coefficient = 0.095, 95% CI: 0.056-0.135) and between sedentary lifestyle and PHQ-9 (effect coefficient = 0.059, 95% CI: 0.017-0.115).
These findings suggest that lifestyle patterns significantly influence depression in women with osteopenia or osteoporosis, with DII serving as a partial mediator.
生活方式因素在骨质疏松症管理中起着关键作用，并且与共病抑郁症的发生和发展密切相关。本研究调查了骨质减少或骨质疏松症患者的生活方式模式及其与抑郁症的关联，同时评估饮食炎症指数（DII）的中介作用。
使用潜在类别分析（LCA）对2009 - 2020年美国国家健康与营养检查调查（NHANES）的数据进行分析，根据生活方式行为对3384名成年人进行分类。采用广义线性模型（GLM）评估生活方式模式对抑郁症的影响，并通过中介分析检验这些模式、DII和患者健康问卷-9（PHQ-9）得分之间的关联。
LCA确定了三种生活方式组：健康但不活跃（34.16%）、不健康（8.78%）和久坐不动（57.06%）。不健康组（OR = 2.848，95% CI = 1.550 - 5.234，P = 0.001）和久坐不动组（OR = 1.600，95% CI = 1.127 - 2.271，P = 0.009）与女性患抑郁症的风险较高相关。DII部分介导了不健康生活方式与PHQ-9之间的关系（效应系数 = 0.095，95% CI：0.056 - 0.135）以及久坐不动生活方式与PHQ-9之间的关系（效应系数 = 0.059，95% CI：0.017 - 0.115）。
这些发现表明，生活方式模式对骨质减少或骨质疏松症女性的抑郁症有显著影响，DII起到部分中介作用。
