Association Between Depression And Osteoporosis

Objective:The objective of this study was to examine the association between depression and osteoporosis among adults aged 50 years and above using the National Health and Nutrition Examination Survey(NHANES)data of the general U.S population.This research will provide theoretical evidence for osteoporosis prevention among depressed patients.Methods:This study identified 2035 participants from the NHANES,2013-2018.Using a cross-sectional study design,we investigated the association between depression and osteoporosis amongst adults aged 50 years and above in the general U.S population.Participants with completed and valid BMD data at the femoral neck,total hip,or lumbar spine,and self-reported data on depression were included.Osteoporosis was diagnosed based on BMD T-score≤-2.5.Depression was accessed using the Patient Health Questionnaire(PHQ-9),a total score cut-off of10 or more was used to define depression.We included participants?gender,age,race/ethnicity,body mass index(BMI),smoking status,alcohol use,history of hypertension,and diabetes as covariates.Odds ratios(ORs)and 95%confidence intervals(95%CIs)were estimated using logistic regression models.All statistical analyses were performed using IBM SPSS software(version 24.0,SPSS Inc.,Chicago,IL,USA).Results:1.Majority of the study?s participants were females(52.97%),40%were in the age group 50-59 years,35.77%were non-Hispanic White,followed by non-Hispanic Black,constituting 22.46%of the total sample.More than three quarters(85.26%)were non-smokers,32.19%were alcohol users,half of the participants(50.02%)were hypertensive,less than twenty percent(19.31%)were diabetic,ten percent(10.07%)of them were osteoporotic,and the proportion of the participants who were depressed was 8.5%.2.The osteoporotic group was older(67.87 years vs 62.01 years)(t=-9.39,P<0.001),thinner(24.64 kg/m~2 vs 28.78 kg/m~2)(t=12.32,P<0.001),and more likely to be female(83.90%)than males(16.10%)(c~2=87.541,P<0.001).There was a higher prevalence of osteoporosis among non-Hispanic whites(46.83%)and those classed as?others?(24.88%)(c~2=43.099,P<0.001)compared to the non-osteoporotic group.3.In the unadjusted model,depression was associated with an increased risk of osteoporosis[OR:1.663,(95%CI:1.066-2.594)],Upon adjusting for covariates,the relationship between depression and osteoporosis remained statistically significant[OR:1.978,(95%CI:1.188-3.294,P<0.05)].4.The significant association between depression and osteoporosis was more obvious in females[OR 5.350(95%CI:3.542-8.079)]than in males[OR 0.187(95%CI:0.124-0.282)].The gender-stratified analyses show depressed females remained at a significantly increased risk for osteoporosis compared to depressed males,[OR:1.849(95%CI:1.031-3.315)],indicating that female gender is a major risk factor for the development of osteoporosis.BMI remained a protective factor for osteoporosis both in females[OR:0.842,(95%CI:0.805-0.881)]and males[OR:0.879,(95%CI:0.804-0.961)].Older aged females[OR:1.095,(95%CI:1.070-1.21)]than older men[OR:1.06,(95%CI:1.017-1.105)]were at an increased risk for osteoporosis.Conclusions:1.Depression was significantly associated with osteoporosis and this association was concentrated in females.2.Age,BMI,gender,and race/ethnicity were risk factors associated with osteoporosis.3.Gender,BMI,smoking,hypertension,diabetes,and race/ethnicity were risk factors associated with depression.