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ORIGINAL RESEARCH article
Front. Neurol.
Sec. Stroke
Volume 16 - 2025 |
doi: 10.3389/fneur.2025.1533565
This article is part of the Research Topic Evaluation of Fitness in Stroke Survivors View all 6 articles
Association Between Stroke and Fracture and the Mediating Role of Depression: A Cross-Sectional Study from NHANES 2017 to 2020
Provisionally accepted- 1 College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- 2 The State University of New York (SUNY), Albany, New York, United States
- 3 The First Affiliated Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
- 4 Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University, guangzhou, China
- 5 Neck, Shoulder, Lumbar and Leg Pain Hospital, Shandong First Medical University, Jinan, Shandong Province, China
- 6 Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
Background: Stroke is a significant health threat, and its complex interplay with fractures warrants further investigation. Depression, a critical psychological mediator in various health conditions, may also play a role. This study aims to clarify the intricate relationships among stroke, depressive symptoms, and fracture risk, potentially informing more holistic clinical strategies.Methods: Utilizing the most recent data from the National Health and Nutrition Examination Survey (NHANES, 2017 to 2020), this study encompassed 4,979 valid samples. T-test and chi square test are conducted to compare the differences between fracture and non fracture subgroups.Subsequently, regression models were applied to assess the mediating impact of depression, with Sobel's test and the bootstrap method deployed to substantiate the mediation pathways.In this study, we conducted subgroup and regression analyses to investigate factors influencing fractures in stroke patients using NHANES data. Subgroup analysis revealed significant associations with gender, race, osteoporosis, and depression. Female stroke patients had a higher fracture rate (73.86% vs. 47.78%, P<0.001), and those with post-stroke depression (29.67% vs. 13.16%, P<0.001) or osteoporosis (33.33% vs. 15.81%, P<0.05) were at increased risk of fractures. Logistic regression models showed a positive association between stroke and fractures in the unadjusted (OR=1.862, 95% CI: 1.348-2.573, P<0.001) and adjusted I models (OR=1.789, 95% CI: 1.240-2.581, P<0.01), but not in the adjusted II model. Depression was significantly correlated with fractures in all models (unadjusted OR=2.785, 95% CI: 1.271-6.101,
Keywords: stroke1, fracture2, depression3, Association4, NHANES5, mediation6
Received: 24 Nov 2024; Accepted: 13 Jan 2025.
Copyright: © 2025 Dan, Pei, Xu, Liu, Wang, Meng, Yu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Gongchang Yu, Neck, Shoulder, Lumbar and Leg Pain Hospital, Shandong First Medical University, Jinan, Shandong Province, China
Li Li, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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