Skip to main content

ORIGINAL RESEARCH article

Front. Nutr.
Sec. Nutritional Epidemiology
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1453062
This article is part of the Research Topic Assessment of Nutritional Status in Chronic Diseases View all 3 articles

Independent and joint influence of depression and advanced lung cancer inflammation index on mortality among individuals with chronic kidney disease

Provisionally accepted
Jie Zhou Jie Zhou 1,2Xiaoxin Liu Xiaoxin Liu 3Hao Zhang Hao Zhang 3Xiangjie Liu Xiangjie Liu 3*
  • 1 Huazhong University of Science and Technology, Wuhan, China
  • 2 Hubei Cancer Hospital, Wuhan, Hubei Province, China
  • 3 Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hebei Province, China

The final, formatted version of the article will be published soon.

    Background: The combined effect of depression and nutritional-inflammatory status on mortality in the chronic kidney disease (CKD) population is unclear. Methods: We prospectively analyzed 3,934 (weighted population: 22,611,423) CKD participants from the National Health and Nutrition Examination Survey (2007-2018). Depression and nutritional-inflammatory status were assessed with Patient Health Questionnaire 9 (PHQ-9) and Advanced Lung Cancer Inflammation Index (ALI), respectively. Weighted multivariate COX regression models, restricted cubic splines (RCS) models, and stratified analyses were used to investigate the association of PHQ-9 scores and ALI with all-cause mortality. Results: During a median follow-up of 5.8 years (interquartile range 3.4-8.6 years), a total of 985 patients died (25.0%). Each point increase in a patient's PHQ-9 score increased the risk of all-cause mortality by 4% (HR, 1.04; 95% CI, 1.02-1.06; p< 0.001), in the full adjusted model. However, an increase in ALI levels was associated with a decreased risk. HRs (95% CI) of 0.76 (0.65-0.90), 0.70 (0.57-0.86), and 0.51 (0.41-0.64) in the Q2, Q3, and Q4 of ALI compared with the Q1 of ALI, respectively. In addition, the joint analysis showed that CKD patients without depression and with higher ALI were associated with a reduced risk of all-cause mortality. Namely, patients in the highest ALI group (Q4) without depression had the lowest risk (HR, 0.32; 95% CI, 0.21-0.48). Furthermore, this combined effect was consistent across all subgroups, and no significant interaction was found (p >0.05 for interaction). Conclusions: In a nationally representative sample of US patients with CKD, coexisting depression and poorer nutrition-inflammation were associated with a significantly increased risk of all-cause mortality.

    Keywords: Inflammatory, nutritional, Chronic Kidney Disease, Depression, Mortality, NHANES

    Received: 22 Jun 2024; Accepted: 03 Sep 2024.

    Copyright: © 2024 Zhou, Liu, Zhang and Liu. 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: Xiangjie Liu, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430077, Hebei Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.