Depression and Muscle Mass Affect Osteoporosis Risk in Hemodialysis Patients: Study
Researchers have established in a new study that depression and skeletal muscle mass significantly influence the risk of osteoporosis in patients undergoing hemodialysis (HD). Osteoporosis and sarcopenia are common complications in HD patients, which often lead to severe health consequences. Depression is also highly prevalent in this population, but its association with osteoporosis remains unclear. This study was recently published in the journal of BMC Nephrology which was conducted by Xiaohua H. and fellow researchers in China.
Eight hundred and fifty-eight HD patients were enrolled across seven dialysis centers-including 524 men and 334 women. Bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry (DXA). Skeletal muscle mass index (SMI) was calculated from body composition data obtained by multifrequency bioimpedance analysis (BIA). Muscle strength was measured by handgrip strength (HGS) with a dynamometer, and physical performance was measured by a 4-meter gait speed test. Depression was diagnosed based on scores from the Patient Health Questionnaire-9 (PHQ-9).
Results
• Osteoporosis prevalence: 39.2% of the HD patients had osteoporosis.
• Sarcopenia prevalence: 18.9% of participants were diagnosed with sarcopenia.
• Depression prevalence: 42.1% of HD patients exhibited depressive symptoms.
• Muscle mass and osteoporosis: Higher SMI was associated with a lower risk of osteoporosis (OR = 0.638, 95% CI = 0.494-0.823, p=0.001).
• Muscle strength and osteoporosis: HGS was not significantly associated with osteoporosis risk (OR = 0.990, 95% CI = 0.963-1.017, p=0.449).
• Sarcopenia and osteoporosis: Patients with HD and sarcopenia had a 1.92 times higher risk of osteoporosis than those patients without sarcopenia.
• Depression and osteoporosis: After adjusting for sarcopenia and SMI, depression emerged as an independent risk factor for osteoporosis. Risk was increased 1.45 times (OR = 1.452, 95% CI = 1.060-1.989, p=0.020).
Researchers concluded that the maintenance of muscle mass is more critical than muscle strength in preventing osteoporosis among HD patients. Depression also stands out as an independent risk factor, further complicating the management of bone health. These results indicate that optimization of osteoporosis prevention strategies for HD patients may require a comprehensive approach that addresses physical and mental health.
Reference:
Hu X, Ye X, Chen H, Wu B, Guo Q, Yu C, Ding W, Niu J, Zhao J, Qi H, Zhang S, Xue C, Zhang L. Depression as a risk factor for osteoporosis independent of sarcopenia in hemodialysis patients: findings from a multicenter cross-sectional study. BMC Nephrol. 2025 Jan 23;26(1):35. doi: 10.1186/s12882-025-03963-1. PMID: 39849392; PMCID: PMC11755883.
