Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2022; 10(14): 4395-4403
Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4395
Association between depression and malnutrition in pulmonary tuberculosis patients: A cross-sectional study
Xue-E Fang, Dan-Ping Chen, Ling-Ling Tang, Yan-Jun Mao
Xue-E Fang, Dan-Ping Chen, Ling-Ling Tang, Department of Tuberculosis, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai 200000, Shanghai Province, China
Yan-Jun Mao, Department of Nursing, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai 200000, Shanghai Province, China
Author contributions: YJ Mao was the guarantor and designed the study; Fang XE, Chen DP, and Tang LL participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; Fang XE, Chen DP, Tang LL, and Mao YJ revised the article critically for important intellectual content.
Institutional review board statement: The study protocol was approved by the Ethics Committee of Shanghai Pulmonary Hospital Affiliated to Tongji University (No. K19-146).
Informed consent statement: All study participants or their legal guardian provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Jun Mao, PhD, Academic Fellow, Department of Nursing, Shanghai Pulmonary Hospital Affiliated to Tongji University, No. 507, Zhengmin Road, Yangpu District, Shanghai 200000, Shanghai Province, China. maoyanjun_fk@tongji.edu.cn
Received: July 16, 2021
Peer-review started: July 16, 2021
First decision: October 18, 2021
Revised: October 26, 2021
Accepted: March 25, 2022
Article in press: March 25, 2022
Published online: May 16, 2022
Processing time: 300 Days and 19.1 Hours
ARTICLE HIGHLIGHTS
Research background

It has been reported that depression is prevalent in patients with pulmonary tuberculosis (PTB). Moreover, several clinical symptoms of PTB and depression overlap, such as loss of appetite and malnutrition. However, the association between depression and malnutrition in TB patients has not been fully understood.

Research motivation

The present study aimed to explore the association between depression and malnutrition in patients with PTB.

Research objectives

The present study aimed to explore the association between depression and malnutrition in patients with PTB.

Research methods

This hospital-based cross-sectional study included patients with PTB in Shanghai Pulmonary Hospital Affiliated to Tongji University from April 2019 to July 2019. The Patient Health Questionnaire-9 (PHQ-9) scale was used to evaluate depression and the cut-off value was set at 10, and the nutritional state was determined by the body mass index (BMI). In addition, the Quality of Life Instruments for Chronic Diseases was employed to quantify the quality of life (QOL). Univariable analysis and multivariable analysis (forward mode) were used to identify the independent factors associated with depression.

Research results

A total of 328 PTB patients were screened for analysis. Eight were excluded for missing demographic data, four excluded for missing nutrition status, and sixteen for missing QOL data. Finally, 300 PTB patients were subjected to analysis. It was found that depressive state was present in 225 PTB patients (75%). The ratio of malnutrition in the depressive PTB patients was 45.33%. It was found that BMI, hemoglobin, and prealbumin in the depression group were significantly lower than those in the control group (P < 0.05). Moreover, the social status (P < 0.05) significantly differed between the groups. In addition, glutamic pyruvic transaminase and glutamic oxaloacetic transaminase in the depression group were significantly higher than those in the control group (P < 0.05). Multivariable logistic regression analysis showed that BMI [odds ratio (OR) =1.21, 95% confidence interval (CI): 1.163-1.257, P < 0.001] and poor social function (OR = 0.95, 95%CI: 0.926-0.974, P = 0.038) were independently associated with depression.

Research conclusions

Malnutrition and poor social function are significantly associated with depressive symptoms in PTB patients. A prospective large-scale study is needed to confirm these findings.

Research perspectives

Malnutrition and poor social function are significantly associated with depressive symptoms in PTB patients. A prospective large-scale study is needed to confirm these findings.