Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study

Yoshihiro Tsuji; Naoki Suzuki; Yasumasa Hitomi; Yuko Mizuno-Matsumoto; Toshiko Tokoro; Masato Nishimura

doi:doi:10.11648/j.ijbecs.20200602.14

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Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study

Yoshihiro Tsuji, Naoki Suzuki, Yasumasa Hitomi, Yuko Mizuno-Matsumoto, Toshiko Tokoro, Masato Nishimura

Published in International Journal of Biomedical Engineering and Clinical Science (Volume 6, Issue 2)

Received: 5 May 2020 Accepted: 15 June 2020 Published: 29 June 2020

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Abstract

Background: Iron status has a critical role in depressive symptoms, but evaluation of depressive symptoms associated with iron metabolism is not usually included as a clinical parameter in hemodialysis (HD) patients. We aimed to assess the correlations between depressive symptoms and clinical, demographic, and laboratory variables including iron metabolism. Methods: One hundred and thirty-eight HD patients were evaluated in this study. The Beck Depression Inventory Second Edition (BDI−II) was used to quantify levels of depressive symptoms. BDI−II scores ≥ 14 were defined as depressive symptoms. Mean age, duration of HD, haemoglobin levels, serum ferritin levels, serum iron levels, transferrin saturation (TSAT), total iron binding capacity, serum albumin levels, and C-reactive protein were included in the model. Patients were categorized into four groups according to serum ferritin levels and TSAT. Backward stepwise logistic regression analysis was performed and odds ratios (ORs) and 95% confidence intervals derived. Results: Depressive symptoms were significantly associated with increased serum ferritin levels (OR, 1.010; p=0.0008). Compared with group 1 (ferritin <100 ng/dL, TSAT ≥20%) as reference, ORs for depressive symptoms were significantly increased in group 4 (ferritin ≥100 ng/dL, TSAT < 20%) (OR, 6.419; p=0.0073). Conclusion: Higher serum ferritin levels and decreased iron utilization efficiency were found to be involved in depressive symptoms among patients undergoing HD. Understanding the pathophysiology of depressive symptoms could provide insights into the design of clinical iron management in HD patients.

Published in	International Journal of Biomedical Engineering and Clinical Science (Volume 6, Issue 2)
DOI	10.11648/j.ijbecs.20200602.14
Page(s)	48-54
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Depressive Symptoms, Hemodialysis, Iron Management

References

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APA Style

Yoshihiro Tsuji, Naoki Suzuki, Yasumasa Hitomi, Yuko Mizuno-Matsumoto, Toshiko Tokoro, et al. (2020). Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study. International Journal of Biomedical Engineering and Clinical Science, 6(2), 48-54. https://doi.org/10.11648/j.ijbecs.20200602.14

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ACS Style

Yoshihiro Tsuji; Naoki Suzuki; Yasumasa Hitomi; Yuko Mizuno-Matsumoto; Toshiko Tokoro, et al. Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study. Int. J. Biomed. Eng. Clin. Sci. 2020, 6(2), 48-54. doi: 10.11648/j.ijbecs.20200602.14

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AMA Style

Yoshihiro Tsuji, Naoki Suzuki, Yasumasa Hitomi, Yuko Mizuno-Matsumoto, Toshiko Tokoro, et al. Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study. Int J Biomed Eng Clin Sci. 2020;6(2):48-54. doi: 10.11648/j.ijbecs.20200602.14

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@article{10.11648/j.ijbecs.20200602.14,
  author = {Yoshihiro Tsuji and Naoki Suzuki and Yasumasa Hitomi and Yuko Mizuno-Matsumoto and Toshiko Tokoro and Masato Nishimura},
  title = {Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study},
  journal = {International Journal of Biomedical Engineering and Clinical Science},
  volume = {6},
  number = {2},
  pages = {48-54},
  doi = {10.11648/j.ijbecs.20200602.14},
  url = {https://doi.org/10.11648/j.ijbecs.20200602.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijbecs.20200602.14},
  abstract = {Background: Iron status has a critical role in depressive symptoms, but evaluation of depressive symptoms associated with iron metabolism is not usually included as a clinical parameter in hemodialysis (HD) patients. We aimed to assess the correlations between depressive symptoms and clinical, demographic, and laboratory variables including iron metabolism. Methods: One hundred and thirty-eight HD patients were evaluated in this study. The Beck Depression Inventory Second Edition (BDI−II) was used to quantify levels of depressive symptoms. BDI−II scores ≥ 14 were defined as depressive symptoms. Mean age, duration of HD, haemoglobin levels, serum ferritin levels, serum iron levels, transferrin saturation (TSAT), total iron binding capacity, serum albumin levels, and C-reactive protein were included in the model. Patients were categorized into four groups according to serum ferritin levels and TSAT. Backward stepwise logistic regression analysis was performed and odds ratios (ORs) and 95% confidence intervals derived. Results: Depressive symptoms were significantly associated with increased serum ferritin levels (OR, 1.010; p=0.0008). Compared with group 1 (ferritin <100 ng/dL, TSAT ≥20%) as reference, ORs for depressive symptoms were significantly increased in group 4 (ferritin ≥100 ng/dL, TSAT < 20%) (OR, 6.419; p=0.0073). Conclusion: Higher serum ferritin levels and decreased iron utilization efficiency were found to be involved in depressive symptoms among patients undergoing HD. Understanding the pathophysiology of depressive symptoms could provide insights into the design of clinical iron management in HD patients.},
 year = {2020}
}

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TY  - JOUR
T1  - Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study
AU  - Yoshihiro Tsuji
AU  - Naoki Suzuki
AU  - Yasumasa Hitomi
AU  - Yuko Mizuno-Matsumoto
AU  - Toshiko Tokoro
AU  - Masato Nishimura
Y1  - 2020/06/29
PY  - 2020
N1  - https://doi.org/10.11648/j.ijbecs.20200602.14
DO  - 10.11648/j.ijbecs.20200602.14
T2  - International Journal of Biomedical Engineering and Clinical Science
JF  - International Journal of Biomedical Engineering and Clinical Science
JO  - International Journal of Biomedical Engineering and Clinical Science
SP  - 48
EP  - 54
PB  - Science Publishing Group
SN  - 2472-1301
UR  - https://doi.org/10.11648/j.ijbecs.20200602.14
AB  - Background: Iron status has a critical role in depressive symptoms, but evaluation of depressive symptoms associated with iron metabolism is not usually included as a clinical parameter in hemodialysis (HD) patients. We aimed to assess the correlations between depressive symptoms and clinical, demographic, and laboratory variables including iron metabolism. Methods: One hundred and thirty-eight HD patients were evaluated in this study. The Beck Depression Inventory Second Edition (BDI−II) was used to quantify levels of depressive symptoms. BDI−II scores ≥ 14 were defined as depressive symptoms. Mean age, duration of HD, haemoglobin levels, serum ferritin levels, serum iron levels, transferrin saturation (TSAT), total iron binding capacity, serum albumin levels, and C-reactive protein were included in the model. Patients were categorized into four groups according to serum ferritin levels and TSAT. Backward stepwise logistic regression analysis was performed and odds ratios (ORs) and 95% confidence intervals derived. Results: Depressive symptoms were significantly associated with increased serum ferritin levels (OR, 1.010; p=0.0008). Compared with group 1 (ferritin <100 ng/dL, TSAT ≥20%) as reference, ORs for depressive symptoms were significantly increased in group 4 (ferritin ≥100 ng/dL, TSAT < 20%) (OR, 6.419; p=0.0073). Conclusion: Higher serum ferritin levels and decreased iron utilization efficiency were found to be involved in depressive symptoms among patients undergoing HD. Understanding the pathophysiology of depressive symptoms could provide insights into the design of clinical iron management in HD patients.
VL  - 6
IS  - 2
ER  -

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Author Information

Yoshihiro Tsuji

Department of Medical Engineering, Faculty of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
Naoki Suzuki

Department of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan
Yasumasa Hitomi

Department of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan
Yuko Mizuno-Matsumoto

Graduate School of Applied Informatics, University of Hyogo, Kobe, Japan
Toshiko Tokoro

Department of Nephrology, Tojinkai Satellite Clinic, Kyoto, Japan
Masato Nishimura

Cardiovascular Division, Tojinkai Satellite Clinic, Kyoto, Japan

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APA Style

Yoshihiro Tsuji, Naoki Suzuki, Yasumasa Hitomi, Yuko Mizuno-Matsumoto, Toshiko Tokoro, et al. (2020). Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study. International Journal of Biomedical Engineering and Clinical Science, 6(2), 48-54. https://doi.org/10.11648/j.ijbecs.20200602.14

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ACS Style

Yoshihiro Tsuji; Naoki Suzuki; Yasumasa Hitomi; Yuko Mizuno-Matsumoto; Toshiko Tokoro, et al. Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study. Int. J. Biomed. Eng. Clin. Sci. 2020, 6(2), 48-54. doi: 10.11648/j.ijbecs.20200602.14

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AMA Style

Yoshihiro Tsuji, Naoki Suzuki, Yasumasa Hitomi, Yuko Mizuno-Matsumoto, Toshiko Tokoro, et al. Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study. Int J Biomed Eng Clin Sci. 2020;6(2):48-54. doi: 10.11648/j.ijbecs.20200602.14

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@article{10.11648/j.ijbecs.20200602.14,
  author = {Yoshihiro Tsuji and Naoki Suzuki and Yasumasa Hitomi and Yuko Mizuno-Matsumoto and Toshiko Tokoro and Masato Nishimura},
  title = {Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study},
  journal = {International Journal of Biomedical Engineering and Clinical Science},
  volume = {6},
  number = {2},
  pages = {48-54},
  doi = {10.11648/j.ijbecs.20200602.14},
  url = {https://doi.org/10.11648/j.ijbecs.20200602.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijbecs.20200602.14},
  abstract = {Background: Iron status has a critical role in depressive symptoms, but evaluation of depressive symptoms associated with iron metabolism is not usually included as a clinical parameter in hemodialysis (HD) patients. We aimed to assess the correlations between depressive symptoms and clinical, demographic, and laboratory variables including iron metabolism. Methods: One hundred and thirty-eight HD patients were evaluated in this study. The Beck Depression Inventory Second Edition (BDI−II) was used to quantify levels of depressive symptoms. BDI−II scores ≥ 14 were defined as depressive symptoms. Mean age, duration of HD, haemoglobin levels, serum ferritin levels, serum iron levels, transferrin saturation (TSAT), total iron binding capacity, serum albumin levels, and C-reactive protein were included in the model. Patients were categorized into four groups according to serum ferritin levels and TSAT. Backward stepwise logistic regression analysis was performed and odds ratios (ORs) and 95% confidence intervals derived. Results: Depressive symptoms were significantly associated with increased serum ferritin levels (OR, 1.010; p=0.0008). Compared with group 1 (ferritin <100 ng/dL, TSAT ≥20%) as reference, ORs for depressive symptoms were significantly increased in group 4 (ferritin ≥100 ng/dL, TSAT < 20%) (OR, 6.419; p=0.0073). Conclusion: Higher serum ferritin levels and decreased iron utilization efficiency were found to be involved in depressive symptoms among patients undergoing HD. Understanding the pathophysiology of depressive symptoms could provide insights into the design of clinical iron management in HD patients.},
 year = {2020}
}

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TY  - JOUR
T1  - Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study
AU  - Yoshihiro Tsuji
AU  - Naoki Suzuki
AU  - Yasumasa Hitomi
AU  - Yuko Mizuno-Matsumoto
AU  - Toshiko Tokoro
AU  - Masato Nishimura
Y1  - 2020/06/29
PY  - 2020
N1  - https://doi.org/10.11648/j.ijbecs.20200602.14
DO  - 10.11648/j.ijbecs.20200602.14
T2  - International Journal of Biomedical Engineering and Clinical Science
JF  - International Journal of Biomedical Engineering and Clinical Science
JO  - International Journal of Biomedical Engineering and Clinical Science
SP  - 48
EP  - 54
PB  - Science Publishing Group
SN  - 2472-1301
UR  - https://doi.org/10.11648/j.ijbecs.20200602.14
AB  - Background: Iron status has a critical role in depressive symptoms, but evaluation of depressive symptoms associated with iron metabolism is not usually included as a clinical parameter in hemodialysis (HD) patients. We aimed to assess the correlations between depressive symptoms and clinical, demographic, and laboratory variables including iron metabolism. Methods: One hundred and thirty-eight HD patients were evaluated in this study. The Beck Depression Inventory Second Edition (BDI−II) was used to quantify levels of depressive symptoms. BDI−II scores ≥ 14 were defined as depressive symptoms. Mean age, duration of HD, haemoglobin levels, serum ferritin levels, serum iron levels, transferrin saturation (TSAT), total iron binding capacity, serum albumin levels, and C-reactive protein were included in the model. Patients were categorized into four groups according to serum ferritin levels and TSAT. Backward stepwise logistic regression analysis was performed and odds ratios (ORs) and 95% confidence intervals derived. Results: Depressive symptoms were significantly associated with increased serum ferritin levels (OR, 1.010; p=0.0008). Compared with group 1 (ferritin <100 ng/dL, TSAT ≥20%) as reference, ORs for depressive symptoms were significantly increased in group 4 (ferritin ≥100 ng/dL, TSAT < 20%) (OR, 6.419; p=0.0073). Conclusion: Higher serum ferritin levels and decreased iron utilization efficiency were found to be involved in depressive symptoms among patients undergoing HD. Understanding the pathophysiology of depressive symptoms could provide insights into the design of clinical iron management in HD patients.
VL  - 6
IS  - 2
ER  -

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