Joint Effects of Physical Activity and Diet Quality on Depression and Mortality in U.S. Adults With Diabetes: A Population-Based Cohort Study Using NHANES 2007-2018 With Mediation and Machine Learning Analyses
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 3,621
- 试验地点
- 1
- 主要终点
- Proportion of Adults With Diabetes Meeting Depression Criteria at Baseline (PHQ-9 ≥5)
研究概览
简要总结
This observational study aims to investigate whether physical activity (PA) and diet quality (DQ) can reduce depression and mortality risk in individuals with diabetes. Participants will be adults diagnosed with diabetes during the 2007-2018 cycle of the National Health and Nutrition Examination Survey (NHANES). The main questions to be answered include:
Does higher levels of physical activity significantly reduce the risk of depression in individuals with diabetes? Is higher diet quality associated with lower mortality in individuals with diabetes? Investigators will compare individuals with varying levels of PA and DQ to examine whether these two lifestyle factors, both individually and in combination, have protective effects on mental health and survival.
Participants will:
Complete questionnaires regarding their physical activity and dietary intake; Be assessed for depressive symptoms (PHQ-9); Be enrolled in long-term mortality follow-up (from the National Death Index); Analyses will be categorized according to their PA (measured in MET-min/week) and HEI-2015 dietary score.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults aged 20 years and older.
- •Diagnosed with diabetes mellitus, defined by self-report, fasting plasma glucose ≥126 mg/dL, or HbA1c ≥6.5%.
- •Available data on physical activity, diet quality (HEI-2015), and depression status (PHQ-9).
- •Complete demographic and mortality follow-up data.
排除标准
- •Missing key exposure or outcome data (e.g., physical activity, HEI-2015, PHQ-9, mortality).
- •Pregnant individuals at the time of the survey.
- •Participants with unreliable or extreme dietary intake data (e.g., energy intake <500 or >5000 kcal/day).
结局指标
主要结局
Proportion of Adults With Diabetes Meeting Depression Criteria at Baseline (PHQ-9 ≥5)
时间窗: At the time of baseline NHANES examination for each 2-year survey cycle, including 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018 (6 cycles in total, each lasting 2 years).
Depression will be measured using the Patient Health Questionnaire-9 (PHQ-9), a validated 9-item self-report instrument scored from 0 to 27. Participants scoring ≥5 will be classified as having depressive symptoms. The outcome is the percentage of participants who meet this criterion at baseline.
次要结局
- Odds Ratio for Depression by Physical Activity Category in Adults With Diabetes(At the time of baseline NHANES examination for each 2-year survey cycle, including 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018 (6 cycles in total, each lasting 2 years).)
- Odds Ratio for Depression by Diet Quality Category in Adults With Diabetes(At the time of baseline NHANES examination for each 2-year survey cycle, including 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018 (6 cycles in total, each lasting 2 years).)
- Odds Ratio for Depression by Combined Physical Activity and Diet Quality Categories in Adults With Diabetes(At the time of baseline NHANES examination for each 2-year survey cycle, including 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018 (6 cycles in total, each lasting 2 years).)
- Subgroup analysis for All-Cause Mortality by Combined Physical Activity and Diet Quality Categories in Adults With Diabetes and Comorbid Depression(From baseline NHANES examination to December 31, 2019 (up to 120 months follow-up))
研究者
Minghui Wang
Principal Investigator
Wuhan Sports University