ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1646514
This article is part of the Research TopicNutrition and Aging: Multidisciplinary Approaches to Address Nutritional Deficiencies and their Impact on Health OutcomesView all 5 articles
Association between Geriatric Nutrition Risk Index and Depression in Older Hemodialysis Patients with and without Type 2 Diabetes Mellitus : A multicenter cross-sectional study
Provisionally accepted
Jinwen Zhang1,2Jing Gao3Siqin Gaowa4Peipei Han2
Xiaoyu Chen2Pingping Cai5Jiangling Guo1,2
WU Qianhao1,2Jingjie Miao1,2Chengzhang Zhao2Keying Zhang2Lingyao Kong2Jing Shui2
Qi Guo1,2*- 1Shanghai University of Traditional Chinese Medicine, Shanghai, China
- 2Shanghai University of Medicine and Health Sciences, Shanghai, China
- 3General Practice Clinic, Pujiang Community Health Service Center in Minhang District, Shanghai, China
- 4Inner Mongolia Autonomous Region People's Hospital, Hohhot, China
- 5Fujian Medical University, Fuzhou, China
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Objectives: The purpose of this study was to observe the relationship between the Geriatric Nutrition Risk Index (GNRI) and depression in the presence or absence of type 2 diabetes mellitus (T2DM) in older adults undergoing hemodialysis. Design: In this multicenter cross-sectional study, 684 clinically stable and aged ≥60 years hemodialysis patients (431 men; mean age: 69.6 ± 6.6 years) were included from seven dialysis units in Shanghai, China. Measures: Depressive symptoms were assessed using the PHQ-9 scale, and T2DM diagnoses were determined by medical records. Multinomial logistic regression was performed to evaluate the association between Geriatric Nutritional Risk Index (GNRI) and depression. Results: Hemodialysis patients with diabetes had a high prevalence of depression (39.4%). In diabetes patients, GNRI was associated with depression after adjusting covariates [OR = 0.984; 95% confidence interval (CI) = 0.969–0.999, P = 0.046]. However, no significant association was found between GNRI and depression in the non-diabetes hemodialysis patients (P > 0.05). Conclusions: This cross-sectional study examines the relationship between the Geriatric Nutritional Risk Index (GNRI) and depression in hemodialysis patients with T2DM rather than the non-T2DM group. Further studies are needed to investigate more causal relationships between GNRI and depression in patients with T2DM.
Keywords: Geriatric Nutritional Risk Index, Depression, type 2 diabetes mellitus, hemodialysis, Malnutrition
Received: 16 Jun 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Zhang, Gao, Gaowa, Han, Chen, Cai, Guo, Qianhao, Miao, Zhao, Zhang, Kong, Shui and Guo. 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: Qi Guo, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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