The relationship between trace elements and depression among older patients with chronic liver disease

Abstract

Introduction: The prevalence of Chronic Liver Disease (CLD) is rising in the older population, older patients with CLD had a Poor Quality of Life (QOL) as they may present with emotional reactions reaching to depression with a deleterious effect on their life. Trace Elements (TEs) and macro-minerals levels may be varied in CLD. They are linked with depression. Objective: Our aim is to detect the association between TEs, macro-minerals, and depression among older patients with CLD. Materials and Methods: A cross-sectional study was conducted among 147 older patients with CLD. Depression was confirmed by the Patient Health Questionnaire (PHQ-9). Liver function tests, electrolytes and TEs (zinc (Zn) and copper (Cu)) were measured. Results: The prevalence of depression was 53.7%. Low serum sodium (Na) and calcium (Ca) levels were statistically significantly related to depression (P-value: 0.020 and 0.000 respectively) with lower serum Magnesium(Mg), serum Phosphorous(P) compared to higher serum Cu levels among depressed than non-depressed CLD, however no difference regarding serum Potassium (K) and Zn levels.By using univariate logistic regression, lower serum Na and Ca levels, malnutrition and diuretics were related to depression among CLD patients (P-value: 0.023, 0.001,0.000, 0.013 respectively). While by using multivariate logistic regression, malnutrition and low serum Ca levels were significantly associated with depression among older CLD patients (P-value: 0.001 and 0.014 respectively) Conclusion: Using diuretics and malnutrition are associated with depression through their effect on serum TEs and macro-minerals. Treating malnutrition and adjusting the dose of diuretics may decrease the risk of depression.