# Relationship between accelerometer-measured physical activity and depressive symptoms in hemodialysis patients with comorbid diabetes mellitus: a multicenter cross-sectional study

## TL;DR

This study found that higher physical activity is linked to fewer depressive symptoms in diabetic patients on hemodialysis, but not in non-diabetic patients.

## Contribution

It identifies a specific link between physical activity and depression in diabetic hemodialysis patients, which was not evident in non-diabetic patients.

## Key findings

- MVPA was negatively associated with depression in diabetic hemodialysis patients after adjusting for covariates.
- No significant association was found between MVPA and depression in non-diabetic hemodialysis patients.
- Depression prevalence was higher in hemodialysis patients with T2DM compared to those without.

## Abstract

The objective of this study was to examine the association between accelerometer-derived moderate-to-vigorous physical activity (MVPA) and depressive symptoms in hemodialysis patients with and without type 2 diabetes mellitus (T2DM).

This cross-sectional study finally included 450 maintenance hemodialysis patients (male 281, average age 62 years) from seven dialysis centers in Shanghai, China. Physical activity (PA) was measured using the triaxial accelerometer (ActiGraph GT3X+, Pensacola, FL, United States). We measured depressive symptoms using the 9-item Patient Health Questionnaire (PHQ-9) (PHQ-9 ⩾ 10). We categorized physical activity into quartile groups (Q1 through Q4), with the first quartile defined as low engagement and the remaining quartiles defined as moderate to high engagement. We used logistic regression and trend test to analyze the relationship between quartile groups and depressive symptoms. The analyses in this study adjusted for a range of confounders.

The prevalence of depression was higher in patients with hemodialysis combined with T2DM (17.2%). In diabetic patients, MVPAQ4 was negatively associated with depression after adjusting for covariates [OR = 0.076; 95% confidence interval (CI) = 0.006–0.955, p = 0.046]. However, in non-diabetic hemodialysis patients, no significant association was found between MVPAQ1-Q4 and depression after adjusting for covariates (p > 0.05).

Moderate-to-vigorous physical activity was associated with depression in the diabetic hemodialysis group, but not in the non-diabetic group. Further studies are needed to investigate more causal relationships between MVPA and depressive symptoms in patients with T2DM.