Association between the cholesterol-high-density lipoprotein-glucose index and the prevalence of depressive symptoms among U.S. adults: An exploratory analysis of nationally representative cross-sectional data.
TL;DR
In this nationally representative sample of U.S. adults, the CHG index was positively associated with the prevalence of depressive symptoms and it was suggested that HOMA-IR and ALB may statistically account for part of this association.
Abstract
Background
The cholesterol, high-density lipoprotein, and glucose (CHG) index is a novel marker of metabolic burden and has been associated with metabolic dysfunction and cardiovascular disease (CVD) risk. However, its association with depressive symptoms remains unclear.
Methods
We analyzed 8,596 adults from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Depressive symptoms were identified using a Patient Health Questionnaire-9 (PHQ-9) score of ≥10. Weighted logistic regression, restricted cubic spline (RCS) analyses, subgroup analyses, and exploratory mediation analyses were used to assess the association between the CHG index and depressive symptoms. Sensitivity analyses were conducted using propensity score matching (PSM), unweighted logistic regression, and a survey-weighted model additionally adjusted for survey cycle.
Results
In fully adjusted models, participants in the highest CHG quartile had greater odds of depressive symptoms than those in the lowest quartile (OR = 1.65, 95% CI: 1.12-2.43; P for trend = 0.013), with consistent findings observed in the sensitivity analyses. RCS analysis indicated a linear dose-response relationship between the CHG index and depressive symptoms (P for nonlinearity = 0.575). After adjustment for potential confounders, exploratory mediation analyses showed that the homeostasis model assessment of insulin resistance (HOMA-IR) and albumin (ALB) statistically accounted for 11.25% and 5.15% of the observed association, respectively.
Conclusions
In this nationally representative sample of U.S. adults, the CHG index was positively associated with the prevalence of depressive symptoms. Exploratory mediation analyses suggested that HOMA-IR and ALB may statistically account for part of this association. Future studies in larger independent cohorts are needed to validate these findings and confirm the potential value of the CHG index in assessing depressive symptoms.