Meng Xudong, Han Liuhu, Fu Jiajing, Hu Chengyang, Lu Yao
Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China.
J Affect Disord. 2025 Apr 15;375:214-221. doi: 10.1016/j.jad.2025.01.108. Epub 2025 Jan 23.
Individuals with metabolic syndrome (MetS) have an increased risk of depressive symptoms, with inflammation hypothesized to mediate this association. This study used data from the National Health and Nutrition Examination Survey (NHANES) (2015-2020) to investigate the relationship between MetS and depression and assess the mediating role of inflammatory markers.
This cross-sectional study included 20,520 participants. MetS was defined using the NCEP ATP III criteria. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9), with scores ≥10 indicating clinical significance. Inflammatory markers evaluated included C-reactive protein (CRP), white blood cell count (WBC), and neutrophil-to-lymphocyte ratio (NLR), among others. Multivariable linear and logistic regression models were applied to examine associations, and mediation analysis was conducted to evaluate the potential mediating effects.
Overall, 7.64 % of participants exhibited depressive symptoms. MetS was associated with an increased risk of depression in both females (OR: 1.49, 95 % CI: 1.28-1.74) and males (OR: 1.32, 95 % CI: 1.09-1.60) after adjusting for confounders. Among MetS components, central obesity, hypertension, and dyslipidemia demonstrated the strongest associations with depression. Inflammatory markers mediated 26.79 % of the MetS-depression relationship, with CRP contributing the largest proportion (17.24 %).
MetS and its components significantly increase the risk of depressive symptoms, with the relationship partially mediated by inflammatory markers. Chronic inflammation may play a critical role in linking MetS to depression, underscoring the importance of integrated management strategies targeting both metabolic and mental health.
患有代谢综合征（MetS）的个体出现抑郁症状的风险增加，炎症被认为是介导这种关联的因素。本研究使用了国家健康与营养检查调查（NHANES）（2015 - 2020年）的数据，以调查MetS与抑郁症之间的关系，并评估炎症标志物的中介作用。
这项横断面研究纳入了20520名参与者。MetS采用美国国家胆固醇教育计划成人治疗组第三次报告（NCEP ATP III）标准进行定义。使用患者健康问卷9项（PHQ - 9）评估抑郁症状，得分≥10表明具有临床意义。评估的炎症标志物包括C反应蛋白（CRP）、白细胞计数（WBC）和中性粒细胞与淋巴细胞比值（NLR）等。应用多变量线性和逻辑回归模型来检验关联，并进行中介分析以评估潜在的中介效应。
总体而言，7.64%的参与者表现出抑郁症状。在调整混杂因素后，MetS与女性（比值比：1.49，95%置信区间：1.28 - 1.74）和男性（比值比：1.32，95%置信区间：1.09 - 1.60）患抑郁症的风险增加相关。在MetS的各组成部分中，中心性肥胖、高血压和血脂异常与抑郁症的关联最为强烈。炎症标志物介导了MetS与抑郁症关系的26.79%，其中CRP贡献的比例最大（17.24%）。
MetS及其组成部分显著增加了抑郁症状的风险，这种关系部分由炎症标志物介导。慢性炎症可能在将MetS与抑郁症联系起来方面起关键作用，强调了针对代谢和心理健康的综合管理策略的重要性。
