视黄酸受体（RAR）与抑郁症患病率及预后的关联：一项基于人群的研究。

Association between RAR and the prevalence and prognosis of depression: A population-based study.

作者信息

Zhu Xiao-Feng, Hu Yu-Qi, Long Zhi-Wei, Cao Ming-Zhu

机构信息

Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, China; Nanshan School, Guangzhou Medical University, Guangzhou 511436, China.

Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, China; Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou 511436, China.

出版信息

J Affect Disord. 2025 Jul 1;380:1-9. doi: 10.1016/j.jad.2025.03.100. Epub 2025 Mar 21.

DOI:10.1016/j.jad.2025.03.100

PMID:40120147

Abstract

BACKGROUND

Depression has become a significant public health issue. The red blood cell distribution width to albumin ratio (RAR) is regarded as a reliable marker of inflammation and nutritional status, yet the association between them remains unknown. Therefore, this study aims to evaluate the association between RAR and depression.

METHODS

28,737 participants were included in the National Health and Nutrition Examination Survey 2005-2018. The weighted multivariate logistic regression and Cox regression explored the relationship between RAR and the prevalence and mortality of depression. Restricted cubic spline (RCS) detected nonlinear relationships and threshold effects. The stratified analysis explored potential interaction variables.

RESULTS

In the cross-sectional study, 2519 participants (7.67 %) had depression. Weighted multivariate logistic regression showed RAR was independently associated depression (OR = 1.26, 95 % CI = 1.12, 1.42, P < 0.001). In the cohort study, there were 301 cases of all-cause mortality (9.94 %) in depression population, including 77 cases of cardiovascular mortality (2.66 %). Weighted multivariate Cox regression analysis presented that RAR was related to higher all-cause mortality (HR = 1.98, 95 % CI = 1.62, 2.42, P < 0.001) and cardiovascular mortality (HR = 1.73, 95 % CI = 1.19, 2.51, P = 0.004) in the depression population. Subgroup analysis showed that RAR was consistently related to the prevalence and mortality of depression across all subgroups (all P < 0.05). RCS revealed that the relationship between RAR and depression was nonlinear (P for nonlinear = 0.011), while the association between RAR and all-cause mortality was linear (P for nonlinear = 0.245).

CONCLUSIONS

RAR is significantly associated with the prevalence and prognosis of depression. Nevertheless, more investigation is required to elucidate the underlying processes.

摘要

背景

抑郁症已成为一个重大的公共卫生问题。红细胞分布宽度与白蛋白比值（RAR）被视为炎症和营养状况的可靠标志物，但其之间的关联尚不清楚。因此，本研究旨在评估RAR与抑郁症之间的关联。

方法

2005 - 2018年国家健康与营养检查调查纳入了28737名参与者。加权多变量逻辑回归和Cox回归探讨了RAR与抑郁症患病率和死亡率之间的关系。受限立方样条（RCS）检测非线性关系和阈值效应。分层分析探索潜在的交互变量。

结果

在横断面研究中，2519名参与者（7.67%）患有抑郁症。加权多变量逻辑回归显示RAR与抑郁症独立相关（OR = 1.26，95%CI = 1.12，1.42，P < 0.001）。在队列研究中，抑郁症人群中有301例全因死亡（9.94%），包括77例心血管死亡（2.66%）。加权多变量Cox回归分析表明，RAR与抑郁症人群中较高的全因死亡率（HR = 1.98，95%CI = 1.62，2.42，P < 0.001）和心血管死亡率（HR = 1.73，95%CI = 1.19，2.51，P = 0.004）相关。亚组分析表明，RAR在所有亚组中均与抑郁症的患病率和死亡率持续相关（所有P < 0.05）。RCS显示，RAR与抑郁症之间的关系是非线性的（非线性P = 0.011），而RAR与全因死亡率之间的关联是线性的（非线性P = 0.245）。