Zhou Junteng, Kong Qihang, Liu Xiaojing, Huang Yan
Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.
Laboratory of Cardiovascular Diseases, Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China.
Front Public Health. 2025 May 7;13:1596844. doi: 10.3389/fpubh.2025.1596844. eCollection 2025.
This study investigates the association between myeloperoxidase (MPO) levels and anxiety risk in Chinese adults and explores potential effect modifiers, with implications for neuroinflammatory biomarker-guided anxiety prevention strategies.
Using cross-sectional data from 30,418 adults undergoing routine health examinations (July 2020-June 2021), anxiety severity was assessed via the Self-Rating Anxiety Scale (SAS; score ≥ 50 as clinically relevant). Plasma MPO was quantified by ELISA. Multivariate logistic regression, restricted cubic splines (RCS), threshold effect analysis, and subgroup interactions were conducted to evaluate nonlinear associations.
A U-shaped relationship between MPO and anxiety risk was identified. In fully adjusted models, participants in the lowest (Q1: ≤29.77 ng/mL, OR = 1.15, 95% CI: 1.03-1.28, = 0.01) and highest quintiles (Q5: ≥47.3 ng/mL, OR = 1.17, 95% CI: 1.05-1.31, = 0.004) exhibited significantly elevated anxiety risks compared to the reference quintile (Q2: 29.8-34.7 ng/mL). RCS analysis confirmed a nonlinear association ( for nonlinearity < 0.01), with an inflection point at 30 ng/mL: below this threshold, each 1 ng/mL MPO increase reduced anxiety risk (OR = 0.982, CI: 0.970-0.994), while levels above it heightened risk (OR = 1.004, CI: 1.001-1.008). Diabetes mellitus significantly modified this relationship (-interaction = 0.028), with diabetic individuals showing amplified risks at higher plasma MPO (Q5 OR = 1.84 vs. non-diabetic Q5 OR = 1.15).
Plasma MPO demonstrates a U-shaped association with anxiety risk independent of cardiometabolic confounders. Diabetic individuals exhibit heightened susceptibility to MPO-related anxiety, suggesting synergistic neuroinflammatory pathways. Monitoring MPO may aid in risk stratification and personalized interventions, particularly in populations with diabetes.
本研究调查中国成年人中髓过氧化物酶（MPO）水平与焦虑风险之间的关联，并探索潜在的效应修饰因素，为神经炎症生物标志物指导的焦虑预防策略提供依据。
利用30418名接受常规健康检查的成年人（2020年7月至2021年6月）的横断面数据，通过自评焦虑量表（SAS；得分≥50为具有临床意义）评估焦虑严重程度。采用酶联免疫吸附测定法（ELISA）对血浆MPO进行定量。进行多变量逻辑回归、限制性立方样条（RCS）分析、阈值效应分析和亚组交互分析，以评估非线性关联。
确定了MPO与焦虑风险之间呈U形关系。在完全调整模型中，最低五分位数组（Q1：≤29.77 ng/mL，OR = 1.15，95%CI：1.03 - 1.28，P = 0.01）和最高五分位数组（Q5：≥47.3 ng/mL，OR = 1.17，95%CI：1.05 - 1.31，P = 0.004）的参与者与参考五分位数组（Q2：29.8 - 34.7 ng/mL）相比，焦虑风险显著升高。RCS分析证实了非线性关联（非线性检验P < 0.01），拐点为30 ng/mL：低于此阈值，MPO每增加1 ng/mL，焦虑风险降低（OR = 0.982，CI：0.970 - 0.994），而高于此水平则风险升高（OR = 1.004，CI：1.001 - 1.008）。糖尿病显著改变了这种关系（交互作用P = 0.028），糖尿病患者在血浆MPO水平较高时风险增加（Q5组中糖尿病患者OR = 1.84，非糖尿病患者OR = 1.15）。
血浆MPO与焦虑风险呈U形关联，独立于心血管代谢混杂因素。糖尿病患者对MPO相关焦虑的易感性更高，提示存在协同的神经炎症途径。监测MPO可能有助于风险分层和个性化干预，特别是在糖尿病患者群体中。
