Association between TG/HDL-C and depression in US adults: A nationally representative cross-sectional study

Lipid profile disturbances are frequently observed in depressive patients. Triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) can be reflective of the level of blood lipids. However, it remains unclear whether higher TG/HDL-C increases the risk of depression. This study aimed to investigate the association between TG/HDL-C and depression. In this cross-sectional study, 20,406 participants were analyzed from the National Health and Nutrition Examination Survey between 2005 and 2020. A weighted multivariable logistic regression model, restricted cubic spline regression model and threshold effect analysis were used to explore the association of TG/HDL-C with depression risk. A total of 20,406 participants who had complete data on TG/HDL-C and depression measurement were included in this study (median age 47 years, 50.51% female). Participants with depression had higher TG/HDL-C than those without depression (0.97 [0.54-1.64] vs 0.82 [0.50-1.38], P < .001). TG/HDL-C was associated with an increased risk of depression after adjusting for all covariates (in model 3: odds ratio (OR) = 1.31, 95% confidence interval (CI): 1.04-1.64, P = .02). Moreover, a nonlinear J-shaped relationship was observed between TG/HDL-C ratio and the risk of depression, with an inflection point of 0.402 by threshold effect analysis. These findings indicate that TG/HDL-C has a J-shaped association with the risk of depression (P for non-linearity = .008).