Association between NHHR and depression symptoms among U.S. adults with hypertension: a cross sectional

BACKGROUND: The non-HDL cholesterol to HDL cholesterol ratio (NHHR) is an emerging and reliable lipid marker for assessing the risk of cardiovascular disease. Previous studies have demonstrated a correlation between lipid metabolism and clinically significant depressive symptoms, while also identifying hypertension as a potential risk factor for this condition. This study aims to investigate the association between NHHR and clinically significant depressive symptoms in patients diagnosed with hypertension. METHODS: The study was conducted over a period from 2007 to 2018, utilizing data from the National Health and Nutrition Examination Survey (NHANES). The study population comprised participants aged 18 years and older from across the United States. Depressive symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9), while NHHR values were derived from laboratory cholesterol test results. The cross-sectional analysis included a total of 10,754 participants. Various methods were employed, including multiple logistic regression, curve analysis, threshold effect modeling, and subgroup analysis, to investigate the relationship between NHHR and depressive symptoms. RESULTS: The curve-fitting model demonstrated a distinct U-shaped relationship among the variables examined. Threshold analysis indicates that a cutoff point of 1.25 exists in the association between log-transformed NHHR and clinically significant depressive symptoms. Below this threshold, NHHR was negatively correlated with the prevalence of depressive symptoms (OR = 0.19, 95% CI: 0.07-0.52, P = 0.001), whereas above the threshold, a positive correlation was observed (OR = 1.14, 95% CI: 1.09-1.19, P < 0.001). CONCLUSIONS: The study findings suggest a U-shaped association between NHHR and depressive symptoms in adults with hypertension in the United States. NHHR appears to serve as a succinct indicator of depressive symptoms in individuals aged 18 and older with hypertension. Consequently, further exploration into the correlated factor NHHR may offer an innovative perspective for research on depressive symptoms among this population.