Kunxiu Wang, Gaofeng Liu, Yuchen Pan, Siyu Li, Xiaoling Zhu, Hui Qu, Xuesong Liang, Song Chen, Wenbin Fu
{"title":"中性粒细胞百分比与白蛋白比率介导了美国成年人抑郁症与全因死亡率之间的关联:来自NHANES 2009-2018的证据。","authors":"Kunxiu Wang, Gaofeng Liu, Yuchen Pan, Siyu Li, Xiaoling Zhu, Hui Qu, Xuesong Liang, Song Chen, Wenbin Fu","doi":"10.1016/j.jad.2025.119736","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Depression significaantly reduces the quality of life for hundreds of millions of people globally. Evidence suggests associations among depression, the neutrophil percentage-to-albumin ratio (NPAR), and all-cause mortality (ACM). However, the interrelationship was not elucidated. This study aimed to unveil whether NPAR mediates the correlation between depression and ACM.</p><p><strong>Methods: </strong>A cross-sectional study was carried out based on data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2018. ACM data were collected up to December 31, 2019. Weighted binary logistic regression and generalized linear regression models were leveraged to unravel pairwise associations among depression scores, NPAR, and ACM. Mediation analysis was performed to evaluate the potential mediating effects of NPAR on the relationship between depression and ACM.</p><p><strong>Results: </strong>18,709 participants were encompassed. In the fully adjusted model, depression scores (OR [95 % CI]: 1.035 [1.012, 1.058]) and NPAR (OR [95 % CI]: 1.15 [1.108, 1.194]) were significantly positively linked to ACM. Depression scores were positively correlated with NPAR (β [95 % CI]: 0.014 [0.001, 0.026]). NPAR mediated 5.27 % of the total association between depression and ACM. Subgroup analyses revealed that the mediating effect of NPAR was more prominent in specific populations.</p><p><strong>Conclusion: </strong>Among U.S. adults, depression significantly increases the risk of ACM, and this relationship is mediated by NPAR. The mediating effect of NPAR varied by sex, age, race, and health status. These findings fill gaps in the existing literature.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119736"},"PeriodicalIF":4.9000,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The neutrophil percentage-to-albumin ratio mediates the association between depression and all-cause mortality in U.S. adults: Evidence from NHANES 2009-2018.\",\"authors\":\"Kunxiu Wang, Gaofeng Liu, Yuchen Pan, Siyu Li, Xiaoling Zhu, Hui Qu, Xuesong Liang, Song Chen, Wenbin Fu\",\"doi\":\"10.1016/j.jad.2025.119736\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Depression significaantly reduces the quality of life for hundreds of millions of people globally. Evidence suggests associations among depression, the neutrophil percentage-to-albumin ratio (NPAR), and all-cause mortality (ACM). However, the interrelationship was not elucidated. This study aimed to unveil whether NPAR mediates the correlation between depression and ACM.</p><p><strong>Methods: </strong>A cross-sectional study was carried out based on data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2018. ACM data were collected up to December 31, 2019. Weighted binary logistic regression and generalized linear regression models were leveraged to unravel pairwise associations among depression scores, NPAR, and ACM. Mediation analysis was performed to evaluate the potential mediating effects of NPAR on the relationship between depression and ACM.</p><p><strong>Results: </strong>18,709 participants were encompassed. In the fully adjusted model, depression scores (OR [95 % CI]: 1.035 [1.012, 1.058]) and NPAR (OR [95 % CI]: 1.15 [1.108, 1.194]) were significantly positively linked to ACM. Depression scores were positively correlated with NPAR (β [95 % CI]: 0.014 [0.001, 0.026]). NPAR mediated 5.27 % of the total association between depression and ACM. Subgroup analyses revealed that the mediating effect of NPAR was more prominent in specific populations.</p><p><strong>Conclusion: </strong>Among U.S. adults, depression significantly increases the risk of ACM, and this relationship is mediated by NPAR. The mediating effect of NPAR varied by sex, age, race, and health status. These findings fill gaps in the existing literature.</p>\",\"PeriodicalId\":14963,\"journal\":{\"name\":\"Journal of affective disorders\",\"volume\":\" \",\"pages\":\"119736\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2025-11-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of affective disorders\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jad.2025.119736\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/20 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of affective disorders","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jad.2025.119736","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/20 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
The neutrophil percentage-to-albumin ratio mediates the association between depression and all-cause mortality in U.S. adults: Evidence from NHANES 2009-2018.
Background: Depression significaantly reduces the quality of life for hundreds of millions of people globally. Evidence suggests associations among depression, the neutrophil percentage-to-albumin ratio (NPAR), and all-cause mortality (ACM). However, the interrelationship was not elucidated. This study aimed to unveil whether NPAR mediates the correlation between depression and ACM.
Methods: A cross-sectional study was carried out based on data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2018. ACM data were collected up to December 31, 2019. Weighted binary logistic regression and generalized linear regression models were leveraged to unravel pairwise associations among depression scores, NPAR, and ACM. Mediation analysis was performed to evaluate the potential mediating effects of NPAR on the relationship between depression and ACM.
Results: 18,709 participants were encompassed. In the fully adjusted model, depression scores (OR [95 % CI]: 1.035 [1.012, 1.058]) and NPAR (OR [95 % CI]: 1.15 [1.108, 1.194]) were significantly positively linked to ACM. Depression scores were positively correlated with NPAR (β [95 % CI]: 0.014 [0.001, 0.026]). NPAR mediated 5.27 % of the total association between depression and ACM. Subgroup analyses revealed that the mediating effect of NPAR was more prominent in specific populations.
Conclusion: Among U.S. adults, depression significantly increases the risk of ACM, and this relationship is mediated by NPAR. The mediating effect of NPAR varied by sex, age, race, and health status. These findings fill gaps in the existing literature.
期刊介绍:
The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.