{"title":"中老年人血清尿酸/肌酐比值与抑郁症状之间的关系:来自中国和美国两项大型人群研究的证据","authors":"Jiang-Yu Tu, Meng-Qin Tu","doi":"10.1177/00912174251384015","DOIUrl":null,"url":null,"abstract":"<p><p>ObjectiveEmerging evidence suggests that serum uric acid (SUA) can modulate depressive symptoms, potentially via mechanisms involving oxidative stress. However, whether the serum uric acid/creatinine ratio (SUA/Cr)-a biomarker reflecting net uric acid production-is linked to depressive symptoms in middle-to-late life populations remains unknown.MethodsLongitudinal and cross-sectional analyses were conducted utilizing nationally representative samples from two countries: the China Health and Retirement Longitudinal Study (CHARLS) for longitudinal assessment and the U.S. National Health and Nutrition Examination Survey (NHANES) for cross-sectional evaluation. Multivariable Cox and logistic regression analyses were employed to examine the relationship between the SUA/Cr and depressive symptoms. Dose-response relationships were modeled using restricted cubic splines (RCS), while sensitivity analyses assessed the stability of results. ResultsFrom CHARLS (N = 4317), multivariable Cox regression revealed an inverse relationship between SUA/Cr and depressive symptoms (P-linearity<0.05), with each 1-unit increase linked to a 3% lower risk (HR = 0.97, 95% CI = 0.94-0.99). Q4 showed reduced risk vs Q1 (HR = 0.87, 95% CI = 0.77-0.97). NHANES analysis of cross-sectional data (N = 18 677) confirmed this inverse association (P- linearity<0.05), with a 6% lower odds of significant depression per 1-unit SUA/Cr increase (OR = 0.94, 95% CI = 0.87-1.03). Q3 and Q4 had significantly lower odds vs Q1 (OR = 0.78, 95% CI = 0.64-0.95, and OR = 0.79, 95% CI = 0.65-0.98, respectively). RCS curves confirmed dose-response relationships in both cohorts. Findings remained consistent in sensitivity analyses.ConclusionDepressive symptoms in middle-to-late adulthood were found to be negatively correlated with SUA/Cr levels in longitudinal and cross-sectional analyses. These findings suggest that SUA/Cr levels may function as a biological indicator to facilitate early detection and proactive intervention for depressive disorders.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"912174251384015"},"PeriodicalIF":1.3000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association Between Serum Uric Acid/Creatinine Ratio and Depressive Symptoms in Middle-Aged and Older Adults: Evidence from Two Large Population-Based Studies in China and the United States.\",\"authors\":\"Jiang-Yu Tu, Meng-Qin Tu\",\"doi\":\"10.1177/00912174251384015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>ObjectiveEmerging evidence suggests that serum uric acid (SUA) can modulate depressive symptoms, potentially via mechanisms involving oxidative stress. However, whether the serum uric acid/creatinine ratio (SUA/Cr)-a biomarker reflecting net uric acid production-is linked to depressive symptoms in middle-to-late life populations remains unknown.MethodsLongitudinal and cross-sectional analyses were conducted utilizing nationally representative samples from two countries: the China Health and Retirement Longitudinal Study (CHARLS) for longitudinal assessment and the U.S. National Health and Nutrition Examination Survey (NHANES) for cross-sectional evaluation. Multivariable Cox and logistic regression analyses were employed to examine the relationship between the SUA/Cr and depressive symptoms. Dose-response relationships were modeled using restricted cubic splines (RCS), while sensitivity analyses assessed the stability of results. ResultsFrom CHARLS (N = 4317), multivariable Cox regression revealed an inverse relationship between SUA/Cr and depressive symptoms (P-linearity<0.05), with each 1-unit increase linked to a 3% lower risk (HR = 0.97, 95% CI = 0.94-0.99). Q4 showed reduced risk vs Q1 (HR = 0.87, 95% CI = 0.77-0.97). NHANES analysis of cross-sectional data (N = 18 677) confirmed this inverse association (P- linearity<0.05), with a 6% lower odds of significant depression per 1-unit SUA/Cr increase (OR = 0.94, 95% CI = 0.87-1.03). Q3 and Q4 had significantly lower odds vs Q1 (OR = 0.78, 95% CI = 0.64-0.95, and OR = 0.79, 95% CI = 0.65-0.98, respectively). RCS curves confirmed dose-response relationships in both cohorts. Findings remained consistent in sensitivity analyses.ConclusionDepressive symptoms in middle-to-late adulthood were found to be negatively correlated with SUA/Cr levels in longitudinal and cross-sectional analyses. These findings suggest that SUA/Cr levels may function as a biological indicator to facilitate early detection and proactive intervention for depressive disorders.</p>\",\"PeriodicalId\":50294,\"journal\":{\"name\":\"International Journal of Psychiatry in Medicine\",\"volume\":\" \",\"pages\":\"912174251384015\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Psychiatry in Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/00912174251384015\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Psychiatry in Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00912174251384015","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Association Between Serum Uric Acid/Creatinine Ratio and Depressive Symptoms in Middle-Aged and Older Adults: Evidence from Two Large Population-Based Studies in China and the United States.
ObjectiveEmerging evidence suggests that serum uric acid (SUA) can modulate depressive symptoms, potentially via mechanisms involving oxidative stress. However, whether the serum uric acid/creatinine ratio (SUA/Cr)-a biomarker reflecting net uric acid production-is linked to depressive symptoms in middle-to-late life populations remains unknown.MethodsLongitudinal and cross-sectional analyses were conducted utilizing nationally representative samples from two countries: the China Health and Retirement Longitudinal Study (CHARLS) for longitudinal assessment and the U.S. National Health and Nutrition Examination Survey (NHANES) for cross-sectional evaluation. Multivariable Cox and logistic regression analyses were employed to examine the relationship between the SUA/Cr and depressive symptoms. Dose-response relationships were modeled using restricted cubic splines (RCS), while sensitivity analyses assessed the stability of results. ResultsFrom CHARLS (N = 4317), multivariable Cox regression revealed an inverse relationship between SUA/Cr and depressive symptoms (P-linearity<0.05), with each 1-unit increase linked to a 3% lower risk (HR = 0.97, 95% CI = 0.94-0.99). Q4 showed reduced risk vs Q1 (HR = 0.87, 95% CI = 0.77-0.97). NHANES analysis of cross-sectional data (N = 18 677) confirmed this inverse association (P- linearity<0.05), with a 6% lower odds of significant depression per 1-unit SUA/Cr increase (OR = 0.94, 95% CI = 0.87-1.03). Q3 and Q4 had significantly lower odds vs Q1 (OR = 0.78, 95% CI = 0.64-0.95, and OR = 0.79, 95% CI = 0.65-0.98, respectively). RCS curves confirmed dose-response relationships in both cohorts. Findings remained consistent in sensitivity analyses.ConclusionDepressive symptoms in middle-to-late adulthood were found to be negatively correlated with SUA/Cr levels in longitudinal and cross-sectional analyses. These findings suggest that SUA/Cr levels may function as a biological indicator to facilitate early detection and proactive intervention for depressive disorders.
期刊介绍:
The International Journal of Psychiatry in Medicine (IJPM) bridges the gap between clinical psychiatry research and primary care clinical research. Providing a forum for addressing: The relevance of psychobiological, psychological, social, familial, religious, and cultural factors in the development and treatment of illness; the relationship of biomarkers to psychiatric symptoms and syndromes in primary care...