ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Public Mental Health
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1589000
This article is part of the Research TopicThe Intersection of Psychology, Healthy Behaviors, and its OutcomesView all 105 articles
Health Risks of Depression in Middle-aged and Older Adults: The Association of Cumulative Average Triglycerides-Glucose-Body Mass Index with Cardiovascular Metabolic Multimorbidity
Provisionally accepted
- 1Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
- 2Xuzhou Medical University, Xuzhou, China
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Background: Depression frequently coexists with cardiovascular metabolic multimorbidity (CMM) in aging populations. This study investigates the association between TyG-BMI (a combined insulin resistance and obesity index) and subsequent CMM development in depressed adults, while assessing whether demographic factors modify this relationship.Methods: This study is based on data from the China Health and Retirement Longitudinal Study (CHARLS). The exposure variable is the cumulative average TyG-BMI, calculated from the average TyG-BMI at baseline and during follow-up studies (2011 and 2015 waves). TyG-BMI is derived from triglycerides, fasting blood glucose, and body mass index. The primary outcome is CMM events. Logistic regression and restricted cubic spline (RCS) regression analysis were used to examine the relationship between cumulative average TyG-BMI and CMM incidence, with subgroup analyses for potential moderating effects and mediation effect analysis.Results: A total of 1,743 participants were included, of whom 1,093 (62.7%) were female, with a mean age of 59.4 (8.77) years. The average cumulative TyG-BMI was 198.12 (36.15). During follow-up, 246 participants (14.1%) experienced CMM. Fully adjusted logistic regression showed a significant association between cumulative average TyG-BMI and CMM [OR 1.651 (1.398-1.95) per 1 SD increase]. RCS regression indicated a positive linear correlation (overall P < 0.001, non-linear P = 0.75). Subgroup analysis showed the relationship varied by age (P < 0.05). Mediation effects suggested age and glycated hemoglobin could elevate CMM risk, emphasizing metabolic health importance.Conclusion: Our study demonstrates a significant association between cumulative average TyG-BMI levels and CMM incidence in middle-aged and elderly individuals with depression. The dose-response pattern suggests TyG-BMI may serve as a metabolic health indicator and screening tool for CMM risk. As the first large-scale longitudinal study in depressed individuals, our findings show sustained TyG-BMI elevation correlates with CMM development independent of key confounders. These results support monitoring TyG-BMI trends alongside depression management, with attention to lifestyle factors and metabolic profiles.
Keywords: Depression, Cumulative average TyG-BMI, Cardiovascular metabolic multimorbidity (CMM), middle-aged and elderly populations, Insulin Resistance, Mediation effects
Received: 06 Mar 2025; Accepted: 29 May 2025.
Copyright: © 2025 Zhang, Dong and Dong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Gege Zhang, Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
Ruiguo Dong, Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
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