ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Public Mental Health
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1596708
This article is part of the Research TopicMental Health of Vulnerable Groups: Predictors, Mechanisms, and InterventionsView all 31 articles
The Uric Acid-to-HDL Ratio as a Predictive Biomarker for Depression Risk in Adult Women
Provisionally accepted
Yang Wu1
Zhe Wang2*- 1Heilongjiang Nursing College, HarBin City, China
- 2Third Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China
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Background: Depression disproportionately affects women, yet biomarkers for early risk stratification remain limited. This study examines the uric acid-to-HDL cholesterol ratio (UHR), a novel inflammatory and metabolic marker, as a potential predictor of depression in women.Objective: To evaluate the association between UHR and depression risk in adult women.Methods: This pooled cross-sectional analysis included 7,925 women aged ≥20 years, using the combined 2005–2018 NHANES cycles. Depression was defined by a Patient Health Questionnaire-9 (PHQ-9) score ≥10. UHR was calculated as uric acid (mg/dL) divided by HDL cholesterol (mg/dL) multiplied by 100%. Multivariable logistic regression was adjusted for sociodemographic, clinical, and lifestyle confounders. Threshold effects and subgroup analyses were conducted to explore nonlinear relationships and robustness across population strata.Results: Elevated UHR showed a linear association with increased depression risk. Each unit increase in UHR corresponded to a 5% higher likelihood of depression (OR=1.05, 95% CI=1.02–1.09). Women in the highest UHR quartile had nearly double the depression risk compared to the lowest quartile (OR=1.97, 95% CI=1.40–2.77). A critical inflection point at UHR=8.12 indicated a 6% incremental risk per unit beyond this threshold. Subgroup analyses confirmed consistent associations across demographic and clinical groups, with heightened effects in women aged <45 years.Conclusion: Higher UHR levels are independently associated with depression in adult women, suggesting its utility as a metabolic-inflammatory biomarker for depression risk stratification. These findings highlight the interplay between lipid metabolism, oxidative stress, and mental health, advocating for UHR integration into preventive strategies for women’s mental well-being.
Keywords: Uric Acid-to-HDL Ratio, Depression risk, metabolic dysregulation, Oxidative Stress, Women's Mental Health
Received: 20 Mar 2025; Accepted: 23 Jul 2025.
Copyright: © 2025 Wu and Wang. 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: Zhe Wang, Third Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China
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