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March 6, 2026European journal of medical research0 citationsOpen Access

Shaped association between cardiometabolic index and depressive symptoms: a population-based cross section study of U.S. adults

ZYZhihong YuWLWei LiMWMeng Wang

Key Result

Higher cardiometabolic index (LnCMI≥-2) was associated with a 92% higher odds of depressive symptoms (OR 1.92, 95% CI 1.40-2.64) in US adults.

Key Points

  • This research aims to explore the relationship between cardiometabolic index and depressive symptoms in U.S. adults.
  • Conducted a population-based cross-sectional study
  • Analyzed data from U.S. adults with body mass index ≥ 25 kg/m²
  • Utilized threshold effect analysis to identify turning points in the association
  • Found a strong association between higher cardiometabolic index levels and depressive symptoms
  • Identified a significant turning point in the relationship during threshold analysis

Study Design

Type

Cross-Sectional (n=7,965)

Multicenter

Yes

Structured PICO

Is a higher cardiometabolic index associated with an increased prevalence of depressive symptoms in US adults?

P
Population
7,965 US adults aged ≥18 years from the NHANES 2007-2018 database with complete data on CMI and depressive symptoms, mean age 46.99, 53.15% male.
I
Intervention
Higher Cardiometabolic Index (CMI), calculated from triglycerides, HDL-C, waist circumference, and height (analyzed as Ln-transformed CMI).
C
Comparator
Lower Cardiometabolic Index (CMI) levels (analyzed continuously, by tertiles, and below the inflection point of LnCMI < -2).
O
Outcome
Presence of clinically significant depressive symptoms, defined as a 9-item Patient Health Questionnaire (PHQ-9) total score ≥10.patient reported

A higher cardiometabolic index exhibits a J-shaped association with increased odds of depressive symptoms in US adults, with the risk particularly pronounced in overweight and obese individuals.

Main Result

Effect estimate: OR 1.92 (95% CI 1.40-2.64)

p-value: p=0.003

Limitations

  • Cross-sectional design limits causal inference
  • Residual confounding from unmeasured factors possible
  • Depressive symptoms assessed by self-report PHQ-9, not clinical diagnosis
  • Findings may not generalize beyond US adult population
  • Cross-sectional design cannot infer causality
  • Residual confounding from unmeasured factors cannot be ruled out
  • Depressive symptoms were assessed via self-report (PHQ-9) rather than clinical diagnosis
  • Findings based on a US adult population may not be generalizable to other ethnic groups or settings

Abstract

Our research findings suggest a strong association between higher CMI levels and increased prevalence of depressive symptoms, particularly among American adults with BMI ≥ 25 kg/m2. We further revealed a turning point by threshold effect analysis.

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Cite This Study

Yu et al. (2026) conducted a cross-sectional in U.S. adults aged ≥18 years with complete data on cardiometabolic index and depressive symptoms (n=7,965). Cardiometabolic Index (CMI) vs. Lower CMI levels was evaluated on Prevalence of depressive symptoms defined as PHQ-9 score ≥10 (OR 1.92, 95% CI 1.40-2.64, p=0.003). Higher cardiometabolic index (LnCMI≥-2) was associated with a 92% higher odds of depressive symptoms (OR 1.92, 95% CI 1.40-2.64) in US adults.

synapsesocial.com/papers/69aa7008531e4c4a9ff59683https://doi.org/10.1186/s40001-026-04160-y
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