Introduction
Methods
Study population
Measurements
Depression
Covariates
Statistical analysis
Results
Variables | Total (n = 17,561) | Non-depression (n = 14,788) | Depression (n = 2773) | p | Statistic |
---|---|---|---|---|---|
Gender, n (%) | < 0.001 | 63.096 | |||
Men | 7916 (45.1) | 6857 (46.4) | 1059 (38.2) | ||
Women | 9645 (54.9) | 7931 (53.6) | 1714 (61.8) |
Variables | Total (n = 7916) | 1 (n = 6857) | 2 (n = 1059) | p | Statistic |
---|---|---|---|---|---|
Age, Mean ± SD | 46.9 ± 18.7 | 46.5 ± 18.9 | 49.0 ± 17.7 | < 0.001 | 16.217 |
Race, n (%) | 0.001 | 17.581 | |||
Mexican American | 1165 (14.7) | 1028 (15) | 137 (12.9) | ||
Other Hispanic | 736 (9.3) | 616 (9) | 120 (11.3) | ||
Non-Hispanic White | 3339 (42.2) | 2878 (42) | 461 (43.5) | ||
Non-Hispanic Black | 1605 (20.3) | 1376 (20.1) | 229 (21.6) | ||
Other Race - Including Multi-Racial | 1071 (13.5) | 959 (14) | 112 (10.6) | ||
Ratio of family income to poverty, Mean ± SD | 2.4 ± 1.6 | 2.5 ± 1.6 | 1.8 ± 1.4 | < 0.001 | 182.806 |
Education level, n (%) | < 0.001 | 91.744 | |||
Less Than 9th Grade | 883 (11.6) | 722 (10.9) | 161 (15.9) | ||
9-11th Grade (Includes 12th grade with no diploma) | 1714 (22.4) | 1427 (21.5) | 287 (28.4) | ||
High School Grad/GED or Equivalent | 1730 (22.6) | 1496 (22.6) | 234 (23.1) | ||
Some College or AA degree | 1821 (23.8) | 1594 (24) | 227 (22.5) | ||
Some College or AA degree | 1491 (19.5) | 1389 (21) | 102 (10.1) | ||
Marital status, n (%) | < 0.001 | 86.871 | |||
Married | 4472 (57.6) | 3999 (59.5) | 473 (45.6) | ||
Widowed | 640 (8.2) | 518 (7.7) | 122 (11.8) | ||
Divorced | 885 (11.4) | 713 (10.6) | 172 (16.6) | ||
Separated | 204 (2.6) | 164 (2.4) | 40 (3.9) | ||
Never married | 987 (12.7) | 834 (12.4) | 153 (14.7) | ||
Living with partner | 575 (7.4) | 497 (7.4) | 78 (7.5) | ||
Body Mass Index, Mean ± SD | 28.9 ± 6.5 | 28.8 ± 6.4 | 29.6 ± 7.2 | < 0.001 | 12.761 |
Waist Circumference..cm., Mean ± SD | 101.2 ± 17.0 | 100.8 ± 16.8 | 103.5 ± 18.4 | < 0.001 | 21.467 |
Alcohol intake status, n (%) | 0.679 | 0.775 | |||
Current drinking | 1090 (45.5) | 929 (45.1) | 161 (47.4) | ||
Former drinking | 791 (33.0) | 680 (33) | 111 (32.6) | ||
Never drinking | 517 (21.6) | 449 (21.8) | 68 (20) | ||
Whether to drink too much alcohol, n (%) | < 0.001 | 11.979 | |||
Moderate current drinking | 5254 (91.3) | 4620 (91.8) | 634 (87.9) | ||
Excessive current drinking | 499 (8.7) | 412 (8.2) | 87 (12.1) | ||
Smoking status, n (%) | 0.245 | 2.813 | |||
Current smoking | 975 (21.3) | 836 (21.2) | 139 (21.9) | ||
Former smoking | 1087 (23.8) | 922 (23.4) | 165 (26) | ||
Never smoking | 2512 (54.9) | 2182 (55.4) | 330 (52.1) |
Variables | Total (n = 9645) | 1 (n = 7931) | 2 (n = 1714) | p | Statistic |
---|---|---|---|---|---|
Age, Mean ± SD | 47.7 ± 18.6 | 47.5 ± 18.8 | 48.5 ± 17.4 | 0.05 | 3.826 |
Race, n (%) | < 0.001 | 24.1 | |||
Mexican American | 1397 (14.5) | 1122 (14.1) | 275 (16) | ||
Other Hispanic | 1111 (11.5) | 881 (11.1) | 230 (13.4) | ||
Non-Hispanic White | 3907 (40.5) | 3230 (40.7) | 677 (39.5) | ||
Non-Hispanic Black | 2079 (21.6) | 1704 (21.5) | 375 (21.9) | ||
Other Race - Including Multi-Racial | 1151 (11.9) | 994 (12.5) | 157 (9.2) | ||
Ratio of family income to poverty, Mean ± SD | 2.3 ± 1.6 | 2.4 ± 1.6 | 1.7 ± 1.4 | < 0.001 | 281.981 |
Pregnancy status at exam, n (%) | 0.224 | 1.479 | |||
Yes | 215 (5.7) | 186 (5.9) | 29 (4.7) | ||
NO | 3542 (94.3) | 2952 (94.1) | 590 (95.3) | ||
Education level, n (%) | < 0.001 | 111.894 | |||
Less Than 9th Grade | 1020 (11.0) | 768 (10) | 252 (15.2) | ||
9-11th Grade (Includes 12th grade with no diploma) | 2202 (23.7) | 1745 (22.8) | 457 (27.5) | ||
High School Grad/GED or Equivalent | 2080 (22.3) | 1721 (22.5) | 359 (21.6) | ||
Some College or AA degree | 2296 (24.7) | 1881 (24.6) | 415 (25) | ||
Some College or AA degree | 1712 (18.4) | 1535 (20.1) | 177 (10.7) | ||
Marital status, n (%) | < 0.001 | 121.746 | |||
Married | 4762 (50.2) | 4105 (52.6) | 657 (39) | ||
Widowed | 1330 (14.0) | 1051 (13.5) | 279 (16.5) | ||
Divorced | 1289 (13.6) | 1002 (12.8) | 287 (17) | ||
Separated | 327 (3.4) | 231 (3) | 96 (5.7) | ||
Never married | 1149 (12.1) | 925 (11.9) | 224 (13.3) | ||
Living with partner | 628 (6.6) | 485 (6.2) | 143 (8.5) | ||
Body Mass Index, Mean ± SD | 30.2 ± 8.2 | 29.8 ± 7.9 | 31.9 ± 9.0 | < 0.001 | 94.711 |
Waist Circumference..cm., Mean ± SD | 98.6 ± 17.6 | 97.8 ± 17.3 | 102.3 ± 18.5 | < 0.001 | 89.081 |
Alcohol intake status, n (%) | 0.018 | 8.016 | |||
Current drinking | 1255 (27.4) | 1056 (27.8) | 199 (25.3) | ||
Former drinking | 1759 (38.4) | 1422 (37.4) | 337 (42.8) | ||
Never drinking | 1572 (34.3) | 1321 (34.8) | 251 (31.9) | ||
Whether to drink too much alcohol, n (%) | < 0.001 | 39.404 | |||
Moderate current drinking | 5940 (97.9) | 4967 (98.5) | 973 (95.4) | ||
Excessive current drinking | 125 (2.1) | 78 (1.5) | 47 (4.6) | ||
Smoking status, n (%) | 0.83 | 0.372 | |||
Current smoking | 1156 (20.6) | 961 (20.7) | 195 (20.1) | ||
Former smoking | 1322 (23.6) | 1087 (23.5) | 235 (24.3) | ||
Never smoking | 3124 (55.8) | 2586 (55.8) | 538 (55.6) |
Variable | Crude model | Model 1 | Model 2 | |||||
---|---|---|---|---|---|---|---|---|
Crude OR (95% CI) | P | Adjusted OR (95% CI)a | Pa | Adjusted OR (95% CI)b | Pb | Adjusted OR (95% CI)c | Pc | |
Albumin (g/L) | 0.94 (0.92 ~ 0.96) | < 0.001 | 0.95 (0.93 ~ 0.97) | < 0.001 | 0.95 (0.93 ~ 0.98) | 0.001 | 0.96 (0.93 ~ 0.99) | 0.013 |
Alanineamino transferase (U/L) | 1 (1 ~ 1) | 0.112 | 1 (1 ~ 1) | 0.044 | 1 (1 ~ 1.01) | 0.033 | 1 (1 ~ 1.01) | 0.166 |
Aspartate aminotransferase (U/L) | 1 (1 ~ 1.01) | 0.002 | 1 (1 ~ 1.01) | 0.003 | 1 (1 ~ 1.01) | 0.272 | 1 (1 ~ 1.01) | 0.285 |
Alkaline phosphatase (U/L) | 1 (1 ~ 1) | 0.111 | 1 (1 ~ 1) | 0.087 | 1 (1 ~ 1.01) | 0.161 | 1 (1 ~ 1.01) | 0.228 |
Blood urea nitrogen (mmol/L) | 1 (0.97 ~ 1.03) | 0.851 | 0.97 (0.94 ~ 1.01) | 0.129 | 1 (1 ~ 1) | 0.087 | 0.96 (0.91 ~ 1.01) | 0.124 |
Total calcium (mmol/L) | 0.72 (0.34 ~ 1.52) | 0.388 | 0.88 (0.41 ~ 1.91) | 0.75 | 0.96 (0.91 ~ 1.01) | 0.24 | 0.73 (0.25 ~ 2.14) | 0.566 |
Cholesterol (mmol/L) | 1.04 (0.98 ~ 1.11) | 0.154 | 1.05 (0.99 ~ 1.11) | 0.119 | 0.53 (0.19 ~ 1.52) | 0.408 | 1.02 (0.94 ~ 1.1) | 0.65 |
Bicarbonate (mmol/L) | 0.97 (0.94 ~ 1) | 0.049 | 0.97 (0.94 ~ 1) | 0.043 | 1.03 (0.96 ~ 1.12) | 0.482 | 0.99 (0.95 ~ 1.03) | 0.747 |
Creatinine (umol/L) | 1 (1 ~ 1) | 0.011 | 1 (1 ~ 1) | 0.082 | 0.99 (0.95 ~ 1.03) | 0.457 | 1 (1 ~ 1) | 0.267 |
Gamma-glutamyl transferase (U/L) | 1 (1 ~ 1) | < 0.001 | 1 (1 ~ 1) | < 0.001 | 1 (1 ~ 1) | 0.013 | 1 (1 ~ 1) | 0.016 |
Glucose (mmol/L) | 1.06 (1.04 ~ 1.09) | < 0.001 | 1.06 (1.03 ~ 1.08) | < 0.001 | 1.06 (1.02 ~ 1.09) | 0.002 | 1.05 (1.01 ~ 1.08) | 0.012 |
Iron (umol/L) | 0.99 (0.98 ~ 1) | 0.02 | 0.99 (0.98 ~ 1) | 0.071 | 0.99 (0.97 ~ 1) | 0.083 | 0.99 (0.98 ~ 1.01) | 0.29 |
Lactate dehydrogenase (U/L) | 1 (1 ~ 1) | 0.059 | 1 (1 ~ 1) | 0.135 | 1 (1 ~ 1) | 0.19 | 1 (1 ~ 1) | 0.538 |
Phosphorus (mmol/L) | 0.89 (0.63 ~ 1.25) | 0.498 | 1 (0.7 ~ 1.42) | 0.992 | 1.17 (0.74 ~ 1.86) | 0.496 | 1.28 (0.8 ~ 2.06) | 0.298 |
Total bilirubin (umol/L) | 0.97 (0.96 ~ 0.98) | < 0.001 | 0.97 (0.96 ~ 0.98) | < 0.001 | 0.97 (0.95 ~ 0.99) | < 0.001 | 0.97 (0.95 ~ 0.99) | 0.001 |
Total protein (g/L) | 0.99 (0.98 ~ 1.01) | 0.359 | 1 (0.98 ~ 1.01) | 0.888 | 0.99 (0.97 ~ 1.01) | 0.359 | 0.99 (0.97 ~ 1.01) | 0.39 |
Triglycerides (mmol/L) | 1.06 (1.02 ~ 1.09) | 0.001 | 1.06 (1.02 ~ 1.1) | 0.001 | 1.08 (1.03 ~ 1.12) | 0.001 | 1.06 (1.01 ~ 1.11) | 0.01 |
Uric acid (umol/L) | 1 (1 ~ 1) | 0.694 | 1 (1 ~ 1) | 0.73 | 1 (1 ~ 1) | 0.479 | 1 (1 ~ 1) | 0.055 |
Sodium (mmol/L) | 0.98 (0.95 ~ 1.01) | 0.167 | 0.98 (0.96 ~ 1.01) | 0.193 | 1.01 (0.97 ~ 1.05) | 0.661 | 1.01 (0.97 ~ 1.05) | 0.641 |
Potassium (mmol/L) | 1.28 (1.07 ~ 1.55) | 0.008 | 1.21 (1 ~ 1.46) | 0.052 | 1.17 (0.9 ~ 1.51) | 0.243 | 1.2 (0.92 ~ 1.56) | 0.185 |
Chloride (mmol/L) | 0.98 (0.95 ~ 1) | 0.02 | 0.98 (0.95 ~ 1) | 0.019 | 1 (0.97 ~ 1.03) | 0.849 | 1 (0.97 ~ 1.03) | 0.763 |
Osmolality (mmol/Kg) | 1.01 (1 ~ 1.02) | 0.166 | 1 (0.99 ~ 1.02) | 0.587 | 1.01 (1 ~ 1.03) | 0.158 | 1.01 (0.99 ~ 1.03) | 0.201 |
Globulin (g/L) | 1.03 (1.01 ~ 1.04) | < 0.001 | 1.03 (1.01 ~ 1.04) | < 0.001 | 1.01 (0.99 ~ 1.03) | 0.168 | 1.01 (0.99 ~ 1.03) | 0.462 |
Variable | Crude model | Model 1 | Model 2 | |||||
---|---|---|---|---|---|---|---|---|
Crude OR (95% CI) | P | Adjusted OR (95% CI)a | Pa | Adjusted OR (95% CI)b | Pb | Adjusted OR (95% CI)c | Pc | |
Albumin (g/L) | 1.01 (1 ~ 1.01) | 0.001 | 1.01 (1 ~ 1.01) | 0.001 | 0.98 (0.94 ~ 1.02) | 0.33 | 1 (0.95 ~ 1.04) | 0.834 |
Alanineamino transferase (U/L) | 1.01 (1 ~ 1.01) | 0.001 | 1 (1 ~ 1.01) | 0.002 | 1.01 (1 ~ 1.01) | 0.15 | 1.01 (1 ~ 1.01) | 0.213 |
Aspartate aminotransferase (U/L) | 1.01 (1 ~ 1.01) | 0.001 | 1.01 (1 ~ 1.01) | 0.001 | 1.01 (1 ~ 1.02) | 0.074 | 1.01 (1 ~ 1.02) | 0.057 |
Alkaline phosphatase (U/L) | 1.01 (1 ~ 1.01) | < 0.001 | 1.01 (1 ~ 1.01) | < 0.001 | 1.01 (1 ~ 1.01) | 0.02 | 1.01 (1 ~ 1.01) | 0.032 |
Blood urea nitrogen (mmol/L) | 0.99 (0.97 ~ 1.02) | 0.515 | 0.98 (0.95 ~ 1.01) | 0.122 | 0.99 (0.92 ~ 1.06) | 0.703 | 0.99 (0.92 ~ 1.07) | 0.807 |
Total calcium (mmol/L) | 0.81 (0.46 ~ 1.44) | 0.48 | 0.78 (0.44 ~ 1.38) | 0.392 | 0.58 (0.13 ~ 2.53) | 0.467 | 0.68 (0.15 ~ 3.14) | 0.622 |
Cholesterol (mmol/L) | 1.04 (0.99 ~ 1.09) | 0.128 | 1.04 (0.98 ~ 1.09) | 0.185 | 1.06 (0.93 ~ 1.21) | 0.397 | 1.07 (0.94 ~ 1.23) | 0.317 |
Bicarbonate (mmol/L) | 0.99 (0.97 ~ 1.02) | 0.508 | 0.99 (0.96 ~ 1.01) | 0.218 | 1.05 (0.99 ~ 1.11) | 0.092 | 1.06 (1 ~ 1.13) | 0.042 |
Creatinine (umol/L) | 1 (1 ~ 1) | < 0.001 | 1 (1 ~ 1) | < 0.001 | 1 (0.99 ~ 1.01) | 0.937 | 1 (1 ~ 1.01) | 0.756 |
Gamma-glutamyl transferase (U/L) | 1 (1 ~ 1.01) | < 0.001 | 1 (1 ~ 1) | < 0.001 | 1 (1 ~ 1.01) | 0.217 | 1 (1 ~ 1.01) | 0.443 |
Glucose (mmol/L) | 1.07 (1.04 ~ 1.09) | < 0.001 | 1.06 (1.04 ~ 1.09) | < 0.001 | 0.96 (0.89 ~ 1.04) | 0.36 | 0.94 (0.87 ~ 1.03) | 0.182 |
Iron (umol/L) | 0.99 (0.98 ~ 1) | 0.019 | 0.99 (0.98 ~ 1) | 0.046 | 0.99 (0.97 ~ 1.01) | 0.496 | 0.99 (0.97 ~ 1.02) | 0.659 |
Lactate dehydrogenase (U/L) | 1 (1 ~ 1) | 0.003 | 1 (1 ~ 1) | 0.01 | 1 (1 ~ 1.01) | 0.239 | 1 (1 ~ 1.01) | 0.287 |
Phosphorus (mmol/L) | 1.18 (0.87 ~ 1.59) | 0.29 | 1.22 (0.9 ~ 1.64) | 0.206 | 1.69 (0.77 ~ 3.7) | 0.188 | 1.82 (0.82 ~ 4.06) | 0.141 |
Total bilirubin (umol/L) | 0.99 (0.97 ~ 1) | 0.021 | 0.99 (0.97 ~ 1) | 0.024 | 0.99 (0.95 ~ 1.03) | 0.533 | 1 (0.96 ~ 1.03) | 0.887 |
Total protein (g/L) | 1 (0.99 ~ 1.01) | 0.934 | 1 (0.99 ~ 1.01) | 0.934 | 0.98 (0.95 ~ 1.01) | 0.195 | 0.99 (0.95 ~ 1.02) | 0.374 |
Triglycerides (mmol/L) | 1.14 (1.09 ~ 1.19) | < 0.001 | 1.14 (1.09 ~ 1.2) | < 0.001 | 1.11 (0.97 ~ 1.28) | 0.135 | 1.07 (0.92 ~ 1.25) | 0.358 |
Uric acid (umol/L) | 1 (1 ~ 1) | 0.037 | 1 (1 ~ 1) | 0.053 | 1 (1 ~ 1) | 0.639 | 1 (1 ~ 1) | 0.286 |
Sodium (mmol/L) | 1 (0.98 ~ 1.03) | 0.73 | 1 (0.98 ~ 1.02) | 0.958 | 1.07 (1.01 ~ 1.12) | 0.02 | 1.08 (1.02 ~ 1.14) | 0.01 |
Potassium (mmol/L) | 1.04 (0.9 ~ 1.22) | 0.575 | 1.03 (0.88 ~ 1.2) | 0.734 | 1.42 (0.95 ~ 2.1) | 0.084 | 1.36 (0.9 ~ 2.04) | 0.141 |
Chloride (mmol/L) | 0.99 (0.97 ~ 1) | 0.163 | 0.99 (0.97 ~ 1) | 0.154 | 1.02 (0.98 ~ 1.07) | 0.307 | 1.03 (0.98 ~ 1.09) | 0.183 |
Osmolality (mmol/Kg) | 1.01 (1 ~ 1.02) | 0.01 | 1.01 (1 ~ 1.02) | 0.051 | 1.02 (1 ~ 1.05) | 0.094 | 1.03 (1 ~ 1.05) | 0.072 |
Globulin (g/L) | 1.02 (1.01 ~ 1.03) | 0.002 | 1.02 (1.01 ~ 1.03) | 0.005 | 0.99 (0.96 ~ 1.02) | 0.549 | 0.99 (0.95 ~ 1.02) | 0.428 |
Variable | B | SE | Wald | df | P | OR | 95% C.I. |
---|---|---|---|---|---|---|---|
Albumin (g/L) | -0.042 | 0.010 | 18.080 | 1 | 0.000 | 0.959 | 0.941-0.978 |
GGT (U/L) | 0.002 | 0.001 | 11.165 | 1 | 0.001 | 1.002 | 1.001-1.003 |
Glucose (mmol/L) | 0.046 | 0.012 | 14.561 | 1 | 0.000 | 1.047 | 1.023-1.072 |
Tbil (μmol/L) | -0.027 | 0.007 | 16.009 | 1 | 0.000 | 0.973 | 0.960-0.986 |
Constant | −0.112 | 0.435 | 0.066 | 1 | 0.797 | 0.894 |
Variable | B | SE | Wald | df | P | OR | 95% C.I. |
---|---|---|---|---|---|---|---|
Albumin (g/L) | −0.018 | 0.008 | 4.846 | 1 | 0.028 | 0.982 | 0.967-0.998 |
GGT (U/L) | 0.002 | 0.001 | 6.937 | 1 | 0.008 | 1.002 | 1.000-1.003 |
Glucose (mmol/L) | 0.033 | 0.012 | 7.947 | 1 | 0.005 | 1.034 | 1.010-1.058 |
AKP (U/L) | 0.003 | 0.001 | 8.553 | 1 | 0.003 | 1.003 | 1.001-1.005 |
Creatinine (μmol/L) | 0.002 | 0.001 | 9.752 | 1 | 0.002 | 1.002 | 1.001-1.004 |
Triglycerides (mmol/L) | 0.125 | 0.025 | 24.452 | 1 | 0.000 | 1.133 | 1.078-1.190 |
Constant | −1.629 | 0.372 | 19.206 | 1 | 0.000 | 0.196 |
Variable | Sensitivity | Specificity | AUC | 95%CI |
---|---|---|---|---|
Albumin (g/L) | 0.473 | 0.621 | 55.99 | 0.54-0.58 |
GGT (U/L) | 0.522 | 0.547 | 54.33 | 0.52-0.56 |
Glucose (mmol/L) | 0.499 | 0.569 | 53.83 | 0.52-0.56 |
Tbil (μmol/L) | 0.715 | 0.373 | 55.67 | 0.54-0.58 |
Combined markers | 0.652 | 0.500 | 59.16 | 0.57-0.61 |
Variable | Sensitivity | Specificity | AUC | 95%CI |
---|---|---|---|---|
AKP (U/L) | 0.562 | 0.523 | 55.75 | 0.54-0.57 |
Bicarbonate (mmol/L) | 0.001 | 0.996 | 49.36 | 0.48-0.51 |
Sodium (mmol/L) | 0.324 | 0.709 | 50.52 | 0.49-0.52 |
Combined markers | 0.646 | 0.476 | 58.19 | 0.57-0.60 |
Conclusion and directions for future research
Acknowledgements
Declarations
Ethics approval and consent to participate
NHANES 2017-2018 | Protocol #2018-01 (Effective beginning October 26, 2017) |
Continuation of Protocol #2011-17 (Effective through October 26, 2017) | |
NHANES 2015-2016 | Continuation of Protocol #2011-17 |
NHANES 2013-2014 | Continuation of Protocol #2011-17 |
NHANES 2011-2012 | Protocol #2011-17 |
NHANES 2009-2010 | Continuation of Protocol #2005-06 |