{
  "abstract": "Background: Low bone mass and depressive symptoms commonly coexist in later life, but their shared metabolic–inflammatory profile is poorly characterized. We examined the remnant cholesterol–inflammation index (RCII) within adults aged ≥50 years with study-defined low bone mass, evaluated its component-specific associations, and assessed directional consistency in a separate outcome-enriched clinical sample.\n\nMethods: This cross-sectional analysis used survey-weighted NHANES data. Logistic and linear regression models examined depressive-symptom screening positivity and PHQ-9 scores, respectively. Restricted cubic splines were used to evaluate dose–response associations, and component-specific models jointly included standardized log-transformed calculated remnant cholesterol (RC) and cycle-specific C-reactive protein (CRP). The primary association was examined in an outcome-enriched clinical sample using the fixed NHANES standard-deviation (SD) scale.\n\nResults: Among 1,743 NHANES participants, 139 screened positive (PHQ-9 ≥10). Each survey-weighted SD increment in ln(RCII) was associated with screening positivity (OR, 1.52; 95% CI, 1.15–2.00; P = 0.004). Odds were higher in the highest versus lowest weighted quartile (OR, 3.00; 95% CI, 1.40–6.43; P for trend = 0.002), with no strong evidence of nonlinearity (P = 0.874). Higher ln(RCII) was also associated with higher PHQ-9 scores (β per SD, 0.38; 95% CI, 0.13–0.63; P = 0.004). In the mutually adjusted component model, the cycle-specific CRP measurement remained associated with screening positivity (OR per SD, 1.44; 95% CI, 1.12–1.84; P = 0.005), whereas calculated RC did not (OR, 1.14; 95% CI, 0.89–1.47; P = 0.284); the direct standardized coefficient contrast was imprecise and nonsignificant (P = 0.179). The direction of association was consistent in the outcome-enriched clinical sample (N = 150; 50 events; adjusted OR per fixed NHANES SD, 3.29; 95% CI, 1.92–5.64; P < 0.001).\n\nConclusion: Higher RCII was associated with greater depressive-symptom burden among adults with low bone mass, with supportive directional clinical corroboration. Prospective studies with clinically confirmed outcomes are needed.",
  "abstract_shown": true,
  "affiliations": [
    "The Seventh Clinical Medical School of Guangzhou University of Chinese Medicine, Shenzhen Bao'an Chinese Medicine Hospital, Shenzhen, Guangdong, China",
    "Shenzhen Bao'an Authentic TCM Therapy Hospital, Shenzhen, Guangdong, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Bin Deng"
    },
    {
      "affs": [
        0
      ],
      "name": "Wei Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaoduo Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhijian Peng"
    },
    {
      "affs": [
        1
      ],
      "name": "Wenhua Liu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4dn4gfn3wds43.bib",
  "cited_by": 0,
  "doi": "10.3389/fpubh.2026.1976857",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13698836/",
  "id": "4dn4gfn3wds43",
  "issns": [
    "2296-2565"
  ],
  "landing_url": "https://doi.org/10.3389/fpubh.2026.1976857",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2746|Lipoproteins and Cardiovascular Health"
    ]
  ],
  "openalex": "W7221161460",
  "pdf_url": "https://europepmc.org/articles/PMC13698836?pdf=render",
  "pmcid": "PMC13698836",
  "pmid": "42935975",
  "published": "2026-10-09",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/4dn4gfn3wds43.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:34Z",
      "native_id": "PMC13698836",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fpubh.2026.1976857"
    },
    {
      "first_seen": "2026-10-30T12:20:22Z",
      "native_id": "10.3389/fpubh.2026.1976857",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1976857/full"
    },
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42935975",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42935975"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Lipoproteins and Cardiovascular Health",
      "subfield": "surgery"
    }
  ],
  "title": "Remnant cholesterol–inflammation index and depressive symptoms in middle-aged and older adults with study-defined low bone mass: component-specific analysis and supportive clinical corroboration",
  "title_text": "Remnant cholesterol–inflammation index and depressive symptoms in middle-aged and older adults with study-defined low bone mass: component-specific analysis and supportive clinical corroboration",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:35:31Z",
  "url": "https://research.draconitic.com/paper/4dn4gfn3wds43",
  "venue": "Frontiers in Public Health",
  "versions": []
}