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
- 1The Seventh Clinical Medical School of Guangzhou University of Chinese Medicine, Shenzhen Bao'an Chinese Medicine Hospital, Shenzhen, Guangdong, China
- 2Shenzhen Bao'an Authentic TCM Therapy Hospital, Shenzhen, Guangdong, China
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.
Methods: 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.
Results: 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).
Conclusion: 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.
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BibTeX
@article{deng2026remnant,
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}},
author = {Bin Deng and Wei Zhang and Xiaoduo Zhang and Zhijian Peng and Wenhua Liu},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1976857},
url = {https://doi.org/10.3389/fpubh.2026.1976857},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - 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
AU - Bin Deng
AU - Wei Zhang
AU - Xiaoduo Zhang
AU - Zhijian Peng
AU - Wenhua Liu
PY - 2026
DA - 2026/10/09
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1976857
UR - https://doi.org/10.3389/fpubh.2026.1976857
AB - 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. Methods: 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. Results: 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). Conclusion: 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.
SN - 2296-2565
ER -