Depression as a mediator between socioeconomic status and risk of All-Cause and cardiovascular mortality in diabetes and prediabetes

作者：Wenlong Ding, Fachao Shi, Cunming Fang, Caoyang Fang, Caoyang Fang, Caoyang Fang · 发表于：Scientific Reports · 年份：2025 · DOI：10.1038/s41598-025-09258-7 · 被引用次数：3 · 研究领域：Cardiac Health and Mental Health、Cardiovascular Health and Risk Factors、Health disparities and outcomes

There is a known association between socioeconomic status (SES) and increased mortality risk in individuals with diabetes and its pre-diabetic state. Depression has been identified as a significant risk factor for mortality in populations with low SES. this study aims to gain a deeper Understanding of the relationship between SES and all-cause and cardiovascular mortality risk in individuals with diabetes and its pre-diabetic state by exploring the mediating role of depression. This study included 17,823 participants who participated in the National health and nutrition examination survey (NHANES) between 2005 and 2018. Weighted multivariate COX regression analysis was conducted to evaluate the association between SES and all-cause and cardiovascular mortality risk in individuals with diabetes and its pre-diabetic state. Additionally, mediation analysis was performed to explore the mediating role of depression. After adjusting for multiple variables, low SES was associated with a hazard ratio (HR) of 1.71 (95% CI: 1.42-2.02; P < 0.0001) for all-cause mortality risk and an HR of 1.88 (95% CI: 1.35-2.63; P < 0.001) for cardiovascular mortality risk in individuals with diabetes and its pre-diabetic state. Furthermore, after adjusting for multiple variables, depression was associated with an HR of 1.51 (95% CI: 1.28-1.79; P < 0.0001) for all-cause mortality risk and an HR of 1.64 (95% CI: 1.18-2.27; P = 0.003) for cardiovascular mortality risk. Mediation model results revealed th...