Socioeconomic status, depressive symptoms and cardiometabolic kidney syndrome: an analysis based on national representative data

作者：Yunzhe Li, Zixin Luo, Zhiyuan Zhang, Nan Huang, Xiao Li, Kang Zou · 发表于：BMC Public Health · 年份：2025 · DOI：10.1186/s12889-025-25228-0 · 被引用次数：4 · 研究领域：Dialysis and Renal Disease Management、Chronic Kidney Disease and Diabetes、Cardiac Health and Mental Health

BACKGROUND: Cardiometabolic Kidney Syndrome (CKM) is a global chronic disease challenge. While links between socioeconomic status (SES) and individual CKM components exist, research often overlooks CKM's multi-system interactions and the role of psychosocial factors. Depression, prevalent in low SES groups and linked to CKM risk, may mediate the SES-CKM relationship. METHODS: Using 2005-2018 NHANES data with 11,367 participants, this study quantified SES via the family poverty-income ratio (PIR), assessed depressive symptoms with the PHQ-9 scale, and defined CKM per AHA criteria. Statistical analyses included multivariable logistic regression and structural equation modeling to examine associations and mediating effects. RESULTS: High SES was associated with 81% lower odds of advanced CKM (OR = 0.19, 95% CI: 0.10-0.36). Each unit increase in PIR was associated with 33% lower odds of depression (OR = 0.67, 95% CI: 0.63-0.72). Depression mediated 27.64% of the SES-advanced CKM link. A nonlinear threshold effect between SES and depression was found at PIR = 3.28, with subgroup analyses highlighting stronger SES-CKM associations in non-Hispanic Blacks and Whites. CONCLUSION: Socioeconomic disadvantage is significantly associated with depressive symptoms and advanced CKM in this cross-sectional study. Depressive symptoms may play a substantial mediating role based on structural equation modeling of observational data. These findings suggest that incorporating mental health interve...