What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Depression and anxiety symptoms (n=181). Intervention: Uric acid. Primary outcome: PHQ-9 total score (RR 0.944, 95% CI 0.898-0.993, p=<0.05).

What does this research mean for the field?

Serum uric acid and lipid levels are significantly associated with depression and anxiety symptoms, with specific symptom dimensions such as neurovegetative and cognitive symptoms exhibiting distinct biological correlates. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

November 17, 2025Discover Mental Health3 citationsOpen Access

Associations of uric acid and lipids with depression, dimensions of depression and anxiety symptoms

Q: What are the key findings of this study?

Higher serum uric acid (RR 0.944) and HDL-C (RR 0.994) were associated with lower depressive symptom scores, while higher LDL-C (RR 1.003) was associated with higher depressive symptom scores.

Q: What does this research mean for the field?

Serum uric acid and lipid levels are significantly associated with depression and anxiety symptoms, with specific symptom dimensions such as neurovegetative and cognitive symptoms exhibiting distinct biological correlates. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

KKKyriakos KintzoglanakisHellenic Agency for Local Development and Local Government PKPavlos KoliasAristotle University of Thessaloniki LPLeonidas Pavlou-Skantzis

Key Result

Higher serum uric acid (RR 0.944) and HDL-C (RR 0.994) were associated with lower depressive symptom scores, while higher LDL-C (RR 1.003) was associated with higher depressive symptom scores.

Study Design

Type

Cross-Sectional (n=181)

Multicenter

Yes

Structured PICO

Are serum uric acid and lipids associated with depression and anxiety symptoms in primary care patients?

Population

181 healthy, ambulatory individuals presenting for interpretation of laboratory results in primary care in Greece, mean age 61.8, 68% female.

Outcome

Depression symptoms (PHQ-9 score) and anxiety symptoms (GAD-7 score)patient reported

Serum uric acid and HDL-C are negatively associated, while LDL-C is positively associated, with depression and anxiety symptoms in primary care patients.

Main Result

Effect estimate: RR 0.944 (95% CI 0.898-0.993)

p-value: p=<0.05

Limitations

Originates from a single Greek region and involves a relatively small number of participants, affecting generalizability
Relied on self-report questionnaires, which can lead to overestimation or underestimation and introduce recall bias
Potential prevalence-incidence bias as individuals with more severe depression or anxiety were likely to seek help from mental health specialists rather than primary care
Cross-sectional design cannot establish a causal inference between uric acid or lipid levels and symptoms

Abstract

OBJECTIVE: Discovering biological correlates of depression (and symptom dimensions) and anxiety is a topic of ongoing research. We aimed to examine the associations of uric acid (UA) and lipids with depression (sum and emotional, neurovegetative, cognitive dimension) and anxiety symptoms. METHODS: Participants were screened for depression and anxiety symptoms using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) questionnaires, respectively, in primary care in Greece during January-June 2022. Serum UA and lipids were recorded and socio-demographic, behavioral, and personal history covariates were also collected. Poisson regression analyses were performed to determine associations between recorded parameters and the PHQ-9 (sum-score and emotional, neurovegetative, cognitive dimension) and GAD-7 scores. RESULTS: A total of 181 individuals answered the questionnaires. The mean age was 61.8 ± 10.8 years, and 68% were female. The prevalence of clinically significant depression (PHQ-9 ≥ 10) and anxiety (GAD-7 ≥ 10) symptoms was 20.4%, respectively. PHQ-9 score was negatively associated with UA, high-density lipoprotein cholesterol (HDL-C) and income, and positively with low-density lipoprotein cholesterol (LDL-C) and physical activity. The neurovegetative dimension of the PHQ-9 score was negatively associated with UA and HDL-C, while the cognitive was positively associated with LDL-C. GAD-7 score was negatively associated with HDL-C and income, and positively with LDL-C and physical activity, while it was higher in females and smokers. CONCLUSIONS: Both UA and lipids were associated with depression and anxiety symptoms. The neurovegetative and cognitive symptoms of depression exhibited different biological correlates with low UA and HDL-C, and high LDL-C, respectively.

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