Menopausal status-specific association between the triglyceride-glucose index and a body shape index (TyG-ABSI) and depression in U.S. women

BACKGROUND Depression disproportionately affects women, particularly during the menopausal transition, a period of significant endocrine and metabolic changes. The triglyceride-glucose index and a body shape index (TyG-ABSI), a novel metabolic indicator, has been associated with depressive symptoms. However, its role across different menopausal statuses requires further characterization. METHODS This cross-sectional study included 2707 premenopausal and 3119 postmenopausal women from the National Health and Nutrition Examination Survey (NHANES) 2007-2020. Depressive symptoms were defined as a Patient Health Questionnaire-9 (PHQ-9) score ≥10. Multivariable logistic regression analyses and restricted cubic spline (RCS) were applied to evaluate the associations between TyG-ABSI and depression. Subgroup and sensitivity analyses were conducted to assess potential effect modification and verify robustness. RESULTS Significantly positive associations between TyG-ABSI and depression were observed exclusively among postmenopausal women (OR = 1.29, 95%CI: 1.09-1.52), whereas no such relationship existed in premenopausal women. Within the postmenopausal group, participants in the lowest quartile exhibited reduced odds of depression compared with the highest quartile (OR = 0.44, 95%CI: 0.27-0.73). RCS analysis confirmed a linear dose-response relationship in postmenopausal women. Subgroup analyses identified a significant interaction with LTPA, with the association remaining significant only among physically inactive individuals. Sensitivity analyses further validated the robustness of the association. CONCLUSION This study highlights a menopausal status-specific association between TyG-ABSI and depression. Elevated TyG-ABSI is independently associated with higher odds of depression among postmenopausal women, with the association varying according to LTPA levels. Our findings extend current understanding of the relationship between metabolic dysfunction and depression in women.