Key result
Higher red blood cell distribution width to albumin ratio was significantly associated with an increased prevalence of depression (OR 1.335), an effect partially mediated by the atherogenic index of plasma.
Why the study?
Recent studies have identified a correlation between inflammation and depression, but the correlation between the red blood cell distribution width to albumin ratio and depression in the general population remained to be explored.
Does a higher red blood cell distribution width to albumin ratio (RAR) correlate with an increased risk of depression in the general adult population?
Cross-Sectional (n=28,932)
Does a higher red blood cell distribution width to albumin ratio (RAR) correlate with an increased risk of depression in the general adult population?
Odds Ratio: 1.335 (95% CI 1.222–1.458)
p-value: p=<0.001
A higher red blood cell distribution width to albumin ratio is independently associated with an increased prevalence of depression, a relationship partially mediated by the atherogenic index of plasma.
Hypothesis-generating for RAR as inflammation marker in depression; prospective studies needed before clinical consideration.
Background: Recent studies have identified a correlation between inflammation and depression. This study aims to explore the correlation between the red blood cell distribution width (RDW) to albumin ratio (RAR), a practical measure for assessing inflammation, and depression in the general population. Methods: In this population-based cross-sectional study, data from 28932 adults aged≥18 years old in the NHANES during the period of 1999-2018 were analyzed. To examine the correlation between RAR and depression, multivariate logistic regression analyses, subgroup analyses, restricted cubic spline analyses, and interaction tests were conducted. Furthermore, a mediation analysis was performed to elucidate the role of atherogenic index of plasma (AIP) in mediating the effect of RAR on depression. Results: Multivariate logistic regression analyses and restricted cubic splines analysis indicated that RAR can exhibit a linearly correlation with depression (OR = 1.335; 95% CI: 1.222, 1.458). Subjects in RAR Q2, Q3, Q4 groups had an increased risk on depression as 22.8%, 22.9% and 51.9% than those in the Q1 group. This positive correlation was more pronounced in those with history of cancers. The ROC analysis indicated that the area under the curve (AUC) for RAR (AUC=0.593) was significantly greater than that for RDW and albumin individually. Mediation analysis indicated that AIP mediated 7.8% of the correlation of RAR with depression. Conclusions: The findings of this study indicated a significant linear positive correlation between RAR and the prevalence of depression, with AIP serving as a mediator.
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Xu et al. (2025) conducted a cross-sectional in Depression (n=28,932). Red blood cell distribution width to albumin ratio (RAR) vs. Lower RAR levels was evaluated on Prevalence of depression (PHQ-9 score ≥10) (OR 1.335, 95% CI 1.222, 1.458, p=<0.001). Higher red blood cell distribution width to albumin ratio was significantly associated with an increased prevalence of depression (OR 1.335), an effect partially mediated by the atherogenic index of plasma.
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