Exploring the Relationship Between Depressive Symptoms and Cardiovascular-Kidney-Metabolic syndrome: Evidence from the CHARLS Database

Background: Cardiovascular-Kidney-Metabolic (CKM) syndrome is a systemic condition characterized by the interrelated pathophysiological interactions between metabolic risk factors, chronic kidney disease (CKD), and the cardiovascular system, leading to an increased incidence of adverse cardiovascular outcomes. Depression has been widely recognized as a major mental health disorder with a significant impact on both cardiovascular disease (CVD) and CKD. However, the relationship between depressive symptoms and CKM syndrome has not been thoroughly explored. This study aims to investigate the association between depressive symptoms and CKM syndrome. Methods: We analyzed baseline data from 2011 and 2015 CKM follow-up data from the China Health and Retirement Longitudinal Study (CHARLS) database. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CESD-10) scale, and CKM syndrome was classified according to the American Heart Association (AHA) staging system. Three logistic regression models were used to estimate the odds ratio (OR) and 95% confidence interval (CI) for the relationship between CESD-10 scores and CKM syndrome. Subgroup and interaction analyses were also performed to explore potential modifying factors. Results: A total of 1,804 participants were included in the analysis. After adjusting for demographic and health-related factors, depressive symptoms, as measured by CESD-10, were significantly associated with an increased risk of CKM syndrome. The association was stronger after adjusting for additional health-related factors. The quartile analysis showed that individuals in the highest CESD-10 quartile had a significantly increased risk of CKM syndrome, with an OR of 2.76 (95% CI: 1.79–4.26, P < 0.01) in the fully adjusted model. Additionally, restricted cubic spline (RCS) analysis confirmed a linear relationship between CESD-10 scores and CKM syndrome. Conclusions: This study identified a significant positive correlation between depressive symptoms and CKM syndrome, with the association becoming more pronounced after adjusting for demographic and health-related factors. Our findings suggest that depressive symptoms may serve as an independent risk factor for CKM syndrome, highlighting the importance of incorporating mental health interventions in the prevention and management of CKM. Further research is needed to explore the mechanisms through which depressive symptoms contribute to CKM syndrome and to validate the causal relationship between these factors.