Association Between Hip and Depression among Cardiovascular Disease: Insights from NHANES 2013~2023

Objective: This study examines the relationship between lifestyle behavior, hip circumference, and depressive symptoms in adults with cardiovascular disease (CVD) in the United States. Methods: A cross-sectional study analyzed data from 986 adults aged 20+ years who self-reported CVD using NHANES (2013-2023). Participants were divided into three lifestyle groups based on smoking, alcohol consumption, physical activity, sedentary behavior, and sleep through potential category analysis. Depressive symptoms were assessed by the PHQ-9 scale, with a score of 10+ indicating significant symptoms. The generalized linear model examined the relationship between lifestyle, hip circumference, and depression, and adjusted for sociodemographic and clinical factors. Mediation analysis explores the potential mediating role of hip circumference in this type of relationship. Results: Of the 986 participants with a mean age of 64.03 years, 41.7% reported depressive symptoms. The latent category analysis identified three lifestyle behavior groups: smoking and alcohol consumption (20.99%), inactivity and sedentary (12.98%), and healthy lifestyle (66.03%). Smoking and alcohol consumption significantly increased the risk of depression compared with the healthy group (OR = 1.524, 95% CI = 1.023–2.271, P = 0.038). Hip circumference was also a key risk factor for depression (OR = 1.053, 95% CI = 1.009–1.099, P = 0.018) and fully mediated the association between inactive lifestyle and PHQ-9 scores, accounting for 27.09% of lifestyle effects on depression. Conclusions: Smoking and alcohol consumption are associated with an increased risk of depression in patients with CVD, and hip circumference may mediate this effect. Addressing lifestyle and body composition factors may help alleviate depression in this group.